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Ruan Y, Wang S, Zhang N, Jiang Z, Mei N, Li P, Ren L, Qian Z, Chang F. In vivo analysis of ankle joint kinematics and ligament deformation of chronic ankle instability patients during level walking. Front Bioeng Biotechnol 2024; 12:1441005. [PMID: 39165404 PMCID: PMC11333339 DOI: 10.3389/fbioe.2024.1441005] [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: 05/30/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024] Open
Abstract
Introduction: Chronic ankle instability (CAI) carries a high risk of progression to talar osteochondral lesions and post-traumatic osteoarthritis. It has been clinically hypothesized the progression is associated with abnormal joint motion and ligament elongation, but there is a lack of scientific evidence. Methods: A total of 12 patients with CAI were assessed during level walking with the use of dynamic biplane radiography (DBR) which can reproduce the in vivo positions of each bone. We evaluated the uninjured and CAI side of the tibiotalar and subtalar joint for three-dimensional kinematics differences. Elongation of the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL) were also calculated bilaterally. Results: For patients with CAI, the dorsiflexion of the tibiotalar joint had reduced (21.73° ± 3.90° to 17.21° ± 4.35°), displacement of the talus increased (2.54 ± 0.64 mm to 3.12 ± 0.55 mm), and the inversion of subtalar joint increased (8.09° ± 2.21° to 11.80° ± 3.41°). Mean ATFL elongation was inversely related to mean dorsiflexion angle (CAI: rho = -0.82, P < 0.001; Control: rho = -0.92, P < 0.001), mean ATFL elongation was related to mean anterior translation (CAI: rho = 0.82, P < 0.001; Control: rho = 0.92, P < 0.001), mean CFL elongation was related to mean dorsiflexion angle (CAI: rho = 0.84, P < 0.001; Control: rho = 0.70, P < 0.001), and mean CFL elongation was inversely related to mean anterior translation (CAI: rho = -0.83, P < 0.001; Control: rho = -0.71, P < 0.001). Furthermore, ATFL elongation was significantly (CAI: rho = -0.82, P < 0.001; Control: rho = -0.78, P < 0.001) inversely correlated with CFL elongation. Discussion: Patients with CAI have significant changes in joint kinematics relative to the contralateral side. Throughout the stance phase of walking, ATFL increases in length during plantarflexion and talar anterior translation whereas the elongation trend of CFL was the opposite. This understanding can inform the development of targeted therapeutic exercises aimed at balancing ligament tension during different phases of gait. The interrelationship between two ligaments is that when one ligament shortens, the other lengthens. The occurrence of CAI didn't change this trend. Surgeons might consider positioning the ankle in a neutral sagittal plane to ensure optimal outcomes during ATFL and CFL repair.
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Affiliation(s)
- Yaokuan Ruan
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Shengli Wang
- Key Laboratory of Bionic Engineering (Ministry of Education, China), Jilin University, Changchun, China
| | - Nan Zhang
- Department of Radiology, The Second Hospital of Jilin University, Changchun, China
| | - Zhende Jiang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Nan Mei
- Orthopaedic Surgeon Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
- Health Technology College, Jilin Sport University, Changchun, China
| | - Pu Li
- Health Technology College, Jilin Sport University, Changchun, China
| | - Lei Ren
- Key Laboratory of Bionic Engineering (Ministry of Education, China), Jilin University, Changchun, China
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering (Ministry of Education, China), Jilin University, Changchun, China
| | - Fei Chang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
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Aragón-Basanta E, Venegas W, Ayala G, Page A, Serra-Añó P. Relationship between neck kinematics and neck dissability index. An approach based on functional regression. Sci Rep 2024; 14:215. [PMID: 38167615 PMCID: PMC10761888 DOI: 10.1038/s41598-023-50562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Numerous studies use numerical variables of neck movement to predict the level of severity of a pathology. However, the correlation between these numerical variables and disability levels is low, less than 0.4 in the best cases, even less in subjects with nonspecific neck pain. This work aims to use Functional Data Analysis (FDA), in particular scalar-on-function regression, to predict the Neck Disability Index (NDI) of subjects with nonspecific neck pain using the complete movement as predictors. Several functional regression models have been implemented, doubling the multiple correlation coefficient obtained when only scalar predictors are used. The best predictive model considers the angular velocity curves as a predictor, obtaining a multiple correlation coefficient of 0.64. In addition, functional models facilitate the interpretation of the relationship between the kinematic curves and the NDI since they allow identifying which parts of the curves most influence the differences in the predicted variable. In this case, the movement's braking phases contribute to a greater or lesser NDI. So, it is concluded that functional regression models have greater predictive capacity than usual ones by considering practically all the information in the curve while allowing a physical interpretation of the results.
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Affiliation(s)
- Elisa Aragón-Basanta
- Camino de Vera s/n, Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, 46022, Valencia, Spain.
| | - William Venegas
- Facultad de Ingeniería Mecánica, Escuela Politécnica Nacional, PO-Box 17-01-2759, Quito, Ecuador
| | - Guillermo Ayala
- Avda Vicent Andrés Estellés 1, Departament of Statistics and Operation Research, Universitat de València, 46100, Burjasot, Spain
| | - Alvaro Page
- Camino de Vera s/n, Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, 46022, Valencia, Spain
| | - Pilar Serra-Añó
- Gascó Oliag 5, Departament of Physiotherapy, Universitat de València, 46010, Valencia, Spain
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