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Haris F, Jan YK, Liau BY, Hsieh CW, Shen WC, Tai CC, Shih YH, Lung CW. Plantar pressure gradient and pressure gradient angle are affected by inner pressure of air insole. Front Bioeng Biotechnol 2024; 12:1353888. [PMID: 38529404 PMCID: PMC10961410 DOI: 10.3389/fbioe.2024.1353888] [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: 12/11/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024] Open
Abstract
Clinically, air insoles may be applied to shoes to decrease plantar pressure gradient (PPG) and increase plantar gradient angle (PGA) to reduce foot ulcers. PPG and PGA may cause skin breakdown. The effects of different inner pressures of inflatable air insoles on dynamic PPG and PGA distributions are largely unknown in non-diabetics and people with diabetes. This study aimed to explore the impact of varying inner air insole pressures on PPG and PGA to establish early mitigation strategies for people at risk of foot ulcers. A repeated measures study design, including three air insoles (80 mmHg, 160 mmHg, and 240 mmHg) and two walking durations (10 and 20 min) for a total of six walking protocols, was tested on 13 healthy participants (height, 165.8 ± 8.4 cm; age, 27.0 ± 7.3 years; and weight, 56.0 ± 7.9 kg, BMI: 20.3 ± 1.7 kg/m^2) over three consecutive weeks. PPG, a measurement of the spatial variation in plantar pressure around the peak plantar pressure (PPP) and PGA, a variation in the gradient direction values at the three plantar regions, big toe (T1), first metatarsal head (M1), and second metatarsal head (M2), were calculated. This study indicated that PPG was lower at 80 mmHg air insoles after 20 min of walking in the M1 region (p = 0.010). The PGA in the M2 increased at an air insole of 80 mmHg compared to 240 mmHg (p = 0.015). Compared to 20 min, the 10 min walking duration at 240 mmHg of air insole had the lowest PPG in the M1 (p = 0.015) and M2 (p = 0.034) regions. The 80 mmHg air insole significantly lowered the PPG compared to a 160 mmHg and 240 mmHg air insole. Moreover, the 80 mmHg air insole significantly decreased PPP and increased PGA compared to the 160 mmHg and 240 mmHg air insole. A shorter walking period (10 min) significantly lowered PPG. The findings of this study suggest that people with a higher risk of foot ulcers should wear softer air insoles to have a lower PPG, as well as an increased PGA.
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Affiliation(s)
- Fahni Haris
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Ben-Yi Liau
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
| | - Chang-Wei Hsieh
- Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
| | - Wei-Cheng Shen
- Department of Digital Media Design, Asia University, Taichung, Taiwan
| | - Chien-Cheng Tai
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chi-Wen Lung
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Department of Creative Product Design, Asia University, Taichung, Taiwan
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Doerks F, Riedel L, Einfeldt AK, Windhagen H, Hurschler C, Jakubowitz E. Contribution of various forefoot areas to push-off peak at different speeds and slopes during walking. Gait Posture 2024; 108:264-269. [PMID: 38150947 DOI: 10.1016/j.gaitpost.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/24/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Push-off during the terminal stance phase has a major impact on forward progression during walking. During this phase, the ground reaction force is applied to a small area under the forefoot. A better understanding of how single forefoot areas contribute to push-off peak in healthy subjects is needed to develop biomimetic orthopedic devices for forefoot amputees. RESEARCH QUESTION What is the contribution of different forefoot sole areas to push-off peak as a function of speed and slope? METHODS In this analytical study, 15 healthy subjects walked on a treadmill at different speeds (0.8 m/s; 1.2 m/s; 1.6 m/s; max. gait speed) without de-/inclination and on different slopes (-10°; -5°; 0°; 5°; 10°) with normal walking speed. The Novel Pedar-X System was used to measure vertical sole force. Push-off peak of the entire sole was determined and relative contributions of the areas under the hallux, first ray, and toes (I-V) were calculated and analyzed using separate repeated-measures ANOVA (α = 0.05). RESULTS Push-off peak increases with faster walking speeds as well as with 10° inclination. Downhill walking is associated with a reduced push-off peak. The contribution of all forefoot areas increases with faster walking speeds and at a declination of -10°. Push-off contribution of the area under the hallux increases by about 64.6% at fast walking compared to slow walking and this increase is higher than that of the area under the first ray and toes (p < 0.05). SIGNIFICANCE These findings indicate the major role of the hallux in speed generation and the importance of the forefoot during downhill walking. The results show the need for an adequate assistive device even in hallux amputation cases to compensate for deficits in the push-off phase.
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Affiliation(s)
- Frithjof Doerks
- Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany
| | - Lisa Riedel
- Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany
| | - Ann-Kathrin Einfeldt
- Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany
| | - Henning Windhagen
- Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany
| | - Christof Hurschler
- Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany
| | - Eike Jakubowitz
- Laboratory of Biomechanics and Biomaterials, Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.
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Deleu PA, Naaim A, Bevernage BD, Cheze L, Dumas R, Birch I, Besse JL, Leemrijse T. Changes in Relative Work of the Lower Extremity and Distal Foot Joints After Total Ankle Replacement: An Exploratory Study. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4376-4381. [PMID: 37906486 DOI: 10.1109/tnsre.2023.3328936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Ankle osteoarthritis does not only led to lower ankle power generation, but also results in compensatory gait mechanics at the hip and Chopart joints. Much of previous work explored the relative work distribution after total ankle replacement (TAR) either across the lower extremity joints where the foot was modelled as a single rigid unit or across the intrinsic foot joints without considering the more proximal lower limb joints. Therefore, this study aims, for the first time, to combine 3D kinetic lower limb and foot models together to assess changes in the relative joint work distribution across the foot and lower limb joints during level walking before and after patients undergo TAR. We included both patients and healthy control subjects. All patients underwent a three-dimensional gait analysis before and after surgery. Kinetic lower limb and multi-segment foot models were used to quantify all inter-segmental joint works and their relative contributions to the total lower limb work. Patients demonstrated a significant increase in the relative ankle positive joint work contribution and a significant decrease in the relative Chopart positive joint work contribution after TAR. Furthermore, there exists a large effect toward decreases in the relative contribution of the hip negative joint work after TAR. In conclusion, this study seems to corroborate the theoretical rationale that TAR reduces the compensatory strategy in the Chopart and hip joints in patients suffering from end-stage ankle osteoarthritis.
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Akuzawa H, Morito T, Oshikawa T, Kumai T, Kaneoka K. Functional relationship between the foot intrinsic and extrinsic muscles in walking. J Electromyogr Kinesiol 2023; 71:102781. [PMID: 37247509 DOI: 10.1016/j.jelekin.2023.102781] [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: 04/01/2023] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
The intrinsic and extrinsic muscles are considered to stabilize the foot and contribute to propulsion during walking. This study aimed to clarify the functional relationship between intrinsic and extrinsic muscles during walking. Thirteen healthy men participated in this study. The muscle activities of the intrinsic muscles (quadratus plantae and abductor hallucis), and the extrinsic muscles (flexor hallucis longus, flexor digitorum longus, and tibialis posterior) were measured using fine-wire and surface electromyography during walking. The muscle onset timing after foot contact was calculated and compared among muscles using the one-way ANOVA. The stance phase was divided into early and late braking, and early and late propulsion phases. Muscle activity among phases was compared using repeated-measures ANOVA. The onset time of the abductor hallucis was significantly earlier than those of the flexor digitorum longus and tibialis posterior. The quadratus plantae demonstrated significantly earlier onset than that of the tibialis posterior. In the late propulsion phase, the activity of extrinsic muscles decreased, whereas intrinsic muscles were continuously active. Early activation of the intrinsic muscles may stabilize the foot for efficient torque production by the extrinsic muscles. Furthermore, the intrinsic muscles may contribute to the final push-off after the deactivation of extrinsic muscles.
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Affiliation(s)
- Hiroshi Akuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan; Institute for Sport Sciences, Waseda University, Nishi-Tokyo, Japan.
| | - Tsuyoshi Morito
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Tomoki Oshikawa
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Koji Kaneoka
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
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Willemse L, Wouters EJM, Pister MF, Vanwanseele B. Plantar intrinsic foot muscle activation during functional exercises compared to isolated foot exercises in younger adults. Physiother Theory Pract 2023:1-13. [PMID: 37126537 DOI: 10.1080/09593985.2023.2204947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Training the plantar intrinsic foot muscles (PIFMs) has the potential to benefit patients with lower extremity musculoskeletal conditions as well as the aged population. Isolated foot exercises, often standard in clinical practice, are difficult to perform, whereas functional exercises are much easier to accomplish. However, it is unclear whether functional exercises are comparable to isolated foot exercises in activating the PIFMs. OBJECTIVE This study aims to compare the activation of PIFMs between functional exercises versus isolated foot exercises. METHODS Using surface electromyography (EMG), muscle activation of three PIFMs was measured in four functional exercises (i.e. normal/unstable toe stance, toe walking, and hopping) versus a muscle-specific isolated foot exercise in 29 younger adults, resulting in 12 comparisons. RESULTS Functional exercises showed larger mean EMG amplitudes than the isolated foot exercises in 25% of the 12 comparisons, while there was no difference in the remaining 75%. CONCLUSION Functional exercises provoked comparable or even more activation of the PIFMs than isolated foot exercises. Given that functional exercises are easier to perform, this finding indicates the need to further investigate the effectiveness of functional exercises in physical therapy to improve muscle function and functional task performance in populations that suffer from PIFM weakness or dysfunction.
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Affiliation(s)
- Lydia Willemse
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Eveline J M Wouters
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Martijn F Pister
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
| | - Benedicte Vanwanseele
- Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
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Khair RM, Stenroth L, Cronin NJ, Ponkilainen V, Reito A, Finni T. Exploration of muscle-tendon biomechanics one year after Achilles tendon rupture and the compensatory role of flexor hallucis longus. J Biomech 2023; 152:111586. [PMID: 37080080 DOI: 10.1016/j.jbiomech.2023.111586] [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: 12/12/2022] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
Achilles tendon (AT) rupture leads to long-term structural and functional impairments. Currently, the predictors of good recovery after rupture are poorly known. Thus, we aimed to explore the interconnections between structural, mechanical, and neuromuscular parameters and their associations with factors that could explain good recovery in patients with non-surgically treated AT rupture. A total of 35 patients with unilateral rupture (6 females) participated in this study. Muscle-tendon structural, mechanical, and neuromuscular parameters were measured 1-year after rupture. Interconnections between the inter-limb differences (Δ) were explored using partial correlations, followed by multivariable linear regression to find associations between the measured factors and the following markers that indicate good recovery: 1) tendon length, 2) tendon non-uniform displacement, and 3) flexor hallucis longus (FHL) normalized EMG amplitude difference between limbs. Δmedial gastrocnemius (MG) (β = -0.12, p = 0.007) and Δlateral gastrocnemius (β = -0.086, p = 0.030) subtendon lengths were associated with MG tendon Δstiffness. MG (β = 11.56, p = 0.003) and soleus (β = 2.18, p = 0.040) Δsubtendon lengths explained 48 % of variance in FHL EMG amplitude. Regression models for tendon length and non-uniform displacement were not significant. Smaller inter-limb differences in Achilles subtendon lengths were associated with smaller differences in the AT stiffness between limbs, and a smaller contribution of FHL muscle to the plantarflexion torque. In the injured limb, the increased contribution of FHL appears to partially counteract a smaller contribution from MG due to the elongated tendon, however the role of FHL should not be emphasized during rehabilitation to allow recovery of the TS muscles.
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Affiliation(s)
- Ra'ad M Khair
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland.
| | - Lauri Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Neil J Cronin
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland; School of Sport and Exercise, University of Gloucestershire, UK
| | | | - Aleksi Reito
- Central Finland Central Hospital Nova, Jyväskylä, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
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Aeles J, Kelly LA, Cresswell AG. Flexor hallucis brevis motor unit behavior in response to moderate increases in rate of force development. PeerJ 2023; 11:e14341. [PMID: 36643633 PMCID: PMC9838207 DOI: 10.7717/peerj.14341] [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: 06/11/2021] [Accepted: 10/13/2022] [Indexed: 01/11/2023] Open
Abstract
Background Studies on motor unit behaviour with varying rates of force development have focussed predominantly on comparisons between slow and ballistic (i.e., very fast) contractions. It remains unclear how motor units respond to less extreme changes in rates of force development. Here, we studied a small intrinsic foot muscle, flexor hallucis brevis (FHB) where the aim was to compare motor unit discharge rates and recruitment thresholds at two rates of force development. We specifically chose to investigate relatively slow to moderate rates of force development, not ballistic, as the chosen rates are more akin to those that presumably occur during daily activity. Methods We decomposed electromyographic signals to identify motor unit action potentials obtained from indwelling fine-wire electrodes in FHB, from ten male participants. Participants performed isometric ramp-and-hold contractions from relaxed to 50% of a maximal voluntary contraction. This was done for two rates of force development; one with the ramp performed over 5 s (slow condition) and one over 2.5 s (fast condition). Recruitment thresholds and discharge rates were calculated over the ascending limb of the ramp and compared between the two ramp conditions for matched motor units. A repeated measures nested linear mixed model was used to compare these parameters statistically. A linear repeated measures correlation was used to assess any relationship between changes in recruitment threshold and mean discharge rate between the two conditions. Results A significant increase in the initial discharge rate (i.e., at recruitment) in the fast (mean: 8.6 ± 2.4 Hz) compared to the slow (mean: 7.8 ± 2.3 Hz) condition (P = 0.027), with no changes in recruitment threshold (P = 0.588), mean discharge rate (P = 0.549) or final discharge rate (P = 0.763) was observed. However, we found substantial variability in motor unit responses within and between conditions. A small but significant negative correlation (R2 = 0.33, P = 0.003) was found between the difference in recruitment threshold and the difference in mean discharge rate between the two conditions. Conclusion These findings suggest that as force increases for contractions with slower force development, increasing the initial discharge rate of recruited motor units produces the increase in rate of force development, without a change in their recruitment thresholds, mean or final discharge rate. However, an important finding was that for only moderate changes in rate of force development, as studied here, not all units respond similarly. This is different from what has been described in the literature for ballistic contractions in other muscle groups, where all motor units respond similarly to the increase in neural drive. Changing the discharge behaviour of a small group of motor units may be sufficient in developing force at the required rate rather than having the discharge behaviour of the entire motor unit pool change equally.
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Affiliation(s)
- Jeroen Aeles
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia,Laboratory of Functional Morphology, Department of Biology, University of Antwerp, Antwerp, Belgium,Laboratory “Movement, Interactions, Performance” (EA 4334), Université de Nantes, Nantes, France
| | - Luke A. Kelly
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew G. Cresswell
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Boivin K, Laurencelle L, Fontaine N, Trudeau F. Modulations morphologiques du pied chez le marcheur au long cours : influence du sexe et de la latéralité du membre inférieur. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Matsumoto Y, Ogihara N, Hanawa H, Kokubun T, Kanemura N. Novel Multi-Segment Foot Model Incorporating Plantar Aponeurosis for Detailed Kinematic and Kinetic Analyses of the Foot With Application to Gait Studies. Front Bioeng Biotechnol 2022; 10:894731. [PMID: 35814002 PMCID: PMC9265906 DOI: 10.3389/fbioe.2022.894731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Kinetic multi-segment foot models have been proposed to evaluate the forces and moments generated in the foot during walking based on inverse dynamics calculations. However, these models did not consider the plantar aponeurosis (PA) despite its potential importance in generation of the ground reaction forces and storage and release of mechanical energy. This study aimed to develop a novel multi-segment foot model incorporating the PA to better elucidate foot kinetics. The foot model comprised three segments: the phalanx, forefoot, and hindfoot. The PA was modeled using five linear springs connecting the origins and the insertions via intermediate points. To demonstrate the efficacy of the foot model, an inverse dynamic analysis of human gait was performed and how the inclusion of the PA model altered the estimated joint moments was examined. Ten healthy men walked along a walkway with two force plates placed in series close together. The attempts in which the participant placed his fore- and hindfoot on the front and rear force plates, respectively, were selected for inverse dynamic analysis. The stiffness and the natural length of each PA spring remain largely uncertain. Therefore, a sensitivity analysis was conducted to evaluate how the estimated joint moments were altered by the changes in the two parameters within a range reported by previous studies. The present model incorporating the PA predicted that 13%–45% of plantarflexion in the metatarsophalangeal (MTP) joint and 8%–29% of plantarflexion in the midtarsal joints were generated by the PA at the time of push-off during walking. The midtarsal joint generated positive work, whereas the MTP joint generated negative work in the late stance phase. The positive and negative work done by the two joints decreased, indicating that the PA contributed towards transfer of the energy absorbed at the MTP joint to generate positive work at the midtarsal joint during walking. Although validation is limited due to the difficulty associated with direct measurement of the PA force in vivo, the proposed novel foot model may serve as a useful tool to clarify the function and mechanical effects of the PA and the foot during dynamic movements.
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Affiliation(s)
- Yuka Matsumoto
- Graduate School of Saitama Prefectural University, Graduate Course of Health and Social Services, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
| | - Hiroki Hanawa
- Department of Health Science, University of Human Arts and Sciences, Saitama, Japan
| | - Takanori Kokubun
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
| | - Naohiko Kanemura
- Department of Health and Social Services, Saitama Prefectural University, Saitama, Japan
- *Correspondence: Naohiko Kanemura,
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Knox J, Gupta A, Banwell HA, Matricciani L, Turner D. Comparison of EMG signal of the flexor hallucis longus recorded using surface and intramuscular electrodes during walking. J Electromyogr Kinesiol 2021; 60:102574. [PMID: 34273727 DOI: 10.1016/j.jelekin.2021.102574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022] Open
Abstract
The purpose of this study was to compare the use of intramuscular (iEMG) and surface (sEMG) electromyography electrodes to record flexor hallucis longus (FHL) muscle activity during walking, and describe the role of the FHL. Muscle activity was recorded in 12 participants using sEMG and iEMG during treadmill and overground walking. Inter-tester reliability for visual detection of onset and offset of muscle activity was high (ICC = 1.00). During the loading period, the number of bursts of muscle activity was statistically significantly greater using iEMG compared to sEMG when treadmill walking (p = 0.016), and the duration of muscle activity was significantly greater for iEMG (p = 0.01) on both walking surfaces. There were no differences for peak and mean root mean squared (p ≥ 0.07). The FHL activity observed during the loading period (heel strike to forefoot strike) supports the function of the FHL to act as a dynamic ankle stabiliser of the rearfoot, as well as contributing to propulsion during the latter part of stance. The choice of electrodes to detect FHL activity should be dependent on whether the loading and propulsive periods are of interest, and whether treadmill or overground walking will be examined.
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Ma R, Li W. CHANGES IN THE FLEXOR AND EXTENSOR MUSCLES AT DIFFERENT SPEEDS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127072021_0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Centrifugal strength is an important element for strength quality. Developing muscle centrifugal strength can effectively increase the stability of lower limbs and reduce the risk of injury. Objective: To explore the characteristics of contractile force of flexor ahods in strength training and rehabilitation training, and the extensor muscles of the knee joint in athletes with different speeds of centripetal force. Methods: The knee joint muscle group of 8 first-level male high jumpers and 8 second-level male high jumpers were tested by isokinetic centrifugal contraction; the angular test velocity was 60 °/s, 120 °/s, 240 °/s, and the indexes included peak torque, relative peak torque (peak torque/body weight), and the peak torque flexural extension ratio. Results: With the centrifugal contraction of the knee joint muscle group (P < 0.05), the second-level high jumpers should increase the ability of the knee flexor muscle group of the take-off leg. In the case of constant velocity centrifugal contraction (P < 0.01), taking off time must be reduced, that is, taking off speed must be accelerated. Conclusions: The difference in the knee joint muscle isokinetic test results is one of the reasons for the difference in knee joint flexor and extensor muscle contractility under the different speed forces of high jumpers. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Rui Ma
- ZhengZhou University, China; Pukyong University in South Korea, South Korea
| | - Wenyan Li
- ZhengZhou University, China; Pukyong University in South Korea, South Korea; Fifth Affiliated Hospital of Zhengzhou University, China
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Effect of Increased Flexor Hallucis Longus Muscle Activity on Ground Reaction Force during Landing. Life (Basel) 2021; 11:life11070630. [PMID: 34209702 PMCID: PMC8303142 DOI: 10.3390/life11070630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022] Open
Abstract
Repeated high-impact ground forces can lead to injury and decreased performance. While increasing flexor hallucis longus (FHL) muscle activity is known to increase stiffness and elasticity, it is unknown if this also decreases ground reaction forces by shock absorption during landing. This study aimed to determine whether increasing FHL muscle activity affects ground reaction force during landing in healthy subjects. Eight subjects performed single-leg steps onto a force platform for five trials, with and without flexion of the metatarsophalangeal (MTP) joint at the moment of landing. Integrated surface electromyography (sEMG) of the FHL and medial gastrocnemius (MG) and ground reaction forces (GRFs) were measured. sEMG and GRF during the 50 ms before and 100 ms following initial ground contact were analyzed and compared. Flexion of the MTP joint condition significantly decreased the vertical and mediolateral force peaks of GRF, and FHL muscle activity increased. Flexion of the MTP joint at the moment of landing reduces GRF in healthy subjects through force dissipation in the foot, by increased FHL muscle activity. The results suggest that this may contribute to injury prevention by reducing the impact force through flexing the MTP joint at the moment of landing.
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Komuro Y, Ohta Y. A new simpler approach to measure the strength of toe plantar flexion requiring no mechanical restraint with a light-weight device. Proc Inst Mech Eng H 2021; 235:726-732. [PMID: 33740881 DOI: 10.1177/09544119211002932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Conventionally, the strength of toe plantar flexion (STPF) is measured in a seated position, in which not only the target toe joints but also the knee and particularly ankle joints, are usually restrained. We have developed an approach for the measurement of STPF which does not involve restraint and considers the interactions of adjacent joints of the lower extremities. This study aimed to evaluate this new approach and comparing with the seated approach. A thin, light-weight, rigid plate was attached to the sole of the foot in order to immobilize the toe area. Participants were 13 healthy young women (mean age: 24 ± 4 years). For measurement of STPF with the new approach, participants were instructed to stand, raise the device-wearing leg slightly, plantar flex the ankle, and push the sensor sheet with the toes to exert STPF. The sensor sheet of the F-scan II system was inserted between the foot sole and the plate. For measurement with the seated approach, participants were instructed to sit and push the sensor with the toes. They were required to maintain the hip, knee, and ankle joints at 90°. The mean values of maximum STPF of the 13 participants obtained with each approach were compared. There was no significant difference in mean value of maximum STPF when the two approaches were compared (new: 59 ± 23 N, seated: 47 ± 33 N). The coefficient of variation of maximum STPF was smaller for data obtained with the new approach (new: 39%, seated: 70%). Our simple approach enables measurement of STPF without the need for the restraints that are required for the conventional seated approach. These results suggest that the new approach is a valid method for measurement of STPF.
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Affiliation(s)
- Yuko Komuro
- Department of Cooperative Major in Human Centered Engineering, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Yuji Ohta
- Department of Cooperative Major in Human Centered Engineering, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
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The influence of an orthopaedic walker boot on forefoot force. Foot (Edinb) 2021; 46:101739. [PMID: 33285492 DOI: 10.1016/j.foot.2020.101739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/07/2020] [Accepted: 08/29/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND In the treatment of an Achilles tendon rupture the patients are commonly equipped with an orthopaedic walker boot with wedges. To what extent this influences the tensile force placed on the Achilles tendon is unclear. PURPOSE To assess the forefoot force and describe changes in muscle activity of the medial gastrocnemius, soleus and tibialis anterior when using one or three wedges during ambulation in a weightbearing orthopaedic walker boot. METHODS The force on the forefoot was measured with a force sensor insole and muscle activity of the medial gastrocnemius, soleus and tibialis anterior were measured using surface electromyography in 10 healthy participants. Three different types of ambulation were performed (walking without crutches (unass.), walking with crutches (+crutch) and walking with crutches and verbal instructions to place body weight on heel (heel+crutch) with one and three heel wedges respectively. FINDINGS The total peak force displayed an interaction where forefoot force decreased when wearing three wedges only for the +crutch ambulation type (80N, p=0.001) although there was a trend to decrease with three wedges also for the heel+crutch ambulation type (48N, p=0.05). The relative peak force on the forefoot showed a main effect with a significant decrease when using three wedges compared to one wedge across all three ambulation types (19.1%, p=0.009). INTERPRETATION The force on the forefoot and hereby the Achilles tendon significantly decreased when using three wedges compared to one wedge. These findings have important implications for the rehabilitation post Achilles tendon rupture.
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15
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Kovács B, Kóbor I, Sebestyén Ö, Tihanyi J. Longer Achilles tendon moment arm results in better running economy. Physiol Int 2021; 107:527-541. [PMID: 33410770 DOI: 10.1556/2060.2020.10000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/29/2020] [Indexed: 11/19/2022]
Abstract
Based on the current literature, the link between Achilles tendon moment arm length and running economy is not well understood. Therefore, the aim of this study was to further investigate the connection between Achilles tendon moment arm and running economy and the influence of Achilles tendon moment arm on the function of the plantarflexor muscle-tendon unit during running.Ten male competitive marathon runners volunteered for this study. The participants ran on a treadmill at two running speeds: 3 and 3.5 m s-1. During running the oxygen consumption, lower leg kinematics, electrical activity of plantar flexor muscles, and fascicle behavior of the lateral gastrocnemius were measured simultaneously. On the second occasion, an MRI scan of the right leg was taken and used to estimate the Achilles tendon moment arm length.There was a negative correlation between running economy and the body height normalized moment arm length at both selected speeds (r = -0.68, P = 0.014 and r = -0.70, P = 0.01). In addition, Achilles tendon moment arm length correlated with the amplitude of the ankle flexion at both speeds (r = -0.59, P = 0.03 and r = -0.60, P = 0.03) and with the electrical activity of the medial gastrocnemius muscle at 3 m s-1 speed (r = -0.62, P = 0.02). Our finding supports the concept that a longer moment arm could be beneficial for distance runners.
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Affiliation(s)
- B Kovács
- 1Department of Kinesiology, University of Physical Education, Budapest, Hungary
| | - I Kóbor
- 2Semmelweis University, MR Research Centre, Budapest, Hungary
| | - Ö Sebestyén
- 1Department of Kinesiology, University of Physical Education, Budapest, Hungary
| | - J Tihanyi
- 1Department of Kinesiology, University of Physical Education, Budapest, Hungary
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16
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Asada Y, Imai T. Measurement of excitation-contraction coupling time in lower extremities. Phys Ther Res 2020; 24:29-34. [PMID: 33981525 DOI: 10.1298/ptr.e10053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/26/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to apply a novel method to measure excitation-contraction coupling time (ECCT) in normal soleus muscles. METHODS We performed simultaneous recordings of soleus compound muscle action potential (CMAP) and foot movement-related potential (MRP), and measured ankle plantar flexion torque in 36 healthy subjects. We calculated ECCT and examined the relations between CMAP, MRP, ECCT and ankle plantar flexion torque. RESULTS Statistical analyses established reference ranges (mean ± SE) for CMAP (13.4 ± 0.9 mV), MRP (5.3 ± 0.4 m/s2), ECCT (5.2 ± 0.1 ms), torque (85.9 ± 6.4 Nm) and torque/body weight (1.4 ± 0.1 Nm/kg). The torque showed a positive linear correlation with CMAP (p = 0.041) and a negative linear correlation with ECCT (p = 0.045). CONCLUSION Soleus ECCT can be recorded easily, and is useful to assess the impairment of E-C coupling in muscles of the lower extremities.
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Affiliation(s)
- Yuta Asada
- Sapporo Medical University Graduate School of Health Sciences, Japan
| | - Tomihiro Imai
- Sapporo Medical University Graduate School of Health Sciences, Japan
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17
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Effect of footwear on intramuscular EMG activity of plantar flexor muscles in walking. J Electromyogr Kinesiol 2020; 55:102474. [PMID: 32979677 DOI: 10.1016/j.jelekin.2020.102474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/21/2022] Open
Abstract
One of the purposes of footwear is to assist locomotion, but some footwear types seem to restrict natural foot motion, which may affect the contribution of ankle plantar flexor muscles to propulsion. This study examined the effects of different footwear conditions on the activity of ankle plantar flexors during walking. Ten healthy habitually shod individuals walked overground in shoes, barefoot and in flip-flops while fine-wire electromyography (EMG) activity was recorded from flexor hallucis longus (FHL), soleus (SOL), and medial and lateral gastrocnemius (MG and LG) muscles. EMG signals were peak-normalised and analysed in the stance phase using Statistical Parametric Mapping (SPM). We found highly individual EMG patterns. Although walking with shoes required higher muscle activity for propulsion than walking barefoot or with flip-flops in most participants, this did not result in statistically significant differences in EMG amplitude between footwear conditions in any muscle (p > 0.05). Time to peak activity showed the lowest coefficient of variation in shod walking (3.5, 7.0, 8.0 and 3.4 for FHL, SOL, MG and LG, respectively). Future studies should clarify the sources and consequences of individual EMG responses to different footwear.
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18
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Yokozuka M, Miki C, Suzuki M, Katsura R. Association Between Toe Flexor Strength and Activity Levels in Community-Dwelling Japanese Older Women. J Aging Phys Act 2020; 28:360-364. [PMID: 31722297 DOI: 10.1123/japa.2018-0217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 10/27/2023]
Abstract
This study aimed to explore the relationship between toe flexor strength and the daily activity levels in 56 Japanese older women aged between 70 and 88 years. The activity levels were measured as the average number of steps/day using a pedometer and the life space assessment (LSA) scores. The Mann-Whitney U test was used to compare toe flexor muscle strength and the LSA scores between those with fewer than and more than 6,000 steps/day. Spearman's correlation coefficient was used to investigate the relationship between toe grip strength according to age and each variable. The LSA scores were significantly higher in the group with >6,000 steps/day (β = 0.188, p < .05). A correlation was found between the number of steps/day and toe flexor strength (r = .424, β = 0.419, p < .05) and the LSA scores (r = .417, β = 0.435, p < .05) in the participants in their 80s. Increasing the number of steps/day may benefit women in their 80s.
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19
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Aeles J, Kelly LA, Yoshitake Y, Cresswell AG. Fine-wire recordings of flexor hallucis brevis motor units up to maximal voluntary contraction reveal a flexible, nonrigid mechanism for force control. J Neurophysiol 2020; 123:1766-1774. [PMID: 32267195 DOI: 10.1152/jn.00023.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Our current knowledge on the neurophysiological properties of intrinsic foot muscles is limited, especially at high forces. This study therefore aimed to investigate the discharge characteristics of single motor units in an intrinsic foot muscle, namely flexor hallucis brevis, during voluntary contractions up to 100% of maximal voluntary contraction. We measured the recruitment threshold and discharge rate of flexor hallucis brevis motor units using indwelling fine-wire electrodes. Ten participants followed a target ramp up to maximal voluntary contraction by applying a metatarso-phalangeal flexion torque. We observed motor unit recruitment thresholds across a wide range of isometric forces (ranging from 10 to 98% of maximal voluntary contraction) as well as across a wide range of discharge rates (ranging from 4.8 to 23.3 Hz for initial discharge rate and 9.5 to 34.2 Hz for peak discharge rate). We further observed patterns of high variability in recruitment threshold and discharge rate as well as crossover in discharge rate between motor units within the same participant. These findings suggest that the force output of a muscle is generated through a mechanism with substantial variability rather than relying on a rigid organization, which is in contrast to the proposed onion-skin theory. The demands placed on the plantar intrinsic foot muscles during high- and low-force tasks may explain these observed neurophysiological properties.NEW & NOTEWORTHY We recorded for the first time single motor unit action potential trains in the flexor hallucis brevis, a short toe muscle, over the full range of maximum voluntary contraction. Its motor units are recruited up to very high (98%) recruitment thresholds with a substantial range of discharge rates. We further show high variability with crossover of discharge rates as a function of recruitment threshold both between participants and between motor units within participants.
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Affiliation(s)
- J Aeles
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - L A Kelly
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Y Yoshitake
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,Graduate School of Science and Technology, Shinshu University, Nagano, Japan
| | - A G Cresswell
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
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20
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Deleu PA, Chèze L, Dumas R, Besse JL, Leemrijse T, Devos Bevernage B, Birch I, Naaim A. Intrinsic foot joints adapt a stabilized-resistive configuration during the stance phase. J Foot Ankle Res 2020; 13:13. [PMID: 32164783 PMCID: PMC7068936 DOI: 10.1186/s13047-020-0381-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study evaluated the 3D angle between the joint moment and the joint angular velocity vectors at the intrinsic foot joints, and investigated if these joints are predominantly driven or stabilized during gait. METHODS The participants were 20 asymptomatic subjects. A four-segment kinetic foot model was used to calculate and estimate intrinsic foot joint moments, powers and angular velocities during gait. 3D angles between the joint moment and the joint angular velocity vectors were calculated for the intrinsic foot joints defined as follows: ankle joint motion described between the foot and the shank for the one-segment foot model (hereafter referred as Ankle), and between the calcaneus and the shank for the multi-segment foot model (hereafter referred as Shank-Calcaneus); joint motion described between calcaneus and midfoot segments (hereafter referred as Chopart joint); joint motion described between midfoot and metatarsus segments (hereafter referred as Lisfranc joint); joint motion described between first phalanx and first metatarsal (hereafter referred as First Metatarso-Phalangeal joint). When the vectors were approximately aligned, the moment was considered to result in propulsion (3D angle <60o) or resistance (3D angle >120o) at the joint. When the vectors are approximately orthogonal (3D angle close to 90°), the moment was considered to stabilize the joint. RESULTS The results showed that the four intrinsic joints of the foot are never fully propelling, resisting or being stabilized, but are instead subject to a combination of stabilization with propulsion or resistance during the majority of the stance phase of gait. However, the results also show that during pre-swing all four the joints are subject to moments that result purely in propulsion. At heel off, the propulsive configuration appears for the Lisfranc joint first at terminal stance, then for the other foot joints at pre-swing in the following order: Ankle, Chopart joint and First Metatarso-Phalangeal joint. CONCLUSIONS Intrinsic foot joints adopt a stabilized-resistive configuration during the majority of the stance phase, with the exception of pre-swing during which all joints were found to adopt a propulsive configuration. The notion of stabilization, resistance and propulsion should be further investigated in subjects with foot and ankle disorders.
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Affiliation(s)
- Paul-André Deleu
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France. .,Foot & Ankle Institute, Brussels, Belgium.
| | - Laurence Chèze
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - Raphaël Dumas
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - Jean-Luc Besse
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de Chirurgie Orthopédique et Traumatologique, Lyon, France
| | | | | | - Ivan Birch
- Sheffield Teaching Hospitals NHS Foundation Trust, Woodhouse Clinic, 3 Skelton Lane, Sheffield, S13 7LY, UK
| | - Alexandre Naaim
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
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21
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Hösl M, Böhm H, Oestreich C, Dussa CU, Schäfer C, Döderlein L, Nader S, Fenner V. Self-perceived foot function and pain in children and adolescents with flexible flatfeet - Relationship between dynamic pedobarography and the foot function index. Gait Posture 2020; 77:225-230. [PMID: 32059141 DOI: 10.1016/j.gaitpost.2020.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/12/2020] [Accepted: 01/17/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is considerable debate as to which parameters to include in the assessment of paediatric flatfeet. Dynamic pedobarography is an objective, dynamic method to measure foot function. Information about its associations to patient-reported measures may help to focus on the most relevant parameters. RESEARCH QUESTION What is the association between the Foot Function Index and pedobarographic assessments in flatfeet of children and adolescents? METHODS A consecutive clinical case series of 51 participants with idiopathic flexible flatfeet aged 7-17 years underwent barefooted pedobarography during gait and completed the Foot Function Index Questionnaire. Pedobarographic data categorized into values related to area, peak pressure and force with respect to the hind-, mid- and forefoot were extracted. To test the associations between the Foot Function Index and pedobarographic assessments, bivariate partial correlations were tested and contact times served as co-variate. RESULTS Several significant associations between peak pressure or forces beneath the hindfoot, midfoot and hallux to self-perceived function were found (|rho| = 0.28-.46, P < 0.05). In particular, reduced peak forces and pressures underneath the hindfoot and hallux, a lateral shift (smaller medio-lateral ratios) of hindfoot pressure and force and a medial shift (larger medio-lateral ratios) of midfoot pressure seem to be negatively associated with foot-related disability. Overall, less evidence was noted for associations to pain scores. Area related outcomes (including the arch index) contained no information for function while a larger BMI was the strongest thread for disability (rho = 0.42, P = 0.002) and pain (rho = 0.31, P = 0.027). SIGNIFICANCE When using pedobarography for the assessment of flexible flatfeet of children and adolescents, less attention should be paid to area related measurements which do not provide information about self-perceived function or disability. Instead, peak pressures or forces in the hind- or midfoot or beneath the hallux may be focussed. Weight reductions are potentially an effective strategy to reduce or prevent symptoms.
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Affiliation(s)
- Matthias Hösl
- Schön Klinik Vogtareuth, Gait and Motion Analysis Laboratory, Krankenhausstraße 20, 83569, Vogtareuth, Germany.
| | - Harald Böhm
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauer Str. 18, 83229, Aschau im Chiemgau, Germany
| | - Claudia Oestreich
- TUM Faculty of Sport and Health Sciences, Department of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60-62, 80992, Munich, Germany
| | - Chakravarthy Ugandhar Dussa
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauer Str. 18, 83229, Aschau im Chiemgau, Germany
| | - Christel Schäfer
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauer Str. 18, 83229, Aschau im Chiemgau, Germany
| | - Leonhard Döderlein
- Helios Aukamm-Klinik, Orthopädie Aukammklinik, Leibnizstraße 21, 65191 Wiesbaden, Germany
| | - Sean Nader
- Schön Klinik Vogtareuth, Pediatric Orthopaedics, Krankenhausstraße 20, 83569, Vogtareuth, Germany
| | - Verena Fenner
- Besser Bewegen, Jahnstr. 26, 78315, Radolfzell, Germany
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22
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Péter A, Andersson E, Hegyi A, Finni T, Tarassova O, Cronin N, Grundström H, Arndt A. Comparing Surface and Fine-Wire Electromyography Activity of Lower Leg Muscles at Different Walking Speeds. Front Physiol 2019; 10:1283. [PMID: 31649557 PMCID: PMC6796797 DOI: 10.3389/fphys.2019.01283] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/25/2019] [Indexed: 11/13/2022] Open
Abstract
Ankle plantar flexor muscles are active in the stance phase of walking to propel the body forward. Increasing walking speed requires increased plantar flexor excitation, frequently assessed using surface electromyography (EMG). Despite its popularity, validity of surface EMG applied on shank muscles is mostly unclear. Thus, we examined the agreement between surface and intramuscular EMG at a range of walking speeds. Ten participants walked overground at slow, preferred, fast, and maximum walking speeds (1.01 ± 0.13, 1.43 ± 0.19, 1.84 ± 0.23, and 2.20 ± 0.38 m s-1, respectively) while surface and fine-wire EMG activities of flexor hallucis longus (FHL), soleus (SOL), medial gastrocnemius (MG) and lateral gastrocnemius (LG), and tibialis anterior (TA) muscles were recorded. Surface and intramuscular peak-normalised EMG amplitudes were compared for each muscle and speed across the stance phase using Statistical Parametric Mapping. In FHL, we found differences around peak activity at all speeds except fast. There was no difference in MG at any speed or in LG at slow and preferred speeds. For SOL and LG, differences were seen in the push-off phase at fast and maximum walking speeds. In SOL and TA, surface EMG registered activity during phases in which intramuscular EMG indicated inactivity. Our results suggest that surface EMG is generally a suitable method to measure MG and LG EMG activity across several walking speeds. Minimising cross-talk in FHL remains challenging. Furthermore, SOL and TA muscle onset/offset defined by surface EMG should be interpreted cautiously. These findings should be considered when recording and interpreting surface EMG of shank muscles in walking.
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Affiliation(s)
- Annamária Péter
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eva Andersson
- The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.,Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - András Hegyi
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Taija Finni
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Olga Tarassova
- The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Neil Cronin
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Helen Grundström
- Department of Radiology, Capio S:t Göran's Hospital, Stockholm, Sweden
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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23
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Mattock J, Steele JR, Mickle KJ. A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners. BMC Sports Sci Med Rehabil 2018; 10:20. [PMID: 30479774 PMCID: PMC6251115 DOI: 10.1186/s13102-018-0109-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 11/05/2018] [Indexed: 12/25/2022]
Abstract
Background Medial tibial stress syndrome (MTSS) is a lower leg injury with a reported incidence rate of up to 35% in active individuals. Although numerous prospective studies have tried to identify risk factors for developing MTSS, managing the syndrome remains difficult. One risk factor yet to be extensively explored in MTSS development is reduced lower leg girth. Further investigation of reduced lower leg girth is required due to the important role lower leg musculature plays in attenuating ground reaction forces during the gait cycle. Therefore, the primary aim of this study is to ascertain whether lower leg muscle morphology and function contribute to the development of MTSS. Our ultimate aim is to identify potential risk factors for MTSS that can be targeted in future studies to better manage the injury or, preferably, prevent individuals developing MTSS. Methods This study will be prospective in design and will recruit asymptomatic distance runners. All participants will be tested at base line and participants will have their training data longitudinally tracked over the following 12 months to assess any individuals who develop MTSS symptoms. At base line, outcome measures will include bilateral measures of lower limb anthropometry; cross sectional area (CSA) and thickness of the tibialis anterior, peroneals, flexor digitorum longus, flexor hallucis longus and thickness of soleus, medial and lateral head of gastrocnemius. Tibial bone speed of sound, ankle dorsiflexion range of motion, strength of the six previously described muscles, foot alignment and ankle plantar flexor endurance will also be assessed. Participants will also complete a treadmill running protocol where three-dimensional kinematics, plantar pressure distribution and electromyography data will be collected. Discussion This study will aim to identify characteristics of individuals who develop MTSS and, in turn, identify modifiable risk factors that can be targeted to prevent individuals developing this injury.
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Affiliation(s)
- Joshua Mattock
- 1Biomechanics Research Laboratory, University of Wollongong, Wollongong, NSW Australia
| | - Julie R Steele
- 1Biomechanics Research Laboratory, University of Wollongong, Wollongong, NSW Australia
| | - Karen J Mickle
- 2Institute of Health and Sport, Victoria University, Melbourne, VIC Australia
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24
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Tanaka T, Suga T, Imai Y, Ueno H, Misaki J, Miyake Y, Otsuka M, Nagano A, Isaka T. Characteristics of lower leg and foot muscle thicknesses in sprinters: Does greater foot muscles contribute to sprint performance? Eur J Sport Sci 2018; 19:442-450. [PMID: 30360695 DOI: 10.1080/17461391.2018.1534991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study aimed to determine the differences in thicknesses of the lower leg and foot muscles between sprinters and non-sprinters and to examine the relationship between these muscle thicknesses and sprint performance in sprinters. Twenty-six well-trained sprinters and 26 body size-matched non-sprinters participated in this study. Total 9 muscle thicknesses of bilateral lower leg and foot muscles in participants were measured using ultrasonography. Regarding the lower leg muscles, thicknesses of the tibialis anterior, gastrocnemius medial, and gastrocnemius lateral were measured. Regarding the foot muscles, thicknesses of the flexor digitorum longus, flexor hallucis longus, peroneal longus and brevis, abductor hallucis, flexor digitorum brevis, and flexor hallucis brevis were measured. Most muscle thicknesses were significantly larger in sprinters than in non-sprinters. The differences in mean thicknesses of both legs between the two groups were greater in the foot muscles, where it ranged from 10.2% to 17.1%, than in the lower leg muscles, where it ranged from -0.9% to 9.4%. Among foot muscles, the thickness of only the abductor hallucis was positively correlated with the personal best 100-m sprint time in sprinters (r = 0.419, P = 0.033), indicating that a greater abductor hallucis may be a negative factor for superior sprint performance. These findings suggest that although the foot muscles in addition to the lower leg muscles are more developed in sprinters than in non-sprinters, these muscle sizes may not contribute to achieve superior sprint performance.
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Affiliation(s)
- Takahiro Tanaka
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Tadashi Suga
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Yuya Imai
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Hiromasa Ueno
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Jun Misaki
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Yuto Miyake
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Mitsuo Otsuka
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Akinori Nagano
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
| | - Tadao Isaka
- a Faculty of Sport and Health Science , Ritsumeikan University , Kusatsu , Japan
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Kelly LA, Lichtwark GA, Farris DJ, Cresswell A. Shoes alter the spring-like function of the human foot during running. J R Soc Interface 2017; 13:rsif.2016.0174. [PMID: 27307512 DOI: 10.1098/rsif.2016.0174] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/26/2016] [Indexed: 11/12/2022] Open
Abstract
The capacity to store and return energy in legs and feet that behave like springs is crucial to human running economy. Recent comparisons of shod and barefoot running have led to suggestions that modern running shoes may actually impede leg and foot-spring function by reducing the contributions from the leg and foot musculature. Here we examined the effect of running shoes on foot longitudinal arch (LA) motion and activation of the intrinsic foot muscles. Participants ran on a force-instrumented treadmill with and without running shoes. We recorded foot kinematics and muscle activation of the intrinsic foot muscles using intramuscular electromyography. In contrast to previous assertions, we observed an increase in both the peak (flexor digitorum brevis +60%) and total stance muscle activation (flexor digitorum brevis +70% and abductor hallucis +53%) of the intrinsic foot muscles when running with shoes. Increased intrinsic muscle activation corresponded with a reduction in LA compression (-25%). We confirm that running shoes do indeed influence the mechanical function of the foot. However, our findings suggest that these mechanical adjustments are likely to have occurred as a result of increased neuromuscular output, rather than impaired control as previously speculated. We propose a theoretical model for foot-shoe interaction to explain these novel findings.
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Affiliation(s)
- Luke A Kelly
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, 26B Blair Drive, St Lucia, Queensland 4072, Australia
| | - Glen A Lichtwark
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, 26B Blair Drive, St Lucia, Queensland 4072, Australia
| | - Dominic J Farris
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, 26B Blair Drive, St Lucia, Queensland 4072, Australia
| | - Andrew Cresswell
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, 26B Blair Drive, St Lucia, Queensland 4072, Australia
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Péter A, Hegyi A, Finni T, Cronin NJ. In vivo fascicle behavior of the flexor hallucis longus muscle at different walking speeds. Scand J Med Sci Sports 2017; 27:1716-1723. [PMID: 28156022 DOI: 10.1111/sms.12810] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 12/27/2022]
Abstract
Ankle plantar flexor muscles support and propel the body in the stance phase of locomotion. Besides the triceps surae, flexor hallucis longus muscle (FHL) may also contribute to this role, but very few in vivo studies have examined FHL function during walking. Here, we investigated FHL fascicle behavior at different walking speeds. Ten healthy males walked overground at three different speeds while FHL fascicle length changes were recorded with ultrasound and muscle activity was recorded with surface electromyography (EMG). Fascicle length at heel strike at toe off and at peak EMG activity did not change with speed. Range of FHL fascicle length change (3.5-4.5 and 1.9-2.9 mm on average in stance and push-off phase, respectively), as well as minimum (53.5-54.9 and 53.8-55.7 mm) and maximum (58-58.4 and 56.8-57.7 mm) fascicle length did not change with speed in the stance or push-off phase. Mean fascicle velocity did not change in the stance phase, but increased significantly in the push-off phase between slow and fast walking speeds (P=.021). EMG activity increased significantly in both phases from slow to preferred and preferred to fast speed (P<.02 in all cases). FHL muscle fascicles worked near-isometrically during the whole stance phase (at least during slow walking) and operated at approximately the same length at different walking speeds. FHL and medial gastrocnemius (MG) have similar fiber length to muscle belly length ratios and, according to our results, also exhibit similar fascicle behavior at different walking speeds.
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Affiliation(s)
- A Péter
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyvaskyla, Jyvaskyla, Finland
| | - A Hegyi
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyvaskyla, Jyvaskyla, Finland
| | - T Finni
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyvaskyla, Jyvaskyla, Finland
| | - N J Cronin
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyvaskyla, Jyvaskyla, Finland
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A Review of Classification Techniques of EMG Signals during Isotonic and Isometric Contractions. SENSORS 2016; 16:s16081304. [PMID: 27548165 PMCID: PMC5017469 DOI: 10.3390/s16081304] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/25/2016] [Accepted: 06/27/2016] [Indexed: 11/23/2022]
Abstract
In recent years, there has been major interest in the exposure to physical therapy during rehabilitation. Several publications have demonstrated its usefulness in clinical/medical and human machine interface (HMI) applications. An automated system will guide the user to perform the training during rehabilitation independently. Advances in engineering have extended electromyography (EMG) beyond the traditional diagnostic applications to also include applications in diverse areas such as movement analysis. This paper gives an overview of the numerous methods available to recognize motion patterns of EMG signals for both isotonic and isometric contractions. Various signal analysis methods are compared by illustrating their applicability in real-time settings. This paper will be of interest to researchers who would like to select the most appropriate methodology in classifying motion patterns, especially during different types of contractions. For feature extraction, the probability density function (PDF) of EMG signals will be the main interest of this study. Following that, a brief explanation of the different methods for pre-processing, feature extraction and classifying EMG signals will be compared in terms of their performance. The crux of this paper is to review the most recent developments and research studies related to the issues mentioned above.
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