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Wang Y, Qi Y, Ma B, Wu H, Wang Y, Wei B, Wei X, Xu Y. Three-dimensional gait analysis of orthopaedic common foot and ankle joint diseases. Front Bioeng Biotechnol 2024; 12:1303035. [PMID: 38456008 PMCID: PMC10919227 DOI: 10.3389/fbioe.2024.1303035] [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: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024] Open
Abstract
Walking is an indispensable mode of transportation for human survival. Gait is a characteristic of walking. In the clinic, patients with different diseases exhibit different gait characteristics. Gait analysis describes the specific situation of human gait abnormalities by observing and studying the kinematics and dynamics of limbs and joints during human walking and depicting the corresponding geometric curves and values. In foot and ankle diseases, gait analysis can evaluate the degree and nature of gait abnormalities in patients and provide an important basis for the diagnosis of patients' diseases, the correction of abnormal gait and related treatment methods. This article reviews the relevant literature, expounds on the clinical consensus on gait, and summarizes the gait characteristics of patients with common ankle and foot diseases. Starting from the gait characteristics of individuals with different diseases, we hope to provide support and reference for the diagnosis, treatment and rehabilitation of clinically related diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Yongsheng Xu
- Orthopedic Center (Sports Medicine Center), Inner Mongolia People’s Hospital, Hohhot, China
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Zhu S, Jenkyn T. Development of a clinically useful multi-segment kinetic foot model. J Foot Ankle Res 2023; 16:86. [PMID: 38017489 PMCID: PMC10685473 DOI: 10.1186/s13047-023-00686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Traditionally, gait analysis studies record the foot as a single rigid segment, leaving movements and loads within the foot undetected. In addition, very few data of multi-segment foot kinetics have been represented in the literature due to measurement and equipment limitations. As a result, this study aims to develop a novel multi-segment kinetic foot model that is clinically feasible and enables both kinematic and kinetic analysis of large patient groups. RESULTS Outcome measurements include rotation angles of intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation, joint moments, joint powers and the medial longitudinal arch (MLA) height/length ratio. Repeatability of joint motions was calculated using coefficients of multiple correlation. Most joint motions measured by this foot model showed strong within-subject reliability (R > 0.7) in healthy adults. Outcome measures were in agreement with other multi-segment foot models found in the biomechanics literature. CONCLUSIONS This novel multi-segment foot model is able to quantify intersegmental foot kinematics and kinetics and can be a useful tool for research and assessments on clinical populations.
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Affiliation(s)
- Songlin Zhu
- Wolf Orthopaedic Biomechanics Laboratory, School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, N6A 5B9, Canada.
| | - Thomas Jenkyn
- Wolf Orthopaedic Biomechanics Laboratory, Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario, N6A 5B9, Canada
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Phillips T, Brierty A, Goodchild D, Patritti BL, Murphy A, Boocock M, Dwan L, Passmore E, McGrath M, Edwards J. Australia and New Zealand Clinical Motion Analysis Group (ANZ-CMAG) clinical practice recommendations. Gait Posture 2023; 106:1-10. [PMID: 37607445 DOI: 10.1016/j.gaitpost.2023.07.001] [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: 08/24/2023]
Abstract
Clinical motion analysis involves quantitative measurement of gait patterns to identify gait anomalies that currently or have the potential to impact function, activities of daily living and participation. Clinical motion analysis services are equipped with motion capture technology and comprise specialised staff who deliver 3-dimensional motion analysis services to children and adults who present with varying levels of gait impairment. Data is then used to inform intervention recommendations to clinicians with a view to maintaining independent, functional and pain free walking (or appropriate mobility). The ANZ-CMAG (established in 2013) identified a need to establish recommendations to assist in standardising practice guidelines for both current and new clinical motion analysis services within the region. The group serves to promote collaboration between services in quality assurance processes, clinical practices, data sets and research activities. The clinical practice recommendations described in this paper cover: i) requirements for a motion analysis service (including staffing, facilities and equipment), ii) patient assessments (requirements, clinical information and data gathered, reporting and interpretation of patient data), iii) quality assurance processes (including motion capture system / biomechanical models & limitations, marker placement, data storage / record keeping, creation of normative dataset); iv) helpful resources. Better outcomes for children and adults with gait deviations is dependent upon accurate measurement and evaluation of walking and requires input from multidisciplinary clinical teams with specialist knowledge and skills. The ANZ-CMAG hopes these clinical practice recommendations are beneficial to motion analysis services with an aim to improve clinical practices, patient outcomes, and support research collaboration.
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Affiliation(s)
- Teresa Phillips
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia.
| | - Alexis Brierty
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
| | - Denni Goodchild
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
| | - Benjamin L Patritti
- South Australian Movement Analysis Centre, Division of Rehabilitation, Aged and Palliative Care, Flinders Medical Centre, Adelaide, 5042, Australia; College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia
| | - Anna Murphy
- Clinical Gait Analysis Service, Monash Health, Victoria, 3192, Australia; Faculty of Medicine, Nursing and Allied Health Sciences, Monash University, Victoria, 3800, Australia
| | - Mark Boocock
- Health and Rehabilitation Research Institute, Auckland University of Technology, Northcote, 0627, New Zealand
| | - Leanne Dwan
- The Children's Hospital at Westmead, Sydney, 2145, Australia; School of Health Sciences, The University of Sydney, Sydney, 2006, Australia
| | - Elyse Passmore
- Royal Children's Hospital, Gait Analysis Laboratory, Parkville, 3052, Australia; Murdoch Children's Research Institute, Developmental Imaging, Parkville, 3052, Australia; University of Melbourne, Engineering and Information Technology, Parkville, 3052, Australia; University of Melbourne, Medicine, Dentistry & Health Sciences, Parkville, 3052, Australia
| | - Michelle McGrath
- Queensland Motion Analysis Centre, Department of Physiotherapy, Royal Brisbane and Women's Hospital, Herston, 4006, Australia
| | - Julie Edwards
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
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Rosemberg DL, Gustafson JA, Bordignon G, Bohl DD, Leporace G, Metsavaht L. Biokinetic Evaluation of Hallux Valgus during Gait: A Systematic Review. Foot Ankle Int 2023; 44:763-777. [PMID: 37086002 DOI: 10.1177/10711007231166667] [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] [Indexed: 04/23/2023]
Abstract
BACKGROUND Foot pathologies can affect the kinetic chain during gait, leading to altered loading at other joints that can lead to subsequent pathologies. Although hallux valgus is the most common foot disease, little has been discussed about the biokinetic effects of hallux valgus on the foot and lower limb. This systematic review evaluated the kinematic, kinetic, and pedobarographic changes of the hallux valgus foot compared to a healthy one. METHODS Several electronic databases were searched up to January 2022, including only cross-sectional studies with clearly defined isolated hallux valgus diseases and healthy groups. Two investigators independently rated studies for methodological quality using the NIH Study Quality Assessment Tool for cross-sectional studies. Kinetic data were extracted, including temporal data, kinematics of the foot joint, kinematics of the proximal lower limb, and pedobarography. We did meta-analyses tests with a random effects model using the metafor package in R. RESULTS Hallux valgus patients walk slower compared to a disease-free control group -0.16 m/s (95% CI -0.27, -0.05). Hallux valgus patients exhibited significantly reduced coronal plane motion of the hindfoot-shank during preswing 1.16 degrees (95% CI 0.31, 2.00). Hallux valgus patients generated less force in the hallux region 33.48 N (95% CI 8.62, 58.35) but similar peak pressures in the hallux compared to controls. Hallux valgus patients generated less peak pressure at the medial and lateral hindfoot as compared to controls: 8.28 kPa (95% CI 2.92, 13.64) and 8.54 kPa (95% CI 3.55, 13.52), respectively. CONCLUSION Although hallux valgus is a deformity of the forefoot, the kinematic changes due to the pathology are associated with significant changes in the range of motion at other joints, underscoring its importance in the kinetic chain. This is demonstrated again with the changes of peak pressure. Nevertheless, more high-quality studies are still needed to develop a fuller understanding of this pathology.
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Affiliation(s)
- Dov Lagus Rosemberg
- Instituto Brasil de Tecnologias da Saúde (IBTS), Rio de Janeiro, RJ, Brasil
- Midwest Orthopedics at Rush (MOR), Chicago, IL, USA
- RUSH-IBTS International Fellowship Program, Chicago, IL, USA
- Lab. Prof. Manlio Mario Marco Napoli, Departamento de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Jonathan A Gustafson
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Glaucia Bordignon
- Instituto Brasil de Tecnologias da Saúde (IBTS), Rio de Janeiro, RJ, Brasil
- Midwest Orthopedics at Rush (MOR), Chicago, IL, USA
- RUSH-IBTS International Fellowship Program, Chicago, IL, USA
- Departamento de Ortopedia e Traumatologia, Hospital Municipal Universitário de Taubaté, Taubaté, SP, Brasil
| | - Daniel D Bohl
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Gustavo Leporace
- Institute Brazil of Technologies in Health, Rio de Janeiro, Brazil
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Campos S, Salami F, Karrasch M, Musagara AR, Hagmann S, Wolf SI. A new alignment device for standardization of marker placement on the hindfoot. Gait Posture 2023; 104:116-119. [PMID: 37379737 DOI: 10.1016/j.gaitpost.2023.06.008] [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: 03/20/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND For multi-segment foot models, next to a (dorsal) heel marker, further markers are typically placed medially (MCL) and laterally (LCL) on the calcaneus. However, there is a lack of easily identifiable landmarks on the hindfoot limiting the repeatability of measurements. For a more consistent placement of these markers, an improved Hindfoot Alignment Device (HiAD) was developed. METHODS With the HiAD, the position of the MCL and LCL can be individually scaled. Flexible bars allow the adaptation to foot deformities. Three rater placed markers with the HiAD four times on ten typical developed subjects (20 feet). Rigid segment residuals of the hindfoot were calculated and compared with the residuals when using the device of Simon et al. (2006) [12]. The variability of the placement of MCL, LCL and the clinical parameter medial arch were determined. For assessing the inter- and intra-rater reliability, intraclass correlation coefficient (ICC) and the standard error of measurement (SEM) were calculated. RESULTS Rigid segment residuals of the hindfoot could be reduced by 70 % by using the HiAD. Largest inter-rater variability in the MCL and LCL placement was found in z-direction with less than 3.2 ± 2.7 mm and 3.8 ± 2.8 mm, respectively. Correspondingly, largest intra-rater variability was 3.4 ± 2.3 mm for LCL and 2.4 ± 1.9 mm for MCL, respectively. Regarding reliability ICC showed good to excellent results for the medial arch (interrater ICC 0.471-0.811). SIGNIFICANCE The application of HiAD to place MCL and LCL appear to be a reliable method with robust marker positions and could be implemented in any multi segment foot model. However, further investigation would be helpful to determine the sensitivity of the marker positions in detecting hindfoot deformities.
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Affiliation(s)
- Sarah Campos
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Firooz Salami
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Melanie Karrasch
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Arik Rehani Musagara
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sébastien Hagmann
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastian I Wolf
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
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Zhang LY, Yick KL, Yue MJ, Yip J, Ng SP. An exploratory study of dynamic foot shape measurements with 4D scanning system. Sci Rep 2023; 13:8628. [PMID: 37244970 DOI: 10.1038/s41598-023-35822-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/24/2023] [Indexed: 05/29/2023] Open
Abstract
Accurate and reliable foot measurements at different stances offer comprehensive geometrical information on foot, thus enabling a more comfortable insole/footwear for practical use and daily activities. However, there lacks investigations on continuous deformation of foot shape during the roll-over process. This study analyses the foot deformation of 19 female diabetic patients during half weight bearing standing and self-selected walking speed by using a novel 4D foot scanning system. The scanning system has good repeatability and accuracy in both static and dynamic scanning situations. Point cloud registration for scanned image reorientation and algorithms to automatically extract foot measurements is developed. During the foot roll-over process, maximum deformation of length and girth dimensions are found at first toe contact. Width dimensions have maximum deformation at heel take off. The findings provide a new understanding of foot shape changes in dynamic situations, thus providing an optimal solution for foot comfort, function and protection.
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Affiliation(s)
- Li-Ying Zhang
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China
| | - Kit-Lun Yick
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China.
| | - Mei-Jun Yue
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Sun-Pui Ng
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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Sacco ICN, Trombini-Souza F, Suda EY. Impact of biomechanics on therapeutic interventions and rehabilitation for major chronic musculoskeletal conditions: A 50-year perspective. J Biomech 2023; 154:111604. [PMID: 37159980 DOI: 10.1016/j.jbiomech.2023.111604] [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: 01/26/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
The pivotal role of biomechanics in the past 50 years in consolidating the basic knowledge that underpins prevention and rehabilitation measures has made this area a great spotlight for health practitioners. In clinical practice, biomechanics analysis of spatiotemporal, kinematic, kinetic, and electromyographic data in various chronic conditions serves to directly enhance deeper understanding of locomotion and the consequences of musculoskeletal dysfunctions in terms of motion and motor control. It also serves to propose straightforward and tailored interventions. The importance of this approach is supported by myriad biomechanical outcomes in clinical trials and by the development of new interventions clearly grounded on biomechanical principles. Over the past five decades, therapeutic interventions have been transformed from fundamentally passive in essence, such as orthoses and footwear, to emphasizing active prevention, including exercise approaches, such as bottom-up and top-down strengthening programs for runners and people with osteoarthritis. These approaches may be far more effective inreducing pain, dysfunction, and, ideally, incidence if they are based on the biomechanical status of the affected person. In this review, we demonstrate evidence of the impact of biomechanics and motion analysis as a foundation for physical therapy/rehabilitation and preventive strategies for three chronic conditions of high worldwide prevalence: diabetes and peripheral neuropathy, knee osteoarthritis, and running-related injuries. We conclude with a summary of recommendations for future studies needed to address current research gaps.
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Affiliation(s)
- Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | - Eneida Yuri Suda
- Postgraduate Program in Physiotherapy, Universidade Ibirapuera, São Paulo, Brazil
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Chang JL, Chen HJ, Chen PY, Chou LW, Lai CH, Lu YH, Chiang SL, Lin CH, Wang XM, Lin CH. Validating stroke-induced bilateral ankle coordination deficits using bilateral ankle measure relationship with motor functions in lower limbs. J Neuroeng Rehabil 2023; 20:32. [PMID: 36932449 PMCID: PMC10022551 DOI: 10.1186/s12984-023-01157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/10/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Coordinated control between the bilateral ankle joints plays an important role in performing daily life functions, such as walking and running. However, few studies have explored the impact of stroke on movement disorders that decrease the coordination control of the bilateral extremities and may decrease daily activities that require coordination control of the bilateral ankles. This study aimed to investigate the coordination control of the bilateral ankles using a novel bilateral ankle measurement system and evaluate the relationship of bilateral movement coordination control deficits with motor and functional performances of the lower extremities in patients with stroke. METHODS Twenty-one healthy adults (36.5 ± 13.2 y/o) and 19 patients with chronic stroke (58.7 ± 10.5 y/o) were enrolled. A novel measurement device with embedded rotary potentiometers was used to evaluate bilateral ankle coordination control. Participants were asked to move their dominant (non-paretic) foot from dorsiflexion to plantarflexion position and non-dominant (paretic) foot from dorsiflexion to plantarflexion position (condition 1) simultaneously, and vice versa (condition 2). Alternating time and angle for coordination control with movements of both ankles were calculated for each condition. Motor and functional performance measurements of the lower extremities included the lower-extremity portion of the Fugl-Meyer assessment (FMA-LE), Berg Balance Test (BBS), Timed Up and Go Test (TUG), and Barthel Index (BI). RESULTS Compared with the healthy group, alternating time was shorter in the stroke group by 8.3% (p = 0.015), and the alternating angles of conditions 1 and 2 were significantly higher than those of the healthy group by 1.4° (p = 0.001) and 2.5° (p = 0.013), respectively. The alternating angle in condition 2 showed moderate correlations with TUG (r = 0.512; p = 0.025), 10-m walk (r = 0.747; p < 0.001), gait speed (r = - 0.497 to - 0.491; p < 0.05), length (r = - 0.518 to - 0.551; p < 0.05), and BI (r = - 0.457; p = 0.049). CONCLUSION Stroke decreases alternating time, increases alternating angle, and shows bilateral ankle coordination control deficits temporally and spatially. A higher alternating angle is moderately to highly associated with motor function and lower limb function in patients with stroke.
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Affiliation(s)
- Jia-Lan Chang
- grid.412955.e0000 0004 0419 7197Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, No. 291, Jhongjheng Rd., Jhonghe, New Taipei, 23561 Taiwan
- grid.412896.00000 0000 9337 0481Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
| | - Hung-Ju Chen
- grid.59784.370000000406229172National Center for Geriatrics and Welfare Research, National Health Research Institutes, 35 Keyan Rd., Zhunan Town, Miaoli County, 350 Taiwan (R.O.C.)
| | - Po-Yin Chen
- grid.412896.00000 0000 9337 0481Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
| | - Li-Wei Chou
- grid.260539.b0000 0001 2059 7017Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 112 Taiwan (R.O.C.)
| | - Chien-Hung Lai
- grid.412896.00000 0000 9337 0481Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
- grid.412897.10000 0004 0639 0994Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, No. 252 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
| | - Yueh-Hsun Lu
- Department of Radiology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., New Taipei City, 235 Taiwan (R.O.C.)
- grid.412896.00000 0000 9337 0481Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
| | - Shang-Lin Chiang
- grid.278244.f0000 0004 0638 9360Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Taipei, 114 Taiwan (R.O.C.)
| | - Chia-Huei Lin
- grid.278244.f0000 0004 0638 9360Department of Nursing, Tri-Service General Hospital; School of Nursing, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Taipei, 114 Taiwan (R.O.C.)
| | - Xin-Miao Wang
- Faculty of Humanities, Zhejiang Dong Fang Polytechnic College, 47Th Floor, China Resources Building B 1366 Qianjiang Road, Hangzhou, China
| | - Chueh-Ho Lin
- grid.412896.00000 0000 9337 0481Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
- grid.416930.90000 0004 0639 4389Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Taipei, 116 Taiwan (R.O.C.)
- grid.412896.00000 0000 9337 0481International Ph.D. Program in Gerontology and Long-Term Care, Taipei Medical University, No. 250 Wu-Xing Street, Taipei, 110 Taiwan (R.O.C.)
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Biomechanical Implications of Congenital Conditions of the Foot/Ankle. Foot Ankle Clin 2023; 28:27-43. [PMID: 36822687 DOI: 10.1016/j.fcl.2022.10.003] [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: 01/03/2023]
Abstract
Segmental foot and ankle models are often used as part of instrumented gait analysis when planning interventions for complex congenital foot conditions. More than 40 models have been used for clinical analysis, and it is important to understand the technical differences among models. These models have been used to improve clinical planning of pediatric foot conditions including clubfoot, planovalgus, and equinovarus. They have also been used to identify clinically relevant subgroups among pediatric populations, quantify postoperative outcomes, and explain variability in healthy populations.
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Fast tool to evaluate 3D movements of the foot-ankle complex using multi-view depth sensors. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2023. [DOI: 10.1016/j.medntd.2023.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Deng Z, Cai Z, Chen S, Liu Y, Chen F, Deng Z, Li Y, Xu J. Comparison of in vivo hindfoot joints motion changes during stance phase between non-flatfoot and stage II adult acquired flatfoot. J Foot Ankle Res 2022; 15:74. [PMID: 36229819 PMCID: PMC9559000 DOI: 10.1186/s13047-022-00577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the kinematic characteristics of hindfoot joints in stage II adult acquired flatfoot deformity (AAFD) with those of non-flatfoot through the 3D-to-2D registration technology and single fluoroscopic imaging system. METHODS Eight volunteers with stage II AAFD and seven volunteers without stage II AAFD were recruited and CT scans were performed bilateral for both groups in neutral positions. Their lateral dynamic X-ray data during the stance phase, including 14 non-flatfeet and 10 flatfeet, was collected. A computer-aided simulated light source for 3D CT model was applied to obtain the virtual images, which were matched with the dynamic X-ray images to register in the "Fluo" software, so that the spatial changes during the stance phase could be calculated. RESULTS During the early-stance phase, the calcaneous was more dorsiflexed, everted, and externally-rotated relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). During the mid-stance phase, the calcaneous was more dorsiflexed and everted relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05); however, the rotation did not differ significantly between the two groups (p > 0.05). During the late-stance phase, the calcaneous was more plantarflexed, but less inverted and internally-rotated, relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). During the early- and mid-stance phase, the navicular was more dorsiflexed, everted, and externally-rotated relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). During the late-stance phase, the navicular was more plantarflexed, but less inverted and internally-rotated, relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). There was no difference in the motion of cuboid between the two groups during the whole stance phase (p > 0.05). CONCLUSIONS During the early- and mid-stance phase, excessive motion was observed in the subtalar and talonavicular joints in stage II AAFD. During the late-stance phase, the motion of subtalar and talonavicular joints appeared to be in the dysfunction state. The current study helps better understanding the biomechanics of the hindfoot during non-flatfoot and flatfoot condition which is critical to the intervention to the AAFD using conservative treatment such as insole or surgical treatment for joint hypermotion.
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Affiliation(s)
- Zhenhan Deng
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Zijun Cai
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Siyu Chen
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Yan Liu
- Department of Critical Care Medicine and Infection Prevention and Control, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Fanglin Chen
- Department of Orthopedics, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker's Hospital, Liuzhou, 545000, Guangxi, China
| | - Zhiqin Deng
- Hand and Foot Surgery Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Yusheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Xu
- Department of Orthopedics, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker's Hospital, Liuzhou, 545000, Guangxi, China. .,Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China.
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Fritz JM, Canseco K, Konop KA, Kruger KM, Tarima S, Long JT, Law BC, Kraus JC, King DM, Harris GF. Multi-segment foot kinematics during gait following ankle arthroplasty. J Orthop Res 2022; 40:685-694. [PMID: 33913547 DOI: 10.1002/jor.25062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/13/2021] [Accepted: 04/19/2021] [Indexed: 02/04/2023]
Abstract
Ankle arthritis is a debilitating disease marked by pain and limited function. Total ankle arthroplasty improves pain while preserving motion and offers an alternative to the traditional treatment of ankle fusion. Gait analysis and functional outcomes tools can provide an objective balanced analysis of ankle replacement for the treatment of ankle arthritis. Twenty-nine patients with end-stage ankle arthritis were evaluated before and after ankle arthroplasty. Multi-segment foot and ankle kinematics were assessed annually following surgery (average 3.5 years, range 1-6 years) using the Milwaukee Foot Model and a Vicon video motion analysis system. Functional outcomes (American Orthopedic Foot and Ankle Society [AOFAS] ankle/hindfoot scale, short form 36 [SF-36] questionnaire) and temporal-spatial parameters were also assessed. Kinematic results were compared to findings from a previously collected group of healthy ambulators. AOFAS and SF-36 mean scores improved postoperatively. Walking speed and stride length increased after surgery. There were significant improvements in tibial sagittal range of motion in terminal stance and hindfoot sagittal range of motion in preswing. Decreased external rotation of the tibia and increased external rotation of the hindfoot were noted throughout the gait cycle. Pain and function improved after ankle replacement as supported by better outcomes scores, increased temporal-spatial parameters, and significant improvement in tibial sagittal range of motion during terminal stance and hindfoot sagittal range of motion during preswing. While multi-segment foot kinematics were improved, they were not restored to control values. Statement of clinical significance: Total ankle arthroplasty does not fully normalize mutli-segment gait kinematics despite improved patient-reported outcomes and gait mechanics.
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Affiliation(s)
- Jessica M Fritz
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Department of Biomedical Engineering, Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA
| | - Karl Canseco
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Orthopedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Katherine A Konop
- Orthopedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Karen M Kruger
- Orthopedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Motion Analysis Center, Shriners Hospitals for Children-Chicago, Chicago, Illinois, USA
| | - Sergey Tarima
- Department of Biostatistics, Institute for Health & Society, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jason T Long
- Department of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Brian C Law
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jonathan C Kraus
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David M King
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Gerald F Harris
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Department of Biomedical Engineering, Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA.,Orthopedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Motion Analysis Center, Shriners Hospitals for Children-Chicago, Chicago, Illinois, USA
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13
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Chinitz N, Bohl DD, Reddy M, Tenenbaum S, Coleman S, Brodsky JW. Preoperative Gait Analysis of Peroneal Tendon Tears. Foot Ankle Int 2022; 43:233-243. [PMID: 34596438 DOI: 10.1177/10711007211036876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Little is known regarding the impact of peroneal tendon tears on function. This study quantifies gait changes associated with operatively-confirmed peroneal tendon tears. METHODS Sixty-five patients with unilateral peroneal tendon tears were prospectively evaluated using preoperative 3D multisegment gait analysis of both limbs. Data were analyzed according to pattern/severity of tears, as confirmed surgically: peroneus brevis tears, reparable (PBR); peroneus brevis tears, irreparable (PBI); peroneus longus tears, irreparable (PLI); and concomitant irreparable tears of both tendons (PBI+PLI). The following parameters were analyzed: ankle sagittal motion, coronal motion, axial rotation, foot progression angle, sagittal power, sagittal moment. RESULTS Twelve patients (18.5%) had the PBR pattern, 37 (56.9%) PBI, 10 (15.4%) PLI, and 6 (9.2%) PBI+PLI. Compared with the contralateral, nonpathologic extremities, limbs with peroneal tears had diminished ankle sagittal motion (mean 23.14 vs 24.30 degrees, P = .012), ankle/hindfoot axial rotation (6.26 vs 7.23 degrees, P = .001), sagittal moment (1.16 vs 1.29 Nm/kg, P < .001), and sagittal power (1.24 vs 1.47 W/kg, P < .001). The most severe tear patterns had the greatest derangements in multiple parameters of gait (PBI+PLI > PBI or PLI > PBR). For example, all groups except PBR had loss of ankle sagittal moment and/or power in the affected limb, and the greatest losses in moment and power were in the PBI+PLI group (1.22 vs 0.91 Nm/kg, P = .003 for moment; 0.73 vs 1.31 W/kg, P < .001 for power). The PBI+PLI group had a >10-degree varus shift in coronal motion on the affected side (P = .002). CONCLUSION This is the first study to demonstrate diminished biomechanical function in patients with peroneal tendon tears. In vivo 3-dimensional gait analysis found significant changes in hindfoot motion, ankle motion, and ankle power. Impairments were related to the pattern and severity of the tears, and demonstrated a strong association of peroneal tendon tears with diminished ankle plantarflexion strength. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Noah Chinitz
- Baylor University Medical Center, Dallas, TX, USA
| | | | - Manoj Reddy
- Baylor University Medical Center, Dallas, TX, USA
| | - Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical Center at Tel Hashomer, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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14
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Yoo HJ, Park HS, Lee DO, Kim SH, Park GY, Cho TJ, Lee DY. Comparison of the kinematics, repeatability, and reproducibility of five different multi-segment foot models. J Foot Ankle Res 2022; 15:1. [PMID: 34991669 PMCID: PMC8734222 DOI: 10.1186/s13047-021-00508-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multi-segment foot models (MFMs) for assessing three-dimensional segmental foot motions are calculated via various analytical methods. Although validation studies have already been conducted, we cannot compare their results because the experimental environments in previous studies were different from each other. This study aims to compare the kinematics, repeatability, and reproducibility of five MFMs in the same experimental conditions. METHODS Eleven healthy males with a mean age of 26.5 years participated in this study. We created a merged 29-marker set including five MFMs: Oxford (OFM), modified Rizzoli (mRFM), DuPont (DFM), Milwaukee (MiFM), and modified Shriners Hospital for Children Greenville (mSHCG). Two operators applied the merged model to participants twice, and then we analysed two relative angles of three segments: shank-hindfoot (HF) and hindfoot-forefoot (FF). Coefficients of multiple correlation (CMC) and mean standard errors were used to assess repeatability and reproducibility, and statistical parametric mapping (SPM) of the t-value was employed to compare kinematics. RESULTS HF varus/valgus of the MiFM and mSHCG models, which rotated the segment according to radiographic or goniometric measurements during the reference frame construction, were significantly more repeatable and reproducible, compared to other models. They showed significantly more dorsiflexed HF and plantarflexed FF due to their static offset angles. DFM and mSHCG showed a greater range of motion (ROM), and some models had significantly different FF points of peak angle. CONCLUSIONS Under the same conditions, rotating the segment according to the appropriate offset angle obtained from radiographic or goniometric measurement increased reliability, but all MFMs had clinically acceptable reliability compared to previous studies. Moreover, in some models, especially HF varus/valgus, there were differences in ROM and points of peak angle even with no statistical difference in SPM curves. Therefore, based on the results of this study, clinicians and researchers involved in the evaluation of foot and ankle dysfunction need an understanding of the specific features of each MFM to make accurate decisions.
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Affiliation(s)
- Hyo Jeong Yoo
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Hye Sun Park
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Dong-Oh Lee
- Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul, South Korea
| | - Seong Hyun Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Gil Young Park
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Tae-Joon Cho
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea.,Department of Orthopedic Surgery, Seoul National University College of Medicine, 101 Daehak-no, Jongno-gu, Seoul, South Korea
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-no, Jongno-gu, Seoul, South Korea. .,Department of Orthopedic Surgery, Seoul National University College of Medicine, 101 Daehak-no, Jongno-gu, Seoul, South Korea.
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15
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Kruger KM, Constantino CS, Graf A, Flanagan A, Smith PA, Krzak JJ. What are the long-term outcomes of lateral column lengthening for pes planovalgus in cerebral palsy? J Clin Orthop Trauma 2021; 24:101717. [PMID: 34926149 PMCID: PMC8646176 DOI: 10.1016/j.jcot.2021.101717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Lateral column lengthening (LCL) is commonly performed on children and adolescents with cerebral palsy (CP) for correction of pes planovalgus (PPV). There are limited reports of the long-term outcomes of this procedure. The purpose of this study was to examine the long-term results of LCL for correction of PPV in individuals with CP by evaluating subjects when they had transitioned to adulthood and were entering the workforce. METHODS Clinical assessments, quantitative gait analysis including the Milwaukee Foot Model (MFM) for segmental foot kinematics, and patient reported outcomes were collected from 13 participants with CP treated with LCL for PPV in childhood (average age 24.4 ± 5.7 years, average 15.3 ± 8.5 years since LCL). Additionally, 27 healthy adults average age 24.5 ± 3.6 years functioned as controls. RESULTS Strength and joint range of motion were reduced in the PPV group (p < 0.05). Sixty nine percent showed operative correction of PPV based on radiologic criteria. Gait analysis showed reduced walking speed and stride length, as well as midfoot break and residual forefoot abduction. Patient reported outcomes indicated that foot pain was not the only factor that caused limited activity and participation. LCL surgery for PPV in childhood resulted in long-term operative correction. Decreased ankle passive range of motion and strength, subtalar joint arthritic changes, inefficient and less stable ambulation, and problems with participation (difficulties in physical function, education, and employment) were observed in the long-term. CONCLUSION This study identified postoperative impairments and limitations to guide future clinical decision-making. These results provide clinicians and researchers the common residual and recurrent issues for these individuals as they age. The inclusion of contextual factors that influence the disease and impairments can equip these individuals with enhanced skills they need as they transition into adulthood.
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Affiliation(s)
- Karen M. Kruger
- Orthopaedic and Rehabilitation Engineering Center, Marquette University & Medical College of Wisconsin, 1250 W. Wisconsin Ave., Milwaukee, WI, 53233, USA
- Motion Analysis Center, Shriners Hospital for Children, 2211 N. Oak Park Ave., Chicago, IL, 60707, USA
- Corresponding author. Orthopaedic and Rehabilitation Engineering Center, Marquette University & Medical College of Wisconsin, 1250 W. Wisconsin Ave., Milwaukee, WI, 53233, USA.
| | - Christopher S. Constantino
- Department of Anatomy, University of the Philippines Manila – College of Medicine, 547 Pedro Gil St., Ermita Manila, Philippines
| | - Adam Graf
- Motion Analysis Center, Shriners Hospital for Children, 2211 N. Oak Park Ave., Chicago, IL, 60707, USA
| | - Ann Flanagan
- Motion Analysis Center, Shriners Hospital for Children, 2211 N. Oak Park Ave., Chicago, IL, 60707, USA
| | - Peter A. Smith
- Motion Analysis Center, Shriners Hospital for Children, 2211 N. Oak Park Ave., Chicago, IL, 60707, USA
| | - Joseph J. Krzak
- Motion Analysis Center, Shriners Hospital for Children, 2211 N. Oak Park Ave., Chicago, IL, 60707, USA
- Midwestern University, Physical Therapy Program, College of Health Sciences, 555 31st St., Downers Grove, IL, 60515, USA
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16
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Kim SJ, Wen Y, Kucuktabak EB, Zhan S, Lynch K, Hargrove L, Perreault EJ, Pons JL. A Framework for Dyadic Physical Interaction Studies During Ankle Motor Tasks. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3092265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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17
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Schallig W, van den Noort JC, Maas M, Harlaar J, van der Krogt MM. Marker placement sensitivity of the Oxford and Rizzoli foot models in adults and children. J Biomech 2021; 126:110629. [PMID: 34320419 DOI: 10.1016/j.jbiomech.2021.110629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022]
Abstract
Understanding the effect of individual marker misplacements is important to improve the repeatability and aid to the interpretation of multi-segment foot models like the Oxford and Rizzoli Foot Models (OFM, RFM). Therefore, this study aimed to quantify the effect of controlled anatomical marker misplacement on multi-segment foot kinematics (i.e. marker placement sensitivity) as calculated by OFM and RFM in a range of foot sizes. Ten healthy adults and nine children were included. A combined OFM and RFM marker set was placed on their right foot and a static standing trial was collected. Each marker was replaced ± 10 mm in steps of 1 mm over the three axes of a foot coordinate system. For each replacement the change in segment orientation (tibia, hindfoot, midfoot, forefoot) was calculated with respect to the reference pose in which no markers were replaced. A linear fit was made to calculate the sensitivity of segment orientation to marker misplacement in °/mm. Additionally, the effect of foot size on the sensitivity was determined using linear regressions. For every foot segment of both models, at least one marker had a sensitivity ≥ 1.0°/mm. Highest values were found for the markers at the posterior aspect of the calcaneus in OFM (1.5°/mm) and the basis of the second metatarsal in RFM (1.4°/mm). Foot size had a small effect on 40% of the sensitivity values. This study identified markers of which consistent placement is critical to prevent clinically relevant errors (>5°). For more repeatable multi-segment models, the role of these markers within the models' definitions needs to be reconsidered.
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Affiliation(s)
- Wouter Schallig
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Josien C van den Noort
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Mario Maas
- Amsterdam UMC, University of Amsterdam, Radiology and Nuclear Medicine, Medical Imaging Quantification Center (MIQC), Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jaap Harlaar
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands; Department of Orthopedics and Sports Medicine, ErasmusMC, Rotterdam, the Netherlands
| | - Marjolein M van der Krogt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
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18
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Liu WJ, Lin LF, Chiang SL, Lu LH, Chen CY, Lin CH. Impacts of Stroke on Muscle Perceptions and Relationships with the Motor and Functional Performance of the Lower Extremities. SENSORS 2021; 21:s21144740. [PMID: 34300480 PMCID: PMC8309499 DOI: 10.3390/s21144740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
Stroke results in paretic limb disabilities, but few studies have investigated the impacts of stroke on muscle perception deficits in multiaxis movements and related functional changes. Therefore, this study aimed to investigate stroke-related changes in muscle perceptions using a multiaxis ankle haptic interface and analyze their relationships with various functions. Sixteen stroke patients and 22 healthy participants performed active reproduction tests in multiaxis movements involving the tibialis anterior (TA), extensor digitorum longus (EDL), peroneus longus, and flexor digitorum longus (FDL) of the ankle joint. The direction error (DE), absolute error (AE), and variable error (VE) were calculated. The lower extremity of Fugl-Meyer Assessment (FMA-LE), Barthel Index (BI), Postural Assessment Scale for Stroke Patients, Tinetti Performance-Oriented Mobility Assessment (POMA), and 10-m walk test (10MWT) were evaluated. VE of EDL for the paretic ankle was significantly lower than that for the nonparetic ankle (p = 0.009). AE of TA, EDL, and FDL and VE of EDL and FDL of muscle perceptions were significantly lower in healthy participants than in stroke patients (p < 0.05 for both). DE of TA for the paretic ankle was moderately correlated with FMA-LE (r = -0.509) and POMA (r = -0.619) scores. AE and VE of EDL for the paretic ankle were moderately correlated with the 10MWT score (r = 0.515 vs. 0.557). AE of FDL for the paretic ankle was also moderately correlated with BI (r = -0.562). This study indicated poorer accuracy and consistency in muscle perception for paretic ankles, which correlated with lower limb functions of stroke patients.
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Affiliation(s)
- Wan-Ju Liu
- Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110, Taiwan;
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan;
| | - Shang-Lin Chiang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan;
| | - Liang-Hsuan Lu
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei 112, Taiwan;
| | - Chao-Ying Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Chueh-Ho Lin
- Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110, Taiwan;
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Correspondence: ; Tel./Fax: +886-2-27361661 (ext. 6325)
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19
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Pfeiffer SJ, Spang JT, Nissman D, Lalush D, Wallace K, Harkey MS, Pietrosimone LS, Padua D, Blackburn T, Pietrosimone B. Association of Jump-Landing Biomechanics With Tibiofemoral Articular Cartilage Composition 12 Months After ACL Reconstruction. Orthop J Sports Med 2021; 9:23259671211016424. [PMID: 34368382 PMCID: PMC8299897 DOI: 10.1177/23259671211016424] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Excessively high joint loading during dynamic movements may negatively influence articular cartilage health and contribute to the development of posttraumatic osteoarthritis after anterior cruciate ligament reconstruction (ACLR). Little is known regarding the link between aberrant jump-landing biomechanics and articular cartilage health after ACLR. PURPOSE/HYPOTHESIS The purpose of this study was to determine the associations between jump-landing biomechanics and tibiofemoral articular cartilage composition measured using T1ρ magnetic resonance imaging (MRI) relaxation times 12 months postoperatively. We hypothesized that individuals who demonstrate alterations in jump-landing biomechanics, commonly observed after ACLR, would have longer T1ρ MRI relaxation times (longer T1ρ relaxation times associated with less proteoglycan density). STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A total of 27 individuals with unilateral ACLR participated in this cross-sectional study. Jump-landing biomechanics (peak vertical ground-reaction force [vGRF], peak internal knee extension moment [KEM], peak internal knee adduction moment [KAM]) and T1ρ MRI were collected 12 months postoperatively. Mean T1ρ relaxation times for the entire weightbearing medial femoral condyle, lateral femoral condyle (global LFC), medial tibial condyle, and lateral tibial condyle (global LTC) were calculated bilaterally. Global regions of interest were further subsectioned into posterior, central, and anterior regions of interest. All T1ρ relaxation times in the ACLR limb were normalized to the uninjured contralateral limb. Linear regressions were used to determine associations between T1ρ relaxation times and biomechanics after accounting for meniscal/chondral injury. RESULTS Lower ACLR limb KEM was associated with longer T1ρ relaxation times for the global LTC (ΔR 2 = 0.24; P = .02), posterior LTC (ΔR 2 = 0.21; P = .03), and anterior LTC (ΔR 2 = 0.18; P = .04). Greater ACLR limb peak vGRF was associated with longer T1ρ relaxation times for the global LFC (ΔR 2 = 0.20; P = .02) and central LFC (ΔR 2 = 0.15; P = .05). Peak KAM was not associated with T1ρ outcomes. CONCLUSION At 12 months postoperatively, lower peak KEM and greater peak vGRF during jump landing were related to longer T1ρ relaxation times, suggesting worse articular cartilage composition.
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Affiliation(s)
- Steven J. Pfeiffer
- Ohio Musculoskeletal & Neurological Institute, Athens, Ohio, USA
- Division of Exercise Physiology, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Athens, Ohio, USA
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffrey T. Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David Lalush
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, North Carolina, USA
| | - Kyle Wallace
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matthew S. Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Laura S. Pietrosimone
- Doctor of Physical Therapy Division, Department of Orthopedic Surgery, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Darin Padua
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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20
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Leardini A, Stebbins J, Hillstrom H, Caravaggi P, Deschamps K, Arndt A. ISB recommendations for skin-marker-based multi-segment foot kinematics. J Biomech 2021; 125:110581. [PMID: 34217032 DOI: 10.1016/j.jbiomech.2021.110581] [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: 11/12/2020] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
The foot is anatomically and functionally complex, and thus an accurate description of intrinsic kinematics for clinical or sports applications requires multiple segments. This has led to the development of many multi-segment foot models for both kinematic and kinetic analyses. These models differ in the number of segments analyzed, bony landmarks identified, required marker set, defined anatomical axes and frames, the convention used to calculate joint rotations and the determination of neutral positions or other offsets from neutral. Many of these models lack validation. The terminology used is inconsistent and frequently confusing. Biomechanical and clinical studies using these models should use established references and describe how results are obtained and reported. The International Society of Biomechanics has previously published proposals for standards regarding kinematic and kinetic measurements in biomechanical research, and in this paper also addresses multi-segment foot kinematics modeling. The scope of this work is not to prescribe a particular set of standard definitions to be used in all applications, but rather to recommend a set of standards for collecting, calculating and reporting relevant data. The present paper includes recommendations for the overall modeling and grouping of the foot bones, for defining landmarks and other anatomical references, for addressing the many experimental issues in motion data collection, for analysing and reporting relevant results and finally for designing clinical and biomechanical studies in large populations by selecting the most suitable protocol for the specific application. These recommendations should also be applied when writing manuscripts and abstracts.
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Affiliation(s)
- Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Julie Stebbins
- Oxford Gait Laboratory, Oxford University Hospitals NHS Foundation Trust, UK
| | - Howard Hillstrom
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, NY, USA
| | - Paolo Caravaggi
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Kevin Deschamps
- Faculty of Movement & Rehabilitation Sciences, KULeuven, Bruges, Belgium
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
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21
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Kim BH, Lee SY. Validity and Reliability of a Novel Instrument for the Measurement of Subtalar Joint Axis of Rotation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105494. [PMID: 34065532 PMCID: PMC8160632 DOI: 10.3390/ijerph18105494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022]
Abstract
Inclination of the subtalar joint (STJ) in the sagittal and transverse planes may be highly associated with ankle pathology. However, the validity and reliability of measuring the inclination of the STJ axis of rotation (AoR) is not well established. This study aimed to develop a custom-made STJ locator (STJL) and evaluate its reliability and validity. To establish the reliability and validity of the measurement device for STJ AoR, 38 healthy male participants were recruited. For the reliability analysis, test–retest was used, and for validity analysis, Pearson’s correlation and Bland–Altman plot analyses were performed. In the reliability analysis of the STJL, a higher correlation was observed with the sagittal plane (0.930) and transverse plane (0.748) (standard error of measurement: 0.56–0.78; minimal detectable difference: 1.57–2.16). In the validity analysis between radiography and STJL, a significantly higher value of 0.798 was obtained with radiography (42.5) and STJL (43.5) with the sagittal plane. The custom-made STJL may be used in the clinical setting as its validity and intraclass correlation coefficient were high, indicating consistent measurements. Further studies including motion analysis are necessary to provide more information regarding the relationship between STJ AoR inclinations and STJ movements.
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Affiliation(s)
- Byong Hun Kim
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre Korea, Yonsei University, Seoul 03722, Korea
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre Korea, Yonsei University, Seoul 03722, Korea
- Institute of Convergence Science, Yonsei University, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2123-6189; Fax: +82-2-2123-8375
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Al-Kharaz AA, Chong A. Reliability of a close-range photogrammetry technique to measure ankle kinematics during active range of motion in place. Foot (Edinb) 2021; 46:101763. [PMID: 33278811 DOI: 10.1016/j.foot.2020.101763] [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: 04/28/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND As the risk of ankle turn during daily activity is very high, studying ankle kinematics in place is important for ankle sprain prevention. The close-range photogrammetry (CRP) technique is used to measure ankle kinematics during active range of motion (AROM) in place. The purpose of the study was to assess the reliability of CRP to measure ankle kinematics. METHODS Twenty adults were recruited and fourteen retro-reflective targets were mounted on the skin of their right feet. Imaging sensors were self-calibrated using a bundle adjustment technique, and the images were downloaded with Australis photogrammetric software. Three trials were conducted and reliability coefficients were used to assess agreement between them. RESULTS Reliability was almost perfect and the results show that the intraclass correlation coefficient (ICC) of ankle angle values were (dorsiflexion = 0.96), (plantarflexion = 0.81), (inversion = 0.92), (eversion = 0.95), (internal rotation = 0.92), and (external rotation = 0.78). The overall intraclass correlation coefficient was 0.89 and the standard error of the measurement (SEM) values ranged from (0.37° to 6.18°). CONCLUSIONS The results indicate that the CRP technique was able to reliably measure ankle kinematics. The results may support and enhance knowledge related to ankle AROM in the clinical arena.
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Affiliation(s)
- Ali A Al-Kharaz
- Faculty of Health, Engineering and Sciences, University of Southern Queensland-Toowoomba, 4350, Australia.
| | - Albert Chong
- Faculty of Health, Engineering and Sciences, University of Southern Queensland-Toowoomba, 4350, Australia
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Matias AB, Caravaggi P, Leardini A, Taddei UT, Ortolani M, Sacco I. Repeatability of skin-markers based kinematic measures from a multi-segment foot model in walking and running. J Biomech 2020; 110:109983. [DOI: 10.1016/j.jbiomech.2020.109983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/15/2020] [Accepted: 08/01/2020] [Indexed: 11/16/2022]
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Eerdekens M, Deschamps K, Wuite S, Matricali G. The Biomechanical Behavior of Distal Foot Joints in Patients with Isolated, End-Stage Tibiotalar Osteoarthritis Is Not Altered Following Tibiotalar Fusion. J Clin Med 2020; 9:jcm9082594. [PMID: 32796511 PMCID: PMC7465493 DOI: 10.3390/jcm9082594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/05/2020] [Accepted: 08/08/2020] [Indexed: 12/16/2022] Open
Abstract
Ankle arthrodesis is considered to be an optimal treatment strategy to relieve pain during walking in patients with isolated, end-stage tibiotalar osteoarthritis. The aim of this study was to investigate the post-operative effect of an arthrodesis on the ankle and foot joint biomechanics. We included both patients (n = 10) and healthy reference data (n = 17). A multi-segment foot model was used to measure the kinematics and kinetics of the ankle, Chopart, Lisfranc, and first metatarsophalangeal joints during a three-dimensional (3D) gait analysis. These data, together with patient reported outcome measures, were collected at baseline (pre-operative) and one year post-operatively. Patients experienced a decrease in pain and an increase in general well-being after surgery. Compared to the baseline measurements, patients only demonstrated a significant average post-operative increase of 0.22 W/kg of power absorption in the ankle joint. No other significant differences were observed between baseline and post-operative measurements. Current findings suggest that the biomechanical behavior of distal foot joints is not altered one year after fusion. The pain relief achieved by the arthrodesis improved the loading patterns during walking. Clinical significance of this study dictates that patients do not have to fear a loss in biomechanical functionality after an ankle arthrodesis.
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Affiliation(s)
- Maarten Eerdekens
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, 3001 Heverlee, Belgium
- Clinical Motion Analysis Laboratorium (CMAL), UZ Leuven, 3210 Pellenberg, Belgium;
- Correspondence:
| | - Kevin Deschamps
- Clinical Motion Analysis Laboratorium (CMAL), UZ Leuven, 3210 Pellenberg, Belgium;
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, 8000 Campus Brugge, Belgium
| | - Sander Wuite
- Department of Orthopedics, UZ Leuven, 3000 Leuven, Belgium; (S.W.); (G.M.)
- Institute for Orthopaedic Research & Training, KU Leuven, 3000 Leuven, Belgium
- Department of development and regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Giovanni Matricali
- Department of Orthopedics, UZ Leuven, 3000 Leuven, Belgium; (S.W.); (G.M.)
- Institute for Orthopaedic Research & Training, KU Leuven, 3000 Leuven, Belgium
- Department of development and regeneration, KU Leuven, 3000 Leuven, Belgium
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Tijskens D, Lobet S, Eerdekens M, Peerlinck K, Hermans C, Van Damme A, Staes F, Deschamps K. Paediatric patients with blood-induced ankle joint arthritis demonstrate physiological foot joint mechanics and energetics during walking. Haemophilia 2020; 26:907-915. [PMID: 32770628 DOI: 10.1111/hae.14128] [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: 03/03/2020] [Revised: 07/18/2020] [Accepted: 07/24/2020] [Indexed: 11/29/2022]
Abstract
AIM To compare foot joint kinetics and energetics in male paediatric boys with and without blood-induced ankle joint destruction to these of matched control groups. METHODS A cross-sectional study was conducted in which 3D gait analysis data were collected from thirty-five male children (6-21 years) with severe or moderate haemophilia and twenty-six typically developing boys. Structural integrity of the tarsal foot joints of all haemophilic patients was assessed using the IPSG-MRI scale. All participants walked barefoot while adopting a physiological gait pattern. Three subgroups were created based on the IPSG-MRI scores: a group with no joint involvement (HealthyHaemo), with uni- or bilaterally involvement (PathoHaemo) and with only unilaterally involvement (Haemo_Unilateral_Patho). RESULTS The PathoHaemo group presented a significant lower Lisfranc peak dorsiflexion angular velocity (34.7°/s vs 71.4°/s, P = .000, Cohen d = 1.31) and a significantly higher Lisfranc peak plantarflexion angular velocity (-130.5°/s vs -51.8°/s, P = .000, Cohen d = 0.98) compared to the control group. The Haemo_Unilateral_Patho side had a significant higher Chopart peak dorsiflexion angular velocity compared to the Haemo_Unilateral_Healthy side (41.7°/s vs 31.9°/s, P = .002, Cohen d = 1.16). CONCLUSION No evidence for mild and severe gait deviations could be demonstrated. Internal moments, used as a surrogate measure of joint loading, quantified by the multi-segment foot model were found to be similar within the three subanalyses. We suggest that the ongoing musculoskeletal development in children compensates for structural damage to the ankle joint.
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Affiliation(s)
- Dorien Tijskens
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KULeuven, Heverlee, Belgium
| | - Sébastien Lobet
- Service D'hématologie, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.,Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Service de Médecine Physique et Réadaptation, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Maarten Eerdekens
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KULeuven, Heverlee, Belgium
| | - Kathelijne Peerlinck
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium
| | - Cédric Hermans
- Service D'hématologie, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - An Van Damme
- Service D'hématologie Pédiatrique, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Filip Staes
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KULeuven, Heverlee, Belgium
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KULeuven, Brugge, Belgium.,Division of Podiatry, Institut D'enseignement Supérieur Parnasse Deux-Alice, Sint-Lambrechts-Woluwe, Belgium.,Department of Podiatry, Artevelde University College, Ghent, Belgium
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Gait analysis - Available platforms for outcome assessment. Injury 2020; 51 Suppl 2:S90-S96. [PMID: 31767371 DOI: 10.1016/j.injury.2019.11.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/24/2019] [Accepted: 11/09/2019] [Indexed: 02/02/2023]
Abstract
Movement or gait analysis has become a viable assessment tool not only used in sports science or basic biomechanical research, but has also expanded to be a very valuable instrument in clinical diagnostics, monitoring functional recovery and musculoskeletal rehabilitation. In this context, this method has long been an integral part solely in neurological disorders such as cerebral palsy. However, in the meantime the benefits have also become apparent in other medical areas, such as foot surgery, orthopaedic technology, or in patients after lower limb amputation. These procedures proved to better understand, objectify and quantify the individual causes of gait and movement disorders in order to optimize patient-specific therapy. Currently we are able to rely on a multitude of available measurement systems. These can either be used in everyday life for simple monitoring of one's own activity or to complement therapeutic approaches in the clinical and scientific environment. The following review highlights the various fields of movement analysis, including markerless motion capture, marker-based analysis, pedobarography and wearable sensors. Each of these areas presents its own field of application and potential usage as well as the advantages and disadvantages arising in this context. The following article will give an overview of the type of measurement technology used, the respective fields of application, and the selected parameters and their interpretation possibilities for each of the areas mentioned.
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Nahm NJ, Sohrweide SS, Wervey RA, Schwartz MH, Novacheck TF. Surgical treatment of pes planovalgus in ambulatory children with cerebral palsy: Static and dynamic changes as characterized by multi-segment foot modeling, physical examination and radiographs. Gait Posture 2020; 76:168-174. [PMID: 31862665 DOI: 10.1016/j.gaitpost.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 12/02/2019] [Accepted: 12/07/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND This study employs multi-segment foot modeling (MSFM) to examine flatfoot reconstruction among ambulatory children with cerebral palsy (CP). RESEARCH QUESTION Does flatfoot reconstruction improve MSFM measures, physical examination and radiographic variables for forefoot varus and midfoot collapse and associated multi-planar compensatory features? METHODS MSFM was performed preoperatively and postoperatively in a cohort of ambulatory CP patients undergoing flatfoot reconstruction (surgical group, n = 24). A comparison group of non-surgical group of ambulatory CP patients with pes planovalgus (flatfoot) who did not undergo flatfoot reconstruction was also identified (n = 17). All patients in this comparison group underwent MSFM at two separate time points. Physical examination was performed and standing AP and lateral foot radiographs were obtained during each gait analysis session. RESULTS Patients in the surgical group had improvement in their forefoot varus deformity, as documented on physical examination and kinematics in the STJN position of the foot and ankle, as well as in the compensatory hindfoot eversion and midfoot abduction during stance phase of gait. Furthermore, patients in the surgical group had improvement in midfoot collapse as identified kinematically by midfoot dorsiflexion, physical examination descriptors of midfoot position, and radiographic measures of calcaneal pitch and AP and lateral talar-first metatarsal angle. Patients in the non-surgical comparison group did not demonstrate these changes. SIGNIFICANCE Improvements in foot motion after flatfoot reconstruction in ambulatory CP patients were identified by MSFM, physical examination measures, and radiographs. Patients in the surgical and non-surgical groups had similar pre-operative radiographic findings, suggesting that physical examination and MSFM data were important in the surgical decision making process. Finally, surgical intervention did not fully restore normal foot kinematic, physical examination, and radiographic parameters, which suggests that a different, perhaps more aggressive, surgical approach for flatfoot reconstruction is needed.
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Affiliation(s)
- Nickolas J Nahm
- Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Blvd Detroit, MI, 48202, USA.
| | - Sue S Sohrweide
- Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA.
| | - Roy A Wervey
- Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA.
| | - Michael H Schwartz
- Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA.
| | - Tom F Novacheck
- Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA.
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Pfeiffer SJ, Spang J, Nissman D, Lalush D, Wallace K, Harkey MS, Pietrosimone LS, Schmitz R, Schwartz T, Blackburn T, Pietrosimone B. Gait Mechanics and T1ρ MRI of Tibiofemoral Cartilage 6 Months after ACL Reconstruction. Med Sci Sports Exerc 2019; 51:630-639. [PMID: 30444797 DOI: 10.1249/mss.0000000000001834] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Aberrant walking biomechanics after anterior cruciate ligament reconstruction (ACLR) are hypothesized to be associated with deleterious changes in knee cartilage. T1ρ magnetic resonance imaging (MRI) is sensitive to decreased proteoglycan density of cartilage. Our purpose was to determine associations between T1ρ MRI interlimb ratios (ILR) and walking biomechanics 6 months after ACLR. METHODS Walking biomechanics (peak vertical ground reaction force (vGRF), vGRF loading rate, knee extension moment, knee abduction moment) were extracted from the first 50% of stance phase in 29 individuals with unilateral ACLR. T1ρ MRI ILR (ACLR limb/uninjured limb) was calculated for regions of interest in both medial and lateral femoral (LFC) and medial and lateral tibial condyles. Separate, stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ MRI ILR after accounting for walking speed and meniscal/chondral injury (P ≤ 0.05). RESULTS Lesser peak vGRF in the ACLR limb was associated with greater T1ρ MRI ILR for the LFC (posterior ΔR = 0.14, P = 0.05; central ΔR = 0.15, P = 0.05) and medial femoral condyle (central ΔR = 0.24, P = 0.01). Lesser peak vGRF loading rate in the ACLR limb (ΔR = 0.21, P = 0.02) and the uninjured limb (ΔR = 0.27, P = 0.01) was associated with greater T1ρ MRI ILR for the anterior LFC. Lesser knee abduction moment for the injured limb was associated with greater T1ρ MRI ILR for the anterior LFC (ΔR = 0.16, P = 0.04) as well as the posterior medial tibial condyle (ΔR = 0.13, P = 0.04). CONCLUSION Associations between outcomes related to lesser mechanical loading during walking and greater T1ρ MRI ILR were found 6 months after ACLR. Although preliminary, our results suggest that underloading of the ACLR limb at 6 months after ACLR may be associated with lesser proteoglycan density in the ACLR limb compared with the uninjured limb.
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Affiliation(s)
- Steven J Pfeiffer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jeffrey Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill NC
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David Lalush
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC
| | - Kyle Wallace
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Laura S Pietrosimone
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Randy Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro NC
| | - Todd Schwartz
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Troy Blackburn
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Smart Footwear Insole for Recognition of Foot Pronation and Supination Using Neural Networks. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9193970] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abnormal foot postures during gait are common sources of pain and pathologies of the lower limbs. Measurements of foot plantar pressures in both dynamic and static conditions can detect these abnormal foot postures and prevent possible pathologies. In this work, a plantar pressure measurement system is developed to identify areas with higher or lower pressure load. This system is composed of an embedded system placed in the insole and a user application. The instrumented insole consists of a low-power microcontroller, seven pressure sensors and a low-energy bluetooth module. The user application receives and shows the insole pressure information in real-time and, finally, provides information about the foot posture. In order to identify the different pressure states and obtain the final information of the study with greater accuracy, a Deep Learning neural network system has been integrated into the user application. The neural network can be trained using a stored dataset in order to obtain the classification results in real-time. Results prove that this system provides an accuracy over 90% using a training dataset of 3000+ steps from 6 different users.
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30
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Segmental foot and ankle kinematic differences between rectus, planus, and cavus foot types. J Biomech 2019; 94:180-186. [DOI: 10.1016/j.jbiomech.2019.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/22/2019] [Accepted: 07/27/2019] [Indexed: 11/19/2022]
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Zavatsky AB, Paik AM, Leitch J, Kothari A, Stebbins J. Comparison of the hindfoot axes of a multi-segment foot model to the underlying bony anatomy. J Biomech 2019; 93:34-41. [DOI: 10.1016/j.jbiomech.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 11/16/2022]
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van Hoeve S, Poeze M. Multisegment Foot Models and Clinical Application After Foot and Ankle Trauma: A Review. J Foot Ankle Surg 2019; 58:748-754. [PMID: 31010768 DOI: 10.1053/j.jfas.2018.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Indexed: 02/03/2023]
Abstract
Since the end of the 1990s, several multisegment foot models (MSFMs) have been developed. Several models were used to describe foot and ankle kinematics in patients with foot and ankle pathologies; however, the diagnostic value for clinical practice of these models is not known. This review searched in the literature for studies describing kinematics in patients after foot and ankle trauma using an MSFM. The diagnostic value of the MSFMs in patients after foot and ankle trauma was also investigated. A search was performed on the databases PubMed/MEDLINE, Embase, and Cochrane Library. To investigate the diagnostic value of MSFMs in patients after foot and ankle trauma, studies were classified and analyzed following the diagnostic research questions formulated by Knottnerus and Buntinx. This review was based on 7 articles. All studies were published between 2010 and 2015. Five studies were retrospective studies, and 2 used an intervention. Three studies described foot and ankle kinematics in patients after fractures. Four studies described foot and ankle kinematics in patients after ankle sprain. In all included studies, altered foot and ankle kinematics were found compared with healthy subjects. No results on patient outcome using MSFMs and costs were found. Seven studies were found reporting foot and ankle kinematics in patients after foot and ankle trauma using an MSFM. Results show altered kinematics compared with healthy subjects, which cannot be seen by other diagnostic tests and add valuable data to the present literature; therefore, MSFMs seem to be promising diagnostic tools for evaluating foot and ankle kinematics. More research is needed to find the additional value for MSFMs regarding patient outcome and costs.
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Affiliation(s)
- Sander van Hoeve
- Professor, Division of Trauma Surgery, Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Martijn Poeze
- Professor, Division of Trauma Surgery, Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Professor, School for Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands
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McHenry BD, Kruger KM, Exten EL, Tarima S, Harris GF. Sagittal subtalar and talocrural joint assessment between barefoot and shod walking: A fluoroscopic study. Gait Posture 2019; 72:57-61. [PMID: 31151088 DOI: 10.1016/j.gaitpost.2019.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND While wearing shoes is common in daily activities, most foot kinematic models report results on barefoot conditions. It is difficult to describe foot position inside shoes. This study used fluoroscopic images to determine talocrural and subtalar motion. RESEARCH QUESTION What are the differences in sagittal talocrual and subtalar kinematics between walking barefoot and while wearing athletic walking shoes? METHODS Thirteen male subjects (mean age 22.9 ± 2.9 years, mean weight 77.2 ± 6.9 kg, mean height 178.2 ± 3.7 cm) screened for normal gait were tested. A fluoroscopy unit was used to collect images during stance. Sagittal motion of the talocrural and subtalar joints of the right foot were analyzed barefoot and in an athletic walking shoe. RESULTS Shod talocrural position at heel strike was 6.0° of dorsiflexion and shod peak talocrural plantarflexion was 4.2°. Barefoot talocrural plantarflexion at heel strike was 4.2° and barefoot peak talocrural plantarflexion was 10.9°. Shod subtalar position at heel strike was 2.6° of plantarflexion and peak subtalar dorsiflexion was 1.5°. The barefoot subtalar joint at heel strike was in 0.4° dorsiflexion and barefoot peak subtalar dorsiflexion was 3.5°. As the result of wearing shoes, average walking speed and stride length increased and average cadence decreased. Comparing barefoot to shod walking there was a statistical significance in talocrural dorsiflexion and at heel strike and peak talocrural dorsiflexion, subtalar plantarflexion at heel strike and peak subtalar dorsiflexion, walking speed, stride length, and cadence. SIGNIFICANCE This work demonstrates the ability to directly measure talocrural and subtalar kinematics of shod walking using fluoroscopy. Future work using this methodology can be used to increase understanding of hindfoot kinematics during a variety of non-barefoot activities.
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Affiliation(s)
- Benjamin D McHenry
- Marquette University/The Medical College of Wisconsin, Department of Biomedical Engineering, 1515 W. Wisconsin Ave, Milwaukee, WI 53233, United States
| | - Karen M Kruger
- Marquette University/The Medical College of Wisconsin, Department of Biomedical Engineering, 1515 W. Wisconsin Ave, Milwaukee, WI 53233, United States; Shriners Hospitals for Children-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States.
| | - Emily L Exten
- OhioHealth Mansfield Campus, Department of Orthopaedic Surgery, Division of Foot and Ankle Surgery, 335 Glessner Ave, Mansfield, OH 44903, United States
| | - Sergey Tarima
- Institute for Health and Equity, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States
| | - Gerald F Harris
- Marquette University/The Medical College of Wisconsin, Department of Biomedical Engineering, 1515 W. Wisconsin Ave, Milwaukee, WI 53233, United States; Shriners Hospitals for Children-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States
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Ghanem I, Massaad A, Assi A, Rizkallah M, Bizdikian AJ, El Abiad R, Seringe R, Mosca V, Wicart P. Understanding the foot's functional anatomy in physiological and pathological conditions: the calcaneopedal unit concept. J Child Orthop 2019; 13:134-146. [PMID: 30996737 PMCID: PMC6442506 DOI: 10.1302/1863-2548.13.180022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND A thorough review of the available orthopaedic literature shows significant controversies, inconsistencies and sparse data regarding the terminology used to describe foot deformities. This lack of consensus on terminology creates confusion in professional discussions of foot anatomy, pathoanatomy and treatment of deformities. The controversies apply to joint movements as well as static relationships between the bones. DESCRIPTION The calcaneopedal unit (CPU) is a specific anatomical and physiological entity, represented by the entire foot excepted the talus. The calcaneus, midfoot and forefoot are solidly bound by three strong ligaments that create a unit that articulates with the talus. The movement of the CPU is complex, as it rotates under the talus, around the axis of Henke that coincides with the talo-calcaneal ligament of Farabeuf.This calcaneopedal unit is deformable. It is compared with a twisted plate, able to adapt to many physiological situations in standing position, in order to acheive a plantigrade position.Moreover, the calcaneopedal unit and the talo-tibiofibular complex are interdependent; rotation of the latter produces morphologic modifications inside the former and vice versa. PURPOSE This paper is a review article of this concept and of its physiopathological applications.
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Affiliation(s)
- I. Ghanem
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon,Orthopedic Surgery Department, Hôtel-Dieu de France Hospital, University of Saint-Joseph, Beirut, Lebanon, Correspondence should be sent to I. Ghanem, MD, Hôtel-Dieu de France Hospital, A. Naccache Avenue- Achrafieh, University of Saint-Joseph, Beirut, Lebanon. E-mail:
| | - A. Massaad
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - A. Assi
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - M. Rizkallah
- Orthopedic Surgery Department, Hôtel-Dieu de France Hospital, University of Saint-Joseph, Beirut, Lebanon
| | - A. J. Bizdikian
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - R. El Abiad
- Orthopedic Surgery Department, Hôtel-Dieu de France Hospital, University of Saint-Joseph, Beirut, Lebanon
| | - R. Seringe
- Orthopedic Surgery Department, Cochin University Hospital – University of Rene Descartes, Paris, France
| | - V. Mosca
- Department of Orthopedic Surgery, Seattle Children’s Hospital, Seattle, Washington, USA
| | - P. Wicart
- Orthopedic Surgery Department, Hôpital Necker-Enfants Malades, University of Paris Descartes, Paris, France
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Leardini A, Caravaggi P, Theologis T, Stebbins J. Multi-segment foot models and their use in clinical populations. Gait Posture 2019; 69:50-59. [PMID: 30665039 DOI: 10.1016/j.gaitpost.2019.01.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Many multi-segment foot models based on skin-markers have been proposed for in-vivo kinematic analysis of foot joints. It remains unclear whether these models have developed far enough to be useful in clinical populations. The present paper aims at reviewing these models, by discussing major methodological issues, and analyzing relevant clinical applications. RESEARCH QUESTION Can multi-segment foot models be used in clinical populations? METHODS Pubmed and Google Scholar were used as the main search engines to perform an extensive literature search of papers reporting definition, validation or application studies of multi-segment foot models. The search keywords were the following: 'multisegment'; 'foot'; 'model'; 'kinematics', 'joints' and 'gait'. RESULTS More than 100 papers published between 1991 and 2018 were identified and included in the review. These studies either described a technique or reported a clinical application of one of nearly 40 models which differed according to the number of segments, bony landmarks, marker set, definition of anatomical frames, and convention for calculation of joint rotations. Only a few of these models have undergone robust validation studies. Clinical application papers divided by type of assessment revealed that the large majority of studies were a cross-sectional comparison of a pathological group to a control population. SIGNIFICANCE This review suggests that there is sufficient evidence that multi-segment foot models may be successfully applied in clinical populations. Analysis of the currently available models allows users to better identify the most suitable protocol for specific clinical applications. However new models require thorough validation and assessment before being used to support clinical decisions.
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Affiliation(s)
- Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Paolo Caravaggi
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Tim Theologis
- Oxford Gait Laboratory, Nuffield Orthopaedic Centre, Oxford, UK.
| | - Julie Stebbins
- Oxford Gait Laboratory, Nuffield Orthopaedic Centre, Oxford, UK.
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Ho NC, Sangiorgio SN, Cassinelli S, Shymon S, Fleming J, Agrawal V, Ebramzadeh E, Harris TG. Biomechanical comparison of fixation stability using a Lisfranc plate versus transarticular screws. Foot Ankle Surg 2019; 25:71-78. [PMID: 29409256 DOI: 10.1016/j.fas.2017.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/28/2017] [Accepted: 08/08/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND To obtain adequate fixation in treating Lisfranc soft tissue injuries, the joint is commonly stabilized using multiple transarticular screws; however iatrogenic injury is a concern. Alternatively, two parallel, longitudinally placed plates, can be used to stabilize the 1st and 2nd tarsometatarsal joints; however this may not provide adequate stability along the Lisfranc ligament. Several biomechanical studies have compared earlier methods of fixation using plates to the standard transarticular screw fixation method, highlighting the potential issue of transverse stability using plates. A novel dorsal plate is introduced, intended to provide transverse and longitudinal stability, without injury to the articular cartilage. METHODS A biomechanical cadaver model was developed to compare the fixation stability of a novel Lisfranc plate to that of traditional fixation, using transarticular screws. Thirteen pairs of cadaveric specimens were tested intact, after a simulated Lisfranc injury, and then following implant fixation, using one method of fixation randomly assigned, on either side of each pair. Optical motion tracking was used to measure the motion between each of the following four bones: 1st metatarsal, 2nd metatarsal, 1st cuneiform, and 2nd cuneiform. Testing included both cyclic abduction loading and cyclic axial loading. RESULTS Both the Lisfranc plate and screw fixation method provided stability such that the average 3D motions across the Lisfranc joint (between 2nd metatarsal and 1st cuneiform), were between 0.2 and 0.4mm under cyclic abduction loading, and between 0.4 and 0.5mm under cyclic axial loading. Comparing the stability of fixation between the Lisfranc plate and the screws, the differences in motion were all 0.3mm or lower, with no clinically significant differences (p>0.16). CONCLUSIONS Diastasis at the Lisfranc joint following fixation with a novel plate or transarticular screw fixation were comparable. Therefore, the Lisfranc plate may provide adequate support without risk of iatrogenic injury to the articular cartilage.
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Affiliation(s)
- Nathan C Ho
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, in Alliance with UCLA, 403 W. Adams Blvd., Los Angeles, CA 90007, United States; University of Southern California Department of Biomedical Engineering, Los Angeles, CA, United States
| | - Sophia N Sangiorgio
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, in Alliance with UCLA, 403 W. Adams Blvd., Los Angeles, CA 90007, United States; University of California, Los Angeles Department of Orthopaedic Surgery, Los Angeles, CA, United States.
| | - Spenser Cassinelli
- Los Angeles County Harbor-UCLA Medical Center, Los Angeles, CA, United States.
| | - Stephen Shymon
- Los Angeles County Harbor-UCLA Medical Center, Los Angeles, CA, United States.
| | - John Fleming
- Los Angeles County Harbor-UCLA Medical Center, Los Angeles, CA, United States.
| | - Virat Agrawal
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, in Alliance with UCLA, 403 W. Adams Blvd., Los Angeles, CA 90007, United States; University of Southern California Department of Biomedical Engineering, Los Angeles, CA, United States.
| | - Edward Ebramzadeh
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, in Alliance with UCLA, 403 W. Adams Blvd., Los Angeles, CA 90007, United States; University of California, Los Angeles Department of Orthopaedic Surgery, Los Angeles, CA, United States.
| | - Thomas G Harris
- Los Angeles County Harbor-UCLA Medical Center, Los Angeles, CA, United States.
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Amene J, Krzak JJ, Kruger KM, Killen L, Graf A, Altiok H, Smith PA, Harris GF. Kinematic foot types in youth with pes planovalgus secondary to cerebral palsy. Gait Posture 2019; 68:430-436. [PMID: 30594871 DOI: 10.1016/j.gaitpost.2018.12.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/24/2018] [Accepted: 12/18/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Kinematic variability of the foot and ankle segments exists during ambulation among individuals with pes planovalgus (PPV) secondary to cerebral palsy (CP). Clinicians have previously recognized such variability through classification schemes to identify subgroups of individuals, but have been unable to identify kinematic foot types. RESEARCH QUESTION The purpose of this work was to identify kinematic foot types among children with PPV secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during gait as inputs for principal component analysis (PCA) and K-means cluster analysis. METHODS In a single assessment session, multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were collected in 31 children/adolescents with pes planovalgus (49 feet) and 16 typically developing (TD) children/adolescents (31 feet). PCA was used as a data reduction technique on 34 kinematic variables. K-means cluster analysis was performed on the identified principal components (PCs) and one-way analyses of variance (ANOVA) was done to determine the effect of subgroup membership on PC scores. RESULTS The PCA reduced the kinematic variables to seven PCs which accounted for 91% of the total variance. Six distinct kinematic foot types were identified by the cluster analysis. The foot types showed unique kinematic characteristics in both the hindfoot and forefoot. SIGNIFICANCE This study provides further evidence of kinematic variability in the foot and ankle during ambulation associated with pes planovalgus secondary to CP. The specific contributions of the hindfoot and forefoot would not have been detected using a single segment foot model. The identification of kinematic foot types with unique foot and ankle characteristics has the potential to improve treatment since patients within a foot type are likely to benefit from similar intervention(s).
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Affiliation(s)
- Juliet Amene
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 N. Wolfe St., Baltimore, MD, United States; Orthopaedic & Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States
| | - Joseph J Krzak
- Orthopaedic & Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States; Midwestern University, Physical Therapy Program, College of Health Sciences, 555 31st Street, Downers Grove, IL, United States; Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States.
| | - Karen M Kruger
- Orthopaedic & Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States; Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States
| | - Logan Killen
- RUSH University Medical Center, Department of Behavioral Sciences, Biological Rhythms Research Laboratory, 1645 W Jackson Blvd, Chicago, IL, United States
| | - Adam Graf
- Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States
| | - Haluk Altiok
- Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States; RUSH University Medical Center, Department of Orthopaedic Surgery, College of Medicine, 1611 West Harrison Street, Chicago, IL, United States
| | - Peter A Smith
- Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States; RUSH University Medical Center, Department of Orthopaedic Surgery, College of Medicine, 1611 West Harrison Street, Chicago, IL, United States
| | - Gerald F Harris
- Orthopaedic & Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, 1515 W Wisconsin Ave, Milwaukee, WI 53233, United States; Shriners Hospitals for Children®-Chicago, 2211 North Oak Park Ave., Chicago, IL, United States
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Mueske NM, Õunpuu S, Ryan DD, Healy BS, Thomson J, Choi P, Wren TAL. Impact of gait analysis on pathology identification and surgical recommendations in children with spina bifida. Gait Posture 2019; 67:128-132. [PMID: 30321794 DOI: 10.1016/j.gaitpost.2018.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/16/2018] [Accepted: 10/07/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait analysis provides quantitative data that can be used to supplement standard clinical evaluation in identifying and understanding gait problems. It has been established that gait analysis changes treatment decision making for children with cerebral palsy, but this has not yet been studied in other diagnoses such as spina bifida. RESEARCH QUESTION To determine the effects of gait analysis data on pathology identification and surgical recommendations in children with spina bifida. METHODS Two pediatric orthopaedic surgeons and two therapists with >10 years of experience in gait analysis reviewed clinical, video, and gait analysis data from 43 ambulatory children with spina bifida (25 male; mean age 11.7 years, SD 3.8; 25 sacral, 18 lumbar). Primary gait pathologies were identified by each assessor both before and after consideration of the gait analysis data. Surgical recommendations were also recorded by the surgeons before and after consideration of the gait analysis data. Frequencies of pathology and surgery identification with and without gait analysis were compared using Fisher's exact test, and percent change in pathology and surgery identification was calculated. RESULTS Pathology identification often changed for common gait problems including crouch (28% of cases), tibial rotation (35%), pes valgus (18%), excessive hip flexion (70%), and abnormal femur rotation (75%). Recognition of excessive hip flexion and abnormal femur rotation increased significantly after consideration of gait analysis data (p < 0.05). Surgical recommendations also frequently changed for the most common surgeries including tibial derotation osteotomy (30%), antero-lateral release (22%), plantar fascia release (33%), knee capsulotomy (25%), 1st metatarsal osteotomy (60%), and femoral derotation osteotomy (89%). At the patient level, consideration of gait analysis data altered surgical recommendations for 44% of patients. SIGNIFICANCE Since gait analysis data often changes pathology identification and surgical recommendations, treatment decision making may be improved by including gait analysis in the patient care process.
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Affiliation(s)
| | - Sylvia Õunpuu
- Connecticut Children's Medical Center, Hartford, CT, USA
| | | | - Bitte S Healy
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Paul Choi
- Children's Hospital Los Angeles, Los Angeles, CA, USA
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van Hoeve S, Stollenwerck G, Willems P, Witlox MA, Meijer K, Poeze M. Gait analysis and functional outcome in patients after Lisfranc injury treatment. Foot Ankle Surg 2018; 24:535-541. [PMID: 29409269 DOI: 10.1016/j.fas.2017.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Lisfranc injuries involve any bony or ligamentous disruption of the tarsometatarsal joint. Outcome results after treatment are mainly evaluated using patient-reported outcome measures (PROM), physical examination and radiographic findings. Less is known about the kinematics during gait. METHODS Nineteen patients (19 feet) treated for Lisfranc injury were recruited. Patients with conservative treatment and surgical treatment consisting of open reduction and internal fixation (ORIF) or primary arthrodesis were included. PROM, radiographic findings and gait analysis using the Oxford Foot Model (OFM) were analysed. Results were compared with twenty-one healthy subjects (31 feet). Multivariable logistic regression was used to determine factors influencing outcome. RESULTS Patients treated for Lisfranc injury had a significantly lower walking speed than healthy subjects (P<0.001). There was a significant difference between the two groups regarding the range of motion (ROM) in the sagittal plane (flexion-extension) in the midfoot during the push-off phase (p<0.001). The ROM in the sagittal plane was significantly correlated with the AOFAS midfoot score (r2=0.56, p=0.012), FADI (r2=0.47, p=0.043) and the SF-36-physical impairment score (r2=0.60, p=0.007) but not with radiographic parameters for quality of reduction. In a multivariable analysis, the best explanatory factors were ROM in the sagittal plane during the push-off phase (β=0.707, p=0.001), stability (β=0.423, p=0.028) and BMI (β=-0.727 p=<0.001). This prediction model explained 87% of patient satisfaction. CONCLUSIONS This study showed that patients treated for Lisfranc injury had significantly lower walking speed and significantly lower flexion/extension in the midfoot than healthy subjects. The ROM in these patients was significantly correlated with PROM, but not with radiographic quality of reduction. Most important satisfaction predictors were BMI, ROM in the sagittal plane during the push-off phase and fracture stability.
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Affiliation(s)
- S van Hoeve
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - G Stollenwerck
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - P Willems
- Department of Movement Sciences, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 616, 6200 MD Maastricht, The Netherlands; NUTRIM, School for Nutrition, Toxicology and Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - M A Witlox
- Department of Orthopaedics, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - K Meijer
- Department of Movement Sciences, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 616, 6200 MD Maastricht, The Netherlands; NUTRIM, School for Nutrition, Toxicology and Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - M Poeze
- Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; NUTRIM, School for Nutrition, Toxicology and Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Kim EJ, Shin HS, Lee JH, Kyung MG, Yoo HJ, Yoo WJ, Lee DY. Repeatability of a Multi-segment Foot Model with a 15-Marker Set in Normal Children. Clin Orthop Surg 2018; 10:484-490. [PMID: 30505418 PMCID: PMC6250958 DOI: 10.4055/cios.2018.10.4.484] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/27/2018] [Indexed: 11/06/2022] Open
Abstract
Background The use of three-dimensional multi-segment foot models (3D MFMs) is increasing since they have superior ability to illustrate the effect of foot and ankle pathologies on intersegmental motion of the foot compared to single-segment foot model gait analysis. However, validation of the repeatability of the 3D MFMs is important for their clinical use. Although many MFMs have been validated in normal adults, research on MFM repeatability in children is lacking. The purpose of this study is to validate the intrasession, intersession, and interrater repeatability of an MFM with a 15-marker set (DuPont foot model) in healthy children. Methods The study included 20 feet of 20 healthy children (10 boys and 10 girls). We divided the participants into two groups of 10 each. One group was tested by the same operator in each test (intersession analysis), while the other group was tested by a different operator in each test (interrater analysis). The multiple correlation coefficient (CMC) and intraclass correlation coefficient (ICC) were calculated to assess repeatability. The difference between the two sessions of each group was assessed at each time point of gait cycle. Results The intrasession CMC and ICC values of all parameters showed excellent or very good repeatability. The intersession CMC of many parameters showed good or better repeatability. Interrater CMC and ICC values were generally lower for all parameters than intrasession and intersession. The mean gaps of all parameters were generally similar to those of the previous study. Conclusions We demonstrated that 3D MFM using a 15-marker set had high intrasession, intersession, and interrater repeatability in the assessment of foot motion in healthy children but recommend some caution in interpreting the hindfoot parameters.
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Affiliation(s)
- Eo Jin Kim
- Department of Orthopaedic Surgery, Hanil General Hospital, Seoul, Korea
| | - Hyuk Soo Shin
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jae Hee Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Min Gyu Kyung
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hyo Jeong Yoo
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Won Joon Yoo
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
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Canseco K, Kruger KM, Fritz JM, Konop KA, Tarima S, Marks RM, Harris GF. Distribution of segmental foot kinematics in patients with degenerative joint disease of the ankle. J Orthop Res 2018; 36:1739-1746. [PMID: 29139570 DOI: 10.1002/jor.23807] [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: 06/29/2017] [Accepted: 11/11/2017] [Indexed: 02/04/2023]
Abstract
Degenerative joint disease (DJD) of the ankle is a debilitating chronic disease associated with severe pain and dysfunction resulting in antalgic gait alteration. Little information is available about segmental foot and ankle motion distribution during gait in ankle osteoarthritis. The aim of the current study was to dynamically characterize segmental foot and ankle kinematics of patients with severe ankle arthrosis requiring total ankle replacement. This was a prospective study involving 36 (19 M, 17 F) adult patients with a clinical diagnosis of ankle arthrosis ("DJD" group) and 36 (23 M, 13 F) healthy subjects ("Control" group). Motion data were collected at 120 Hz using a 3-D motion camera system at self-selected speed along a 6-m walkway and processed using the Milwaukee Foot Model (MFM). The SF-36 Health Survey and Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale were administered to evaluate functional levels. Findings include decreases in walking speed, cadence, stride length and swing phase, and reduced outcomes scores (SF-36 and AOFAS). Multisegemental motion in patients with ankle DJD demonstrates significant changes in foot mechanics characterized by altered segment kinematics and significant reduction in dynamic ROM at the tibia, hindfoot, forefoot, and hallux when compared to controls. The results demonstrate decreased temporal-spatial parameters and low outcomes scores indicative of functional limitations. Statement of clinical significance: Altered segment kinematics and reduced overall range of motion demonstrate how a single joint pathology affects kinematic distribution in the other segments of the foot and ankle and alters patients' overall gait. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1739-1746, 2018.
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Affiliation(s)
- Karl Canseco
- Orthopaedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Suite 323, 1515W. Wisconsin Avenue, Milwaukee, Wisconsin, 53233
| | - Karen M Kruger
- Orthopaedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Suite 323, 1515W. Wisconsin Avenue, Milwaukee, Wisconsin, 53233
| | - Jessica M Fritz
- Orthopaedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Suite 323, 1515W. Wisconsin Avenue, Milwaukee, Wisconsin, 53233.,Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Katherine A Konop
- Orthopaedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Suite 323, 1515W. Wisconsin Avenue, Milwaukee, Wisconsin, 53233
| | - Sergey Tarima
- Division of Biostatistics, Institute for Health & Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Richard M Marks
- Department of Orthopaedic Surgery, University of South Alabama College of Medicine, Mobile, Alabama
| | - Gerald F Harris
- Orthopaedic and Rehabilitation Engineering Center, Marquette University/Medical College of Wisconsin, Suite 323, 1515W. Wisconsin Avenue, Milwaukee, Wisconsin, 53233.,Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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Pfeiffer SJ, Blackburn JT, Luc-Harkey B, Harkey MS, Stanley LE, Frank B, Padua D, Marshall SW, Spang JT, Pietrosimone B. Peak knee biomechanics and limb symmetry following unilateral anterior cruciate ligament reconstruction: Associations of walking gait and jump-landing outcomes. Clin Biomech (Bristol, Avon) 2018; 53:79-85. [PMID: 29471191 DOI: 10.1016/j.clinbiomech.2018.01.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/13/2017] [Accepted: 01/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aberrant walking-gait and jump-landing biomechanics may influence the development of post-traumatic osteoarthritis and increase the risk of a second anterior cruciate ligament injury, respectively. It remains unknown if individuals who demonstrate altered walking-gait biomechanics demonstrate similar altered biomechanics during jump-landing. Our aim was to determine associations in peak knee biomechanics and limb-symmetry indices between walking-gait and jump-landing tasks in individuals with a unilateral anterior cruciate ligament reconstruction. METHODS Thirty-five individuals (74% women, 22.1 [3.4] years old, 25 [3.89] kg/m2) with an anterior cruciate ligament reconstruction performed 5-trials of self-selected walking-gait and jump-landing. Peak kinetics and kinematics were extracted from the first 50% of stance phase during walking-gait and first 100 ms following ground contact for jump-landing. Pearson product-moment (r) and Spearman's Rho (ρ) analyses were used to evaluate relationships between outcome measures. Significance was set a priori (P ≤ 0.05). FINDINGS All associations between walking-gait and jump-landing for the involved limb, along with the majority of associations for limb-symmetry indices and the uninvolved limb, were negligible and non-statistically significant. There were weak significant associations for instantaneous loading rate (ρ = 0.39, P = 0.02) and peak knee abduction angle (ρ = 0.36, p = 0.03) uninvolved limb, as well as peak abduction displacement limb-symmetry indices (ρ= - 0.39, p = 0.02) between walking-gait and jump-landing. INTERPRETATION No systematic associations were found between walking-gait and jump-landing biomechanics for either limb or limb-symmetry indices in people with unilateral anterior cruciate ligament reconstruction. Individuals with an anterior cruciate ligament reconstruction who demonstrate high-involved limb loading or asymmetries during jump-landing may not demonstrate similar biomechanics during walking-gait.
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Affiliation(s)
- Steven J Pfeiffer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - J Troy Blackburn
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brittney Luc-Harkey
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, United States
| | - Matthew S Harkey
- Department of Rheumatology, Tufts Medical Center, Boston, MA, United States
| | - Laura E Stanley
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Barnett Frank
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Darin Padua
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Stephen W Marshall
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jeffrey T Spang
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, NC, United States
| | - Brian Pietrosimone
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Iaquinto JM, Kindig MW, Haynor DR, Vu Q, Pepin N, Tsai R, Sangeorzan BJ, Ledoux WR. Model-based tracking of the bones of the foot: A biplane fluoroscopy validation study. Comput Biol Med 2018; 92:118-127. [PMID: 29175098 DOI: 10.1016/j.compbiomed.2017.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/26/2022]
Abstract
Measuring foot kinematics using optical motion capture is technically challenging due to the depth of the talus, small bone size, and soft tissue artifact. We present a validation of our biplane X-ray system, demonstrating its accuracy in tracking the foot bones directly. Using an experimental linear/rotary stage we imaged pairs of tali, calcanei, and first metatarsals, with embedded beads, through 30 poses. Model- and bead-based algorithms were employed for semi-automatic tracking. Translational and rotational poses were compared to the experimental stage (a reference standard) to determine registration performance. For each bone, 10 frames per pose were analyzed. Model-based: The resulting overall translational bias of the six bones was 0.058 mm with a precision of ± 0.049 mm. The overall rotational bias of the six bones was 0.42° with a precision of ± 0.41°. Bead-based: the overall translational bias was 0.037 mm with a precision of ± 0.032 mm and for rotation was 0.29° with a precision of ± 0.26°. We validated the accuracy of our system to determine the spatial position and orientation of isolated foot bones, including the talus, calcaneus, and first metatarsal over a range of quasi-static poses. Although the accuracy of dynamic motion was not assessed, use of an experimental stage establishes a reference standard.
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Affiliation(s)
- Joseph M Iaquinto
- RR&D Center for Limb Loss and MoBility, Department of Veterans Affairs, Seattle, WA 98108, USA; Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Matthew W Kindig
- RR&D Center for Limb Loss and MoBility, Department of Veterans Affairs, Seattle, WA 98108, USA
| | - David R Haynor
- Department of Radiology, University of Washington, Seattle, WA 98195, USA
| | - QuocBao Vu
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Nathan Pepin
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Richard Tsai
- RR&D Center for Limb Loss and MoBility, Department of Veterans Affairs, Seattle, WA 98108, USA
| | - Bruce J Sangeorzan
- RR&D Center for Limb Loss and MoBility, Department of Veterans Affairs, Seattle, WA 98108, USA; Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA 98195, USA
| | - William R Ledoux
- RR&D Center for Limb Loss and MoBility, Department of Veterans Affairs, Seattle, WA 98108, USA; Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA; Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA 98195, USA.
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Jackson JN, Hass CJ, Fregly BJ. Development of a Subject-Specific Foot-Ground Contact Model for Walking. J Biomech Eng 2017; 138:2532908. [PMID: 27379886 DOI: 10.1115/1.4034060] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Indexed: 11/08/2022]
Abstract
Computational walking simulations could facilitate the development of improved treatments for clinical conditions affecting walking ability. Since an effective treatment is likely to change a patient's foot-ground contact pattern and timing, such simulations should ideally utilize deformable foot-ground contact models tailored to the patient's foot anatomy and footwear. However, no study has reported a deformable modeling approach that can reproduce all six ground reaction quantities (expressed as three reaction force components, two center of pressure (CoP) coordinates, and a free reaction moment) for an individual subject during walking. This study proposes such an approach for use in predictive optimizations of walking. To minimize complexity, we modeled each foot as two rigid segments-a hindfoot (HF) segment and a forefoot (FF) segment-connected by a pin joint representing the toes flexion-extension axis. Ground reaction forces (GRFs) and moments acting on each segment were generated by a grid of linear springs with nonlinear damping and Coulomb friction spread across the bottom of each segment. The stiffness and damping of each spring and common friction parameter values for all springs were calibrated for both feet simultaneously via a novel three-stage optimization process that used motion capture and ground reaction data collected from a single walking trial. The sequential three-stage process involved matching (1) the vertical force component, (2) all three force components, and finally (3) all six ground reaction quantities. The calibrated model was tested using four additional walking trials excluded from calibration. With only small changes in input kinematics, the calibrated model reproduced all six ground reaction quantities closely (root mean square (RMS) errors less than 13 N for all three forces, 25 mm for anterior-posterior (AP) CoP, 8 mm for medial-lateral (ML) CoP, and 2 N·m for the free moment) for both feet in all walking trials. The largest errors in AP CoP occurred at the beginning and end of stance phase when the vertical ground reaction force (vGRF) was small. Subject-specific deformable foot-ground contact models created using this approach should enable changes in foot-ground contact pattern to be predicted accurately by gait optimization studies, which may lead to improvements in personalized rehabilitation medicine.
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Design of the wearable device for hemiplegic gait detection using an accelerometer and a gyroscope. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:1409-1412. [PMID: 29060141 DOI: 10.1109/embc.2017.8037097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hemiplegic walking is the main symptom of hemiplegia and is the basis for judging the outcome or severity of hemiplegia. In this study, we developed a wearable measurement module for measuring the inertia signal generated during walking and evaluated the possibility of gait measurement as a basic study of the new hemiplegia diagnosis technology using wearable device. The developed measurement module is worn on the waist. It is equipped with 3-axis acceleration sensor and 3-axis angular velocity sensor and has the function to transmit and record data through wireless communication. As a result of measuring the gait signals using the developed measurement module, specific patterns are shown for each axis according to each step, and it is confirmed that gait signals can be distinguished intuitively.
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Affiliation(s)
- Sarah L. Carter
- Podiatric Medicine and Surgery Division, Faculty of Health & Medical Sciences, School of Allied Health, The University of Western Australia, Perth, Australia
- Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia
| | - Nahoko Sato
- Department of Physical Therapy, Faculty of Rehabilitation Science, Nagoya Gakuin University, Seto, Aichi, Japan
| | - Luke S. Hopper
- Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia
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Holowka NB, O'Neill MC, Thompson NE, Demes B. Chimpanzee ankle and foot joint kinematics: Arboreal versus terrestrial locomotion. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 164:131-147. [DOI: 10.1002/ajpa.23262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/27/2017] [Accepted: 05/22/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Nicholas B. Holowka
- Department of Human Evolutionary BiologyHarvard UniversityCambridge Massachusetts02138
- Department of AnthropologyStony Brook UniversityStony Brook New York11795
| | - Matthew C. O'Neill
- Department of Basic Medical SciencesUniversity of Arizona College of Medicine‐PhoenixPhoenix Arizona85004
| | - Nathan E. Thompson
- Department of AnatomyNYIT College of Osteopathic MedicineOld Westbury New York11568
- Department of Anatomical SciencesStony Brook University School of MedicineStony Brook New York11795
| | - Brigitte Demes
- Department of Anatomical SciencesStony Brook University School of MedicineStony Brook New York11795
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Jagos H, Pils K, Haller M, Wassermann C, Chhatwal C, Rafolt D, Rattay F. Mobile gait analysis via eSHOEs instrumented shoe insoles: a pilot study for validation against the gold standard GAITRite ®. J Med Eng Technol 2017; 41:375-386. [PMID: 28573909 DOI: 10.1080/03091902.2017.1320434] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Clinical gait analysis contributes massively to rehabilitation support and improvement of in-patient care. The research project eSHOE aspires to be a useful addition to the rich variety of gait analysis systems. It was designed to fill the gap of affordable, reasonably accurate and highly mobile measurement devices. With the overall goal of enabling individual home-based monitoring and training for people suffering from chronic diseases, affecting the locomotor system. Motion and pressure sensors gather movement data directly on the (users) feet, store them locally and/or transmit them wirelessly to a PC. A combination of pattern recognition and feature extraction algorithms translates the motion data into standard gait parameters. Accuracy of eSHOE were evaluated against the reference system GAITRite in a clinical pilot study. Eleven hip fracture patients (78.4 ± 7.7 years) and twelve healthy subjects (40.8 ± 9.1 years) were included in these trials. All subjects performed three measurements at a comfortable walking speed over 8 m, including the 6-m long GAITRite mat. Six standard gait parameters were extracted from a total of 347 gait cycles. Agreement was analysed via scatterplots, histograms and Bland-Altman plots. In the patient group, the average differences between eSHOE and GAITRite range from -0.046 to 0.045 s and in the healthy group from -0.029 to 0.029 s. Therefore, it can be concluded that eSHOE delivers adequately accurate results. Especially with the prospect as an at home supplement or follow-up to clinical gait analysis and compared to other state of the art wearable motion analysis systems.
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Affiliation(s)
- Harald Jagos
- a Institute for Analysis and Scientific Computing , Vienna University of Technology , Vienna , Austria
| | - Katharina Pils
- b Institut für Physikalische Medizin und Rehabilitation , Sophienspital , Wien , Austria
| | - Michael Haller
- c Center for Medical Physics and Biomedical Engineering , Medical University of Vienna , Vienna , Austria
| | - Claudia Wassermann
- b Institut für Physikalische Medizin und Rehabilitation , Sophienspital , Wien , Austria
| | - Christa Chhatwal
- b Institut für Physikalische Medizin und Rehabilitation , Sophienspital , Wien , Austria
| | - Dietmar Rafolt
- c Center for Medical Physics and Biomedical Engineering , Medical University of Vienna , Vienna , Austria
| | - Frank Rattay
- a Institute for Analysis and Scientific Computing , Vienna University of Technology , Vienna , Austria
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Chopra S, Favre J, Crevoisier X. Qualitative analysis of foot intersegment coordination in the sagittal plane following surgery for end-stage ankle osteoarthrosis. J Orthop Res 2017; 35:1304-1310. [PMID: 27474886 DOI: 10.1002/jor.23379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 07/26/2016] [Indexed: 02/04/2023]
Abstract
Today, ankle joint kinematic assessment gives important information regarding the intersegment range of motion. It does not, however, provide information regarding coordination between the segments. This study aimed to determine whether or not intersegment coordination can provide valuable, otherwise missed information in relation to kinematic alterations of the ankle joint. The study consisted of 40 participants, including 12 total ankle replacement (TAR) patients, 12 ankle arthrodesis (AA) patients, and 16 controls. Gait assessment was carried out wearing 3-D inertial sensors. Intersegment coordination was determined by calculation of the continuous relative phase (CRP) between foot intersegments. CRP analysis found useful information regarding the magnitude and directionality of segment motion throughout the gait cycle, with AA patients reporting an altered coordination pattern for all three intersegments, forefoot-hindfoot, hindfoot-shank, and forefoot-shank, and TAR patients showing alterations in the hindfoot-shank intersegment. Results show that assessment of intersegment coordination can provide further information, otherwise overlooked by the general kinematic assessment, which could be used to optimize patient rehabilitation. Furthermore, the study showed that such information could be used to compare surgical outcomes. As a result, the study concludes that the inclusion of intersegment coordination assessment could be beneficial in clinical practice. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1304-1310, 2017.
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Affiliation(s)
- Swati Chopra
- Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Pierre-Decker 4, Lausanne, CH-1011, Switzerland
| | - Julien Favre
- Swiss Biomotion Lab, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Xavier Crevoisier
- Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Pierre-Decker 4, Lausanne, CH-1011, Switzerland
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50
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Kruger KM, Konop KA, Krzak JJ, Graf A, Altiok H, Smith PA, Harris GF. Segmental kinematic analysis of planovalgus feet during walking in children with cerebral palsy. Gait Posture 2017; 54:277-283. [PMID: 28384608 DOI: 10.1016/j.gaitpost.2017.03.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 03/16/2017] [Accepted: 03/21/2017] [Indexed: 02/02/2023]
Abstract
Pes planovalgus (flatfoot) is a common deformity among children with cerebral palsy. The Milwaukee Foot Model (MFM), a multi-segmental kinematic foot model, which uses radiography to align the underlying bony anatomy with reflective surface markers, was used to evaluate 20 pediatric participants (30feet) with planovalgus secondary to cerebral palsy prior to surgery. Three-dimensional kinematics of the tibia, hindfoot, forefoot, and hallux segments are reported and compared to an age-matched control set of typically-developing children. Most results were consistent with known characteristics of the deformity and showed decreased plantar flexion of the forefoot relative to hindfoot, increased forefoot abduction, and decreased ranges of motion during push-off in the planovalgus group. Interestingly, while forefoot characteristics were uniformly distributed in a common direction in the transverse plane, there was marked variability of forefoot and hindfoot coronal plane and hindfoot transverse plane positioning. The key finding of these data was the radiographic indexing of the MFM was able to show flat feet in cerebral palsy do not always demonstrate more hindfoot eversion than the typically-developing hindfoot. The coronal plane kinematics of the hindfoot show cases planovalgus feet with the hindfoot in inversion, eversion, and neutral. Along with other metrics, the MFM can be a valuable tool for monitoring kinematic deformity, facilitating clinical decision making, and providing a quantitative analysis of surgical effects on the planovalgus foot.
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Affiliation(s)
- Karen M Kruger
- Marquette University, P.O. Box 1881, Milwaukee, WI 53201, USA.
| | | | - Joseph J Krzak
- Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA; Midwestern University, Physical Therapy Program, 555 31st St., Downers Grove, IL 60515, USA
| | - Adam Graf
- Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA
| | - Haluk Altiok
- Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA
| | - Peter A Smith
- Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA
| | - Gerald F Harris
- Marquette University, P.O. Box 1881, Milwaukee, WI 53201, USA; Shriners Hospitals for Children - Chicago, 2211 N Oak Park Ave., Chicago, IL 60707, USA
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