Change in Achilles Tendon Length after Walking on Treadmill with Gradient.

Objectives: Improving ankle joint contracture is important because stiffness in ankle dorsiflexion can lead to pain, especially when weight-bearing during walking, which tends to concentrate on the forefoot. We hypothesized that the contraction of the gastrocnemius muscle in ankle dorsiflexion would increase the Achilles tendon length and improve the dorsiflexion range of motion. We evaluated the effects of walking with and without a gradient on Achilles tendon length. Methods: This study included 23 men who underwent ultrasound imaging to measure the Achilles tendon length while they stood on an inclined table adjusted according to the dorsiflexion angle. Treadmill walking was performed for 10 min with a 10° incline (gradient condition) or without gradient (level condition). The measurements were compared using a paired t-test. Results: In the gradient condition, the range of motion for ankle dorsiflexion was significantly increased after the intervention. In the gradient condition, the Achilles tendon length while standing on an inclined surface was significantly increased after the intervention. Conclusions: Walking under gradient conditions led to the extension of the Achilles tendon in the ankle dorsiflexion position. This was accompanied by contraction of the gastrocnemius muscle, resulting in lengthening of the Achilles tendon. This finding suggests that such interventions may have clinical applications.

Examination of gait characteristics and related factors in elderly subjects with and without hallux valgus.

OBJECTIVE: Elderly people with hallux valgus have decreased gait speed, which can result in reduced capacity to perform the activities of daily living. Therefore, this study examined the gait ability and related factors of patients with hallux valgus. METHODS: The study participants were 10 patients with hallux valgus and 10 without. Ground reaction forces were measured as front-rear (X), lateral (Y), and vertical (Z) components from the early to late stance phases. Three-dimensional motion analysis was used to measure gait speed; touchdown distance; release distance; the angles of the limb joints and trunk at heel contact, toe-off, and peak ground reaction force; and the center of mass (COM) displacement in the sagittal plane. The height of the COM was calculated as a percentage of the body height. The hallux valgus and control groups were compared using the Mann-Whitney U-test. RESULTS: In the hallux valgus group, the ground reaction force showed a significant increase in the Y component in each stance phase and in the Z component in the late stance phase. The lowest COM position in the hallux valgus group was significantly higher than that in the control group, resulting in a smaller difference in COM height over a gait cycle. CONCLUSIONS: The hallux valgus group was found to have reduced gait speed because of a shortened touchdown distance. Moreover, the continued high COM position in the hallux valgus group meant that potential energy could not efficiently be converted to kinetic energy.

Function of the Distal Part of the Vastus Medialis Muscle as a Generator of Knee Extension Twitch Torque.

The distal part of the vastus medialis (VM) (VM obliquus: VMO) muscle acts as the medial stabilizer of the patella. However, it has been known to facilitate VMO contraction during training of the quadriceps femoris muscle in knee joint rehabilitation. This study aimed to examine the contribution degree of VMO as a knee joint extension torque generator. Sixteen healthy male volunteers participated in this study. Electrical muscle stimulation (EMS) was performed on VMO at 60° knee angle for 20 min to induce muscle fatigue. Knee extension twitch torques (TT) at 90° and 30° knee angle evoked by femoral nerve stimulation were measured before and after EMS. Although each TT at 90° and 30° knee angle significantly decreased after EMS, the decreased TT rate in both joint angles showed no significant difference. Our results show that VMO might contribute to the generation of the knee joint torque at the same level in the range from flexion to extension. Therefore, it was suggested that the facilitating the neural drive for VMO is important during the quadriceps femoris muscle strengthening exercise.

Gender differences in joint torque focused on hip internal and external rotation during a change in direction while walking.

[Purpose] To investigate lower-extremity joint torque during walking direction changes, focused on gender differences in pelvic width. [Subjects and Methods] Healthy males and females (n=10) changed direction while walking by side-stepping (SS) and crossover stepping (CS), stepping the left leg to the left or right, respectively, over the right leg. Movements were recorded using four infrared cameras, and ground reaction force of each lower extremity measured using two force platforms. Joint torque of each lower extremity was calculated, and each joint peak torque among walking, SS and CS was compared between genders. Moreover, correlation between joint torque showed a gender difference and width of pelvis normalized by width of shoulder (P/S ratio) was examined. [Results] Right external and internal rotation torques during CS were higher in males. Left- and right-ankle plantar flexion torques were also higher in males during CS, while the P/S ratio was larger in females, with a positive correlation between P/S ratio and hip external and internal rotation torques. [Conclusion] No gender differences were found in joint torque during walking and SS, but only during CS. The hip external and internal rotators are necessary for smooth CS in females in terms of P/S ratio.

Effect of exercise therapy combining electrical therapy and balance training on functional instability resulting from ankle sprain-focus on stability of jump landing.

[Purpose] Functional instability leads to a delay in the muscle reaction time and weakness of the peroneal muscles. The present study examined the effects of transcutaneous electrical nerve stimulation during balance exercise on patients with functional instability of the ankles, including the ability to land after jumping at the center of foot pressure. [Subjects] The subjects were seven males with a history of ankle sprain. All had a sprained ankle score of ≤80 points on Karlson's functional instability test. [Methods] They were asked to jump over a 20-cm-high platform sideways for 10 consecutive seconds on a force plate with one leg. The length of the center of pressure was measured for comparison of balance exercise and balance exercise with simultaneous transcutaneous electrical nerve stimulation. [Results] The length of the center of foot pressure on the sprain side was significantly greater than on the non-sprain side under both conditions. Under the balance exercise with simultaneous transcutaneous electrical nerve stimulation therapy condition, the length of the center of foot pressure on the sprain side was significantly reduced, with the values being 627.0 ± 235.4 and 551.8 ± 171.1 mm before and after the challenge, respectively. [Conclusion] Ankle instability on the sprain side was significantly reduced under the balance exercise with simultaneous transcutaneous electrical nerve stimulation therapy condition before and after the challenge. Peroneal muscles showed increased activity caused by common peroneal innervation.

Spinal reflex arc excitability corresponding to the vastus medialis obliquus and vastus medialis longus muscles.

[Purpose] The gross morphology of the vastus medialis (VM) muscle has been thoroughly described. However, there is insufficient evidence of physiological differentiation between the VM obliquus (VMO) and VM longus (VML). To elucidate spinal reflex arc excitability in two divisions of the VM, we compared H-reflexes and T-waves in VMO and VML. [Subjects] Twenty-three healthy male volunteers participated in this study. [Methods] The H-reflex was evoked from the VMO and VML by electrical stimulation of the femoral nerve during knee extension at 10% maximal voluntary isometric contraction. Also, the patellar tendon was tapped by an examiner using an electrical tendon hammer, and a component of the compound muscle action potential (T-wave) was recorded. [Results] The configurations of the H-reflex and T-wave were sharp and slow in VMO and VML, respectively. No significant differences in the amplitudes of the H-reflexes and T-waves were observed between VMO and VML. The durations of VML H-reflexes and T-waves were significantly longer than those in VMO. [Conclusion] Spinal reflex arc excitability corresponding to VMO and VML was similar. However, the configurations and durations of the H-reflex and T-wave were differentiated with electromyography. On the basis of these findings, we suggest that VMO and VML are electrophysiologically distinct entities.