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Gauci J, Falzon O, Camilleri KP, Formosa C, Gatt A, Ellul C, Mizzi S, Mizzi A, Cassar K, Sturgeon C, Chockalingam N. Automated segmentation of regions of interest from thermal images of hands. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:3822-3826. [PMID: 29060731 DOI: 10.1109/embc.2017.8037690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Thermal imaging can provide an image of the surface temperature of an object in a non-contact and noninvasive manner, making it particularly appealing for use in medical applications. In applications where it is desirable to extract temperature data from anatomical regions of interest (ROIs) in a standardised and consistent manner, the use of automated segmentation and analysis techniques can provide a faster, more reliable and more consistent approach than manual segmentation of these ROIs. In this paper we present an algorithm which automatically extracts temperature data from eight ROIs in thermal images of the volar aspect of human hands. The algorithm first identifies the hand from the background in the thermal image and then identifies pixels which make up the fingers and the palm. Finally, eight ROIs are extracted from the identified regions. The methods proposed in this work can also be extended for the processing of similar visual images.
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Chockalingam N, Needham R, Healy A, Naemi R. Coordination pattern between the forefoot and rearfoot during walking on an inclined surface. Footwear Science 2017. [DOI: 10.1080/19424280.2017.1314372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Robert Needham
- Faculty of Health, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Aoife Healy
- Faculty of Health, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Roozbeh Naemi
- Faculty of Health, Staffordshire University, Stoke-on-Trent, United Kingdom
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Abstract
Abnormal-pronation, excessive-pronation, over-pronation, or hyper-pronation, are terms with a long historical use in both medical and research terminology pertaining to an abnormal movement of the foot. These terms are commonly used as a potential kinematic aetiology to explain the occurrence of multiple lower limb and foot pathologies. Yet despite this widespread use there is no clear definition to explain what the terms abnormal, excess, over, or hyper-pronation, mean. Without a strict definition the use of these terms as a patho-mechanical explanation of injuries, leaves a distinct lack of clarity and is meaningless in regards to being able to distinguish what movement may need clinical intervention. It is unlikely that hyper-pronation can be given a quantitative scale because individual anatomy and activity changes the necessary range of pronation within the foot. This paper attempts to give hyper-pronationa philosophically justifiable definition so that the term may be used in a more precise manner and avoid the confusion that presently exists clinically as well as in research literature.
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Affiliation(s)
- Andrew M Horwood
- Faculty of Health Sciences, Staffordshire University, Stoke on Trent ST 42DF, United Kingdom.
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, Staffordshire University, Stoke on Trent ST 42DF, United Kingdom
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Bagheri A, Liu XC, Tassone C, Thometz J, Chaloupka A, Tarima S, Cohen L, Simic M, Dennis S, Refshauge K, Pappas E, Parent EC, Pietrosanu M, Redford E, Schmidt S, Hill D, Moreau M, Hedden D, Adeeb S, Lou E, Brink RC, Schlösser TPC, Colo D, Vincken KL, van Stralen M, Hui SCN, Chu WCW, Cheng JCY, Castelein RM, Kechagias V, Grivas TB, Vlasis K, Michas K, Grivas TB, Kechagias V, Vlasis K, Michas K, Tam EMS, Yu FWP, Hung VWY, Shi L, Qin L, Ng BKW, Chu WCW, Griffith J, Cheng JCY, Lam TP, Xue C, Shi L, Hui SCN, Lam TP, Ng BKW, Cheng JCY, Chu WCW, Hui SCN, Pialasse JP, Wong JYH, Lam TP, Ng BKW, Cheng JCY, Chu WCW, Vo QN, Le LH, Lou EHM, Zheng R, Hill DL, Moreau MJ, Hedden DM, Mahood JK, Southon S, Lou E, Brignol A, Cheriet F, Miron MC, Laporte C, Qiu Y, Liu H, Liu Z, Zhu ZZ, Qian BP, Liu X, Rizza R, Thometz J, Rosol D, Tassone C, Tarima S, North P, Zaina F, Pesenti F, Negrini S, Persani L, Capodaglio P, Polli N, Yip BHK, Yu FWP, Hung VWY, Lam TP, Qin L, Ng BKW, Cheng JCY, Zhang J, Lee WYW, Chen H, Tam EMS, Man GC, Lam TP, Ng BKW, Qiu Y, Cheng JCY, Liu H, Liu Z, Zhu Z, Qian BP, Qiu Y, Harasymczuk P, Andrusiewicz M, Janusz P, Biecek P, Kotwicki T, Kotwicka M, Lee JS, Shin JK, Goh TS, Son SM, Chen H, Lee WYW, Zhang J, Tam EMS, Man GCW, Lam TP, Ng BKW, Qiu Y, Cheng JCY, Schwartz M, Gilday S, Bylski-Austrow DI, Glos DL, Schultz L, O’Hara S, Jain VV, Sturm PF, Wang X, Crandall DG, Parent S, Larson N, Labelle H, Aubin CE, Fard NB, Southon S, Moreau M, Hedden D, Duke K, Southon S, Lukenchuk L, Kerslake M, Huynh G, Chorney J, Tsui B, Tobert D, Bakarania P, Berdishevsky H, Grimes K, Matsumoto H, Hyman J, Roye B, Roye D, Vitale M, Black J, Bradley M, Drake S, Glynn D, Maude E, Berdishevsky H, Lindgren A, Bakarania P, Grimes K, Matsumoto H, Feinberg N, Bloom Z, Roye D, Vitale M, Dupuis S, Fortin C, Caouette C, Aubin CÉ, Gur G, Yakut Y, Jevtić N, Schreiber S, Hennes A, Pantović M, de Mauroy JC, Barral F, Pourret S, de Mauroy JC, Barral F, Pourret S, Aulisa AG, Guzzanti V, Galli M, Falciglia F, Aulisa L, Bernard JC, Deceuninck J, Berthonnaud E, Rougelot A, Pickering ME, Chaleat-Valayer E, Webb R, Bettany-Saltikov J, Neil B, Zaina F, Poggio M, Donzelli S, Lusini M, Minnella S, Negrini S, de Mauroy JC, Barral F, Hoang A, Mao S, Shi B, Qian B, Zhu Z, Sun X, Qiu Y, Cobetto N, Aubin CÉ, Parent S, Barch S, Turgeon I, Labelle H, Raihan HMA, Kumar DT, Khasnabis C, Equbal A, Chakraborty AK, Biswas A, Gur G, Dilek B, Ayhan C, Simsek E, Aras O, Aksoy S, Yakut Y, Lou E, Hill D, Zheng R, Donauer A, Tilburn M, Raso J, Morau M, Hedden D, Chen H, Man-Sang W, Cohen L, Kobayashi S, Simic M, Dennis S, Refshauge K, Pappas E, Aslanzadeh F, Parent EC, MacIntosh B, Maragkoudakis EG, Grivas TB, Gelalis ID, Mazioti C, Tsilimidos G, Burwell RG, Zheng Y, Wu XJ, Dang YN, Sun N, Yang Y, Wang T, He CQ, Wong MS, Donzelli S, Martinez G, Negrini A, Zaina F, Negrini S, Matsumoto H, Feinberg N, Shirley M, Swindell H, Bloom Z, Roye DP, Akbarnia BA, Garg S, Sanders JO, Skaggs DL, Smith JT, Vitale MG, Rizza R, Liu X, Thometz J, Lou E, Hill D, Donauer A, Tilburn M, Hedden D, Moreau M, Healy A, Farmer S, Chockalingam N, Aulisa AG, Guzzanti V, Galli M, Pizzetti P, Aulisa L, Maruyama T, Kobayashi Y, Nakao Y, Liu H, Qian BP, Qiu Y, Mao SH, Wang B, Yu Y, Zhu Z, Berdishevsky H, Lindgren AM, Bakarania P, Grimes K, Makhni MC, Shillingford J, Vitale MG, Black J, Maude E, Turland A, Glynn D, Caronni A, Sciumè L, Donzelli S, Zaina F, Negrini S, Schreiber S, Parent EC, Moez EK, Hedden DM, Hill DL, Moreau M, Lou E, Watkins EM, Southon SC, Parent EC, Schreiber S, Moez EK, Sloan P, Hedden D, Moreau M, Hill D, Southon S, Watkins E, Parent EC, Ghaneei M, Adeeb S, Schreiber S, Moreau M, Hedden D, Hill D, Southon S, Karavidas N, Dritsa D, Bettany-Saltikov J, Hanchard N, Kim D, Kim J, Sbihli A, Parent E, Levey L, Holowka M, Davis L, Dolan LA, Weinstein SL, Larson JE, Meyer MA, Boody B, Sarwark JF, Schreiber S, Parent EC, Hedden DM, Hill DL, Thometz J, Liu X, Rizza R, Tassone C, Liu X, Gundlach B, Tarima S, Grant A, Kalyan R, Hekal W, Honeyman C, Cook T, Murray S, Pitruzzella M, Donzelli S, Zaina F, Negrini S, de Mauroy JC, Barral F, Pourret S, de Mauroy JC, Barral F, Pourret S, Grimes K, Feinberg N, Hope J, Berdishevsky H, Bakarania P, Matsumoto H, Swindell H, Yoshimachi J, Roye D, Vitale M, Touchette J, St-Jean A, Brousseau D, Marcotte L, Théroux J, Doucet C, Lin Y, Wong MS, MacMahon J, MacMahon E, Boyette J, Stikeleather L, Lebel A, Lebel VA, Pancholi-Parekh CA, Stolze L, Selthafner M, Hong K, Liu X, Thometz J, Tassone C, Morrison PR, Hanke TA, Knott P, Krumdick ND, Chockalingam N, Shannon T, Davenhill R, Needham R, Jasani V, Ahmed EN, St-Jean A, Touchette J, Drake S, Brousseau D, Marcotte L, Théroux J, Doucet C, Aulisa AG, Guzzanti V, Gordano M, Mastantuoni G, Aulisa L, Chandrinos M, Grivas TB, Kechagias V, Głowka P, Gaweł D, Kasprzak B, Nowak M, Morzyński M, Kotwicki T, Deceuninck J, Bernard JC, Lecante C, Berthonnaud E, Fortin C, Aubin-Fournier JF, Bettany-Saltikov J, Parent EC, Feldman DE, Bernard JC, Liu Z, Zhang W, Hu Z, Zhu W, Jin M, Han X, Qiu Y, Cheng JCY, Zhu Z, Liu Z, Guo J, Wu T, Qian B, Zhu Z, Zhu F, Jiang J, Qiu Y, Han X, Liu Z, Liu H, Qiu Y, Guo J, Yan H, Sun X, Cheng JCY, Zhu Z, Di Felice F, Zaina F, Pitruzzella M, Donzelli S, Negrini S, Needham RA, Chatzistergos P, Chockalingam N, Brink RC, Schlösser TPC, Colo D, Vincken KL, van Stralen M, Hui SCN, Chu WCW, Cheng JCY, Castelein RM, Bylski-Austrow DI, Glos DL, Jain VV, Reynolds JE, Sturm PF, Wall EJ, Igoumenou VG, Megaloikonomos PD, Tsiavos K, Panagopoulos GN, Mavrogenis AF, Grivas TB, Soultanis K, Papagelopoulos PJ, Fard NB, Duke K, Chan A, Parent EC, Lou E, Lee JS, Shin JK, Goh TS, Son SM, Kobayashi S, Togawa D, Hasegawa T, Yamato Y, Oe S, Banno T, Mihara Y, Matsuyama Y. 13th International Conference on Conservative Management of Spinal Deformities and First Joint Meeting of the International Research Society on Spinal Deformities and the Society on Scoliosis Orthopaedic and Rehabilitation Treatment – SOSORT-IRSSD 2016 meeting. Scoliosis 2017. [PMCID: PMC5461518 DOI: 10.1186/s13013-017-0124-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Zarb F, McNulty J, Gatt A, Formosa C, Chockalingam N, Evanoff M, Rainford L. Comparison of in vivo vs. frozen vs. Thiel cadaver specimens in visualisation of anatomical structures of the ankle on proton density Magnetic Resonance Imaging (MRI) through a visual grading analysis (VGA) study. Radiography (Lond) 2017; 23:117-124. [DOI: 10.1016/j.radi.2016.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/28/2016] [Accepted: 12/08/2016] [Indexed: 12/01/2022]
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Naemi R, Chatzistergos P, Suresh S, Sundar L, Chockalingam N, Ramachandran A. Can plantar soft tissue mechanics enhance prognosis of diabetic foot ulcer? Diabetes Res Clin Pract 2017; 126:182-191. [PMID: 28259007 DOI: 10.1016/j.diabres.2017.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/16/2017] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
AIM To investigate if the assessment of the mechanical properties of plantar soft tissue can increase the accuracy of predicting Diabetic Foot Ulceration (DFU). METHODS 40 patients with diabetic neuropathy and no DFU were recruited. Commonly assessed clinical parameters along with plantar soft tissue stiffness and thickness were measured at baseline using ultrasound elastography technique. 7 patients developed foot ulceration during a 12months follow-up. Logistic regression was used to identify parameters that contribute to predicting the DFU incidence. The effect of using parameters related to the mechanical behaviour of plantar soft tissue on the specificity, sensitivity, prediction strength and accuracy of the predicting models for DFU was assessed. RESULTS Patients with higher plantar soft tissue thickness and lower stiffness at the 1st Metatarsal head area showed an increased risk of DFU. Adding plantar soft tissue stiffness and thickness to the model improved its specificity (by 3%), sensitivity (by 14%), prediction accuracy (by 5%) and prognosis strength (by 1%). The model containing all predictors was able to effectively (χ2 (8, N=40)=17.55, P<0.05) distinguish between the patients with and without DFU incidence. CONCLUSION The mechanical properties of plantar soft tissue can be used to improve the predictability of DFU in moderate/high risk patients.
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Affiliation(s)
- R Naemi
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom.
| | - P Chatzistergos
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom
| | - S Suresh
- India Diabetes Research Foundation, Chennai, India
| | - L Sundar
- India Diabetes Research Foundation, Chennai, India
| | - N Chockalingam
- School of Life Sciences and Education, Staffordshire University, Stoke on Trent, United Kingdom
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Behforootan S, Chatzistergos PE, Chockalingam N, Naemi R. A clinically applicable non-invasive method to quantitatively assess the visco-hyperelastic properties of human heel pad, implications for assessing the risk of mechanical trauma. J Mech Behav Biomed Mater 2017; 68:287-295. [DOI: 10.1016/j.jmbbm.2017.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/27/2017] [Accepted: 02/08/2017] [Indexed: 10/20/2022]
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Hill M, Naemi R, Branthwaite H, Chockalingam N. The relationship between arch height and foot length: Implications for size grading. Appl Ergon 2017; 59:243-250. [PMID: 27890134 DOI: 10.1016/j.apergo.2016.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 07/03/2016] [Accepted: 08/24/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Medial longitudinal Arch Height is synonymous with classifying foot type and conversely foot function. Detailed knowledge of foot anthropometry is essential in the development of ergonomically sound footwear. Current Footwear design incorporates a direct proportionate scaling of instep dimensions with those of foot length. The objective of this paper is to investigate if a direct proportional relationship exists between human arch height parameters and foot length in subjects with normal foot posture. METHOD A healthy convenience sample of 62 volunteers was recruited to participate in this observational study. All subjects were screened for normal foot health and posture. Each subject's foot dimensions were scanned and measured using a 3D Foot Scanner. From this foot length and arch height parameters were obtained. Normalised ratios of arch height with respect to foot length were also calculated. The arch height parameters and the normalised arch ratios were used interchangeably as the dependent variables with the foot length parameters used as the independent variable for Simple Linear Regression and Correlation. RESULTS Analysis of foot length measures demonstrated poor correlation with all arch height parameters. CONCLUSION No significant relationships between arch height and foot length were found. The predictive value of the relationship was found to be poor. This holds significant implications for the current method of proportionate scaling of footwear in terms of fit and function to the midfoot region for a normative population.
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Affiliation(s)
- Matthew Hill
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom.
| | - Roozbeh Naemi
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom
| | - Helen Branthwaite
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom
| | - Nachiappan Chockalingam
- CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, United Kingdom
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Gatt A, De Giorgio S, Chockalingam N, Formosa C. A pilot investigation into the relationship between static diagnosis of ankle equinus and dynamic ankle and foot dorsiflexion during stance phase of gait: Time to revisit theory? Foot (Edinb) 2017; 30:47-52. [PMID: 28259030 DOI: 10.1016/j.foot.2017.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although the clinical assessment of ankle dorsiflexion has traditionally been measured utilising various goniometric means, the validity of this static examination has never been investigated. Since any impairment in ankle flexibility is likely to result in injuries, it is imperative that the correct examination technique is conducted. HYPOTHESIS/PURPOSE To determine whether a clinical diagnosis of ankle equinus, or limited ankle dorsiflexion, correlates with a decreased dorsiflexion range of movement of the foot and ankle during gait. METHODS Twenty participants with a clinical diagnosis of ankle equinus underwent optoelectronic motion capture utilising the Rizzoli foot model. Participants were divided into two groups, Group A with <-5° of dorsiflexion and Group B with -5° to 0° of ankle dorsiflexion. RESULTS Participants in Group B had a mean dynamic ankle dorsiflexion angle of 13.9°, while those in Group A had a mean dorsiflexion angle of 4.4°, resulting in a significant difference (p=0.004) between the two groups. Likewise, foot mean dynamic dorsiflexion angle of Group B was 17.13° and Group A 8.6° (p=0.006). CONCLUSION There is no relationship between a static diagnosis of ankle dorsiflexion at 0° with dorsiflexion during gait. On the other hand, those subjects with less than -5° of dorsiflexion during static examination did exhibit reduced ankle range of motion during gait.
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Affiliation(s)
- Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta; Faculty of Health Sciences, Staffordshire University, Stoke on Trent ST4 2DF, United Kingdom
| | | | - Nachiappan Chockalingam
- Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta; Faculty of Health Sciences, Staffordshire University, Stoke on Trent ST4 2DF, United Kingdom
| | - Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta; Faculty of Health Sciences, Staffordshire University, Stoke on Trent ST4 2DF, United Kingdom.
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Durrant B, Chockalingam N, Morriss-Roberts C. Assessment and Diagnosis of Posterior Tibial Tendon Dysfunction: Do We Share the Same Opinions and Beliefs? J Am Podiatr Med Assoc 2017; 106:27-36. [PMID: 26895358 DOI: 10.7547/14-122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Posterior tibial tendon dysfunction is a disabling pathologic flatfoot disorder. Evidence supports the notion that this condition is poorly diagnosed by health-care professionals. In addition, opinion is divided as to the most appropriate assessment and diagnostic techniques used to reflect the progression or stage of the condition. Hence, this study intended to explore the views and opinions of health-care professionals who may be involved in its assessment and diagnosis. METHODS A two-phase sequential mixed methods design was used that combined a questionnaire survey and a focus group interview. RESULTS The questionnaire data were analyzed using the Kendall levels of concordance and the Cohen kappa statistic, and the focus group data were analyzed using thematic analysis, which led to three main themes: resource implications, scope of practice, and awareness of the condition. CONCLUSIONS This study highlights what may have been suspected previously but that has never been investigated in a structured manner. One approach to the assessment and diagnosis of posterior tibial tendon dysfunction is not necessarily the best, and depending on the clinical teams, different guidance may be required to ensure that patients are receiving the most appropriate and best care.
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Affiliation(s)
- Beverley Durrant
- Department of Podiatry, University of Brighton, Eastbourne, England
- Faculty of Health, Staffordshire University, Stoke-on-Trent, England
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111
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Abstract
Background Pressure-related skin lesions on the digits are a significant cause of discomfort. Most foot pain related to ill-fitting shoes occurs in the forefoot and digital areas. Pain has been associated with poor shoe fit, reduced toe box volume, as well as contour and shape of the shoe Off-the-shelf medical-grade footwear is designed as an intervention for chronic lesions on the digits. These shoes are designed with a flexible neoprene fabric upper that is thought to reduce pressure on the forefoot and reduce discomfort associated with ill-fitting shoes. The aim of this study was to investigate the effect of an off-the-shelf, medical-grade shoe on dorsal digital pressure and perceived comfort when compared to participant’s own preferred shoe. Methods Thirty participants (18 females, 12 males) scored their perceived comfort whilst wearing each footwear style using a visual analog comfort scale. Dorsal digital and interdigital pressures were measured in using the WalkinSense® in-shoe pressure system. Sensors were placed on predetermined anatomical landmarks on the digits. Participants were randomly assigned the test shoe and their own shoe. Once wearing the shoe, the participants walked across a 6 m walkway and pressure data from each sensor was collected and processed to obtain peak pressure, time to peak pressure and contact time. Results Participants scored the test shoe with higher comfort points than their own footwear. Overall peak pressure, pressure time integral and contact time decreased, whilst the time taken to reach peak pressure increased across all anatomical landmarks whilst wearing the test shoe. Statistically significant changes were observed for all of the measured variables relating to pressure on the medial border of the first metatarsophalangeal joint. Conclusion The test shoe provided greater comfort and reduced the amount of pressure on the forefoot. The medical-grade footwear therefore, is a viable alternative to custom made prescription footwear and is more suitable than a regular everyday shoe when treating digital lesions associated with pressure.
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Affiliation(s)
- Bessie Hurst
- Faculty of Health Sciences Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF UK
| | - Helen Branthwaite
- Faculty of Health Sciences Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF UK
| | - Andrew Greenhalgh
- Faculty of Health Sciences Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF UK
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Negrini S, Minozzi S, Bettany-Saltikov J, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Zaina F. Braces for Idiopathic Scoliosis in Adolescents. Spine (Phila Pa 1976) 2016; 41:1813-1825. [PMID: 27584672 DOI: 10.1097/brs.0000000000001887] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A Cochrane systematic review. OBJECTIVE To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological, and cosmetic issues. SUMMARY OF BACKGROUND DATA Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. Although adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic. METHODS We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015. We also checked reference lists and hand searched grey literature. Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. We used standard methodological procedures expected by the Cochrane Collaboration. RESULTS We included seven studies. Five were planned as RCTs, two as prospective controlled clinical trials. One RCT failed completely, another was continued as an observational study. There was very low quality evidence from one small RCT that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation. CONCLUSION Two studies showed that bracing did not change QoL during treatment, and QoL, back pain psychological and cosmetic issues in the long term (16 years.) All articles showed that bracing prevented curve progression. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. LEVEL OF EVIDENCE 1.
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Affiliation(s)
- Stefano Negrini
- Physical and Rehabilitation Medicine, University of Brescia, IRCCS Fondazione Don Gnocchi Milan, Brescia, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | | | - Theodoros B Grivas
- Department of Trauma and Orthopedics, Tzanio General Hospital of Piraeus, Piraeus, Greece
| | - Tomasz Kotwicki
- Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland
| | - Toru Maruyama
- Department of Orthopedic Surgery, Saitama Medical University, Kawagoe, Japan
| | | | - Fabio Zaina
- ISICO, Italian Scientific Spine Institute, Milan, Italy
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Needham R, Naemi R, Healy A, Chockalingam N. Multi-segment kinematic model to assess three-dimensional movement of the spine and back during gait. Prosthet Orthot Int 2016; 40:624-35. [PMID: 25991730 DOI: 10.1177/0309364615579319] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/22/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Relatively little is known about spine during gait compared to movement analysis of the lower extremities. The trunk is often regarded and analysed as a single rigid segment and there is a paucity of information on inter-segmental movement within the spine and its relationship to pelvis and lower limbs. OBJECTIVES To develop and validate a new multi-segment kinematic model to assess regional three-dimensional movement of the lumbar, lower thoracic and upper thoracic spine during gait. STUDY DESIGN Observational study. METHODS The study was conducted in two parts: (1) to provide validation measures on the kinematic model built in commercially available software and (2) to apply the marker configuration to the spine at T3, T8 and L3 during gait analysis on 10 healthy male volunteers. RESULTS Proposed model revealed excellent concurrent validation measures between an applied input angle to the recorded output angle from the kinematic model. A high reliability was observed during gait analysis, both during a single session and between sessions for all participants. CONCLUSION The thoracic region of the spine should not be modelled as a single rigid segment and the proposed three-dimensional cluster is reliable and repeatable to assess the inter-segmental movement of the spine. CLINICAL RELEVANCE Reliable kinematic data can be collected using the three-dimensional cluster technique, thus, allowing researchers to accurately distinguish between movement patterns of healthy individuals to those with a clinical condition, and provide confidence in data acquisition during the monitoring process of an implemented rehabilitation intervention programme.
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Affiliation(s)
| | | | - Aoife Healy
- Staffordshire University, Stoke-on-Trent, UK
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115
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Naemi R, Chatzistergos P, Sundar L, Chockalingam N, Ramachandran A. Differences in the mechanical characteristics of plantar soft tissue between ulcerated and non-ulcerated foot. J Diabetes Complications 2016; 30:1293-9. [PMID: 27338509 DOI: 10.1016/j.jdiacomp.2016.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 05/23/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
Abstract
AIMS The purpose of this study was to investigate the differences in mechanical properties of the plantar soft tissue between the ulcerated and non-ulcerated feet in patients with diabetic neuropathy. METHODS Thirty nine patients who met the inclusion criteria participated in this study. Ten out of 39 participants had an active ulcer at a site other than the plantar heel and the first metatarsal head. Real time ultrasound elastography was performed to measure the soft tissue thickness and stiffness of the heel pad and sub-metatarsal fat pad. To account for the qualitative nature of conventional real time elastography, relative tissue stiffness was assessed against that of a standardised ultrasound standoff material. RESULTS The results indicated that the ulcerated group had a significantly lower heel pad relative stiffness (t (37)=2.559, P=0.015, η2=0.150) in the left foot. CONCLUSIONS The observed difference in the stiffness of the heel pad between the ulcerated and non-ulcerated feet indicates a possible link between tissue mechanics and ulceration. Further analysis of the data proposed in this study provided a quantitative assessment of plantar fat pad deformability which can contribute to understanding the role of tissue biomechanics in ulceration.
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Affiliation(s)
- Roozbeh Naemi
- Faculty of Health Sciences, Staffordshire University, Stoke on Trent, Staffordshire, UK.
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Formosa C, Gatt A, Chockalingam N. A Critical Evaluation of Existing Diabetic Foot Screening Guidelines. Rev Diabet Stud 2016; 13:158-186. [PMID: 28012281 PMCID: PMC5553765 DOI: 10.1900/rds.2016.13.158] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 10/19/2015] [Accepted: 10/25/2015] [Indexed: 12/15/2022] Open
Abstract
AIM To evaluate critically the current guidelines for foot screening in patients with diabetes, and to examine their relevance in terms of advancement in clinical practice, improvement in technology, and change in socio-cultural structure. METHODS A structured literature search was conducted in Pubmed/Medline, CINAHL, Cochrane Register of Controlled Trials, and Google between January 2011 and January 2015 using the keywords '(Diabetes) AND (Foot Screening) AND (Guidelines)'. RESULTS Ten complete diabetes foot screening guidelines were identified and selected for analysis. Six of them included the full-process guidelines recommended by the International Diabetes Federation. Evaluation of the existing diabetes foot screening guidelines showed substantial variability in terms of different evidence-based methods and grading systems to achieve targets, making it difficult to compare the guidelines. In some of the guidelines, it is unclear how the authors have derived the recommendations, i.e. on which study results they are based, making it difficult for the users to understand them. CONCLUSIONS Limitations of currently available guidelines and lack of evidence on which the guidelines are based are responsible for the current gaps between guidelines, standard clinical practice, and development of complications. For the development of standard recommendations and everyday clinical practice, it will be necessary to pay more attention to both the limitations of guidelines and the underlying evidence.
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Affiliation(s)
- Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta
- Faculty of Health Sciences, Staffordshire University, UK
| | - Alfred Gatt
- Faculty of Health Sciences, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta
- Faculty of Health Sciences, Staffordshire University, UK
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta
- Faculty of Health Sciences, Staffordshire University, UK
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117
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Gatt A, Briffa A, Chockalingam N, Formosa C. The Applicability of Plantar Padding in Reducing Peak Plantar Pressure in the Forefeet of Healthy AdultsImplications for the Foot at Risk. J Am Podiatr Med Assoc 2016; 106:246-51. [PMID: 27489964 DOI: 10.7547/15-025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND We investigated the effectiveness and durability of two types of plantar padding, the plantar metatarsal pad and the single wing plantar cover, which are commonly used for reducing forefoot plantar pressures. METHODS Mean peak plantar pressure and impulse at the hallux and at the first, second, third, and fourth metatarsophalangeal joints across both feet were recorded using the two-step method in 18 individuals with normal asymptomatic feet. Plantar paddings were retained for 5 days, and their durability and effectiveness were assessed by repeating the foot plantar measurement at baseline and after 3 and 5 days. RESULTS The single wing plantar cover devised from 5-mm felt adhesive padding was effective and durable in reducing peak plantar pressure and impulse at the first metatarsophalangeal joint (P = .001 and P = .015, respectively); however, it was not found to be effective in reducing peak plantar pressure and impulse at the hallux (P = .782 and P = .845, respectively). The plantar metatarsal pad was not effective in reducing plantar forefoot pressure and impulse at the second, third, and fourth metatarsophalangeal joints (P = .310 and P = .174, respectively). CONCLUSIONS These results imply limited applicability of the single wing plantar cover and the plantar metatarsal pad in reducing hallux pressure and second through fourth metatarsophalangeal joint pressure, respectively. However, the single wing plantar cover remained durable for the 5 days of the trial and was effective in reducing the peak plantar pressure and impulse underneath the first metatarsophalangeal joint.
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Affiliation(s)
- Alfred Gatt
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Andrea Briffa
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida, Malta
| | | | - Cynthia Formosa
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida, Malta
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Marshall J, Branthwaithe H, Chockalingam N. Heel pressures with generic and focused rigid heel cast devices while in a static supine and seated position. J Wound Care 2016; 25:328-34. [DOI: 10.12968/jowc.2016.25.6.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To identify if the choice of material used to make focused rigid cast (FRC) and generic heel cups has an effect on heel pressure in healthy individuals during a static supine and seated position. Method: A repeated measure design was used to compare the effect of two focused rigidity heel devices made from different materials (3M semi-rigid and Benecast FLEX) and a generic polymer gel heel cup device on barefoot heel pressures. Subjects had heel pressures taken while barefoot and with the three different heel devices while in a supine and seated position using the device. Results: We recruited 32 healthy participants (21 females, and 11 males). When comparing Benecast FLEX and 3M semi-rigid focused rigidity casts with barefoot and the generic heel cups significant reductions in pressures were seen in all areas while seated and in the distal area while supine. However, there was no statistical difference between the two FRC devices, or between barefoot and the generic heel cup in either position. Conclusion: This study demonstrates that FRC heel devices effectively reduced heel pressures in healthy individuals and therefore could be used in practice when a reduction in pressure is required for the management of heel pressure ulcers in bedbound or chair-bound patients. Declaration of interest: Materials were supplied from Benecare Medical (who agreed to supply 20 rolls of Benecast FLEX), and the podiatry department of Kent Community Health NHS Trust (who agreed to supply some of the materials).
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Affiliation(s)
- J. Marshall
- Rochester Community, Healthy Living Centre, Medway Community Healthcare, Delce Road, Rochester Kent
| | - H. Branthwaithe
- Staffordshire University, Brindley Building, Leek Road, Stoke-on-Trent
| | - N. Chockalingam
- Staffordshire University, Brindley Building, Leek Road, Stoke-on-Trent
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119
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Needham R, Stebbins J, Chockalingam N. Three-dimensional kinematics of the lumbar spine during gait using marker-based systems: a systematic review. J Med Eng Technol 2016; 40:172-85. [DOI: 10.3109/03091902.2016.1154616] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Robert Needham
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke on Trent, UK
| | - Julie Stebbins
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, UK
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Witchel HJ, Santos CP, Ackah JK, Westling CEI, Chockalingam N. Non-Instrumental Movement Inhibition (NIMI) Differentially Suppresses Head and Thigh Movements during Screenic Engagement: Dependence on Interaction. Front Psychol 2016; 7:157. [PMID: 26941666 PMCID: PMC4762992 DOI: 10.3389/fpsyg.2016.00157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 01/27/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Estimating engagement levels from postural micromovements has been summarized by some researchers as: increased proximity to the screen is a marker for engagement, while increased postural movement is a signal for disengagement or negative affect. However, these findings are inconclusive: the movement hypothesis challenges other findings of dyadic interaction in humans, and experiments on the positional hypothesis diverge from it. HYPOTHESES (1) Under controlled conditions, adding a relevant visual stimulus to an auditory stimulus will preferentially result in Non-Instrumental Movement Inhibition (NIMI) of the head. (2) When instrumental movements are eliminated and computer-interaction rate is held constant, for two identically-structured stimuli, cognitive engagement (i.e., interest) will result in measurable NIMI of the body generally. METHODS Twenty-seven healthy participants were seated in front of a computer monitor and speakers. Discrete 3-min stimuli were presented with interactions mediated via a handheld trackball without any keyboard, to minimize instrumental movements of the participant's body. Music videos and audio-only music were used to test hypothesis (1). Time-sensitive, highly interactive stimuli were used to test hypothesis (2). Subjective responses were assessed via visual analog scales. The computer users' movements were quantified using video motion tracking from the lateral aspect. Repeated measures ANOVAs with Tukey post hoc comparisons were performed. RESULTS For two equivalently-engaging music videos, eliminating the visual content elicited significantly increased non-instrumental movements of the head (while also decreasing subjective engagement); a highly engaging user-selected piece of favorite music led to further increased non-instrumental movement. For two comparable reading tasks, the more engaging reading significantly inhibited (42%) movement of the head and thigh; however, when a highly engaging video game was compared to the boring reading, even though the reading task and the game had similar levels of interaction (trackball clicks), only thigh movement was significantly inhibited, not head movement. CONCLUSIONS NIMI can be elicited by adding a relevant visual accompaniment to an audio-only stimulus or by making a stimulus cognitively engaging. However, these results presume that all other factors are held constant, because total movement rates can be affected by cognitive engagement, instrumental movements, visual requirements, and the time-sensitivity of the stimulus.
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Affiliation(s)
- Harry J Witchel
- Brighton and Sussex Medical School, University of Sussex Brighton, UK
| | - Carlos P Santos
- Brighton and Sussex Medical School, University of Sussex Brighton, UK
| | - James K Ackah
- Brighton and Sussex Medical School, University of Sussex Brighton, UK
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121
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Bodden JG, Needham RA, Chockalingam N. The effect of an intervention program on functional movement screen test scores in mixed martial arts athletes. J Strength Cond Res 2015; 29:219-25. [PMID: 23860293 DOI: 10.1519/jsc.0b013e3182a480bf] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study assessed the basic fundamental movements of mixed martial arts (MMA) athletes using the functional movement screen (FMS) assessment and determined if an intervention program was successful at improving results. Participants were placed into 1 of the 2 groups: intervention and control groups. The intervention group was required to complete a corrective exercise program 4 times per week, and all participants were asked to continue their usual MMA training routine. A mid-intervention FMS test was included to examine if successful results were noticed sooner than the 8-week period. Results highlighted differences in FMS test scores between the control group and intervention group (p = 0.006). Post hoc testing revealed a significant increase in the FMS score of the intervention group between weeks 0 and 8 (p = 0.00) and weeks 0 and 4 (p = 0.00) and no significant increase between weeks 4 and 8 (p = 1.00). A χ analysis revealed that the intervention group participants were more likely to have an FMS score >14 than participants in the control group at week 4 (χ = 7.29, p < 0.01) and week 8 (χ = 5.2, p ≤ 0.05). Finally, a greater number of participants in the intervention group were free from asymmetry at week 4 and week 8 compared with the initial test period. The results of the study suggested that a 4-week intervention program was sufficient at improving FMS scores. Most if not all, the movements covered on the FMS relate to many aspects of MMA training. The knowledge that the FMS can identify movement dysfunctions and, furthermore, the fact that the issues can be improved through a standardized intervention program could be advantageous to MMA coaches, thus, providing the opportunity to adapt and implement new additions to training programs.
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Affiliation(s)
- Jamie G Bodden
- Center for Sport, Health and Exercise Research, Faculty of Health Sciences, Sport & Exercise, Staffordshire University, Stoke on Trent, United Kingdom
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122
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Sinclair J, Naemi R, Chockalingam N, Taylor PJ, Shore H. The effects of shoe temperature on the kinetics and kinematics of running. Footwear Science 2015. [DOI: 10.1080/19424280.2015.1084389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gatt R, Vella Wood M, Gatt A, Zarb F, Formosa C, Azzopardi KM, Casha A, Agius TP, Schembri-Wismayer P, Attard L, Chockalingam N, Grima JN. Negative Poisson's ratios in tendons: An unexpected mechanical response. Acta Biomater 2015; 24:201-8. [PMID: 26102335 DOI: 10.1016/j.actbio.2015.06.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/11/2015] [Accepted: 06/16/2015] [Indexed: 11/28/2022]
Abstract
Tendons are visco-elastic structures that connect bones to muscles and perform the basic function of force transfer to and from the skeleton. They are essential for positioning as well as energy storing when involved in more abrupt movements such as jumping. Unfortunately, they are also prone to damage, and when injuries occur, they may have dilapidating consequences. For instance, there is consensus that injuries of tendons such as Achilles tendinopathies, which are common in athletes, are difficult to treat. Here we show, through in vivo and ex vivo tests, that healthy tendons are highly anisotropic and behave in a very unconventional manner when stretched, and exhibit a negative Poisson's ratio (auxeticity) in some planes when stretched up to 2% along their length, i.e. within their normal range of motion. Furthermore, since the Poisson's ratio is highly dependent on the material's microstructure, which may be lost if tendons are damaged or diseased, this property may provide a suitable diagnostic tool to assess tendon health. STATEMENT OF SIGNIFICANCE We report that human tendons including the Achilles tendons exhibits the very unusual mechanical property of a negative Poisson's ratio (auxetic) meaning that they get fatter rather than thinner when stretched. This report is backed by in vivo and ex vivo experiments we performed which clearly confirm auxeticity in this living material for strains which correspond to those experienced during most normal everyday activities. We also show that this property is not limited to the human Achilles tendon, as it was also found in tendons taken from sheep and pigs. This new information about tendons can form the scientific basis for a test for tendon health as well as enable the design of better tendon prosthesis which could replace damaged tendons.
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Affiliation(s)
- Ruben Gatt
- Metamaterials Unit, Faculty of Science, University of Malta, Msida MSD 2080, Malta.
| | - Michelle Vella Wood
- Metamaterials Unit, Faculty of Science, University of Malta, Msida MSD 2080, Malta
| | - Alfred Gatt
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta; Faculty of Health Sciences, Staffordshire University, Science Centre, Leek Road ST4 2DF, UK
| | - Francis Zarb
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Cynthia Formosa
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta; Faculty of Health Sciences, Staffordshire University, Science Centre, Leek Road ST4 2DF, UK
| | - Keith M Azzopardi
- Metamaterials Unit, Faculty of Science, University of Malta, Msida MSD 2080, Malta
| | - Aaron Casha
- Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, Msida MSD 2080, Malta
| | - Tonio P Agius
- Department of Physiotherapy, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Pierre Schembri-Wismayer
- Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, Msida MSD 2080, Malta
| | - Lucienne Attard
- Department of Orthopaedics, MaterDei Hospital, Msida MSD 2090, Malta
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, Staffordshire University, Science Centre, Leek Road ST4 2DF, UK; Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Joseph N Grima
- Metamaterials Unit, Faculty of Science, University of Malta, Msida MSD 2080, Malta; Department of Chemistry, Faculty of Science, University of Malta, Msida MSD 2080, Malta
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Durrant B, Chockalingam N, Morriss-Roberts C. Assessment and Diagnosis of Posterior Tibial Tendon Dysfunction: Do We Share the Same Opinions and Beliefs? J Am Podiatr Med Assoc 2015:14-122.1. [PMID: 26200225 DOI: 10.7547/14-122.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Posterior tibial tendon dysfunction is a disabling pathologic flatfoot disorder. Evidence supports the notion that this condition is poorly diagnosed by health-care professionals. In addition, opinion is divided as to the most appropriate assessment and diagnostic techniques used to reflect the progression or stage of the condition. Hence, this study intended to explore the views and opinions of health-care professionals who may be involved in its assessment and diagnosis. METHODS A two-phase sequential mixed methods design was used that combined a questionnaire survey and a focus group interview. RESULTS The questionnaire data were analyzed using the Kendall levels of concordance and the Cohen kappa statistic, and the focus group data were analyzed using thematic analysis, which led to three main themes: resource implications, scope of practice, and awareness of the condition. CONCLUSIONS This study highlights what may have been suspected previously but that has never been investigated in a structured manner. One approach to the assessment and diagnosis of posterior tibial tendon dysfunction is not necessarily the best, and depending on the clinical teams, different guidance may be required to ensure that patients are receiving the most appropriate and best care.
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Chatzistergos P, Naemi R, Chockalingam N. Numerical investigation of the optimum cushioning properties of insole materials: the effect of subject-specific geometry and loading. Footwear Science 2015. [DOI: 10.1080/19424280.2015.1038652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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126
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Hurst B, Branthwaite H, Chockalingam N. The effects of medical grade footwear on forefoot pressure. Footwear Science 2015. [DOI: 10.1080/19424280.2015.1038616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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127
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Greenhalgh A, Chockalingam N, Naemi R, Sinclair J. Patellofemoral kinetics during running in heelless and conventional running shoes. Footwear Science 2015. [DOI: 10.1080/19424280.2015.1038637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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128
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Naemi R, Healy A, Revathi T, Sundar L, Chockalingam N, Ramachandran A. The effect of wearing a diabetic sandal in altering standing balance parameters in people with diabetes and neuropathy. Footwear Science 2015. [DOI: 10.1080/19424280.2015.1038312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Negrini S, Minozzi S, Bettany‐Saltikov J, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Zaina F. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2015; 2015:CD006850. [PMID: 26086959 PMCID: PMC10616811 DOI: 10.1002/14651858.cd006850.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. While adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. OBJECTIVES To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, and psychological and cosmetic issues. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015 for relevant clinical trials. We also checked the reference lists of relevant articles and conducted an extensive handsearch of grey literature. SELECTION CRITERIA Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included seven studies (662 participants). Five were planned as RCTs and two as prospective controlled trials. One RCT failed completely, another was continued as an observational study, reporting also the results of the participants that had been randomized.There was very low quality evidence from one small RCT (111 participants) that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation (mean difference (MD) -2.10, 95% confidence interval (CI) -7.69 to 3.49). There was very low quality evidence from a subgroup of 77 adolescents from one prospective cohort study showing that QoL, back pain, psychological, and cosmetic issues did not differ significantly between rigid bracing and observation in the long term (16 years).Results of the secondary outcomes showed that there was low quality evidence that rigid bracing compared with observation significantly increased the success rate in 20° to 40° curves at two years' follow-up (one RCT, 116 participants; risk ratio (RR) 1.79, 95% CI 1.29 to 2.50). There was low quality evidence that elastic bracing increased the success rate in 15° to 30° curves at three years' follow-up (one RCT, 47 participants; RR 1.88, 95% CI 1.11 to 3.20).There is very low quality evidence from two prospective cohort studies with a control group that rigid bracing increases the success rate (curves not evolving to 50° or above) at two years' follow-up (one study, 242 participants; RR 1.50, 95% CI 1.19 to 1.89) and at three years' follow-up (one study, 240 participants; RR 1.75, 95% CI 1.42 to 2.16). There was very low quality evidence from a prospective cohort study (57 participants) that very rigid bracing increased the success rate (no progression of 5° or more, fusion, or waiting list for fusion) in adolescents with high degree curves (above 45°) (one study, 57 adolescents; RR 1.79, 95% CI 1.04 to 3.07 in the intention-to-treat (ITT) analysis).There was low quality evidence from one RCT that a rigid brace was more successful than an elastic brace at curbing curve progression when measured in Cobb degrees in low degree curves (20° to 30°), with no significant differences between the two groups in the subjective perception of daily difficulties associated with wearing the brace (43 girls; risk of success at four years' follow-up: RR 1.40, 1.03 to 1.89). Finally, there was very low quality evidence from one RCT (12 participants) that a rigid brace with a pad pressure control system is no better than a standard brace in reducing the risk of progression.Only one prospective cohort study (236 participants) assessed adverse events: neither the percentage of adolescents with any adverse event (RR 1.27, 95% CI 0.96 to 1.67) nor the percentage of adolescents reporting back pain, the most common adverse event, were different between the groups (RR 0.72, 95% CI 0.47 to 1.10). AUTHORS' CONCLUSIONS Due to the important clinical differences among the studies, it was not possible to perform a meta-analysis. Two studies showed that bracing did not change QoL during treatment (low quality), and QoL, back pain, and psychological and cosmetic issues in the long term (16 years) (very low quality). All included papers consistently showed that bracing prevented curve progression (secondary outcome). However, due to the strength of evidence (from low to very low quality), further research is very likely to have an impact on our confidence in the estimate of effect. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. This challenge may prevent us from seeing increases in the quality of the evidence over time. Other designs need to be implemented and included in future reviews, including 'expertise-based' trials, prospective controlled cohort studies, prospective studies conducted according to pre-defined criteria such as the Scoliosis Research Society (SRS) and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria. Future studies should increase their focus on participant outcomes, adverse effects, methods to increase compliance, and usefulness of physiotherapeutic scoliosis specific exercises added to bracing.
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Affiliation(s)
- Stefano Negrini
- University of Brescia ‐ IRCCS Fondazione Don Gnocchi MilanPhysical and Rehabilitation MedicineViale EuropaBresciaItaly25121
| | - Silvia Minozzi
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
| | - Josette Bettany‐Saltikov
- University of TeessideSchool of Health and Social CareVictoria RoadMiddlesbroughClevelandUKTS13BA
| | | | - Theodoros B. Grivas
- "Tzanio" General Hospital of PiraeusDepartment of Trauma and OrthopaedicsPiraeusAtticaGreece18536
| | - Tomasz Kotwicki
- University of Medical SciencesDepartment of Pediatric Orthopedics and Traumatologyul. 28 Czerwca 1956 nr 135PoznanPoland61‐545
| | - Toru Maruyama
- Saitama Medical UniversityDepartment of Orthopaedic Surgery1981 KamodaKawagoeSaitamaJapan350‐8550
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute)Via Roberto Bellarmino 13/1MilanItaly20141
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute)Via Roberto Bellarmino 13/1MilanItaly20141
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131
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Needham R, Naemi R, Chockalingam N. Quantification of rear-foot, fore-foot coordination pattern during gait using a new classification. Footwear Science 2015. [DOI: 10.1080/19424280.2015.1038311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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132
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Naemi R, Chatzistergos PE, Chockalingam N. A mathematical method for quantifying in vivo mechanical behaviour of heel pad under dynamic load. Med Biol Eng Comput 2015; 54:341-50. [DOI: 10.1007/s11517-015-1316-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 05/18/2015] [Indexed: 11/27/2022]
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Davies N, Branthwaite H, Chockalingam N. Where should a school shoe provide flexibility and support for the asymptomatic 6- to 10-year-olds and on what information is this based? A Delphi yielded consensus. Prosthet Orthot Int 2015; 39:213-8. [PMID: 24570017 DOI: 10.1177/0309364614522684] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 01/13/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is a paucity of evidence regarding the design of children's footwear in relation to musculoskeletal structure. OBJECTIVES The aim was to gain consensus regarding where flexibility and support should be given on a school shoe for the 6- to 10-year-olds. STUDY DESIGN Delphi Questionnaire. METHODS Recruitment of 10 Allied Health Professionals yielded a consensus group. Those recruited had dedicated experience in paediatrics and foot health. Rounds of questions were delivered to investigate the basis of the opinions made by the group on the location of support and flexibility in a school shoe for the age range identified. RESULTS Six themes were generated. Four themes gained 100% consensus regarding footwear allowing normal foot movement, footwear allowing normal forefoot function, footwear providing a stable base and the foot being secure in the shoe. Fleiss' kappa calculations revealed 'poor agreement' for the remaining two themes regarding clinical intervention and the purpose of footwear design in the midfoot in both the upper and sole of the shoe. CONCLUSION The qualitative data generated through discussion have highlighted areas where more understanding and research are required, particularly in understanding how, in the long term, shoe design can affect the developing foot. CLINICAL RELEVANCE Children's footwear advice is often delivered from experience and personal belief. This article questions current understanding and opinion from clinical experts in the field of paediatric footwear and highlights that there is a lack of knowledge and confidence into the effects of children's footwear. There is a strong requirement for further empirical research to be completed on children's footwear to allow clinicians to formulate relevant and appropriate footwear advice.
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Affiliation(s)
- Nina Davies
- Leeds Community Healthcare NHS Trust, Leeds, UK
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134
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Affiliation(s)
- Nicola Eddison
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UK
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135
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Bettany-Saltikov J, Weiss HR, Chockalingam N, Taranu R, Srinivas S, Hogg J, Whittaker V, Kalyan RV, Arnell T. Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis. Cochrane Database Syst Rev 2015:CD010663. [PMID: 25908428 DOI: 10.1002/14651858.cd010663.pub2] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine. While AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. Interventions for the prevention of AIS progression include scoliosis-specific exercises, bracing, and surgery. The main aims of all types of interventions are to correct the deformity and prevent further deterioration of the curve and to restore trunk asymmetry and balance, while minimising morbidity and pain, allowing return to full function. Surgery is normally recommended for curvatures exceeding 40 to 50 degrees to stop curvature progression with a view to achieving better truncal balance and cosmesis. Short-term results of the surgical treatment of people with AIS demonstrate the ability of surgery to improve various outcome measures. However there is a clear paucity of information on long-term follow-up of surgical treatment of people with AIS. OBJECTIVES To examine the impact of surgical versus non-surgical interventions in people with AIS who have severe curves of over 45 degrees, with a focus on trunk balance, progression of scoliosis, cosmetic issues, quality of life, disability, psychological issues, back pain, and adverse effects, at both the short term (a few months) and the long term (over 20 years). SEARCH METHODS We searched the Cochrane Back Review Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, four other databases, and three trials registers up to August 2014 with no language limitations. We also checked the reference lists of relevant articles and conducted an extensive handsearch of the grey literature. SELECTION CRITERIA We searched for randomised controlled trials (RCTs) and prospective controlled trials comparing spinal fusion surgery with non-surgical interventions in people with AIS with a Cobb angle greater than 45 degrees. We were interested in all types of instrumented surgical interventions with fusion that aimed to provide curve correction and spine stabilisation. DATA COLLECTION AND ANALYSIS We found no RCTs or prospective controlled trials that met our inclusion criteria. MAIN RESULTS We did not identify any evidence comparing surgical to non-surgical interventions for AIS with severe curves of over 45 degrees. AUTHORS' CONCLUSIONS We cannot draw any conclusions.
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Affiliation(s)
- Josette Bettany-Saltikov
- School of Health and Social Care, University of Teesside, Victoria Road, Middlesbrough, Cleveland, UK, TS13BA
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Eddison N, Chockalingam N, Osborne S. Ankle foot orthosis-footwear combination tuning: an investigation into common clinical practice in the United Kingdom. Prosthet Orthot Int 2015; 39:126-33. [PMID: 24567349 DOI: 10.1177/0309364613516486] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ankle foot orthoses are used to treat a wide variety of gait pathologies. Ankle foot orthosis-footwear combination tuning should be routine clinical practice when prescribing an ankle foot orthosis. Current research suggests that failure to tune ankle foot orthosis-footwear combinations can lead to immediate detrimental effect on function, and in the longer term, it may actually contribute to deterioration. OBJECTIVES The purpose of this preliminary study was to identify the current level of knowledge clinicians have in the United Kingdom regarding ankle foot orthosis-footwear combination tuning and to investigate common clinical practice regarding ankle foot orthosis-footwear combination tuning among UK orthotists. STUDY DESIGN Cross-sectional survey. METHODS A prospective study employing a multi-item questionnaire was sent out to registered orthotists and uploaded on to the official website of British Association of Prosthetists and Orthotists to be accessed by their members. RESULTS A total of 41 completed questionnaires were received. The results demonstrate that only 50% of participants use ankle foot orthosis-footwear combination tuning as standard clinical practice. The most prevalent factors preventing participants from carrying out ankle foot orthosis-footwear combination tuning are a lack of access to three-dimensional gait analysis equipment (37%) and a lack of time available in their clinics (27%). CLINICAL RELEVANCE Although, ankle foot orthosis-footwear combination tuning has been identified as an essential aspect of the prescription of ankle foot orthoses, the results of this study show a lack of understanding of the key principles behind ankle foot orthosis-footwear combination tuning.
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Affiliation(s)
| | | | - Stephen Osborne
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke on Trent, UK
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137
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Błażkiewicz M, Sundar L, Healy A, Ramachandran A, Chockalingam N, Naemi R. Assessment of lower leg muscle force distribution during isometric ankle dorsi and plantar flexion in patients with diabetes: a preliminary study. J Diabetes Complications 2015; 29:282-7. [PMID: 25454742 DOI: 10.1016/j.jdiacomp.2014.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/06/2014] [Accepted: 10/15/2014] [Indexed: 12/25/2022]
Abstract
AIM The aim of this study was to evaluate the differences in ankle muscle strength using hand-held dynamometry and to assess difference in the isometric muscle force distribution between the people with diabetes and control participants. METHODS The maximal muscle strength of ankle plantarflexion, dorsiflexion, eversion, inversion, lesser toes flexors and extensors, hallux flexors, and extensors was assessed in 20 people with diabetes and 20 healthy participants using hand-held dynamometry. The maximal isometric ankle plantarflexion and dorsiflexion were imported to OpenSim software to calculate 12 individual muscle (8 plantarflexors and 4 dorsiflexors) forces acting on ankle joint. RESULTS A significant reduction in ankle strength for all measured actions and a significant decrease in muscle force for each of the 12 muscles during dorsi and plantar flexion were observed. Furthermore, the ratios of agonist to antagonist muscle force for 6 of the muscles were significantly different between the control group and the group with diabetes. CONCLUSIONS It is likely that the muscles for which the agonist/antagonist muscle force ratio was significantly different for the healthy people and the people with diabetes could be more affected by diabetes.
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Affiliation(s)
- Michalina Błażkiewicz
- Department of Physiotherapy, Józef Piłsudski University of Physical Education, Warsaw, Poland; CSHER, Faculty of Health Sciences, Staffordshire University, Stoke on Trent, ST4 2DF, UK.
| | - Lakshmi Sundar
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke on Trent, ST4 2DF, UK; AR Hospitals, India Diabetic Research Foundation, Egmore, Chennai, India
| | - Aoife Healy
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke on Trent, ST4 2DF, UK
| | | | | | - Roozbeh Naemi
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke on Trent, ST4 2DF, UK
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Gatt A, Formosa C, Cassar K, Camilleri KP, De Raffaele C, Mizzi A, Azzopardi C, Mizzi S, Falzon O, Cristina S, Chockalingam N. Thermographic patterns of the upper and lower limbs: baseline data. Int J Vasc Med 2015; 2015:831369. [PMID: 25648145 PMCID: PMC4310239 DOI: 10.1155/2015/831369] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 12/22/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives. To collect normative baseline data and identify any significant differences between hand and foot thermographic distribution patterns in a healthy adult population. Design. A single-centre, randomized, prospective study. Methods. Thermographic data was acquired using a FLIR camera for the data acquisition of both plantar and dorsal aspects of the feet, volar aspects of the hands, and anterior aspects of the lower limbs under controlled climate conditions. Results. There is general symmetry in skin temperature between the same regions in contralateral limbs, in terms of both magnitude and pattern. There was also minimal intersubject temperature variation with a consistent temperature pattern in toes and fingers. The thumb is the warmest digit with the temperature falling gradually between the 2nd and the 5th fingers. The big toe and the 5th toe are the warmest digits with the 2nd to the 4th toes being cooler. Conclusion. Measurement of skin temperature of the limbs using a thermal camera is feasible and reproducible. Temperature patterns in fingers and toes are consistent with similar temperatures in contralateral limbs in healthy subjects. This study provides the basis for further research to assess the clinical usefulness of thermography in the diagnosis of vascular insufficiency.
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Affiliation(s)
- Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta ; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta ; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Kevin Cassar
- Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta
| | - Kenneth P Camilleri
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | | | - Anabelle Mizzi
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Carl Azzopardi
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | - Stephen Mizzi
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta
| | - Owen Falzon
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | - Stefania Cristina
- Centre for Biomedical Cybernetics, University of Malta, Msida MSD 2080, Malta
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, University of Malta, Msida MSD 2080, Malta ; Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
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139
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Sinclair J, Chockalingam N, Naemi R, Vincent H. The effects of sport-specific and minimalist footwear on the kinetics and kinematics of three netball-specific movements. Footwear Science 2014. [DOI: 10.1080/19424280.2014.983445] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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140
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Needham R, Naemi R, Chockalingam N. Corrigendum to “Quantifying lumbar–pelvis coordination during gait using a modified vector coding technique” [J. Biomech. 47(5) (2014) 1020–1026]. J Biomech 2014. [DOI: 10.1016/j.jbiomech.2014.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Branthwaite H, Chockalingam N, Greenhalgh A, Chatzistergos P. The impact of different footwear characteristics, of a ballet flat pump, on centre of pressure progression and perceived comfort. Foot (Edinb) 2014; 24:116-22. [PMID: 24939663 DOI: 10.1016/j.foot.2014.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 05/06/2014] [Accepted: 05/25/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Uncomfortable shoes have been attributed to poor fit and the cause of foot pathologies. Assessing and evaluating comfort and fit have proven challenging due to the subjective nature. The aim of this paper is to investigate the relationship between footwear characteristics and perceived comfort. METHODS Twenty-seven females assessed three different styles of ballet pump shoe for comfort using a comfort scale whilst walking along a 20 m walkway. The physical characteristics of the shoes and the progression of centre of pressure during walking were assessed. RESULTS There were significant physical differences between each style, square shoe being the shortest, widest and stiffest and round shoe having the least volume at the toe box. Centre of pressure progression angle was centralised to the longitudinal axis of the foot when wearing each of the three shoes compared to barefoot. Length, width and cantilever bending stiffness had no impact on perceived comfort. CONCLUSION Wearing snug fitting flexible soled round ballet flat pump is perceived to be the most comfortable of the shoe shapes tested producing a faster more efficient gait. Further investigations are required to assess impact/fit and upper material on perceived comfort to aid consumers with painful feet in purchasing shoes.
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Affiliation(s)
- Helen Branthwaite
- Centre for Sport, Health and Exercise Research, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent ST4 2DF, United Kingdom.
| | - Nachiappan Chockalingam
- Centre for Sport, Health and Exercise Research, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent ST4 2DF, United Kingdom.
| | - Andrew Greenhalgh
- Centre for Sport, Health and Exercise Research, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent ST4 2DF, United Kingdom; London Sport Institute, School of Health and Social Science, Middlesex University, Hendon, London NW4 4BT, United Kingdom.
| | - Panagiotis Chatzistergos
- Centre for Sport, Health and Exercise Research, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent ST4 2DF, United Kingdom.
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142
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Chatzistergos PE, Naemi R, Sundar L, Ramachandran A, Chockalingam N. The relationship between the mechanical properties of heel-pad and common clinical measures associated with foot ulcers in patients with diabetes. J Diabetes Complications 2014; 28:488-93. [PMID: 24795257 DOI: 10.1016/j.jdiacomp.2014.03.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 03/17/2014] [Accepted: 03/17/2014] [Indexed: 11/26/2022]
Abstract
AIM The present study aims at investigating the correlation between the mechanical properties of the heel-pad of people with type-2 diabetes and the clinical parameters used to monitor their health and ulceration risk. METHODS A new device for the in-vivo testing of plantar soft tissues was built and pilot-tested. This device consists of an ultrasound probe connected in series with a dynamometer. Loading is applied manually using a ball-screw actuator. A total of 35 volunteers with type-2 diabetes were recruited and the thickness, stiffness of their heel-pads as well as the energy absorbed during loading were assessed. The participants with diabetes also underwent blood tests and measurements of Ankle Brachial Index and Vibration Perception Threshold. RESULTS Pearson correlation analysis revealed strong correlations between triglycerides and heel-pad stiffness (r=0.675, N=27, p<0.001) and between triglycerides and energy (r=-0.598, N=27, p=0.002). A correlation of medium strength was found between Fasting Blood Sugar (FBS) and stiffness (r=0.408, N=29, p=0.043). CONCLUSIONS People with type-2 diabetes and high levels of triglycerides and FBS are more likely to have stiffer heel-pads. Increased stiffness could limit the tissues' ability to evenly distribute loads making them more vulnerable to trauma and ulceration.
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Affiliation(s)
| | - Roozbeh Naemi
- CSHER, Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, United Kingdom
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Abstract
BACKGROUND Although assessment of passive maximum foot dorsiflexion angle is performed routinely, there is a paucity of information regarding adolescents' foot and foot segment motion during this procedure. There are currently no trials investigating the kinematics of the adolescent foot during passive foot dorsiflexion. METHODS A six-camera optoelectronic motion capture system was used to collect kinematic data using the Oxford Foot Model. Eight female amateur gymnasts 11 to 16 years old (mean age, 13.2 years; mean height, 1.5 m) participated in the study. A dorsiflexing force was applied to the forefoot until reaching maximum resistance with the foot placed in the neutral, pronated, and supinated positions in random order. The maximum foot dorsiflexion angle and the range of movement of the forefoot to hindfoot, tibia to forefoot, and tibia to hindfoot angles were computed. RESULTS Mean ± SD maximum foot dorsiflexion angles were 36.3° ± 7.2° for pronated, 36.9° ± 4.0° for neutral, and 33.0° ± 4.9° for supinated postures. One-way repeated-measures analysis of variance results were nonsignificant among the 3 groups (P = .70), as were the forefoot to tibia angle and hindfoot to tibia angle variations (P = .091 and P = .188, respectively). Forefoot to hindfoot angle increased with the application of force, indicating that in adolescents, the forefoot does not lock at any particular posture as portrayed by the traditional Rootian paradigm. CONCLUSIONS Participants had very flexible foot dorsiflexion, unlike those in another study assessing adolescent athletes. This finding, together with nonsignificant statistical results, implies that foot dorsiflexion measurement may be performed at any foot posture without notably affecting results.
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Affiliation(s)
- Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida, Malta
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144
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Sinclair J, Naemi R, Chockalingam N, Greenhalgh A. Investigation into the kinetics and kinematics during running in the heelless shoe. Footwear Science 2014. [DOI: 10.1080/19424280.2014.889221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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145
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Needham R, Naemi R, Chockalingam N. Quantifying lumbar–pelvis coordination during gait using a modified vector coding technique. J Biomech 2014; 47:1020-6. [DOI: 10.1016/j.jbiomech.2013.12.032] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 12/09/2013] [Accepted: 12/30/2013] [Indexed: 11/16/2022]
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146
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Sinclair J, Franks C, Goodwin J, Naemi R, Chockalingam N. Influence of footwear designed to boost energy return on the kinetics and kinematics of running compared to conventional running shoes. Comparative Exercise Physiology 2014. [DOI: 10.3920/cep140010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Runners have sought to utilise athletic footwear as one of the mechanisms by which they might attenuate their risk of injury and improve their performance. New commercially available footwear which claims to boost energy return have been designed utilising an expanded thermoplastic polyurethane midsole. These footwear have been shown to improve running economy, but their clinical efficacy has not yet been established. This study aimed to examine the 3-D kinetics and kinematics when running in footwear that claims to promote energy return in relation to conventional running trainers. Fifteen male participants ran at 4.0 m/s (±5%) in each footwear condition. Lower extremity kinematics were collected in the sagittal, coronal and transverse planes using a 3-D motion analysis system. Simultaneous tibial acceleration and vertical ground reaction force parameters were also obtained. Impact parameters and 3-D kinematics were contrasted using paired samples t-tests. The results indicate that tibial accelerations were significantly greater in the footwear designed to improve energy return. In addition the 3-D kinematic analysis also showed that peak eversion and tibial internal rotation were significantly greater in the footwear designed to improve energy return. On the basis of these observations the current investigation suggests that these new footwear may place runners at an increased risk from chronic injury.
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Affiliation(s)
- J. Sinclair
- University of Central Lancashire, Fylde road, PR1 2HE Preston, Lancashire, United Kingdom
| | - C. Franks
- University of Central Lancashire, Fylde road, PR1 2HE Preston, Lancashire, United Kingdom
| | - J.F. Goodwin
- University of Central Lancashire, Fylde road, PR1 2HE Preston, Lancashire, United Kingdom
| | - R. Naemi
- Staffordshire University, Leek Road, ST4 2DF Stoke-on-Trent, United Kingdom
| | - N. Chockalingam
- Staffordshire University, Leek Road, ST4 2DF Stoke-on-Trent, United Kingdom
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Healy A, Naemi R, Chockalingam N. The effectiveness of footwear and other removable off-loading devices in the treatment of diabetic foot ulcers: a systematic review. Curr Diabetes Rev 2014; 10:215-30. [PMID: 25245020 DOI: 10.2174/1573399810666140918121438] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 11/22/2022]
Abstract
AIM To conduct a systematic review which examined the effectiveness of footwear and other removable off-loading devices as interventions for the treatment of diabetic foot ulcers or the alteration of biomechanical factors associated with ulcer healing and to discuss the quality and interpret the findings of research to date. METHODS The CINAHL, Medline and Cochrane Register of Controlled Trials databases were searched with seventeen articles identified for review. RESULTS Majority of the identified studies were randomised control trials which compared the ulcer healing rates of different footwear and other removable off-loading device interventions. Three categories of interventions were identified; 1) removable cast walkers (RCWs), 2) half or heel relief shoes and 3) therapeutic shoes. Most studies compared at least one intervention to a total contact cast (TCC). Factors which influenced study findings such as TCC application method, compliance, activity levels, and the footwear worn on the contralateral limb are discussed with recommendations provided for future studies. CONCLUSION Due to the lack of randomised controlled studies conducted in this area it is not currently possible to make strong conclusions on the interventions effectiveness. However, it appears the currently available therapeutic shoes were the least effective intervention followed by half or heel relief shoes. RCWs were found to be the most effective of the removable devices.
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Affiliation(s)
| | | | - Nachiappan Chockalingam
- R009 Science Centre, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, UK.
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148
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Scalpello A, Gatt A, Chockalingam N. A pilot comparison of forefoot plantar pressures in newly diagnosed rheumatoid arthritis patients and non-rheumatic subjects. Foot (Edinb) 2013; 23:120-2. [PMID: 24070689 DOI: 10.1016/j.foot.2013.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 08/01/2013] [Accepted: 08/17/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND In rheumatoid arthritis (RA) forefoot pathology is often related to increased peak plantar pressures under the metatarsal heads. OBJECTIVES This study sought to assess peak plantar pressures in newly diagnosed RA patients compared to non-rheumatic subjects. METHOD Plantar pressure in a group of 10 pain free RA patients diagnosed within two years before the starting date of the study and 10 healthy volunteers matched for gender, age and weight were assessed. Each group consisted of seven females and three males aged between 30 and 55 years. RESULTS The results showed no significant difference (ρ=0.420) at the hallux, however there was a statistical difference in all the other regions (ρ=0.000 and p=0.011 for 1st MPJ and 2nd-4th MPJ respectively and p=0.007 for 5th MPJ). The RA group had higher pressure underneath the 1st and 2nd-4th MPJ regions and lower pressures underneath the 5th MPJ. CONCLUSION Although it is for a small group of patients, the results from this pilot study show that even at an early stage of RA, forefoot pressures are shifted toward the medial MPJs.
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Naemi R, Chockalingam N. Development of a method for quantifying the midsole reaction model parameters. Comput Methods Biomech Biomed Engin 2013; 16:1273-7. [DOI: 10.1080/10255842.2012.666795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Formosa C, Cassar K, Gatt A, Mizzi A, Mizzi S, Camileri KP, Azzopardi C, DeRaffaele C, Falzon O, Cristina S, Chockalingam N. Hidden dangers revealed by misdiagnosed peripheral arterial disease using ABPI measurement. Diabetes Res Clin Pract 2013; 102:112-6. [PMID: 24209599 DOI: 10.1016/j.diabres.2013.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 06/26/2013] [Accepted: 10/01/2013] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to compare ankle brachial indices (APBI) with pedal waveforms utilizing the continuous wave Doppler in a population with diabetes mellitus. METHODS A prospective study design was employed to investigate the ABPI in a cohort of 49 people with type 2 diabetes mellitus. ABPI assessment was completed using a portable handheld Doppler and ankle pressures of <0.9 were taken as suggestive of peripheral arterial disease (PAD). Arterial spectral waveforms in each foot were also recorded and compared to the ABPI readings. RESULTS Inconsistencies were identified between ABPIs and waveform interpretations in the study population. Approximately 35% of subjects had inconsistencies between their ABPI result and waveform interpretation in their right or left foot. CONCLUSIONS Both ABPIs and Doppler waveforms should be used in the assessment of people with diabetes in order to screen for PAD. This would ensure an accurate assessment of PAD and would allow initiation of appropriate secondary risk factor control measures.
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