Applications of Finite Element Modeling in Biomechanical Analysis of Foot Arch Deformation: A Scoping Review.

Excessive foot arch deformation is associated with plantar tissue overload and ligamentous injury pathologies. Finite element (FE) analysis, as an effective tool for modeling and simulation, has been utilized clinically for providing insights into arch biomechanics. This systematic scoping review aimed to summarize the current state of computational modeling techniques utilized in arch biomechanics from 2000 onwards and outline the main challenges confronting the further development of accurate models in clinical conditions. English-language searches of the electronic databases were conducted in the Web of Science, PubMed, and Scopus until July 2022. Articles that investigated arch deformation mechanisms by FE modeling were included. The methodological quality was assessed utilizing the Methodological Quality Assessment of Subject-Specific Finite Element Analysis Used in Computational Orthopedics (MQSSFE). Seventeen articles were identified in this systematic scoping review, mostly focusing on constructing models for specific pathological conditions, such as progressive collapsing foot deformity, valgus foot, and posterior tibial tendon dysfunction. However, given the complexity of the arch problem, geometrical simplifications regarding the balance between accurate detail and computational cost and assumptions made in defining modeling parameters (material properties and loading and boundary conditions) may bring challenges to the accuracy and generalizability of models applied to clinical settings. Overall, advances in computational modeling techniques have contributed to reliable foot deformation simulation and analysis in modern personalized medicine.

[The importance of MR imaging in the diagnosis and management of acute stroke]. / Az MR-képalkotás jelentosége az akut stroke diagnosztikájában és ellátásában ­ Az MRI FIRST! Projekt.

Background and purpose:

In our collaborative project, called MRI First!, every patient arriving with neurological symptoms of acute stroke and without contraindications was examined by MRI. Our aim was to detect the symptomatic lesions, to obtain appropriate information about the brain parenchyma and to analyse parenchymal perfusion and brain vasculature.

The examinations were conduc­ted on a Philips Ingenia 1.5 Tesla scanner with the following protocol: DWI-ADC, FLAIR, T2 FFE/SWI, PWI, and contrast-enhanced MRA. 415 patients were examined between January 2020 and May 2021. 179 patients arrived within-, and 136 patients after 4.5 hours symptoms onset time, while 100 patients had “wake-up” stroke.

Within the 4.5 hours group, 81 cases had acute ischemic lesion, 48 of them received reperfusion therapy. Acute ische­mic lesion was found in 64 patients in the wake-up stroke group and in 64 in the 4.5-24 hours group. In these groups 10 and 12 patients obtained reperfusion therapy, respectively. Further 117 cases were considered as stroke mimics, in which cases unnecessary intravenous thrombolysis was avoidable.

MRI is accepted as a sensitive diagnostic modality providing detailed information regarding the brain parenchyma, its perfusion and vasculature. Nonetheless, its worldwide utilization in acute stroke is low and further information should be collected on which patient groups would gain the most benefit from acute MR imaging. Our continuous work is aimed at that goal.

Performance Evaluation of a Robot-Mounted Interferometer for an Industrial Environment.

High value manufacturing requires production-integrated, fast, multi-sensor and multi-scale inspection. To meet this need, the robotic deployment of sensors within the factory environment is becoming increasingly popular. For microscale measurement applications, robot-mountable versions of high-resolution instruments, that are traditionally deployed in a laboratory environment, are now becoming available. However, standard methodologies for the evaluation of these instruments, particularly when mounted to a robot, have yet to be fully defined, and therefore, there is limited independent evaluation data to describe the potential performance of these systems. In this paper, a detailed evaluation approach is presented for light-weight robot mountable scanning interferometric sensors. Traditional evaluation approaches are considered and extended to account for robotic sensor deployment within industrial environments. The applicability and value of proposed evaluation is demonstrated through the comprehensive characterization of a Heliotis H6 interferometric sensors. The results indicate the performance of the sensor, in comparison to a traditional laboratory-based system, and demonstrate the limits of the sensor capability. Based-on the evaluation an effective strategy for robotic deployment of the sensor is demonstrated.

[Dopamine agonists in Parkinson's disease therapy - 15 years of experience of the Neurological Clinics from Tîrgu Mureș. A cross-sectional study]. / A dopaminagonisták jelentosége a Parkinson-kór kezelésében a marosvásárhelyi ideggyógyászati klinikák 15 éves gyakorlatában - keresztmetszeti vizsgálat.

BACKGROUND AND PURPOSE: There is relatively few data regarding the usage of dopaminagonists for the treatment of Parkinson's disease; furthermore, there are no publications regarding Central- and Eastern-European countries. The aim of the study was to evaluate the use of dopamine agonists as a therapeutic option amongst Parkinson's disease patients admitted to the Neurological Clinics of Tîrgu Mures during the last 15 years. METHODS: In our study we investigated the data of all Parkinson's patients treated at our clinics between the 1st of January 2003 and the 31st of December 2017. We analyzed the particularities of dopamine agonists' usage based on the therapeutic recommendations from the final report of these patients. Regarding time since the diagnosis, we divided the patients in two groups: less than or equal to 5 years and more than 5 years. RESULTS: During the studied period a total of 2379 patients with Parkinson's disease were treated at the Clinics. From the 1237 patients with disease duration under 5 years 665 received dopamine agonists: 120 as monotherapy, 83 together with monoamine oxidase inhibitors and in 234 cases associated with levodopa. The remaining 228 patients were treated with a triple combination of levodopa, dopamine agonists and monoamine oxidase inhibitors. In patients suffering from Parkinson's disease for more than 5 years, in 364 cases out of 653 a dopamine agonist was part of the therapy. CONCLUSION: The usage of dopamine agonists was similar to the data presented in other studies. We consider that clinicians treating the disease should, with the necessary prudence, use the available and recommended dopamine agonist with the utmost courage to their maximum therapeutic potential.

Dynamical response properties of neocortical neurons to conductance-driven time-varying inputs.

Ensembles of cortical neurons can track fast-varying inputs and relay them in their spike trains, far beyond the cut-off imposed by membrane passive electrical properties and mean firing rates. Initially explored in silico and later demonstrated experimentally, investigating how neurons respond to sinusoidally modulated stimuli provides a deeper insight into spike initiation mechanisms and information processing than conventional F-I curve methodologies. Besides net membrane currents, physiological synaptic inputs can also induce a stimulus-dependent modulation of the total membrane conductance, which is not reproduced by standard current-clamp protocols. Here, we investigated whether rat cortical neurons can track fast temporal modulations over a noisy conductance background. We also determined input-output transfer properties over a range of conditions, including: distinct presynaptic activation rates, postsynaptic firing rates and variability and type of temporal modulations. We found a very broad signal transfer bandwidth across all conditions, similar large cut-off frequencies and power-law attenuations of fast-varying inputs. At slow and intermediate input modulations, the response gain decreased for increasing output mean firing rates. The gain also decreased significantly for increasing intensities of background synaptic activity, thus generalising earlier studies on F-I curves. We also found a direct correlation between the action potentials' onset rapidness and the neuronal bandwidth. Our novel results extend previous investigations of dynamical response properties to non-stationary and conductance-driven conditions, and provide computational neuroscientists with a novel set of observations that models must capture when aiming to replicate cortical cellular excitability.

Comparison of ground reaction forces as running speed increases between male and female runners.

Introduction: The biomechanics associated with human running are affected by gender and speed. Knowledge regarding ground reaction force (GRF) at various running speeds is pivotal for the prevention of injuries related to running. This study aimed to investigate the gait pattern differences between males and females while running at different speeds, and to verify the relationship between GRFs and running speed among both males and females. Methods: GRF data were collected from forty-eight participants (thirty male runners and eighteen female runners) while running on an overground runway at seven discrete speeds: 10, 11, 12, 13, 14, 15 and 16 km/h. Results: The ANOVA results showed that running speed had a significant effect (p < 0.05) on GRFs, propulsive and vertical forces increased with increasing speed. An independent t-test also showed significant differences (p < 0.05) in vertical and anterior-posterior GRFs at all running speeds, specifically, female runners demonstrated higher propulsive and vertical forces than males during the late stance phase of running. Pearson correlation and stepwise multiple linear regression showed significant correlations between running speed and the GRF variables. Discussion: These findings suggest that female runners require more effort to keep the same speed as male runners. This study may provide valuable insights into the underlying biomechanical factors of the movement patterns at GRFs during running.

Effect of orthopedic insoles on lower limb motion kinematics and kinetics in adults with flat foot: a systematic review.

Flatfoot is characterized by the collapse of the medial longitudinal arch, eversion of the rearfoot and abduction of the loaded forefoot. Orthopedic insoles are the frequently recommended treatment to support the arch of the foot, adjust the structure of the foot, reduce pain, improve stability and new techniques have been applied to the design of orthopedic insoles in recent years. However, the effectiveness of orthopedic insoles in different motions is still debated from the perspective of biomechanics. Therefore, this study aimed to explore the impact of orthopedic insoles on the kinematics and kinetics of lower limb motion, and to verify effectiveness and propose possible future research directions. We conducted a literature search across three databases employing Boolean operations and filtered results based on eligibility criteria. A total of 671 relevant literature were searched in this review, and 19 literature meeting the requirements were finally included. The results showed that: 1) orthopedic insoles were effective when patients walk, run and jump from the perspective of biomechanics; 2) orthopedic insoles had different result on the change of ankle sagittal angle, moment and peak pressure in the metatarsal region; 3) Whether the effect of insoles, which uses new techniques such as different 3D printed technologies and adds various accessories, can be further improved remains to be further studied; 4) Follow-up studies can pay more attention to the differences between diverse populations, increase the breadth of running and jumping and other movements research and long-term intervention.

Influence of changes in foot morphology and temperature on bruised toenail injury risk during running.

Despite runners frequently suffering from dermatologic issues during long distance running, there is no compelling evidence quantitatively investigating their underlying injury mechanism. This study aimed to determine the foot morphology and temperature changes during long distance running and reveal the effect of these alterations on the injury risk of bruised toenail by measuring the subjective-perceived hallux comfort and gap length between the hallux and toebox of the shoe. Ten recreational runners participated in the experimental tests before (baseline), immediately after 5 and 10 km of treadmill running (12 km/h), in which the foot morphology was measured by a 3D foot scanner, the foot temperature was detected by an infrared camera, the perceived comfort was recorded by a visual analogue scale, and the gap length in the sagittal plane was captured by a high-speed camera. Ball width became narrower (106.39 ± 6.55 mm) and arch height (12.20 ± 2.34 mm) was reduced greatly after the 10 km run (p < 0.05). Foot temperature increased significantly after 5 and 10 km of running, and the temperature of dorsal hallux (35.12 ± 1.46 °C), dorsal metatarsal (35.92 ± 1.59 °C), and medial plantar metatarsal (37.26 ± 1.34 °C) regions continued to increase greatly from 5 to 10 km of running (p < 0.05). Regarding hallux comfort, the perceived scores significantly reduced after 5 and 10 km of running (2.10 ± 0.99, p < 0.05). In addition, during one running gait cycle, there was a significant increase in gap length at initial contact (39.56 ± 6.45 mm, p < 0.05) for a 10 km run, followed by a notable decrease upon reaching midstance (29.28 ± 6.81 mm, p < 0.05). It is concluded that the reduced ball width and arch height while increased foot temperature during long-distance running would exacerbate foot-shoe interaction, potentially responsible for bruised toenail injuries.

Curved carbon-plated shoe may further reduce forefoot loads compared to flat plate during running.

Using a curved carbon-fiber plate (CFP) in running shoes may offer notable performance benefit over flat plates, yet there is a lack of research exploring the influence of CFP geometry on internal foot loading during running. The objective of this study was to investigate the effects of CFP mechanical characteristics on forefoot biomechanics in terms of plantar pressure, bone stress distribution, and contact force transmission during a simulated impact peak moment in forefoot strike running. We employed a finite element model of the foot-shoe system, wherein various CFP configurations, including three stiffnesses (stiff, stiffer, and stiffest) and two shapes (flat plate (FCFP) and curved plate (CCFP)), were integrated into the shoe sole. Comparing the shoes with no CFP (NCFP) to those with CFP, we consistently observed a reduction in peak forefoot plantar pressure with increasing CFP stiffness. This decrease in pressure was even more notable in a CCFP demonstrating a further reduction in peak pressure ranging from 5.51 to 12.62%, compared to FCFP models. Both FCFP and CCFP designs had a negligible impact on reducing the maximum stress experienced by the 2nd and 3rd metatarsals. However, they greatly influenced the stress distribution in other metatarsal bones. These CFP designs seem to optimize the load transfer pathway, enabling a more uniform force transmission by mainly reducing contact force on the medial columns (the first three rays, measuring 0.333 times body weight for FCFP and 0.335 for CCFP in stiffest condition, compared to 0.373 in NCFP). We concluded that employing a curved CFP in running shoes could be more beneficial from an injury prevention perspective by inducing less peak pressure under the metatarsal heads while not worsening their stress state compared to flat plates.

Effects of plantar fascia stiffness on the internal mechanics of idiopathic pes cavus by finite element analysis: implications for metatarsalgia.

Metatarsalgia occurring in individuals with pes cavus is typically associated with abnormal loading patterns in the forefoot resulting from structural alterations. Simultaneously, the frequent overstress of the plantar fascia (PF) caused by the persistence of this foot deformity may further exacerbate the chronic pain induced by metatarsal overload. We aimed to investigate and quantify the effects of PF stiffness on the internal biomechanics of pes cavus using a computational modelling approach. A patient-specific finite element model of the foot-ankle complex using the actual three-dimensional geometry of idiopathic pes cavus bones and soft tissues was reconstructed. A sensitivity study was conducted to evaluate the effects of varying elastic modulus (0-700 MPa) of the PF on the metatarsal stress distribution, and force transmission through the metatarsophalangeal (MTP) and tarsometatarsal (TMT) joints in the pes cavus. The results indicated that variations in PF stiffness led to stress redistribution in the metatarsal region. Peak stress gradually reduced with decreasing stiffness until the PF was released, eventually resulting in a reduction of 22.39% compared to the reference value of 350 MPa. Furthermore, adjusting the PF stiffness to twice the reference value (700 MPa) increased the contact forces through the TMT and MTP joints by up to 23% and 116%, respectively. The reduction of PF stiffness alleviated focal metatarsal loading, and therefore, surgical fascia release can be considered to alleviate metatarsalgia in patients with pes cavus.

Comparative Efficacy of Vibration foam Rolling and Cold Water Immersion in Amateur Basketball Players after a Simulated Load of Basketball Game.

To compare the efficacy of different recovery strategies (sitting; cold water immersion, CWI; vibration foam rolling, VFR) on the lower extremities of amateur basketball players after the simulated load of a basketball game, we assessed the power, agility, and dynamic balance before and after interventions. Ten amateur basketball players alternately underwent 12 min of sitting, 12 min of CWI at 5 °C, and 12 min of VFR. The power, agility, and dynamic balance were measured immediately post-warm-up, immediately post-game, immediately post-intervention, 1 h after interventions, and 24 h after interventions. To simulate the load of a basketball game, specific movements were designed and implemented. Jump height was measured using a Kistler force plate. Reaction time and dynamic balance score were assessed using the Pavigym agility response system and the Y balance test, respectively. The data were analyzed with a two-way repeated measures analysis of variance (ANOVA). The results showed that the vertical jump height significantly decreased after the CWI intervention compared to the CON and VFR groups (p < 0.001). At 1 h after the intervention, the vertical jump height in the CON group showed delayed recovery compared to the CWI and VFR groups (p = 0.007; p < 0.001). At 24 h after the intervention, the vertical jump height in the CWI group further increased and was significantly different from the CON and VFR groups (p < 0.001; p = 0.005). Additionally, reaction times significantly increased immediately after the CWI intervention (p = 0.004) but showed further recovery at 24 h compared to the CON group (p < 0.001). The dynamic balance score significantly rebounded after the CWI intervention compared to the CON group (p = 0.021), with further improvement at 24 h (p < 0.001). CWI initially showed negative effects, but over time, its recovery effect was superior and more long-lasting. VFR had the best immediate effect on lower limb recovery after the game.

The influence of running shoe with different carbon-fiber plate designs on internal foot mechanics: A pilot computational analysis.

A carbon-fiber plate (CFP) embedded into running shoes is a commonly applied method to improve running economy, but little is known in regard the effects of CFP design features on internal foot mechanics. This study aimed to explore how systematic changes in CFP geometrical variations (i.e., thickness and location) can alter plantar pressure and strain under the forefoot as well as metatarsal stress state through computational simulations. A foot-shoe finite element (FE) model was built and different CFP features including three thicknesses (1 mm, 2 mm, and 3 mm) and three placements (high-loaded (just below the insole), mid-loaded (in between the midsole), and low-loaded (just above the outsole)) were further modulated within the shoe sole. Simulations were conducted at the impact peak instant during forefoot strike running. Compared with the no-CFP shoe, peak plantar pressure and compressive strain under the forefoot consistently decreased when the CFP thickness increased, and the low-loaded conditions were found more effective (peak pressure decreased up to 31.91% and compressive strain decreased up to 18.61%). In terms of metatarsal stress, CFP designs resulted in varied effects and were dependent on their locations. Specifically, high-loaded CFP led to relatively higher peak metatarsal stress without the reduction trend as thickness increased (peak stress increased up to 12.91%), while low-loaded conditions showed a gradual reduction in peak stress, decreasing by 0.74%. Therefore, a low-loaded thicker CFP should be considered to achieve the pressure-relief effects of running shoes without the expense of increased metatarsal stress.

PCA of Running Biomechanics after 5 km between Novice and Experienced Runners.

Increased running experience appears to lower the risk of running-related injuries, but the mechanisms underlying this are unknown. Studying the biomechanics of runners with different running experiences before and after long-distance running can improve our understanding of the relationship between faulty running mechanics and injury. The purpose of the present study was to investigate if there were any differences in lower-limb biomechanics between runners after a 5 km run. Biomechanical data were collected from 15 novice and 15 experienced runners. Principal component analysis (PCA) with single-component reconstruction was used to identify variations in running biomechanics across the gait waveforms. A two-way repeated-measures ANOVA was conducted to explore the effects of runner and a 5 km run. Significant runner group differences were found for the kinematics and kinetics of lower-limb joints and ground reaction force (GRF) with respect to the magnitude across the stance phase. We found that novice runners exhibited greater changes in joint angles, joint moments, and GRFs than experienced runners regardless of the prolonged running session, and those patterns may relate to lower-limb injuries. The results of this study suggest that the PCA approach can provide unique insight into running biomechanics and injury mechanisms. The findings from the study could potentially guide training program developments and injury prevention protocols for runners with different running experiences.

The effects of non-Newtonian fluid material midsole footwear on tibial shock acceleration and attenuation.

Introduction: Given the possibility of higher ground temperatures in the future, the pursuit of a cushioning material that can effectively reduce sports injuries during exercise, particularly one that retains its properties at elevated temperatures, has emerged as a serious concern. Methods: A total of 18 man recreational runners were recruited from Ningbo University and local clubs for participation in this study. Frequency analysis was employed to investigate whether there is a distinction between non-Newtonian (NN) shoes and ethylene vinyl acetate (EVA) shoes. Results: The outcomes indicated that the utilization of NN shoes furnished participants with superior cushioning when engaging in a 90° cutting maneuver subsequent to an outdoor exercise, as opposed to the EVA material. Specifically, participants wearing NN shoes exhibited significantly lower peak resultant acceleration (p = 0.022) and power spectral density (p = 0.010) values at the distal tibia compared to those wearing EVA shoes. Moreover, shock attenuation was significantly greater in subjects wearing NN shoes (p = 0.023) in comparison to EVA shoes. Performing 90° cutting maneuver in NN shoes resulted in significantly lower peak ground reaction force (p = 0.010), vertical average loading rate (p < 0.010), and vertical instantaneous loading rate (p = 0.030) values compared to performing the same maneuvers in EVA shoes. Conclusion: The study found that the PRA and PSD of the distal tibia in NN footwear were significantly lower compared to EVA footwear. Additionally, participants exhibited more positive SA while using NN footwear compared to EVA. Furthermore, during the 90° CM, participants wearing NN shoes showed lower PGRF, VAIL, and VILR compared to those in EVA shoes. All these promising results support the capability of NN footwear to offer additional reductions in potential injury risk to runners, especially in high-temperature conditions.

Chloride ions in the pore of glycine and GABA channels shape the time course and voltage dependence of agonist currents.

In the vertebrate CNS, fast synaptic inhibition is mediated by GABA and glycine receptors. We recently reported that the time course of these synaptic currents is slower when intracellular chloride is high. Here we extend these findings to measure the effects of both extracellular and intracellular chloride on the deactivation of glycine and GABA currents at both negative and positive holding potentials. Currents were elicited by fast agonist application to outside-out patches from HEK-293 cells expressing rat glycine or GABA receptors. The slowing effect of high extracellular chloride on current decay was detectable only in low intracellular chloride (4 mm). Our main finding is that glycine and GABA receptors "sense" chloride concentrations because of interactions between the M2 pore-lining domain and the permeating ions. This hypothesis is supported by the observation that the sensitivity of channel gating to intracellular chloride is abolished if the channel is engineered to become cation selective or if positive charges in the external pore vestibule are eliminated by mutagenesis. The appropriate interaction between permeating ions and channel pore is also necessary to maintain the channel voltage sensitivity of gating, which prolongs current decay at depolarized potentials. Voltage dependence is abolished by the same mutations that suppress the effect of intracellular chloride and also by replacing chloride with another permeant ion, thiocyanate. These observations suggest that permeant chloride affects gating by a foot-in-the-door effect, binding to a channel site with asymmetrical access from the intracellular and extracellular sides of the membrane.

Finite element modelling for footwear design and evaluation: A systematic scoping review.

Finite element modelling has become an efficient tool for an in-depth understanding of the foot, footwear biomechanics and footwear optimization. The aim of this paper was to provide an updated overview in relation to the footwear finite element (FE) analysis published since 2000. The paper will attempt to outline the main challenges and research gaps that need confronting in the further development of realistic and accurate models for clinical and industrial applications. English databases of the Web of Science and PubMed were used to search ('finite element' OR 'FEA' OR 'computational model') AND ('shoe' OR 'footwear') until 16 December 2021. Articles that conducted FE analyses on the whole foot and footwear structures were included in this review. Twelve articles met the eligibility criteria, and were grouped into three categories for further analysis, (1) finite element modelling of the foot and high-heeled shoes; (2) finite element modelling of the foot and boot; (3) finite element modelling of the foot and sports shoe. Even though most of the existing foot-shoe FE analyses were performed under certain simplifications and assumptions, they have provided essential contributions in identifying the mechanical response of the foot in casual or athletic footwear. Further to this, the results have provided information in relation to optimizing footwear design to enhance functional performance. Nevertheless, further simulations still present several challenges, including reliable data information for geometry reconstruction, the balance between accurate details and computational cost, accurate representations of material properties, realistic boundary and loading conditions, and thorough model validation. In addition, some research gaps in terms of the coverage of footwear design, the consideration of insole/orthosis and socks, and the internal and external validity of the FE design should be fully covered.

The Effect of Arch Stiffness on the Foot-Ankle Temporal Kinematics during Gait Termination: A Statistical Nonparametric Mapping Study.

This study compares foot-ankle temporal kinematics characteristics during planned and unplanned gait termination (PGT and UGT) in subjects with different arch stiffnesses (ASs) based on the statistical nonparametric mapping (SnPM) method. By measuring three-dimensional arch morphological parameters under different loading conditions, 28 healthy male subjects were classified and participated in gait termination (GT) tests to collect metatarsophalangeal (MTP) and ankle-joint kinematics data. The two-way repeated-measures ANOVA using SnPM was employed to assess the impacts of AS on foot-ankle kinematics during PGT and UGT. Our results show that joint angles (MTP and ankle joints) were altered owing to AS and GT factors. The flexible arches hahadve periods of significantly greater MTP and ankle joint angles than those of stiff arches during the stance phase of GT, whereas subjects exhibited significantly smaller ankle and MTP joint angles during UGT. These results add additional insights into the morphological arch biomechanical function, and the comprehensive compensatory adjustment of lower-limb joints during gait stopping caused by unplanned stimulation.

Effect of Long-Distance Running on Inter-segment Foot Kinematics and Ground Reaction Forces: A Preliminary Study.

Long-distance running has gained massive popularity in recent years, yet the intra-foot adaptations during this event remain unclear. This study aimed to examine the kinematic and ground reaction force alterations induced within the foot following a 5 and 10 km run using the Oxford Foot Model Ten marathon-experienced recreational runners participated in this study. Five-kilometer running led to more rearfoot dorsiflexion, rearfoot eversion, and rearfoot rotation while less forefoot plantarflexion during the stance phase. Increased rearfoot plantarflexion, while decreased forefoot plantarflexion, supination, adduction, and hallux plantarflexion were observed at 10 km. In addition, the forefoot space of footwear was found to play a role in hallux kinematics. Concerning GRFs, only a lesser propulsive force was presented after a 10 km run. Findings of this study showed that 5 km of running would induce excessive foot motion while 10 km of running may gradually change the foot posture and lead to reduced propulsive forces, which could potentially increase the risks of running-related injuries (RRI) due to overuse or fatigue. Nevertheless, further research is warranted, and this study could be used as a preliminary reference to evaluate and predict foot running-related injuries.

Effect of Heel Lift Insoles on Lower Extremity Muscle Activation and Joint Work during Barbell Squats.

The effect of heel elevation on the barbell squat remains controversial, and further exploration of muscle activity might help find additional evidence. Therefore, 20 healthy adult participants (10 males and 10 females) were recruited for this study to analyze the effects of heel height on lower extremity kinematics, kinetics, and muscle activity using the OpenSim individualized musculoskeletal model. One-way repeated measures ANOVA was used for statistical analysis. The results showed that when the heel was raised, the participant's ankle dorsiflexion angle significantly decreased, and the percentage of ankle work was increased (p < 0.05). In addition, there was a significant increase in activation of the vastus lateralis, biceps femoris, and gastrocnemius muscles and a decrease in muscle activation of the anterior tibialis muscle (p < 0.05). An increase in knee moments and work done and a reduction in hip work were observed in male subjects (p < 0.05). In conclusion, heel raises affect lower extremity kinematics and kinetics during the barbell squat and alter the distribution of muscle activation and biomechanical loading of the joints in the lower extremity of participants to some extent, and there were gender differences in the results.

Development and Validation of a Subject-Specific Coupled Model for Foot and Sports Shoe Complex: A Pilot Computational Study.

Nowadays, footwear serves an essential role in improving athletic performance and decreasing the risk of unexpected injuries in sports games. Finite element (FE) modeling is a powerful tool to reveal the biomechanical interactions between foot and footwear, and establishing a coupled foot-shoe model is the prerequisite. The purpose of this pilot study was to develop and validate a 3D FE coupled model of the foot and sports shoe complex during balanced standing. All major foot and shoe structures were constructed based on the participant's medical CT images, and 3D gait analysis was conducted to define the loading and boundary conditions. Sensitivity analysis was applied to determine the optimum material property for shoe sole. Both the plantar and shoe sole areas were further divided into four regions for model validation, and the Bland-Altman method was used for consistency analysis between methods. The simulated peak plantar and sole pressure distribution showed good consistency with experimental pressure data, and the prediction errors were all less than 10% during balanced standing with only two exceptions (medial and lateral forefoot regions). Meanwhile, the Bland-Altman analysis demonstrated a good agreement between the two approaches. The sensitivity analysis suggested that shoe sole with Young's modulus of 2.739 MPa presented the greatest consistency with the measured data in our scenario. The established model could be used for investing the complex biomechanical interactions between the foot and sports shoe and optimizing footwear design, after it has been fully validated in the subsequent works under different conditions.