Efficiency and Stability of Step-To Gait in Slow Walking

As humans, we constantly change our movement strategies to adapt to changes in physical functions and the external environment. We have to walk very slowly in situations with a high risk of falling, such as walking on slippery ice, carrying an overflowing cup of water, or muscle weakness owing to aging or motor deficit. However, previous studies have shown that a normal gait pattern at low speeds results in reduced efficiency and stability in comparison with those at a normal speed. Another possible strategy is to change the gait pattern from normal to step-to gait, in which the other foot is aligned with the first swing foot. However, the efficiency and stability of the step-to gait pattern at low speeds have not been investigated yet. Therefore, in this study, we compared the efficiency and stability of the normal and step-to gait patterns at intermediate, low, and very low speeds. Eleven healthy participants were asked to walk with a normal gait and step-to gait on a treadmill at five different speeds (i.e., 10, 20, 30, 40, and 60 m/min), ranging from very low to normal walking speed. The efficiency parameters (percent recovery and walk ratio) and stability parameters (center of mass lateral displacement) were analyzed from the motion capture data and then compared for the two gait patterns. The results suggested that step-to gait had a more efficient gait pattern at very low speeds of 10–30 m/min, with a larger percent recovery, and was more stable at 10–60 m/min in comparison with a normal gait. However, the efficiency of the normal gait was better than that of the step-to gait pattern at 60 m/min. Therefore, step-to gait is effective in improving gait efficiency and stability when faced with situations that force us to walk slowly or hinder quick walking because of muscle weakness owing to aging or motor deficit along with a high risk of falling.

Open Reduction and Internal Fixation of a Pediatric Talar Body Fracture using a Medial Malleolar Osteotomy – A Case Report

Introduction:Talus fracture injuries are rare and most literature pertains to fractures in skeletally mature adults. It is unusual for pediatric talus fractures to be treated operatively and is normally treated with immobilization. The location of the talus fracture required a medial malleolar osteotomy to facilitate exposure and reduction, which was fixed with temporary smooth K-wires. The authors were unable to identify a previous description of this technique in the literature. Case Report:An 11-year-old female was referred to our hospital due to polytraumatic injuries sustained in a roll-over MVC. A displaced fracture of the talus body was present. Due to the fracture location, a medial malleolar osteotomy was required for exposure. An open reduction and internal fixation was performed using subchondral minifragment screws under general anesthesia. The patient healed uneventfully, regained a normal gait and full, pain-free range of motion. Conclusions:Medial malleolar osteotomy with smooth K-wire fixation appears to be a safe method for gaining access to the talus when required for reduction and/or fixation of pediatric talus fractures. Keywords:Adolescent, talus fracture, osteotomy.

The compartmental approach to revision of partial knee arthroplasty results in nearer-normal gait and improved patient reported outcomes compared to total knee arthroplasty

Purpose This study investigated the gait and patient reported outcome measures of subjects converted from a partial knee arthroplasty to combined partial knee arthroplasty, using a compartmental approach. Healthy subjects and primary total knee arthroplasty patients were used as control groups. Methods Twenty-three patients converted from partial to combined partial knee arthroplasty were measured on the instrumented treadmill at top walking speeds, using standard gait metrics. Data were compared to healthy controls (n = 22) and primary posterior cruciate-retaining total knee arthroplasty subjects (n = 23) where surgery were performed for one or two-compartment osteoarthritis. Groups were matched for age, sex and body mass index. At the time of gait analysis, combined partial knee arthroplasty subjects were median 17 months post-revision surgery (range 4–81 months) while the total knee arthroplasty group was median 16 months post-surgery (range 6–150 months). Oxford Knee Scores and EuroQol-5D 5L scores were recorded at the time of treadmill assessment, and results analysed by question and domain. Results Subjects revised from partial to combined partial knee arthroplasty walked 16% faster than total knee arthroplasty (mean top walking speed 6.4 ± 0.8 km/h, vs. 5.5 ± 0.7 km/h p = 0.003), demonstrating nearer-normal weight-acceptance rate (p < 0.001), maximum weight-acceptance force (p < 0.006), mid-stance force (p < 0.03), contact time (p < 0.02), double support time (p < 0.009), step length (p = 0.003) and stride length (p = 0.051) compared to primary total knee arthroplasty. Combined partial knee arthroplasty subjects had a median Oxford Knee Score of 43 (interquartile range 39–47) vs. 38 (interquartile range 32–41, p < 0.02) and reported a median EQ-5D 0.94 (interquartile range 0.87–1.0) vs. 0.84 (interquartile range 0.80–0.89, p = 0.006). Conclusion This study finds that a compartmental approach to native compartment degeneration following partial knee arthroplasty results in nearer-normal gait and improved patient satisfaction compared to total knee arthroplasty. Level of evidence III.

Kinematic Synthesis of Gait Correction for a Rehabilitation Machine

This paper outlines the synthesis process for a redesign of the intelligently controlled assistive rehabilitation elliptical’s (ICARE) pedal system to enhance replication of gait-like movement patterns while training. The synthesized mechanism overcomes some limitations identified in certain ellipticals, specifically generation of taller, more rounded foot paths compared to over-ground gait. The proposed solution minimizes the position and angle difference curves between the ICARE foot motion and normal gait.

Wearable Feet Pressure Sensor for Human Gait and Falling Diagnosis

Human falls pose a serious threat to the person’s health, especially for the elderly and disease-impacted people. Early detection of involuntary human gait change can indicate a forthcoming fall. Therefore, human body fall warning can help avoid falls and their caused injuries for the skeleton and joints. A simple and easy-to-use fall detection system based on gait analysis can be very helpful, especially if sensors of this system are implemented inside the shoes without causing a sensible discomfort for the user. We created a methodology for the fall prediction using three specially designed Velostat®-based wearable feet sensors installed in the shoe lining. Measured pressure distribution of the feet allows the analysis of the gait by evaluating the main parameters: stepping rhythm, size of the step, weight distribution between heel and foot, and timing of the gait phases. The proposed method was evaluated by recording normal gait and simulated abnormal gait of subjects. The obtained results show the efficiency of the proposed method: the accuracy of abnormal gait detection reached up to 94%. In this way, it becomes possible to predict the fall in the early stage or avoid gait discoordination and warn the subject or helping companion person.

Tendoachilles reconstruction and overlying skin cover with a peroneus brevis flap

We report a post-traumatic case of tendoachilles injury with an overlying skin defect. Following debridement, tendon reconstruction was done by using vascularised peroneus brevis musculotendinous unit and proximal part of the same muscle provided the skin cover. Postoperative recovery was uneventful. At 2 years follow-up, he had a near-normal gait. The main advantage of this flap is not being only a local flap but also providing a vascularised tendon.

Nanomaterials in the Sports Rehabilitation of Basketball Players After Anterior Cruciate Ligament Reconstruction

Nanomaterials have now become a hotspot and frontier in the medical world, with broad application prospects and industrial development space. This study explored the effects of knee-related training on knee-related activities and knee-related activities during arthroscopic anterior cruciate ligament reconstruction. In this study, 100 cases of anterior cruciate ligament reconstruction under arthroscopy were used as the research object. They were divided into an observation group and a control group by random number table method, with 50 cases in each group. The observation group was given preoperative care and rehabilitation guidance, and the control group was given routine care. The normal walking recovery rate and total knee mobility of the two groups were compared. Two months after surgery, the normal gait, normal knee joint mobility, and knee joint mobility of the observation group were higher than those of the control group (P < 0.05). The number of normal gait in the observation group was 41, accounting for 82% of the total number of observation groups; the number of knees with full angle or more in the observation group was 43, accounting for 86% of the total number of observation groups; normal gait in the control group The number was 23, which accounted for 46% of the total number of observation groups; the number of full-angle knees in the control group was 20, which accounted for 40% of the total number of observation groups. The results show that the guidelines and related nursing for knee training before arthroscopic osteotomy reduction can be improved, and the operation can strengthen the knee function.