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Xu D, Zhou H, Wang M, Ma X, Gusztav F, Chon TE, Fernandez J, Baker JS, Gu Y. Contribution of ankle motion pattern during landing to reduce the knee-related injury risk. Comput Biol Med 2024; 180:108965. [PMID: 39084051 DOI: 10.1016/j.compbiomed.2024.108965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/04/2024] [Accepted: 07/27/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Single-leg landing (SL) is an essential technique in sports such as basketball, soccer, and volleyball, which is often associated with a high risk of knee-related injury. The ankle motion pattern plays a crucial role in absorbing the load shocks during SL, but the effect on the knee joint is not yet clear. This work aims to explore the effects of different ankle plantarflexion angles during SL on the risk of knee-related injury. METHODS Thirty healthy male subjects were recruited to perform SL biomechanics tests, and one standard subject was selected to develop the finite element model of foot-ankle-knee integration. The joint impact force was used to evaluate the impact loads on the knee at various landing angles. The internal load forces (musculoskeletal modeling) and stress (finite element analysis) around the knee joint were simulated and calculated to evaluate the risk of knee-related injury during SL. To more realistically revert and simulate the anterior cruciate ligament (ACL) injury mechanics, we developed a knee musculoskeletal model that reverts the ACL ligament to a nonlinear short-term viscoelastic mechanical mechanism (strain rate-dependent) generated by the dense connective tissue as a function of strain. RESULTS As the ankle plantarflexion angle increased during landing, both the peak knee vertical impact force (p = 0.001) and ACL force (p = 0.001) decreased significantly. The maximum von Mises stress of ACL, meniscus, and femoral cartilage decreased as the ankle plantarflexion angle increased. The overall range of variation in ACL stress was small and was mainly distributed in the femoral and tibial attachment regions, as well as in the mid-lateral region. CONCLUSION The current findings revealed that the use of larger ankle plantarflexion angles during landing may be an effective solution to reduce knee impact load and the risk of rupture of the medial femoral attachment area in the ACL. The findings of this study have the potential to offer novel perspectives in the optimized application of landing strategies, thus giving crucial theoretical backing for decreasing the risk of knee-related injury.
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Affiliation(s)
- Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China; Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Fekete Gusztav
- Department of Material Science and Technology, Audi Hungaria Faculty of Automotive Engineering, Széchenyi István University, Gyor, Hungary
| | - Teo-Ee Chon
- Faculty of Sports Science, Ningbo University, Ningbo, China; School of Chemical and Biomedical Engineering, Nanyang Technological University, 639798, Singapore
| | - Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Julien S Baker
- Faculty of Sports Science, Ningbo University, Ningbo, China; Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China.
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Zhou Z, Zhou H, Jie T, Xu D, Teo EC, Wang M, Gu Y. Analysis of stress response distribution in patients with lateral ankle ligament injuries: a study of neural control strategies utilizing predictive computing models. Front Physiol 2024; 15:1438194. [PMID: 39113939 PMCID: PMC11303170 DOI: 10.3389/fphys.2024.1438194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Background Ankle sprains are prevalent in sports, often causing complex injuries to the lateral ligaments. Among these, anterior talofibular ligament (ATFL) injuries constitute 85%, and calcaneofibular ligament (CFL) injuries comprise 35%. Despite conservative treatment, some ankle sprain patients develop chronic lateral ankle instability (CLAI). Thus, this study aimed to investigate stress response and neural control alterations during landing in lateral ankle ligament injury patients. Method This study recruited twenty individuals from a Healthy group and twenty CLAI patients performed a landing task using relevant instruments to collect biomechanical data. The study constructed a finite element (FE) foot model to examine stress responses in the presence of laxity of the lateral ankle ligaments. The lateral ankle ligament was modeled as a hyperelastic composite structure with a refined representation of collagen bundles and ligament laxity was simulated by adjusting material parameters. Finally, the validity of the finite element model is verified by a high-speed dual fluoroscopic imaging system (DFIS). Result CLAI patients exhibited earlier Vastus medialis (p < 0.001) and tibialis anterior (p < 0.001) muscle activation during landing. The FE analysis revealed that with laxity in the ATFL, the peak von Mises stress in the fifth metatarsal was 20.74 MPa, while with laxity in the CFL, it was 17.52 MPa. However, when both ligaments were relaxed simultaneously, the peak von Mises stress surged to 21.93 MPa. When the ATFL exhibits laxity, the CFL is subjected to a higher stress of 3.84 MPa. Conversely, when the CFL displays laxity, the ATFL experiences a peak von Mises stress of 2.34 MPa. Conclusion This study found that changes in the laxity of the ATFL and the CFL are linked to shifts in metatarsal stress levels, potentially affecting ankle joint stability. These alterations may contribute to the progression towards CLAI in individuals with posterolateral ankle ligament injuries. Additionally, significant muscle activation pattern changes were observed in CLAI patients, suggesting altered neural control strategies post-ankle ligament injury.
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Affiliation(s)
- Zhifeng Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Tianle Jie
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Ee-Chon Teo
- Faculty of Sports Science, Ningbo University, Ningbo, China
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - Meizi Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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Farhadi F. Extended finite element analysis for the 2 nd and 3 rd metatarsals stress fracture during push-off. Comput Methods Biomech Biomed Engin 2024:1-11. [PMID: 38973524 DOI: 10.1080/10255842.2024.2374528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/21/2024] [Indexed: 07/09/2024]
Abstract
Metatarsal stress fractures (MSF), particularly the 2nd and 3rd MSF, are common injuries among athletes. Although there are several practices to reduce foot and ankle injuries, there is no injury prevention program specifically designed to minimize MSF. This is mainly due to the lack of information about the loadings/postures that cause MSF. Therefore, this study aimed to investigate dangerous loadings/postures potentially causing MSF during push-off (PO). The analysis was conducted with Finite Element Modelling (FEM), calibrated with the three-point bending test, and validated with peak plantar pressure (PPP) and fracture force measurement. Extended Finite Element Method was used for MSF simulation such that ten different foot and ankle configurations were designed, with five for each of the 2nd and 3rd MSF under pure vertical loadings. A more complex loading, ankle eversion/inversion during PO, was also examined for the MSF. The average error percentage for the calibration of the model with the three-point bending test was 3.05%. The average error percentages for the validation of the model with PPP and fracture force measurements were 18% and 30%, respectively. The outcomes of pure vertical loadings indicated the higher potential for the 2nd and 3rd MSF at 30% PO and 70% PO, respectively. The results of ankle eversion/inversion loadings represented that the most dangerous posture for MSF was 30° ankle eversion for the 3rd metatarsal at 70% PO. These results provide a guide, including what postures to avoid for the 2nd and 3rd MSF among people who are at high risk of MSF.
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Affiliation(s)
- Fatemeh Farhadi
- University of Michigan and Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China
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4
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Zhang L, Zhang Q, Zhong Y, Hortobagyi T, Gu Y. Effect of forefoot transverse arch stiffness on foot biomechanical response--based on finite element method. Front Bioeng Biotechnol 2024; 12:1387768. [PMID: 39040495 PMCID: PMC11260739 DOI: 10.3389/fbioe.2024.1387768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/19/2024] [Indexed: 07/24/2024] Open
Abstract
Background The plantar vault, comprising the transverse and longitudinal arches of the human foot, is essential for impact absorption, elastic energy storage, and propulsion. Recent research underscores the importance of the transverse arch, contributing over 40% to midfoot stiffness. This study aimed to quantify biomechanical responses in the ankle-foot complex by varying the stiffness of the deep metatarsal transverse ligament (DTML). Methods Using CT image reconstruction, we constructed a complex three-dimensional finite element model of the foot and ankle joint complex, accounting for geometric complexity and nonlinear characteristics. The focus of our study was to evaluate the effect of different forefoot transverse arch stiffness, that is, different Young's modulus values of DTML (from 135 MPa to 405 MPa), on different biomechanical aspects of the foot and ankle complex. Notably, we analyzed their effects on plantar pressure distribution, metatarsal stress patterns, navicular subsidence, and plantar fascial strain. Results Increasing the stiffness of the DTML has significant effects on foot biomechanics. Specifically, higher DTML stiffness leads to elevate von Mises stress in the 1st, 2nd, and 3rd metatarsals, while concurrently reducing plantar pressure by 14.2% when the Young's modulus is doubled. This stiffening also impedes navicular bone subsidence and foot lengthening. Notably, a 100% increase in the Young's modulus of DTML results in a 54.1% decrease in scaphoid subsidence and a 2.5% decrease in foot lengthening, which collectively contribute to a 33.1% enhancement in foot longitudinal stiffness. Additionally, doubling the Young's modulus of DTML can reduce the strain stretch of the plantar fascia by 38.5%. Conclusion Preserving DTML integrity sustains the transverse arch, enhancing foot longitudinal stiffness and elastic responsiveness. These findings have implications for treating arch dysfunction and provide insights for shoe developers seeking to enhance propulsion.
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Affiliation(s)
- Linjie Zhang
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
| | - Qiaolin Zhang
- Doctoral School of Safety and Security Sciences, Obuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yilin Zhong
- Faculty of Sport Science, Ningbo University, Ningbo, China
| | - Tibor Hortobagyi
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
| | - Yaodong Gu
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
- Faculty of Sport Science, Ningbo University, Ningbo, China
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Keller M, Saltrick B, Gull L, Reade B. Fifth Metatarsal Fractures. Clin Podiatr Med Surg 2024; 41:391-405. [PMID: 38789160 DOI: 10.1016/j.cpm.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Fifth metatarsal features are the most common fractures in the foot. They have a long history that has resulted in many classification systems and little consensus on appropriate treatment. Although there is some agreement among experts, there are also many questions yet to be answered. There is a general consensus that dancer's fractures and zone 1 fractures can generally be treated nonoperatively. There is much more debate about zone 2 and 3 fractures and appropriate treatment guidelines. The authors review the current literature and give the recommendation for treatment based on their experience in a community-based private practice.
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Affiliation(s)
| | | | - Logan Gull
- Health Alliance Hospital, Kingston, NY, USA
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Xu D, Zhou H, Quan W, Ma X, Chon TE, Fernandez J, Gusztav F, Kovács A, Baker JS, Gu Y. New Insights Optimize Landing Strategies to Reduce Lower Limb Injury Risk. CYBORG AND BIONIC SYSTEMS 2024; 5:0126. [PMID: 38778877 PMCID: PMC11109754 DOI: 10.34133/cbsystems.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024] Open
Abstract
Single-leg landing (SL) is often associated with a high injury risk, especially anterior cruciate ligament (ACL) injuries and lateral ankle sprain. This work investigates the relationship between ankle motion patterns (ankle initial contact angle [AICA] and ankle range of motion [AROM]) and the lower limb injury risk during SL, and proposes an optimized landing strategy that can reduce the injury risk. To more realistically revert and simulate the ACL injury mechanics, we developed a knee musculoskeletal model that reverts the ACL ligament to a nonlinear short-term viscoelastic mechanical mechanism (strain rate-dependent) generated by the dense connective tissue as a function of strain. Sixty healthy male subjects were recruited to collect biomechanics data during SL. The correlation analysis was conducted to explore the relationship between AICA, AROM, and peak vertical ground reaction force (PVGRF), joint total energy dissipation (TED), peak ankle knee hip sagittal moment, peak ankle inversion angle (PAIA), and peak ACL force (PAF). AICA exhibits a negative correlation with PVGRF (r = -0.591) and PAF (r = -0.554), and a positive correlation with TED (r = 0.490) and PAIA (r = 0.502). AROM exhibits a positive correlation with TED (r = 0.687) and PAIA (r = 0.600). The results suggested that the appropriate increases in AICA (30° to 40°) and AROM (50° to 70°) may reduce the lower limb injury risk. This study has the potential to offer novel perspectives on the optimized application of landing strategies, thus giving the crucial theoretical basis for decreasing injury risk.
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Affiliation(s)
- Datao Xu
- Faculty of Sports Science,
Ningbo University, Ningbo, China
| | - Huiyu Zhou
- Faculty of Sports Science,
Ningbo University, Ningbo, China
| | - Wenjing Quan
- Faculty of Sports Science,
Ningbo University, Ningbo, China
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital,
Fudan University, Shanghai, China
| | - Teo-Ee Chon
- Faculty of Sports Science,
Ningbo University, Ningbo, China
- School of Chemical and Biomedical Engineering,
Nanyang Technological University, Singapore 639798, Singapore
| | - Justin Fernandez
- Auckland Bioengineering Institute,
University of Auckland, Auckland, New Zealand
- Department of Engineering Science,
University of Auckland, Auckland, New Zealand
| | - Fekete Gusztav
- Department of Material Science and Technology, Audi Hungaria Faculty of Automotive Engineering,
Széchenyi István University, Gyor, Hungary
| | - András Kovács
- Faculty of Engineering,
University of Pannonia, Veszprém, Hungary
| | - Julien S. Baker
- Faculty of Sports Science,
Ningbo University, Ningbo, China
- Department of Sport and Physical Education,
Hong Kong Baptist University, Hong Kong, China
| | - Yaodong Gu
- Faculty of Sports Science,
Ningbo University, Ningbo, China
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Kamal Z, Hekman EEG, Verkerke GJ. A combined musculoskeletal and finite element model of a foot to predict plantar pressure distribution. Biomed Phys Eng Express 2024; 10:035024. [PMID: 38277697 DOI: 10.1088/2057-1976/ad233d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/26/2024] [Indexed: 01/28/2024]
Abstract
In this study, a combined subject-specific numerical and experimental investigation was conducted to explore the plantar pressure of an individual. The research utilized finite element (FE) and musculoskeletal modelling based on computed tomography (CT) images of an ankle-foot complex and three-dimensional gait measurements. Muscle forces were estimated using an individualized multi-body musculoskeletal model in five gait phases. The results of the FE model and gait measurements for the same subject revealed the highest stress concentration of 0.48 MPa in the forefoot, which aligns with previously-reported clinical observations. Additionally, the study found that the encapsulated soft tissue FE model with hyper-elastic properties exhibited higher stresses compared to the model with linear-elastic properties, with maximum ratios of 1.16 and 1.88 MPa in the contact pressure and von-Mises stress, respectively. Furthermore, the numerical simulation demonstrated that the use of an individualized insole caused a reduction of 8.3% in the maximum contact plantar pressure and 14.7% in the maximum von-Mises stress in the encapsulated soft tissue. Overall, the developed model in this investigation holds potential for facilitating further studies on foot pathologies and the improvement of rehabilitation techniques in clinical settings.
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Affiliation(s)
- Zeinab Kamal
- Department of Biomechanical Engineering, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Edsko E G Hekman
- Department of Biomechanical Engineering, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Gijsbertus J Verkerke
- Department of Biomechanical Engineering, University of Twente, Enschede, 7500 AE, The Netherlands
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Zhou H, Xu D, Quan W, Ugbolue UC, Zhou Z, Gu Y. Can the Entire Function of the Foot Be Concentrated in the Forefoot Area during the Running Stance Phase? A Finite Element Study of Different Shoe Soles. J Hum Kinet 2024; 92:5-17. [PMID: 38736608 PMCID: PMC11079938 DOI: 10.5114/jhk/174311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/19/2023] [Indexed: 05/14/2024] Open
Abstract
The goal of this study was to use the finite element (FE) method to compare and study the differences between bionic shoes (BS) and normal shoes (NS) forefoot strike patterns when running. In addition, we separated the forefoot area when forefoot running as a way to create a small and independent area of instability. An adult male of Chinese descent was recruited for this investigation (age: 26 years old; body height: 185 cm; body mass: 82 kg) (forefoot strike patterns). We analyzed forefoot running under two different conditions through FE analysis, and used bone stress distribution feature classification and recognition for further analysis. The metatarsal stress values in forefoot strike patterns with BS were less than with NS. Additionally, the bone stress classification of features and the recognition accuracy rate of metatarsal (MT) 2, MT3 and MT5 were higher than other foot bones in the first 5%, 10%, 20% and 50% of nodes. BS forefoot running helped reduce the probability of occurrence of metatarsal stress fractures. In addition, the findings further revealed that BS may have important implications for the prevention of hallux valgus, which may be more effective in adolescent children. Finally, this study presents a post-processing method for FE results, which is of great significance for further understanding and exploration of FE results.
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Affiliation(s)
- Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
- School of Health and Life Sciences, University of the West of Scotland, Scotland, UK
| | - Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
- Savaria Institute of Technology, Eotvos Lorand University, Budapest, Hungary
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
- Savaria Institute of Technology, Eotvos Lorand University, Budapest, Hungary
| | - Ukadike Chris Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Scotland, UK
| | - Zhanyi Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
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Zhou H, Xu D, Quan W, Ugbolue UC, Gu Y. Effects of different contact angles during forefoot running on the stresses of the foot bones: a finite element simulation study. Front Bioeng Biotechnol 2024; 12:1337540. [PMID: 38390360 PMCID: PMC10882086 DOI: 10.3389/fbioe.2024.1337540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction: The purpose of this study was to compare the changes in foot at different sole-ground contact angles during forefoot running. This study tried to help forefoot runners better control and improve their technical movements by comparing different sole-ground contact angles. Methods: A male participant of Chinese ethnicity was enlisted for the present study, with a recorded age of 25 years, a height of 183 cm, and a body weight of 80 kg. This study focused on forefoot strike patterns through FE analysis. Results: It can be seen that the peak von Mises stress of M1-5 (Metatarsal) of a (Contact angle: 9.54) is greater than that of b (Contact angle: 7.58) and c (Contact angle: 5.62) in the three cases. On the contrary, the peak von Mises stress of MC (Medial Cuneiform), IC (Intermediate Cuneiform), LC (Lateral Cuneiform), C (Cuboid), N (Navicular), T (Tarsal) in three different cases is opposite, and the peak von Mises stress of c is greater than that of a and b. The peak von Mises stress of b is between a and c. Conclusion: This study found that a reduced sole-ground contact angle may reduce metatarsal stress fractures. Further, a small sole-ground contact angle may not increase ankle joint injury risk during forefoot running. Hence, given the specialized nature of the running shoes designed for forefoot runners, it is plausible that this study may offer novel insights to guide their athletic pursuits.
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Affiliation(s)
- Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
- School of Health and Life Sciences, University of the West of Scotland, Paisley, United Kingdom
| | - Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Ukadike Chris Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Paisley, United Kingdom
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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Xu D, Zhou H, Quan W, Gusztav F, Wang M, Baker JS, Gu Y. Accurately and effectively predict the ACL force: Utilizing biomechanical landing pattern before and after-fatigue. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 241:107761. [PMID: 37579552 DOI: 10.1016/j.cmpb.2023.107761] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND OBJECTIVE As a fundamental exercise technique, landing can commonly be associated with anterior cruciate ligament (ACL) injury, especially during after-fatigue single-leg landing (SL). Presently, the inability to accurately detect ACL loading makes it difficult to recognize the risk degree of ACL injury, which reduces the effectiveness of injury prevention and sports monitoring. Increased risk of ACL injury during after-fatigue SL may be related to changes in ankle motion patterns. Therefore, this study aims to develop a highly accurate and easily implemented ACL force prediction model by combining deep learning and the explored relationship between ACL force and ankle motion pattern. METHODS First, 56 subjects' during before and after-fatigue SL data were collected to explore the relationship between the ankle initial contact angle (AIC), ankle range of motion (AROM) and peak ACL force (PAF). Then, the musculoskeletal model was developed to simulate and calculate the ACL force. Finally, the ACL force prediction model was constructed by combining the explored relationship and sparrow search algorithm (SSA) to optimize the extreme learning machine (ELM) and long short-term memory (LSTM). RESULTS There was almost a stronger linear relationship between the PAF and AIC (R = -0.70), AROM (R2 = -0.61). By substituting AIC and AROM as independent variables in the SSA-ELM prediction model, the model shows excellent prediction performance because of very strong correlation (R2 = 0.9992, MSE = 0.0023, RMSE = 0.0474). Based on the equal scaling by combining results of SSA-ELM and SSA-LSTM, the prediction model achieves excellent performance in ACL force prediction of the overall waveform (R2 = 0.9947, MSE = 0.0076, RMSE = 0.0873). CONCLUSION By increasing the AIC and AROM during SL, the lower limb joint energy dissipation can be increased and the PAF reduced, thus reducing the impact loads on the lower limb joints and reducing ACL injuries. The proposed ACL dynamic load force prediction model has low input variable demands (sagittal joint angles), excellent generalization capabilities and superior performance in terms of high accuracy. In the future, we plan to use it as an accurate ACL injury risk assessment tool to promote and apply it to a wider range of sports training and injury monitoring.
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Affiliation(s)
- Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; School of Health and Life Sciences, University of the West of Scotland, Scotland, G72 0LH, United Kingdom
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Fekete Gusztav
- Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong, China
| | - Julien S Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, 999077, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China.
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11
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Cen X, Song Y, Yu P, Sun D, Simon J, Bíró I, Gu Y. Effects of plantar fascia stiffness on the internal mechanics of idiopathic pes cavus by finite element analysis: implications for metatarsalgia. Comput Methods Biomech Biomed Engin 2023:1-9. [PMID: 37817665 DOI: 10.1080/10255842.2023.2268231] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/01/2023] [Indexed: 10/12/2023]
Abstract
Metatarsalgia occurring in individuals with pes cavus is typically associated with abnormal loading patterns in the forefoot resulting from structural alterations. Simultaneously, the frequent overstress of the plantar fascia (PF) caused by the persistence of this foot deformity may further exacerbate the chronic pain induced by metatarsal overload. We aimed to investigate and quantify the effects of PF stiffness on the internal biomechanics of pes cavus using a computational modelling approach. A patient-specific finite element model of the foot-ankle complex using the actual three-dimensional geometry of idiopathic pes cavus bones and soft tissues was reconstructed. A sensitivity study was conducted to evaluate the effects of varying elastic modulus (0-700 MPa) of the PF on the metatarsal stress distribution, and force transmission through the metatarsophalangeal (MTP) and tarsometatarsal (TMT) joints in the pes cavus. The results indicated that variations in PF stiffness led to stress redistribution in the metatarsal region. Peak stress gradually reduced with decreasing stiffness until the PF was released, eventually resulting in a reduction of 22.39% compared to the reference value of 350 MPa. Furthermore, adjusting the PF stiffness to twice the reference value (700 MPa) increased the contact forces through the TMT and MTP joints by up to 23% and 116%, respectively. The reduction of PF stiffness alleviated focal metatarsal loading, and therefore, surgical fascia release can be considered to alleviate metatarsalgia in patients with pes cavus.
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Affiliation(s)
- Xuanzhen Cen
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yang Song
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Peimin Yu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Dong Sun
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - János Simon
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - István Bíró
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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12
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Sanada T, Murakami R, Iwaso H, Honda E, Yoshitomi H, Inagawa M. Predictive factors for the bone union disorder of intramedullary screw fixation in proximal fifth metatarsal bone fractures. Arch Orthop Trauma Surg 2023; 143:1949-1955. [PMID: 35235029 DOI: 10.1007/s00402-022-04398-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/14/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Although intramedullary screw fixation likely leads to successful union of Jones fractures compared to that of nonoperative treatments, bony union disorder after surgical treatment remains to be elucidated. METHODS Intramedullary screw fixation was performed for the surgical treatment of proximal fifth metatarsal stress fractures in this series. Between January 2008 and December 2019, the feet of 222 patients were investigated regarding the effective factors for postoperative bony union between the normal union group and the bony union disorder group according to the patients' physical status, radiological assessment, and screw size. The mean postoperative follow-up period was 11.1 months. Bone union disorder was defined as delayed union, nonunion, or a re-fracture recognized through a radiographic image. RESULTS The prevalence rate of union disorders occurred in 14% (31/222) of the patients. The risk of bone union disorder significantly increased when using a small-diameter screw (odds ratio 4.81, 95% confidence interval [CI] 1.62-14.2, p = 0.004) and non-bone graft procedures (odds ratio 3.13, 95% CI 1.22-8.02, p = 0.02). Screw length, preoperative Torg's classification, or patients' physical status did not affect postoperative bony union. CONCLUSIONS Approximately 14.0% of the patients in our study had postoperative bone union disorder. Small-diameter screws and non-bone graft procedures increased the risk of bone union disorder in the intramedullary screw fixation technique of fifth metatarsal bone stress fractures. LEVEL OF EVIDENCE Level 4, case series.
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Affiliation(s)
- Takaki Sanada
- Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan.
| | - Ryo Murakami
- Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan
| | - Hiroshi Iwaso
- Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan
| | - Eisaburo Honda
- Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan
| | - Hiroki Yoshitomi
- Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan
| | - Miyu Inagawa
- Department of Sports Orthopedics Surgery, Kanto Rosai Hospital, 1-1, Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan
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13
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Moayedi M, Arshi AR, Salehi M, Akrami M, Javadi Asl N, Naemi R. An investigation into the hammer toe effects on the lower extremity mechanics and plantar fascia tension: A case for a vicious cycle and progressive damage. Comput Biol Med 2023; 152:106381. [PMID: 36563541 DOI: 10.1016/j.compbiomed.2022.106381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/14/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Hammer toes are one of the common deformities of the forefoot that can lead to compensatory changes during walking in individuals with this condition. Predicting the adverse effects of tissue damage on the performance of other limbs is very important in the prevention of progressive damage. Finite element (FE) and musculoskeletal modeling can be helpful by allowing such effects to be studied in a way where the internal stresses in the tissue could be investigated. Hence, this study aims to investigate the effects of the hammer toe deformity on the lower extremity, especially on the plantar fascia functions. To compare the joint reactions of the hammer toe foot (HTF) and healthy foot (HF), two musculoskeletal models (MSM) of the feet of a healthy individual and that of a participant with hammer toe foot were developed based on gait analysis. A previously validated 3D finite element model which was constructed using Magnetic Resonance Imaging (MRI) of the diabetic participant with the hammer toe deformity was processed at five different events during the stance phase of gait. It was found that the hammer toe deformity makes dorsiflexion of the toes and the windlass mechanism less effective during walking. Specifically, the FE analysis results showed that plantar fascia (PF) in HTF compared to HF played a less dominant role in load bearing with both medial and lateral parts of PF loaded. Also, the results indicated that the stored elastic energy in PF was less in HTF than the HF, which can indicate a higher metabolic cost during walking. Internal stress distribution shows that the majority of ground reaction forces are transmitted through the lateral metatarsals in hammer toe foot, and the probability of fifth metatarsal fracture and also progressive deformity was subsequently increased. The MSM results showed that the joint reaction forces and moments in the hammer toe foot have deviated from normal, where the metatarsophalangeal joint reactions in the hammer toe were less than the values in the healthy foot. This can indicate a vicious cycle of foot deformity, leading to changes in body weight force transmission line, and deviation of joint reactions and plantar fascia function from normal. These in turn lead to increased internal stress concentration, which in turn lead to further foot deformities. This vicious cycle cause progressive damage and can lead to an increase in the risk of ulceration in the diabetic foot.
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Affiliation(s)
- M Moayedi
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - A R Arshi
- Biomechanics and Sports Engineering Groups, Biomedical Engineering Department, Amirkabir University of Technology, Iran.
| | - M Salehi
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - M Akrami
- Department of Engineering, College of Engineering, Mathematics, and Physical Sciences, University of Exeter, UK.
| | - N Javadi Asl
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - R Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, UK.
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14
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Development and Validation of a Subject-Specific Coupled Model for Foot and Sports Shoe Complex: A Pilot Computational Study. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9100553. [PMID: 36290521 PMCID: PMC9598393 DOI: 10.3390/bioengineering9100553] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022]
Abstract
Nowadays, footwear serves an essential role in improving athletic performance and decreasing the risk of unexpected injuries in sports games. Finite element (FE) modeling is a powerful tool to reveal the biomechanical interactions between foot and footwear, and establishing a coupled foot-shoe model is the prerequisite. The purpose of this pilot study was to develop and validate a 3D FE coupled model of the foot and sports shoe complex during balanced standing. All major foot and shoe structures were constructed based on the participant’s medical CT images, and 3D gait analysis was conducted to define the loading and boundary conditions. Sensitivity analysis was applied to determine the optimum material property for shoe sole. Both the plantar and shoe sole areas were further divided into four regions for model validation, and the Bland–Altman method was used for consistency analysis between methods. The simulated peak plantar and sole pressure distribution showed good consistency with experimental pressure data, and the prediction errors were all less than 10% during balanced standing with only two exceptions (medial and lateral forefoot regions). Meanwhile, the Bland–Altman analysis demonstrated a good agreement between the two approaches. The sensitivity analysis suggested that shoe sole with Young’s modulus of 2.739 MPa presented the greatest consistency with the measured data in our scenario. The established model could be used for investing the complex biomechanical interactions between the foot and sports shoe and optimizing footwear design, after it has been fully validated in the subsequent works under different conditions.
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15
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Xu D, Zhou H, Zhang Q, Baker JS, Ugbolue UC, Radak Z, Ma X, Gusztav F, Wang M, Gu Y. A new method proposed to explore the feline's paw bones of contributing most to landing pattern recognition when landed under different constraints. Front Vet Sci 2022; 9:1011357. [PMID: 36299631 PMCID: PMC9589501 DOI: 10.3389/fvets.2022.1011357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/21/2022] [Indexed: 11/04/2022] Open
Abstract
Felines are generally acknowledged to have natural athletic ability, especially in jumping and landing. The adage “felines have nine lives” seems applicable when we consider its ability to land safely from heights. Traditional post-processing of finite element analysis (FEA) is usually based on stress distribution trend and maximum stress values, which is often related to the smoothness and morphological characteristics of the finite element model and cannot be used to comprehensively and deeply explore the mechanical mechanism of the bone. Machine learning methods that focus on feature pattern variable analysis have been gradually applied in the field of biomechanics. Therefore, this study investigated the cat forelimb biomechanical characteristics when landing from different heights using FEA and feature engineering techniques for post-processing of FEA. The results suggested that the stress distribution feature of the second, fourth metacarpal, the second, third proximal phalanx are the features that contribute most to landing pattern recognition when cats landed under different constraints. With increments in landing altitude, the variations in landing pattern differences may be a response of the cat's forelimb by adjusting the musculoskeletal structure to reduce the risk of injury with a more optimal landing strategy. The combination of feature engineering techniques can effectively identify the bone's features that contribute most to pattern recognition under different constraints, which is conducive to the grasp of the optimal feature that can reveal intrinsic properties in the field of biomechanics.
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Affiliation(s)
- Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Savaria Institute of Technology, Eötvös Loránd University, Szombathely, Hungary,Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China,School of Health and Life Sciences, University of the West of Scotland, Scotland, United Kingdom
| | - Qiaolin Zhang
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Julien S. Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Ukadike C. Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Scotland, United Kingdom
| | - Zsolt Radak
- Research Institute of Sport Science, University of Physical Education, Budapest, Hungary
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Fekete Gusztav
- Savaria Institute of Technology, Eötvös Loránd University, Szombathely, Hungary,Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Faculty of Health and Safety, Óbuda University, Budapest, Hungary
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,*Correspondence: Yaodong Gu
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16
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Malakoutikhah H, Madenci E, Latt LD. The contribution of the ligaments in progressive collapsing foot deformity: A comprehensive computational study. J Orthop Res 2022; 40:2209-2221. [PMID: 34981558 DOI: 10.1002/jor.25244] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/28/2021] [Accepted: 12/13/2021] [Indexed: 02/04/2023]
Abstract
The contribution of each of the ligaments in preventing the arch loss, hindfoot valgus, and forefoot abduction seen in progressive collapsing foot deformity (PCFD) has not been well characterized. An improved understanding of the individual ligament contributions to the deformity would aid in selecting among available treatments, optimizing current surgical techniques, and developing new ones. In this study, we evaluated the contribution of each ligament to the maintenance of foot alignment using a finite element model of the foot reconstructed from computed tomography scan images. The collapsed foot was modeled by simulating the failure of all the ligaments involved in PCFD. The ligaments were removed one at a time to determine the impact of each ligament on foot alignment, and then restored one at a time to simulate isolated reconstruction. Our findings show that the failure of any one ligament did not immediately lead to deformity, but that combined failure of only a few (the plantar fascia, long plantar, short plantar, deltoid, and spring ligaments) could lead to significant deformity. The plantar fascia, deltoid, and spring ligaments were primarily responsible for the prevention of arch collapse, hindfoot valgus, and forefoot abduction, respectively. Moreover, to produce deformity, a considerable amount of attenuation in the spring, tibiocalcaneal, interosseous talocalcaneal, plantar naviculocuneiform, and first plantar tarsometatarsal ligaments, but only a small amount in the plantar fascia, long plantar, and short plantar ligaments was needed. The results of this study suggest that the ability of a ligament to prevent deformity may not correlate with its attenuation in a collapsed foot.
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Affiliation(s)
- Hamed Malakoutikhah
- Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Erdogan Madenci
- Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Leonard Daniel Latt
- Department of Orthopaedic Surgery, University of Arizona, Tucson, Arizona, USA
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17
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Hoffman JW, Bitar RC, Williams N, Steineman BD, Sturnick DR, Garrison GW, Demetracopoulos CA, Drakos MC, O'Malley MJ. Orthosis and Foot Structure Affect the Fifth Metatarsal Principal Strains During Simulated Level Walking. Am J Sports Med 2022; 50:1659-1667. [PMID: 35302902 DOI: 10.1177/03635465221079652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Fractures of the proximal fifth metatarsal bone are common injuries in elite athletes and are associated with high rates of delayed union and nonunion. Structural features of the foot may increase fracture risk in some individuals, emphasizing the need for intervention strategies to prevent fracture. Although orthotic devices have shown promise in reducing fractures of the fifth metatarsal bone, the effect of orthosis on fifth metatarsal strains is not well understood. PURPOSE To quantify the effects of different foot orthotic constructs on principal tensile strains in the proximal fifth metatarsal bone during cadaveric simulations of level walking. An additional purpose was to investigate the relationships between structural features of the foot and corresponding strains on the fifth metatarsal bone during level walking. STUDY DESIGN Controlled laboratory study. METHODS A total of 10 midtibial cadaveric specimens were attached to a 6 degrees of freedom robotic gait simulator. Strain gauges were placed at the metaphyseal-diaphyseal junction (zone II) and the proximal diaphysis (zone III) during level walking simulations using 11 different foot orthotic configurations. Images of each specimen were used to measure structural features of the foot in an axially loaded position. The peak tensile strains were measured and reported relative to the sneaker-only condition for each orthotic condition and orthotic-specific association between structural features and principal strains of both zones. RESULTS In total, 2 of the 11 orthotic conditions significantly reduced strain relative to the sneaker-only condition in zone II. Further, 6 orthotic conditions significantly reduced strain relative to the sneaker-only condition in zone III. Increased zone II principal strain incurred during level walking in the sneaker-only condition showed a significant association with increases in the Meary's angle. Changes in zone III principal strain relative to the sneaker-only condition were significantly associated with increases in the Meary's angle and fourth-fifth intermetatarsal angle. CONCLUSION The use of orthotic devices reduced principal strain relative to the condition of a sneaker without any orthosis in zone II and zone III. The ability to reduce strain relative to the sneaker-only condition in zone III was indicated by increasing values of the Meary's angle and levels of the fourth-fifth intermetatarsal angle. CLINICAL RELEVANCE Clinicians can use characteristics of foot structure to determine the proper foot orthosis to potentially reduce stress fracture risk in high-risk individuals.
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Affiliation(s)
| | | | | | | | | | | | | | - Mark C Drakos
- Hospital for Special Surgery, New York, New York, USA
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18
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Sun D, Song Y, Cen X, Wang M, Baker JS, Gu Y. Workflow assessing the effect of Achilles tendon rupture on gait function and metatarsal stress: Combined musculoskeletal modeling and finite element analysis. Proc Inst Mech Eng H 2022; 236:676-685. [PMID: 35311405 DOI: 10.1177/09544119221085795] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Achilles tendon rupture (ATR) incidence has increased among badminton players in recent years. The foot internal stress was hard to obtain through experimental testing. The purpose of the current research is to develop a methodology that could improve the finite element model derived foot internal stress prediction for ATR clinical and rehabilitation applications. A subject-specific musculoskeletal model was combined with a 3D finite element model to predict the metatarsal stress. The 80% point during the push-off phase of walking was selected for the comparing between injured and uninjured sides. The surgical repaired Achilles tendon (AT) after 12 months was elongated by 5.5% than the uninjured tendon. At 80% point of stance phase, the ankle plantarflexion angle and AT force decreased by 39.6% and 21.9% on the injured side, respectively. The foot inversion degree increased by 22.9% and was accompanied by the redistribution of metatarsals von Mises stress. The stresses on the fourth and fifth metatarsals were increased by 59.5% and 85.9% on the injured side. The workflow is available to assess musculoskeletal disorders and obtain foot internal stress after ATR. The decreased ankle plantar flexor force may be affected by triceps surae muscle atrophy and weakened force transmission ability of elongated AT. The increased von Mises stress on fourth and fifth metatarsals accompanied by higher foot inversion may increase the ankle lateral sprain injury risk.
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Affiliation(s)
- Dong Sun
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yang Song
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Doctoral School on Safety and Security Sciences, Obuda University, Budapest, Hungary.,Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Xuanzhen Cen
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Doctoral School on Safety and Security Sciences, Obuda University, Budapest, Hungary.,Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Doctoral School on Safety and Security Sciences, Obuda University, Budapest, Hungary
| | - Julien Steven Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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19
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Lu C, Fan Y, Yu G, Chen H, Sinclair J, Fan Y. Asymptomatic foot and ankle structural injuries: a 3D imaging and finite element analysis of elite fencers. BMC Sports Sci Med Rehabil 2022; 14:50. [PMID: 35346343 PMCID: PMC8962477 DOI: 10.1186/s13102-022-00444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Fencing is a highly asymmetrical combat sport, that imposes high mechanical demands over repeated exposures on the musculoskeletal structures, a primary cause of injuries in fencers. However, there are limited epidemiological studies on the structural injuries of the foot and ankle in fencers. This study aimed to investigate foot and ankle structural injuries, and explore how metatarsophalangeal joint structural changes may affect the mechanisms of foot and ankle injuries in asymptomatic fencers. METHODS 3D images of foot and ankle morphology using computed tomography were obtained from ten elite fencers. We then constructed finite element models of the first metatarsophalangeal joint in the foot of their trail legs. The validated models were used to simulate stress distribution changes from different ankle joint angles during lunging. RESULTS The findings showed that stress distribution changes at the medial and lateral sesamoid may have caused sesamoid fractures, and that habitual and concentrated stress on the metatarsal bones might have flattened the sesamoid groove. This process may damage the integrity of the first metatarsophalangeal joint, and consequently affect the efficiency of the windlass mechanism in fencers. During lunging, different ankle joint angles of the trail foot increased the total stress difference of the medial and lateral foot, and thus influenced the lunging quality and its stability. CONCLUSIONS Our findings revealed that the asymmetric nature of fencing might have caused asymptomatic foot and ankle structural injuries, and finite element analysis results indicated that this might increase the incidence of the serious injuries if unattended. Regular computed tomography examination should be introduced to monitor elite fencers' lower limb alterations, permitting unique angle adjustments in the trail foot without sacrificing technical or physiologic properties based on the exam results and reduce the lower limb injury risk.
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Affiliation(s)
- Congfei Lu
- Foot Research Laboratory, Key Laboratory of Sport and Health Science of Fujian Province, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350117, China
| | - Yuxuan Fan
- Foot Research Laboratory, Key Laboratory of Sport and Health Science of Fujian Province, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350117, China
| | - Genyu Yu
- Foot Research Laboratory, Key Laboratory of Sport and Health Science of Fujian Province, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350117, China
| | - Hua Chen
- Foot Research Laboratory, Key Laboratory of Sport and Health Science of Fujian Province, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350117, China
| | - Jonathan Sinclair
- Research Centre for Applied Sport, Physical Activity and Performance, School of Sport and Health Sciences, University of Central Lancashire, Lancashire, Preston, PR1 2HE, UK
| | - Yifang Fan
- Foot Research Laboratory, Key Laboratory of Sport and Health Science of Fujian Province, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350117, China.
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20
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Ito K, Nakamura T, Suzuki R, Negishi T, Oishi M, Nagura T, Jinzaki M, Ogihara N. Comparative Functional Morphology of Human and Chimpanzee Feet Based on Three-Dimensional Finite Element Analysis. Front Bioeng Biotechnol 2022; 9:760486. [PMID: 35096789 PMCID: PMC8793834 DOI: 10.3389/fbioe.2021.760486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022] Open
Abstract
To comparatively investigate the morphological adaptation of the human foot for achieving robust and efficient bipedal locomotion, we develop three-dimensional finite element models of the human and chimpanzee feet. Foot bones and the outer surface of the foot are extracted from computer tomography images and meshed with tetrahedral elements. The ligaments and plantar fascia are represented by tension-only spring elements. The contacts between the bones and between the foot and ground are solved using frictionless and Coulomb friction contact algorithms, respectively. Physiologically realistic loading conditions of the feet during quiet bipedal standing are simulated. Our results indicate that the center of pressure (COP) is located more anteriorly in the human foot than in the chimpanzee foot, indicating a larger stability margin in bipedal posture in humans. Furthermore, the vertical free moment generated by the coupling motion of the calcaneus and tibia during axial loading is larger in the human foot, which can facilitate the compensation of the net yaw moment of the body around the COP during bipedal locomotion. Furthermore, the human foot can store elastic energy more effectively during axial loading for the effective generation of propulsive force in the late stance phase. This computational framework for a comparative investigation of the causal relationship among the morphology, kinematics, and kinetics of the foot may provide a better understanding regarding the functional significance of the morphological features of the human foot.
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Affiliation(s)
- Kohta Ito
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Tomoya Nakamura
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
| | - Ryo Suzuki
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
| | - Takuo Negishi
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
- Department of Biological Science, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Motoharu Oishi
- Department of Veterinary Medicine, Azabu University, Sagamihara, Japan
| | - Takeo Nagura
- Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Naomichi Ogihara
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
- Department of Biological Science, Graduate School of Science, The University of Tokyo, Tokyo, Japan
- *Correspondence: Naomichi Ogihara,
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21
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Zhang Q, Zhang Y, Huang J, Teo EC, Gu Y. Effect of Displacement Degree of Distal Chevron Osteotomy on Metatarsal Stress: A Finite Element Method. BIOLOGY 2022; 11:127. [PMID: 35053125 PMCID: PMC8772834 DOI: 10.3390/biology11010127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The stress of foot bone can effectively evaluate the functional damage caused by foot deformity and the results of operation. In this study, the finite element method was used to investigate the degree of displacement of distal chevron osteotomy on metatarsal stress and metatarsophalangeal joint load; Methods: Four finite element models of displacement were established by using the CT images of a patient with moderate hallux valgus (hallux valgus angle and intermetatarsal angle were 26.74° and 14.09°, respectively), and the validity of the model was verified. Each finite element model consisted of bones and various cartilage structures, ligaments, and plantar fascia, as well as encapsulated soft tissue. Except for soft tissue, the material properties of other parts were isotropic linear elastic material, and the encapsulated soft tissue was set as nonlinear hyperelastic material. The mesh was tetrahedral mesh. Link elements were used in ligament and plantar fascia. A ground reaction force with a half-body weight was applied at the bottom of the floor to simulate the ground reaction when standing. The upper surfaces of the encapsulated soft tissue, distal tibia, and distal fibula were fixed. The stress distribution of metatarsals and the stress of cartilage of the first metatarsophalangeal joint were compared and analyzed; Results: Compared with the hallux valgus without osteotomy, the stress of the first metatarsals and second metatarsals of 2-4 mm decreased, and the stress of the interarticular cartilage of the first metatarsophalangeal joint with 4 mm was reduced. In the case of 6 mm, the stress value between the first metatarsal and the first metatarsophalangeal joint increased, and 4 mm was the most suitable distance; Conclusions: Compared with the hallux valgus without osteotomy, the stress of the first metatarsals and second metatarsals of 2-4 mm decreased, and the stress of the interarticular cartilage of the first metatarsophalangeal joint with 4 mm was reduced. In the case of 6 mm, the stress value between the first metatarsal and the first metatarsophalangeal joint increased, and 4 mm was the most suitable distance. For the degree of displacement of the distal chevron osteotomy, the postoperative stability and the stress distribution of metatarsal bone should be considered. Factors such as hallux valgus angle, intermetatarsal angle, patient's age, body weight, and metatarsal width should be considered comprehensively. The factors affecting osteotomy need to be further explored. The degree of displacement of osteotomy can be evaluated by FE method before the operation, and the most suitable distance can be obtained.
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Affiliation(s)
- Qiaolin Zhang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Q.Z.); (Y.Z.); (J.H.)
| | - Yan Zhang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Q.Z.); (Y.Z.); (J.H.)
| | - Jialu Huang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Q.Z.); (Y.Z.); (J.H.)
| | - Ee Chon Teo
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Q.Z.); (Y.Z.); (J.H.)
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Q.Z.); (Y.Z.); (J.H.)
- Faculty of Engineering, University of Szeged, 6720 Szeged, Hungary
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22
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Wang M, Li S, Teo EC, Fekete G, Gu Y. The Influence of Heel Height on Strain Variation of Plantar Fascia During High Heel Shoes Walking-Combined Musculoskeletal Modeling and Finite Element Analysis. Front Bioeng Biotechnol 2022; 9:791238. [PMID: 34988067 PMCID: PMC8720874 DOI: 10.3389/fbioe.2021.791238] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022] Open
Abstract
The therapeutic benefit of high heel shoes (HHS) for plantar fasciitis treatment is controversial. It has been suggested that plantar fascia strain can be decreased by heel elevation of shoes which helps in body weight redistribution throughout the length of the foot. Yet it is a fact that the repetitive tension caused by HHS wearing resulting in plantar fasciitis is a high-risk disease in HHS individuals who suffer heel and plantar pain. To explore the biomechanical function on plantar fascia under HHS conditions, in this study, musculoskeletal modeling (MsM) and finite element method (FEM) were used to investigate the effect of heel height on strain distribution of plantar fascia. Three-dimensional (3D) and one-dimensional (1D) finite element models of plantar fascia were generated to analyze the computed strain variation in 3-, 5-, and 7-cm heel heights. For validation, the computed foot contact pressure was compared with experimental measurement, and the strain value on 1D fascia was compared with previous studies. Results showed that the peak strain of plantar fascia was progressively increased on both 3D and 1D plantar fascia as heel elevated from 3 to 7 cm, and the maximum strain of plantar fascia occurs near the heel pain site at second peak stance. The 3D fascia model predicted a higher strain magnitude than that of 1D and provided a more reliable strain distribution on the plantar fascia. It is concluded that HHS with narrow heel support could pose a high risk on plantar fasciitis development, rather than reducing symptoms. Therefore, the heel elevation as a treatment recommendation for plantar fasciitis is questionable. Further studies of different heel support structures of shoes to quantify the effectiveness of heel elevation on the load-bearing mechanism of plantar fascia are recommended.
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Affiliation(s)
- Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Faculty of Health and Safety, Óbuda University, Budapest, Hungary
| | - Shudong Li
- Faculty of Health and Safety, Óbuda University, Budapest, Hungary
| | - Ee-Chon Teo
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - Gusztáv Fekete
- Savaria Institute of Technology, Eötvös Loránd University, Budapest, Hungary
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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23
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Choi C, Lee SJ, Choo HJ, Lee IS, Kim SK. Avulsion injuries: an update on radiologic findings. Yeungnam Univ J Med 2021; 38:289-307. [PMID: 34411477 PMCID: PMC8688780 DOI: 10.12701/yujm.2021.01102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/08/2021] [Accepted: 06/22/2021] [Indexed: 11/05/2022] Open
Abstract
Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.
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Affiliation(s)
- Changwon Choi
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| | - Sun Joo Lee
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| | - Hye Jung Choo
- Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| | - In Sook Lee
- Department of Radiology, Pusan National University Hospital, Pusan, Korea
- Biomedical Research Institute, Pusan National University School of Medicine, Pusan, Korea
| | - Sung Kwan Kim
- Department of Radiology, Pusan Himchan Hospital, Pusan, Korea
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24
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Single-Leg Landings Following a Volleyball Spike May Increase the Risk of Anterior Cruciate Ligament Injury More Than Landing on Both-Legs. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app11010130] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Volleyball players often land on a single leg following a spike shot due to a shift in the center of gravity and loss of balance. Landing on a single leg following a spike may increase the probability of non-contact anterior cruciate ligament (ACL) injuries. The purpose of this study was to compare and analyze the kinematics and kinetics differences during the landing phase of volleyball players using a single leg (SL) and double-leg landing (DL) following a spike shot. The data for vertical ground reaction forces (VGRF) and sagittal plane were collected. SPM analysis revealed that SL depicted a smaller knee flexion angle (about 13.8°) and hip flexion angle (about 10.8°) during the whole landing phase, a greater knee and hip power during the 16.83–20.45% (p = 0.006) and 13.01–16.26% (p = 0.008) landing phase, a greater ankle plantarflexion angle and moment during the 0–41.07% (p < 0.001) and 2.76–79.45% (p < 0.001) landing phase, a greater VGRF during the 5.87–8.25% (p = 0.029), 19.75–24.14% (p = 0.003) landing phase when compared to DL. Most of these differences fall within the time range of ACL injury (30–50 milliseconds after landing). To reduce non-contact ACL injuries, a landing strategy of consciously increasing the hip and knee flexion, and plantarflexion of the ankle should be considered by volleyball players.
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25
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Wang M, Song Y, Baker JS, Fekete G, Ugbolue UC, Li S, Gu Y. The biomechanical characteristics of a feline distal forelimb: A finite element analysis study. Comput Biol Med 2020; 129:104174. [PMID: 33338893 DOI: 10.1016/j.compbiomed.2020.104174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/17/2022]
Abstract
As a typical digitigrade mammal, the uniquely designed small distal limbs of the feline support two to three times of its body weight during daily movements. To understand how force transmission occurs in relation to the distal joint in a feline limb, which transfers bodyweight to the ground, it is necessary to examine the internal stress distribution of the distal joint limb in detail. Therefore, finite element models (FEM) of a healthy feline were established to predict the internal stress distribution of the distal limb. The FEM model included 23 bony components, various cartilaginous ligaments, as well as the encapsulated soft tissue of the paw. The FEM model was validated by comparison of paw pressure distribution, obtained from an experiment for balance standing. The results demonstrated a good agreement between the experimentally measured and numerically predicted pressure distribution in the feline paw. Additionally, higher stress levels were noted in the metacarpal segment, with smaller stresses observed in the phalanges portion including the proximal, middle, and distal segments. The raised metacarpal segment plays an important role in creating a stiff junction between the metacarpophalangeal (MCP) and wrist joint, stabilizing the distal limb. The paw pads help to optimize stress distribution in phalanx region. Findings from this study contribute to our understanding of feline distal forelimb biomechanical behavior. This information can be applied to bionic design of footwear since an optimal stiff junction and pressure distribution can be adapted to enhance injury relief and sports activities. Further developments may include progress, evaluation, and treatment of metatarsophalangeal joint injuries in human populations.
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Affiliation(s)
- Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia Veszprém, Hungary
| | - Yang Song
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Gusztáv Fekete
- Savaria Institute of Technology, Eötvös Loránd University, Hungary
| | - Ukadike Chris Ugbolue
- Division of Sport and Exercise, School of Health and Life Sciences, West of Scotland University of the West of Scotland, Hamilton, Scotland, G72 0LH, UK
| | - Shudong Li
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China.
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26
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Kaneko F, Edama M, Ikezu M, Matsuzawa K, Hirabayashi R, Kageyama I. Anatomic Characteristics of Tissues Attached to the Fifth Metatarsal Bone. Orthop J Sports Med 2020; 8:2325967120947725. [PMID: 32995346 PMCID: PMC7503013 DOI: 10.1177/2325967120947725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/06/2020] [Indexed: 11/15/2022] Open
Abstract
Background Two types of stress, bending stress and traction stress, have been reported to be involved in the mechanism of Jones fracture. However, little is known about the risk factors for traction stress. Purpose To classify the attachment position of the peroneus brevis muscle (PB), peroneus tertius (PT), lateral band of the plantar aponeurosis (LB), and the long plantar ligament (LPL), focusing on the zone where a Jones fracture occurs (zone 2), and to compare the footprint area of each tissue type. Study Design Descriptive laboratory study. Methods This study examined 102 legs from 55 Japanese cadavers. Type classification was performed by focusing on the positional relationship between each tissue attachment and the zone where Jones fracture occurs (zone 2). The classifications were as follows: type I, attached proximal to the border between zones 1 and 2; type IIa, attached to the border between zones 1 and 2 with one attached part; and type IIb, attached across the border between zones 1 and 2 with two or more attached parts. The footprint areas of the PB, PT, LB, and LPL were compared between tissue types and within each attachment classification. Results The PB was recorded as type I in 41 feet (40.2%), type IIa in 56 feet (54.9%), and type IIb in 5 feet (4.9%); the PT was recorded as type IIa in 54 feet (60.0%) and type IIb in 36 feet (40.0%); and the LB was recorded as type I in 27 feet (26.5%) and type IIa in 75 feet (73.5%). The LPL did not attach to the fifth metatarsal bone. No significant difference was found in the footprint area between type I PB and type I LB. Conclusion The results indicate that type I, which attaches proximal to zone 2, occurs with PB and LB, and there was no significant difference in the footprint area between them. These findings suggest that type I is involved in traction stress. In the future, biomechanical research based on the results of this study will be necessary. Clinical Relevance The results of this study provide basic research for investigating the mechanism of Jones fracture and the cause of delayed healing.
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Affiliation(s)
- Fumiya Kaneko
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Mutsuaki Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Anatomy, School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan
| | - Masahiro Ikezu
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kanta Matsuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryo Hirabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ikuo Kageyama
- Department of Anatomy, School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan
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27
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Xu D, Cen X, Wang M, Rong M, István B, Baker JS, Gu Y. Temporal Kinematic Differences between Forward and Backward Jump-Landing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186669. [PMID: 32933208 PMCID: PMC7559031 DOI: 10.3390/ijerph17186669] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/04/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022]
Abstract
Backward jump-landing during sports performance will result in dynamic postural instability with a greater risk of injury, and most research studies have focused on forward landing. Differences in kinematic temporal characteristics between single-leg and double-leg backward jump-landing are seldom researched and understood. The purpose of this study was to compare and analyze lower extremity kinematic differences throughout the landing phases of forward and backward jumping using single-leg and double-leg landings (FS and BS, FD and BD). Kinematic data were collected during the landing phases of FS and BS, FD and BD in 45 participants. Through statistical parametric mapping (SPM) analysis, we found that the BS showed smaller hip and knee flexion and greater vertical ground reactive force (VGRF) than the FS during 0–37.42% (p = 0.031), 16.07–32.11% (p = 0.045), and 23.03–17.32% (p = 0.041) landing phases. The BD showed smaller hip and knee flexion than the FD during 0–20.66% (p = 0.047) and 0–100% (p < 0.001) landing phases. Most differences appeared within a time frame during the landing phase at 30–50 ms in which non-contact anterior cruciate ligament (ACL) injuries are thought to occur and are consistent with the identification of risk in biomechanical analysis. A landing strategy that consciously increases the knee and hip flexion angles during backward landing should be considered for people as a measure to avoid injury during the performance of this type of physical activity.
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Affiliation(s)
- Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (D.X.); (X.C.)
| | - Xuanzhen Cen
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (D.X.); (X.C.)
| | - Meizi Wang
- Savaria Institute of Technology, Eötvös Loránd University, 9700 Szombathely, Hungary;
| | - Ming Rong
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (D.X.); (X.C.)
- Correspondence: (M.R.); (Y.G.); Tel.: +86-574-87600456 (M.R.); +86-574-87600208 (Y.G.)
| | - Bíró István
- Faculty of Engineering, University of Szeged, 6724 Szeged, Hungary;
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong 999077, China;
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (D.X.); (X.C.)
- Correspondence: (M.R.); (Y.G.); Tel.: +86-574-87600456 (M.R.); +86-574-87600208 (Y.G.)
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28
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Ellison MA, Akrami M, Fulford J, Javadi AA, Rice HM. Three dimensional finite element modelling of metatarsal stresses during running. J Med Eng Technol 2020; 44:368-377. [DOI: 10.1080/03091902.2020.1799092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- M. A Ellison
- Sport and Health Sciences, University of Exeter, Exeter, UK
| | - M. Akrami
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - J. Fulford
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK
| | - A. A Javadi
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | - H. M Rice
- Sport and Health Sciences, University of Exeter, Exeter, UK
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29
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Kathirgamanathan B, Silva P, Fernandez J. Implication of obesity on motion, posture and internal stress of the foot: an experimental and finite element analysis. Comput Methods Biomech Biomed Engin 2018; 22:47-54. [PMID: 30398076 DOI: 10.1080/10255842.2018.1527320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Obesity causes increased loading on the foot which can damage the soft tissue and bone ultimately leading to foot problems. Experimental and computational methods were used to analyse the chain of biomechanical changes in the lower limb due to obesity. The experimental study shows some changes in foot posture and gait where obese subjects were more likely to have pronated feet, smaller joint angles in the sagittal and frontal planes, smaller cadence, and smaller stride length. Anatomically correct finite element models generated on obese subjects showed increased and altered internal and plantar stress. Altered foot posture was identified as a key indicator of increased internal stress indicating the importance of foot posture correction.
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Affiliation(s)
- B Kathirgamanathan
- a Department of Electronic and Telecommunication Engineering , University of Moratuwa , Moratuwa , Sri Lanka
| | - P Silva
- a Department of Electronic and Telecommunication Engineering , University of Moratuwa , Moratuwa , Sri Lanka
| | - J Fernandez
- b Auckland Bioengineering Institute , University of Auckland , Auckland , New Zealand.,c Department of Engineering Science , University of Auckland , Auckland , New Zealand
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30
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Zhang Y, Awrejcewicz J, Baker JS, Gu Y. Cartilage Stiffness Effect on Foot Biomechanics of Chinese Bound Foot: A Finite Element Analysis. Front Physiol 2018; 9:1434. [PMID: 30364272 PMCID: PMC6193066 DOI: 10.3389/fphys.2018.01434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/20/2018] [Indexed: 12/04/2022] Open
Abstract
The purpose of this study is to investigate the effect of cartilage stiffness on inner foot biomechanics of Chinese bound foot while balanced standing using finite element method. A three-dimensional FE model of bound foot involving 28 bones, 72 ligaments, 5 plantar fascia, cartilages, and encapsulated soft tissue was constructed and validated. To conduct the sensitivity analysis of cartilage stiffness, the incremental Young’s modulus of 1, 5, 10, and 15 MPa were assigned to the cartilage. 25% of the body weight was applied to the Achilles tendon to adjust the anterior- posterior displacement of center of pressure agreeable with the measured result. As the Young’s modulus of cartilage increased, the peak von Mises stress in the fifth metatarsal increased obviously, while that in the calcaneus remains unchanged. The plantar fascia experienced reduced total tension with stiffer cartilage. The cartilage stiffening also caused a general increase of contact pressure at mid- and forefoot joints. Cartilage stiffening due to foot binding gave rise to risks of foot pain and longitude arch damage. Knowledge of this study contributes to the understanding of bound foot biomechanical behavior and demonstrating the mechanism of long-term injury and function damage in terms of weight-bearing due to foot binding.
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Affiliation(s)
- Yan Zhang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Department of Automation, Biomechanics and Mechatronics, Lodz University of Technology, Lódź, Poland
| | - Jan Awrejcewicz
- Department of Automation, Biomechanics and Mechatronics, Lodz University of Technology, Lódź, Poland
| | - Julien S Baker
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Paisley, United Kingdom
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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31
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Saita Y, Nagao M, Kawasaki T, Kobayashi Y, Kobayashi K, Nakajima H, Takazawa Y, Kaneko K, Ikeda H. Range limitation in hip internal rotation and fifth metatarsal stress fractures (Jones fracture) in professional football players. Knee Surg Sports Traumatol Arthrosc 2018; 26:1943-1949. [PMID: 28444437 DOI: 10.1007/s00167-017-4552-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify unknown risk factors associated with fifth metatarsal stress fracture (Jones fracture). METHODS A case-controlled study was conducted among male Japanese professional football (soccer) players with (N = 20) and without (N = 40) a history of Jones fracture. Injury history and physical examination data were reviewed, and the two groups were compared. Univariate and multivariate logistic regression controlling for age, leg dominance and body mass index were used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) to describe the association between physical examination data and the presence or absence of Jones fractures. RESULTS From 2000 to 2014, among 162 professional football club players, 22 (13.6%; 21 Asians and one Caucasian) had a history of Jones fracture. Thirteen out of 22 (60%) had a Jones fracture in their non-dominant leg. The mean range of hip internal rotation (HIR) was restricted in players with a history of Jones fracture [25.9° ± 7.5°, mean ± standard deviation (SD)] compared to those without (40.4° ± 11.1°, P < 0.0001). Logistic regression analyses demonstrated that HIR limitation increased the risk of a Jones fracture (OR = 3.03, 95% CI 1.45-6.33, P = 0.003). Subgroup analysis using data prior to Jones fracture revealed a causal relationship, such that players with a restriction of HIR were at high risk of developing a Jones fracture [Crude OR (95% CI) = 6.66 (1.90-23.29), P = 0.003, Adjusted OR = 9.91 (2.28-43.10), P = 0.002]. In addition, right HIR range limitation increased the risks of developing a Jones fracture in the ipsilateral and the contralateral feet [OR = 3.11 (1.35-7.16) and 2.24 (1.22-4.12), respectively]. Similarly, left HIR range limitation increased the risks in the ipsilateral or the contralateral feet [OR (95% CI) = 4.88 (1.56-15.28) and 2.77 (1.08-7.08), respectively]. CONCLUSION The restriction of HIR was associated with an increased risk of developing a Jones fracture. Since the HIR range is a modifiable factor, monitoring and improving the HIR range can lead to prevent reducing the occurrence of this fracture. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Yoshitomo Saita
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,FIFA Medical Centre of Excellence Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan. .,Jones Fracture Research Group, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Masashi Nagao
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takayuki Kawasaki
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yohei Kobayashi
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Keiji Kobayashi
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroki Nakajima
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yuji Takazawa
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kazuo Kaneko
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroshi Ikeda
- Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,FIFA Medical Centre of Excellence Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
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32
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Thomson A, Akenhead R, Whiteley R, D'Hooghe P, Van Alsenoy K, Bleakley C. Fifth metatarsal stress fracture in elite male football players: an on-field analysis of plantar loading. BMJ Open Sport Exerc Med 2018; 4:e000377. [PMID: 29955378 PMCID: PMC6018868 DOI: 10.1136/bmjsem-2018-000377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 12/26/2022] Open
Abstract
Objective Evaluate plantar loading during ‘on-field’ common football movements in players after fifth metatarsal (MT-5) stress fracture and compare with matched healthy players. Methods Fourteen elite male soccer players participated in the study conducted on a natural grass playing surface using firm ground football boots. Seven players who had suffered a primary stress fracture (MT-5 group) and seven matched healthy players (controls, CON) performed three common football movements while in-shoe plantar loading data were collected. Results Large between-group differences exist for maximal vertical force normalised to bodyweight (Fmax) at the lateral toes (2-5) of the stance leg during a set-piece kick (MT-5: 0.2±0.06 bodyweight (BW), CON: 0.1±0.05 BW, effect size (ES) 1.4) and the curved run where the MT-5 group showed higher Fmax with very large effect size at the lateral forefoot of the injured (closest to curve) limb when running a curve to receive a pass (MT-5 injured−CON=0.01 BW, ES 1.5). Small between-group differences were evident during straight-line running. However, between-limb analysis of MT-5 group showed significant unloading of the lateral forefoot region of the involved foot. Conclusions Elite male football players who have returned to play after MT-5 stress fracture display significantly higher maximum plantar force at the lateral forefoot and lateral toes (2-5) compared with healthy matched control players during two football movements (kick and curved run) with the magnitude of these differences being very large. These findings may have important implications for manipulating regional load during rehabilitation or should a player report lateral forefoot prodromal symptoms.
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Affiliation(s)
- Athol Thomson
- Exercise and Sports Science Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Ulster Sports Academy, University of Ulster, Ulster, UK
| | | | - Rodney Whiteley
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Pieter D'Hooghe
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Ken Van Alsenoy
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Chris Bleakley
- Department of Physical Therapy, School of Health Sciences, High Point University, High Point, North Carolina, USA
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Zhang Y, Awrejcewicz J, Szymanowska O, Shen S, Zhao X, Baker JS, Gu Y. Effects of severe hallux valgus on metatarsal stress and the metatarsophalangeal loading during balanced standing: A finite element analysis. Comput Biol Med 2018; 97:1-7. [DOI: 10.1016/j.compbiomed.2018.04.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/14/2018] [Accepted: 04/14/2018] [Indexed: 11/26/2022]
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34
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Li S, Zhang Y, Gu Y, Ren J. Stress distribution of metatarsals during forefoot strike versus rearfoot strike: A finite element study. Comput Biol Med 2017; 91:38-46. [DOI: 10.1016/j.compbiomed.2017.09.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/24/2017] [Accepted: 09/24/2017] [Indexed: 11/25/2022]
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35
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Akrami M, Qian Z, Zou Z, Howard D, Nester CJ, Ren L. Subject-specific finite element modelling of the human foot complex during walking: sensitivity analysis of material properties, boundary and loading conditions. Biomech Model Mechanobiol 2017; 17:559-576. [PMID: 29139051 PMCID: PMC5845092 DOI: 10.1007/s10237-017-0978-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 10/31/2017] [Indexed: 01/03/2023]
Abstract
The objective of this study was to develop and validate a subject-specific framework for modelling the human foot. This was achieved by integrating medical image-based finite element modelling, individualised multi-body musculoskeletal modelling and 3D gait measurements. A 3D ankle-foot finite element model comprising all major foot structures was constructed based on MRI of one individual. A multi-body musculoskeletal model and 3D gait measurements for the same subject were used to define loading and boundary conditions. Sensitivity analyses were used to investigate the effects of key modelling parameters on model predictions. Prediction errors of average and peak plantar pressures were below 10% in all ten plantar regions at five key gait events with only one exception (lateral heel, in early stance, error of 14.44%). The sensitivity analyses results suggest that predictions of peak plantar pressures are moderately sensitive to material properties, ground reaction forces and muscle forces, and significantly sensitive to foot orientation. The maximum region-specific percentage change ratios (peak stress percentage change over parameter percentage change) were 1.935-2.258 for ground reaction forces, 1.528-2.727 for plantar flexor muscles and 4.84-11.37 for foot orientations. This strongly suggests that loading and boundary conditions need to be very carefully defined based on personalised measurement data.
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Affiliation(s)
- Mohammad Akrami
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Jilin University, Changchun, 130022, People's Republic of China
| | - Zhemin Zou
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK
| | - David Howard
- School of Computing, Science and Engineering, University of Salford, Salford, M5 4WT, UK
| | - Chris J Nester
- Centre for Health Sciences Research, School of Health Sciences, University of Salford, Salford, M5 4WT, UK
| | - Lei Ren
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK. .,Key Laboratory of Bionic Engineering, Jilin University, Changchun, 130022, People's Republic of China.
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36
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Hong CC, Pearce CJ, Ballal MS, Calder JDF. Management of sports injuries of the foot and ankle: An update. Bone Joint J 2017; 98-B:1299-1311. [PMID: 27694582 DOI: 10.1302/0301-620x.98b10.37896] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/05/2016] [Indexed: 12/23/2022]
Abstract
Injuries to the foot in athletes are often subtle and can lead to a substantial loss of function if not diagnosed and treated appropriately. For these injuries in general, even after a diagnosis is made, treatment options are controversial and become even more so in high level athletes where limiting the time away from training and competition is a significant consideration. In this review, we cover some of the common and important sporting injuries affecting the foot including updates on their management and outcomes. Cite this article: Bone Joint J 2016;98-B:1299-1311.
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Affiliation(s)
- C C Hong
- National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore
| | - C J Pearce
- Jurong Health, NTFGH Hospital, 609606, Singapore
| | - M S Ballal
- Fortius Clinic, 17 Fitzhardinge Street, London W1H 6EQ, UK
| | - J D F Calder
- Fortius Clinic, 17 Fitzhardinge Street, London W1H 6EQ, UK
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37
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Finite element modelling of the foot for clinical application: A systematic review. Med Eng Phys 2017; 39:1-11. [DOI: 10.1016/j.medengphy.2016.10.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 10/13/2016] [Accepted: 10/23/2016] [Indexed: 11/20/2022]
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38
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GUIOTTO ANNAMARIA, SCARTON ALESSANDRA, SAWACHA ZIMI, GUARNERI GABRIELLA, AVOGARO ANGELO, COBELLI CLAUDIO. GAIT ANALYSIS DRIVEN 2D FINITE ELEMENT MODEL OF THE NEUROPATHIC HINDFOOT. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416500123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The diabetic foot is one of the most serious complications of diabetes mellitus and it can lead to foot ulcerations and amputations. Finite element analysis quantifies the loads developed in the different anatomical structures and describes how these affect foot tissue during foot–floor interaction. This approach for the diabetic subjects’ foot could provide valuable information in the process of plantar orthosis fabrication and fit. The purpose of this study was to develop two finite element models of the hindfoot, of healthy and diabetic neuropathic subjects. These models accounts for in vivo kinematics, kinetics, plantar pressure (PP) data and magnetic resonance images. These were acquired during gait analysis on 10 diabetic neuropathics and 10 healthy subjects. Validity of the models has been assessed through comparison between the peak PPs of simulated and experimental data: root mean square error (RMSE) in percentage of the experimental peak value was evaluated. Two different finite elements analysis were performed: subject-specific simulations in terms of both geometry and gait analysis, and by adopting the complete gait analysis dataset as boundary conditions. Model predicted plantar pressures were in good agreement with those experimentally measured. Best agreement was obtained in the subject-specific case (RMSE of 13%).
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Affiliation(s)
- ANNAMARIA GUIOTTO
- Department of Information Engineering, University of Padova, Via Gradenigo 6b, 35131 Padova, Italy
| | - ALESSANDRA SCARTON
- Department of Information Engineering, University of Padova, Via Gradenigo 6b, 35131 Padova, Italy
| | - ZIMI SAWACHA
- Department of Information Engineering, University of Padova, Via Gradenigo 6b, 35131 Padova, Italy
| | - GABRIELLA GUARNERI
- Department of Clinical Medicine and Metabolic Disease, University Polyclinic of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - ANGELO AVOGARO
- Department of Clinical Medicine and Metabolic Disease, University Polyclinic of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - CLAUDIO COBELLI
- Department of Information Engineering, University of Padova, Via Gradenigo 6b, 35131 Padova, Italy
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39
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Fontanella CG, Favaretto E, Carniel EL, Natali AN. Constitutive formulation and numerical analysis of the biomechanical behaviour of forefoot plantar soft tissue. Proc Inst Mech Eng H 2014; 228:942-51. [DOI: 10.1177/0954411914551852] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this work is to provide a numerical approach for the investigation of the mechanical behaviour of the forefoot soft tissues. The development of reliable numerical models of biological structures requires the definition of constitutive formulations that actually interpret the mechanical response of the constituent biological tissues and their structural arrangement. A specific visco-hyperelastic constitutive model is provided to account for the typical features of soft plantar tissue mechanics, as geometric and material non-linearity, almost-incompressible behaviour and time-dependent phenomena. Constitutive parameters are evaluated by the analysis of experimental data from compression and stress relaxation tests on tissue samples. A three-dimensional finite element model of the forefoot region is developed starting from the analysis of biomedical images, leading to the evaluation of overall structural response. The reliability of model and analyses is assessed by the comparison of experimental and numerical results pertaining to indentation tests. The numerical model developed allows to evaluate the mechanical response of plantar soft tissue in terms of stress and strain distribution.
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Affiliation(s)
| | - Elena Favaretto
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Emanuele Luigi Carniel
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Arturo Nicola Natali
- Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
- Department of Industrial Engineering, University of Padova, Padova, Italy
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Trabelsi N, Milgrom C, Yosibash Z. Patient-specific FE analyses of metatarsal bones with inhomogeneous isotropic material properties. J Mech Behav Biomed Mater 2014; 29:177-89. [DOI: 10.1016/j.jmbbm.2013.08.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 08/18/2013] [Accepted: 08/31/2013] [Indexed: 11/24/2022]
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41
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Finite element modeling mesh quality, energy balance and validation methods: A review with recommendations associated with the modeling of bone tissue. J Biomech 2013; 46:1477-88. [DOI: 10.1016/j.jbiomech.2013.03.022] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 03/06/2013] [Accepted: 03/16/2013] [Indexed: 11/23/2022]
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42
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DANESI VALENTINA, CRISTOFOLINI LUCA, JUSZCZYK MATEUSZMARIA, ERANI PAOLO, VICECONTI MARCO. MECHANICAL PROPERTIES OF THE HUMAN METATARSAL BONES. J MECH MED BIOL 2012. [DOI: 10.1142/s0219519412005034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite the incidence of metatarsal fractures and the associated risk of significant disability, little is known about the biomechanical properties (strength and stiffness) of metatarsal bones. In most cases a single metatarsal bone (first, second and fifth) has been investigated. An extensive investigation of the biomechanical properties of the metatarsal bones is essential in the understanding and prevention of metatarsal injuries. Entire sets of metatarsal bones from four feet were tested. The first foot was used to fine-tune the testing set-ups. To measure the stiffness, each metatarsal bone was subjected to non-destructive four-point-bending in the sagittal and transverse planes, axial compression and torsion. Strain was measured at two locations. To measure the strength, each metatarsal bone was tested to failure in torsion. Significant differences (p < 0.0001) existed among the stiffness of the five metatarsal bones: (i) in torsion the first metatarsal bone was 2–3 times stiffer than the others; (ii) in four-point-bending and axial compression this difference was less pronounced than in torsion; (iii) differences were smaller among the other metatarsal bones; (iv) the second metatarsal bone was less stiff than the third and fourth in bending. The second, third and fourth metatarsal bones were stiffer in the sagittal than in the transverse plane (p < 0.0001). Conversely, there was no significant difference between the two planes of bending for the first and fifth bones. During destructive testing, all metatarsal bones exhibited a linear elastic behavior and brittle failure. The torsional strength at failure ranged between 1.9 Nm and 6.9 Nm. The first metatarsal bone was stronger than all the others. Stiffness in different loading conditions and failure were measured and compared for all metatarsal bones. These data corroborate previous biomechanical studies concerning the role and load sharing of the different metatarsal bones.
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Affiliation(s)
- VALENTINA DANESI
- Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Bologna, Italy
- Facoltà di Ingegneria, Università di Bologna, Italy
| | - LUCA CRISTOFOLINI
- Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Bologna, Italy
- Facoltà di Ingegneria, Università di Bologna, Italy
| | - MATEUSZ MARIA JUSZCZYK
- Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Bologna, Italy
- Facoltà di Ingegneria, Università di Bologna, Italy
| | - PAOLO ERANI
- Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - MARCO VICECONTI
- Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Bologna, Italy
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43
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Brilakis E, Kaselouris E, Xypnitos F, Provatidis CG, Efstathopoulos N. Effects of foot posture on fifth metatarsal fracture healing: a finite element study. J Foot Ankle Surg 2012; 51:720-8. [PMID: 22981485 DOI: 10.1053/j.jfas.2012.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Indexed: 02/03/2023]
Abstract
The goal of this study was to evaluate the effects of maintaining different foot postures during healing of proximal fifth metatarsal fractures for each of 3 common fracture types. A 3-dimensional (3D) finite element model of a human foot was developed and 3 loading situations were evaluated, including the following: (1) normal weightbearing, (2) standing with the affected foot in dorsiflexion at the ankle, and (3) standing with the affected foot in eversion. Three different stages of the fracture-healing process were studied, including: stage 1, wherein the material interposed between the fractured edges was the initial connective tissue; stage 2, wherein connective tissue had been replaced by soft callus; and stage 3, wherein soft callus was replaced by mature bone. Thus, 30 3D finite element models were analyzed that took into account fracture type, foot posture, and healing stage. Different foot postures did not statistically significantly affect the peak-developed strains on the fracture site. When the fractured foot was everted or dorsiflexed, it developed a slightly higher strain within the fracture than when it was in the normal weightbearing position. In Jones fractures, eversion of the foot caused further torsional strain and we believe that this position should be avoided during foot immobilization during the treatment of fifth metatarsal base fractures. Tuberosity avulsion fractures and Jones fractures seem to be biomechanically stable fractures, as compared with shaft fractures. Our understanding of the literature and experience indicate that current clinical observations and standard therapeutic options are in accordance with the results that we observed in this investigation, with the exception of Jones fractures.
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Affiliation(s)
- Emmanuel Brilakis
- Second Department of Trauma and Orthopaedics, National and Kapodistrian University of Athens, Konstantopoulion General Hospital of Nea Ionia, Athens, Greece.
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