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1.
Biomed Eng Online ; 21(1): 61, 2022 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-36058910

RESUMO

The age-related changes of gait symmetry in healthy children concerning individual joint and muscle activation data have previously been widely studied. Extending beyond individual joints or muscles, identifying age-related changes in the coordination of multiple joints or muscles (i.e., muscle synergies and kinematic synergies) could capture more closely the underlying mechanisms responsible for gait symmetry development. To evaluate the effect of age on the symmetry of the coordination of multiple joints or muscles during childhood, we measured gait symmetry by kinematic and EMG data in 39 healthy children from 2 years old to 14 years old, divided into three equal age groups: preschool children (G1; 2.0-5.9 years), children (G2; 6.0-9.9 years), pubertal children (G3; 10.0-13.9 years). Participants walked barefoot at a self-selected walking speed during three-dimensional gait analysis (3DGA). Kinematic synergies and muscle synergies were extracted with principal component analysis (PCA) and non-negative matrix factorization (NNMF), respectively. The synergies extracted from the left and right sides were compared with each other to obtain a symmetry value. Statistical analysis was performed to examine intergroup differences. The results showed that the effect of age was significant on the symmetry values extracted by kinematic synergies, while older children exhibited higher kinematic synergy symmetry values compared to the younger group. However, no significant age-related changes in symmetry values of muscle synergy were observed. It is suggested that kinematic synergy of lower joints can be asymmetric at the onset of independent walking and showed improving symmetry with increasing age, whereas the age-related effect on the symmetry of muscle synergies was not demonstrated. These data provide an age-related framework and normative dataset to distinguish age-related differences from pathology in children with neuromotor disorders.


Assuntos
Marcha , Músculo Esquelético , Adolescente , Fenômenos Biomecânicos , Criança , Pré-Escolar , Eletromiografia/métodos , Marcha/fisiologia , Humanos , Extremidade Inferior/fisiologia , Músculo Esquelético/fisiologia
2.
Sci Transl Med ; 14(661): eabo1800, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36070366

RESUMO

Disruption of subthalamic nucleus dynamics in Parkinson's disease leads to impairments during walking. Here, we aimed to uncover the principles through which the subthalamic nucleus encodes functional and dysfunctional walking in people with Parkinson's disease. We conceived a neurorobotic platform embedding an isokinetic dynamometric chair that allowed us to deconstruct key components of walking under well-controlled conditions. We exploited this platform in 18 patients with Parkinson's disease to demonstrate that the subthalamic nucleus encodes the initiation, termination, and amplitude of leg muscle activation. We found that the same fundamental principles determine the encoding of leg muscle synergies during standing and walking. We translated this understanding into a machine learning framework that decoded muscle activation, walking states, locomotor vigor, and freezing of gait. These results expose key principles through which subthalamic nucleus dynamics encode walking, opening the possibility to operate neuroprosthetic systems with these signals to improve walking in people with Parkinson's disease.


Assuntos
Estimulação Encefálica Profunda , Transtornos Neurológicos da Marcha , Doença de Parkinson , Núcleo Subtalâmico , Estimulação Encefálica Profunda/métodos , Marcha/fisiologia , Transtornos Neurológicos da Marcha/terapia , Humanos , Doença de Parkinson/terapia , Núcleo Subtalâmico/fisiologia
3.
J Foot Ankle Res ; 15(1): 68, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36071489

RESUMO

BACKGROUND: Different multi-segment foot models have been used to explore the effect of foot orthoses. Previous studies have compared the kinematic output of different multi-segment foot models, however, no study has explored if different multi-segment foot models detect similar kinematic changes when wearing a foot orthoses. The aim of this study was to compare the ability of two different multi-segment foot models to detect kinematic changes at the hindfoot and forefoot during the single and double support phases of gait when wearing a foot orthosis. METHODS: Foot kinematics were collected during walking from a sample of 32 individuals with and without a foot orthosis with a medial heel bar using an eight-camera motion capture system. The Oxford Foot Model (OFM) and a multi-segment foot model using the Calibrated Anatomical System Technique (CAST) were applied simultaneously. Vector field statistical analysis was used to explore the kinematic effects of a medial heel bar using the two models, and the ability of the models to detect any changes in kinematics was compared. RESULTS: For the hindfoot, both models showed very good agreement of the effect of the foot orthosis across all three anatomical planes during the single and double support phases. However, for the forefoot, the level of agreement between the models varied with both models showing good agreement of the effect in the coronal plane but poorer agreement in the transverse and sagittal planes. CONCLUSIONS: This study showed that while consistency exists across both models for the hindfoot and forefoot in the coronal plane, the forefoot in the transverse and sagittal planes showed inconsistent responses to the foot orthoses. This should be considered when interpreting the efficacy of different interventions which aim to change foot biomechanics.


Assuntos
Órtoses do Pé , Fenômenos Biomecânicos/fisiologia , Pé/fisiologia , Marcha/fisiologia , Humanos , Caminhada/fisiologia
4.
Biomed Res Int ; 2022: 5029663, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36072470

RESUMO

In recent years, due to the increase in the incidence of traffic accidents, the number of people with limb injuries has also increased. At the same time, among the aging population, neurological diseases or cardiovascular and cerebrovascular diseases have caused many people to have limb hemiplegia. It has been clinically proven that the use of rehabilitation equipment can help patients with limb injuries to restore limb motor function. This paper takes wearable lower limb rehabilitation exoskeleton as the research object, and its main contents are mechanical structure design, kinematics analysis, gait planning, virtual prototype simulation, and experimental verification and analysis. Based on the physiological characteristics of human body and the principle of comfortable and reliable wearing, this paper designs wearable exoskeleton for lower limb rehabilitation. Firstly, the physiological structure characteristics and movement mechanism of human lower limbs were studied and analyzed. By referring to the rotation range and height and size of each joint of human lower limbs, the overall scheme of wearable lower limb rehabilitation exoskeleton was designed and the degree of freedom was allocated. At the same time, Solidworks was used to establish a three-dimensional model. On the basis of a 3D model, a kinematics model was established, and the forward kinematics solution was obtained by using homogeneous coordinate transformation. Since the inverse kinematics solution was relatively complicated, the inverse kinematics solution was conducted in this paper according to the geometric relations of the joints of the lower limbs. Kinematics analysis of the exoskeleton structure of wearable lower limb rehabilitation was carried out to lay a theoretical foundation for gait planning. The off-line gait planning was carried out by using the method based on ZMP stability criterion, and the gait planning was divided into five stages: squat, start, middle step, stop and rise, and the motion trajectory of the center of mass and ankle joint was planned. Based on the inverse kinematics formula, the function of the change of joint angle with time in walking process is derived. The virtual prototype is established in ADAMS, and the simulation of virtual prototype is carried out by using the function of gait planning's joint angle and time. The correctness of structural design and gait planning was verified by measuring the trajectories of the centroid and ankle joints in each gait stage and the functional relationship between the rotation angle of each joint and time. Then, using a 3D dynamic capture system to capture the human lower limb motion trajectory of each joint, each joint trajectory data output, using the MATLAB software to output data, gets the joint trajectory change over time function curve and is used to verify feasibility and applicability of human gait planning. Through the research and analysis of the joints of the lower limbs of the human body, it can be concluded that the hip joint and the knee joint have 3 degrees of freedom, respectively, and the knee joint has 1 degree of freedom.


Assuntos
Exoesqueleto Energizado , Dispositivos Eletrônicos Vestíveis , Idoso , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Extremidade Inferior
5.
Trials ; 23(1): 729, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056399

RESUMO

BACKGROUND: High-intensity repetitive task-specific practice might be the most effective strategy to promote motor recovery after stroke, and electromechanical-assisted gait training represents one of the treatment options. However, there is still difficulty in clarifying the difference between conventional gait training and electromechanically assisted gait training. METHODS: The study is a multicenter, randomized, parallel-group clinical trial for stroke patients. Three clinical research centers in Korea (Dongguk University Ilsan Hospital, Chungnam National University Hospital, and Seoul National University Bundang Hospital) will participate in the clinical trial and 144 stroke patients will be registered. Enrolled patients are assigned to two groups, an experimental group and a control group, according to a randomization table. In addition, patients are treated for half an hour (one session) five times a week for 4 weeks. Both groups carry out basic rehabilitation (central nervous system development therapy and strength exercise) and the experimental group executes robotic walking rehabilitation treatment, and the control group executes conventional gait rehabilitation treatment. The primary endpoint variable is the Functional Ambulation Category (FAC) that determines the degree of independent walking and is measured before, after, and after 4 weeks of treatment. Secondary endpoint variables are 11 variables that take into account motor function and range, measured at the same time as the primary endpoint variable. DISCUSSION: There are still insufficient data on the effectiveness of electromechanical-assisted gait training for stroke patients and large-scale research is lacking. Thus, the research described here is a large-scale study of stroke patients that can supplement the limitations mentioned in other previous studies. In addition, the clinical studies described here include physical epidemiological analysis parameters that can determine walking ability. The results of this study can lead to prove the generalizable effectiveness and safety of electromechanical-assisted gait training with EXOWALK®. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea KCT0003411, Registered on 30 October 2018.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Terapia por Exercício/métodos , Marcha/fisiologia , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento , Caminhada/fisiologia
6.
Brain Nerve ; 74(9): 1067-1079, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36065667

RESUMO

Regulation of posture-gait control by the basal ganglia (BG) plays a critical role in the acquisition of automatically executed context-dependent learned motor acts, technically referred to as habit formation. Patients with Parkinson's disease (PD) show posture-gait disturbances and progressively lose habitual behaviors. Injury to dopamine (DA) neurons in the midbrain is implicated as the primary pathophysiological mechanism underlying PD; therefore, DA actions in the BG play a pivotal role in optimal BG function. In this commentary, we discuss the mechanism underlying BG-modulated regulation of cognitive posture-gait control by the cerebral cortex through the cortico-BG loop and the basic posture-gait mechanisms underlying the actions of the brainstem and spinal cord via the BG-brainstem projection. The BG primarily regulates excitability of the cerebral cortex and brainstem through its DA-mediated inhibitory action. Based on these considerations, we describe the pathophysiological mechanisms that contribute to posture-gait disturbances in PD. Recent clinical studies suggest that posture-gait disturbances may be attributable to functional disconnection between the BG and the cerebral cortex and brainstem. Injury to various neurotransmitter systems in addition to the DA system and significant alpha-synuclein (Lewy body)-induced degeneration of the brainstem neurons may worsen posture-gait control impairment in PD.


Assuntos
Doença de Parkinson , Gânglios da Base , Neurônios Dopaminérgicos , Marcha/fisiologia , Humanos , Postura/fisiologia
7.
Brain Nerve ; 74(9): 1095-1100, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36065670

RESUMO

How the CNS deals with instability of upright posture is the core in the control of bipedal gait. In this review, we summarize our recent findings comparing kinematics and EMG activity during quadrupedal and bipedal gait in Japanese macaques. Trunk/hindlimb muscles showed step cycle-modulated activity, which was more active in bipedal than in quadrupedal gait. For bipedal gait, enhanced activity during longer double support phase was predominantly observed in distal hindlimb muscles. Alternate burst activity in bilateral back muscles cyclically brought back the tilted trunk. In monkeys' quadrupedal gait, hindlimbs formed functional pairs with contralateral forelimbs, unlike in non-primate quadrupeds. These diagonal pairs acted differently on movements of the center of mass (COM). For bipedal gait, the hindlimbs solely carried the COM. Our results suggest that, compared to non-primate quadrupeds, hindlimbs in macaques contribute more critically to weight support and balance control even for quadrupedal gait. Additionally, for more unstable bipedal gait, the monkeys' CNS reinforces such hindlimb roles and actively controls the trunk posture in maintaining dynamic balance, in a manner similar to humans. Studies on Japanese macaques will further our understanding of the neural basis for the control of gait in mammals by bridging non-primate quadrupeds and humans.


Assuntos
Hominidae , Macaca fuscata , Animais , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Macaca/fisiologia , Mamíferos , Equilíbrio Postural
8.
Brain Nerve ; 74(9): 1101-1109, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36065671

RESUMO

Recent studies have reported the neural mechanisms underlying gait and motor function recovery; neurorehabilitation involves application of these findings to clinical rehabilitation. This article focuses on post-stroke gait disorders. Gait disorder in patients with hemiplegic stroke is characterized by reduced walking speed, which is attributable to merged muscle synergies and a decreased trail limb angle. This paper describes the aforementioned factors and recent clinical research that confirms the role of the volume of gait as the most important factor, as well as evidence of various intervention methods. Furthermore, it is necessary to experience walking in various contexts and environments to achieve adaptive gait.


Assuntos
Transtornos Neurológicos da Marcha , Reabilitação Neurológica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Marcha/fisiologia , Humanos , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos , Caminhada/fisiologia
9.
J Am Acad Orthop Surg ; 30(16): 747-756, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-36067460

RESUMO

Footdrop is a common musculoskeletal condition defined by weakness in ankle joint dorsiflexion. Although the etiology varies, footdrop is characterized by specific clinical and gait abnormalities used by the patient to overcome the loss of active ankle dorsiflexion. The condition is often associated with deformity because soft-tissue structures may become contracted if not addressed. Patients may require the use of special braces or need surgical treatment to address the notable level of physical dysfunction. Surgical treatment involving deformity correction to recreate a plantigrade foot along with tendon transfers has been used with notable success to restore a near-normal gait. However, limitations and postoperative dorsiflexion weakness have prompted investigation in nerve transfer as a possible alternative surgical treatment.


Assuntos
Neuropatias Fibulares , Adulto , Braquetes , Pé/cirurgia , Marcha/fisiologia , Humanos , Transferência Tendinosa
10.
Artigo em Inglês | MEDLINE | ID: mdl-36074521

RESUMO

BACKGROUND: Perceived acceptability of barefoot use has largely been ignored in the literature despite its importance to long-term implementation and behavior change. This study aimed to compare the acceptability of undertaking weightbearing physical activities in regular running shoes versus barefoot in habitually shod individuals. METHODS: Healthy young men and women were recruited from the Gold Coast. Participants completed six activities (ie, lunges, walking, jogging, sidestep, vertical jump, and hop) in shod and barefoot conditions then answered questions pertaining to level and source of discomfort, ease of performance, and acceptability. Indices of bone quality were measured from their dominant calcaneus by quantitative ultrasound. RESULTS: Seventeen healthy male (n = 8) and female (n = 9) university students participated in the study (age, 26.59 ± 7.26 years; body mass index, 23.08 ± 3.58 kg/m2). Men were taller, heavier, and had higher broadband ultrasound attenuation than women (P < .05). For "no" discomfort, "very easy" ease of performance, and a "good amount" or "very good amount" of acceptability, the shod condition demonstrated response rates of 87.25%, 55.88%, and 72.55%, respectively. The barefoot condition demonstrated rates of those responses of 62.75%, 39.22%, and 48.03%, respectively, and reported more ball-of-foot, forefoot, heel, and plantar skin locations as sources of discomfort during activity than in the shod condition. The group vertical jump height was higher barefoot than shod (44.88 ± 8.44 cm and 43.25 ± 8.76 cm, respectively; P < .05), but no difference was seen for the hop. Men jumped and hopped higher than women under both footwear conditions (P < .05). CONCLUSIONS: Participants initiating barefoot weightbearing exercise may experience slightly greater discomfort and less ease of performance in the initial transition from the shod condition, but may perform better in vertical jump. Whether those differences in experience persist over the long term will require longitudinal studies.


Assuntos
Marcha , Sapatos , Adulto , Fenômenos Biomecânicos , Exercício Físico , Feminino , Marcha/fisiologia , Humanos , Masculino , Suporte de Carga , Adulto Jovem
11.
J Healthc Eng ; 2022: 1151753, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36046010

RESUMO

Unilateral knee extension restriction might change trunk alignment and increase mechanical load on the lumbar region during walking. We aimed to clarify lumbar region mechanical load during walking with restricted knee extension using a musculoskeletal model simulation. Seventeen healthy adult males were enrolled in this study. Participants walked 10 m at a comfortable velocity with and without restricted right knee extension of 15° and 30° using a knee brace. L4-5 joint moment, joint reaction force, and muscle forces around the lumbar region during walking were calculated for each condition. Peaks of kinetic data were compared among three gait conditions during 0%-30% and 50%-80% of the right gait cycle. Lumbar extension moment at early stance of the bilateral lower limbs was significantly increased in the 30° restricted condition (p ≤ 0.021). Muscle force of the multifidus showed peaks at stance phase of the contralateral side during walking, and the erector spinae showed force peaks at early stance of the bilateral lower limb. Muscle force of the multifidus and erector spinae increased with increasing degree of knee flexion (p ≤ 0.010), with a large effect size (η 2 = 0.273-0.486). The joint force acting on L4-5 showed two peaks at early stance of the bilateral lower limbs during the walking cycle. The anterior and vertical joint force on L4-5 increased by 14.2%-36.5% and 10.0%-23.0% in walking with restricted knee extension, respectively (p ≤ 0.010), with a large effect size (η 2 = 0.149-0.425). Restricted knee joint extension changed trunk alignment and increased the muscle force and the vertical and anterior joint force on the L4-5 joint during walking; this tendency became more obvious with increased restriction angle. Our results provide important information for therapists engaged in the rehabilitation of patients with knee contracture.


Assuntos
Marcha , Região Lombossacral , Adulto , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Articulação do Joelho/fisiologia , Extremidade Inferior/fisiologia , Masculino
12.
Sensors (Basel) ; 22(17)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36081055

RESUMO

The ankle joint is one of the important joints of the human body to maintain the ability to walk. Diseases such as stroke and ankle osteoarthritis could weaken the body's ability to control joints, causing people's gait to be out of balance. Ankle-foot orthoses can assist users with neuro/muscular or ankle injuries to restore their natural gait. Currently, passive ankle-foot orthoses are mostly designed to fix the ankle joint and provide support for walking. With the development of materials, sensing, and control science, semi-active orthoses that release mechanical energy to assist walking when needed and can store the energy generated by body movement in elastic units, as well as active ankle-foot orthoses that use external energy to transmit enhanced torque to the ankle, have received increasing attention. This article reviews the development process of ankle-foot orthoses and proposes that the integration of new ankle-foot orthoses with rehabilitation technologies such as monitoring or myoelectric stimulation will play an important role in reducing the walking energy consumption of patients in the study of human-in-the-loop models and promoting neuro/muscular rehabilitation.


Assuntos
Órtoses do Pé , Tornozelo , Articulação do Tornozelo , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Pesquisa , Caminhada/fisiologia
13.
J Neuroeng Rehabil ; 19(1): 99, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104706

RESUMO

BACKGROUND: Robot-assisted gait training (RAGT) is a practical treatment that can complement conventional rehabilitation by providing high-intensity repetitive training for patients with stroke. RAGT systems are usually either of the end-effector or exoskeleton types. We developed a novel hybrid RAGT system that leverages the advantages of both types. OBJECTIVE: This single-blind randomized controlled trial evaluated the beneficial effects of the novel RAGT system both immediately after the intervention and at the 3-month follow-up in nonambulatory patients with subacute stroke. METHODS: We recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation either alone or with the addition of 15 RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl-Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance-Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3-m and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up. RESULTS: Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3-m and 6-m walking speed tests before and after intervention and at the 3-month follow-up (p < 0.05). The RAGT group significantly outperformed the control group only in the FMA-LE (p = 0.014) and total (p = 0.002) assessments. CONCLUSION: Although the novel hybrid RAGT is effective, strong evidence supporting its clinical effectiveness relative to controls in those with substantial leg dysfunction after stroke remains elusive. Trial registration The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered retrospectively on September 16, 2016, at https://www.isrctn.com/ISRCTN15088682.


Assuntos
Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Marcha/fisiologia , Humanos , Compostos Organometálicos , Ácidos Polimetacrílicos , Estudos Retrospectivos , Método Simples-Cego , Acidente Vascular Cerebral/complicações
14.
Artigo em Inglês | MEDLINE | ID: mdl-36078419

RESUMO

The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores-although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).


Assuntos
Sistema Musculoesquelético , Corrida , Marcha/fisiologia , Humanos , Corrida/fisiologia , Sapatos , Análise e Desempenho de Tarefas
15.
Foot (Edinb) ; 52: 101910, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36049266

RESUMO

INTRODUCTION: Flatfoot is a very common static deformity. It occurs frequently in soldiers and causes problems in the lower extremities. There is a lack of data regarding therapy with insoles, especially with sensorimotor insoles. The objective of this study was to investigate the influence in muscle activity of supporting/correcting and sensorimotor insoles in combat boots in the muscles of the lower limb and thus to draw conclusions according to the benefits of insole therapy in military footwear. METHODS: 73 patients (12 female, 61 males; average age: 30.8 ± 7.9 years) with pes planovalgus deformity were included in this prospective randomized placebo-controlled study. For intervention supporting (N = 23), sensorimotor (N = 28) and placebo insoles (N = 22) were used. During gait analysis muscle activity was measured by means of surface electromyography (EMG) of the tibialis anterior and peroneus longus muscle in combat boots with and without insoles. Statistical evaluation was performed using two-factor ANOVA with repeated measures. RESULTS: EMG measures (amplitude, integral, maximum, mean) showed mainly activating effects in the peroneus longus muscle in the case of sensorimotor and activity reductions in supporting insoles. Comparing effects of different kinds of insoles to the peroneus longus muscle, significant differences could be shown. No significant differences in muscular activation were observed for the tibialis anterior muscle. CONCLUSION: Even in combat boots effects of sensorimotor insoles on the peroneus longus muscle can be detected. The expected effects, attributed to the different kinds of insole, could be observed, too. While sensorimotor insoles had an activating kind of effect, supportive insoles reduced muscular activity of the peroneus longus. In contrast for the tibialis anterior muscle no clear conclusion could be drawn. Its muscular activity seems not to be influenced by insoles in combat boots. However, it remains unclear whether clinical long term effects, e.g. pain and function, can be improved.


Assuntos
Pé Chato , Marcha , Adulto , Eletromiografia , Feminino , Marcha/fisiologia , Humanos , Perna (Membro) , Masculino , Músculo Esquelético/fisiologia , Estudos Prospectivos , Sapatos , Adulto Jovem
16.
Eur Rev Med Pharmacol Sci ; 26(17): 6236-6241, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36111924

RESUMO

OBJECTIVE: Knee osteoarthritis (KOA) is a progressive disease affecting the biomechanics of the knee and other parts of the lower extremities, such as the ankle and foot. Little is known about the pathophysiology of plantar pressure in patients with KOA, which could lead to foot disability. This review aimed to provide more in-depth information regarding the pathophysiology of plantar pressure patterns and their related parameters in older adults with KOA. MATERIALS AND METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed database was searched with the keywords "foot pressure and knee osteoarthritis" and "center of pressure and knee osteoarthritis". The eligible articles were evaluated based on five characteristics: KOA stages, sample size, country, study tool, and findings. The primary outcomes were plantar pressure and center of pressure (COP) in each area. Other outcomes were also evaluated, such as knee flexion angle, knee abductor moment, and clinical scores. RESULTS: Nine full-text articles were eligible for review, including 495 participants (256 patients with KOA and 239 healthy individuals). The mean age of patients with KOA was 60.2-77 years. Patients with KOA had a higher tendency for pronounced plantar pressure on the medial forefoot, mid-foot, or the foot's central area. The COP patterns were shorter and more lateralized in patients with KOA, reflecting the functional ability, pain, and well-being of patients with KOA. CONCLUSIONS: Abnormalities in plantar pressure and COP were observed in older adults with KOA. This information could be a basis for designing biomedical devices, orthoses, and other realignment osteotomies of the lower extremities that could relieve symptoms at the knee or foot, or reduce KOA progression.


Assuntos
Osteoartrite do Joelho , Idoso , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Articulação do Joelho , Extremidade Inferior , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico
17.
J Foot Ankle Res ; 15(1): 70, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36089598

RESUMO

BACKGROUND: Idiopathic toe walking (ITW) is an exclusionary diagnosis. There has been limited exploration of lower limb active range of motion and strength measures in children with ITW. This researched aimed to determine any differences in lower limb muscle active range of motion and strength in children who have ITW, compared to normative data collected from children who displayed typical gait. METHODS: Children were recruited with had a diagnosis of ITW, aged between 4 and 10 years, and no recent treatment. Data collected included parent reported data such as time spent toe walking, percentage of time spent toe walking, and clinician collected data such as age, height and weight. Joint ranges of motion and strength measures were collected by an experience clinician. Active and weight bearing joint ranges of motion were evaluated with a goniometer or digital inclinometer. Lower limb muscle strength measures were evaluated with a hand-held dynamometer. Published normative data sets were used for comparison. Measures were analysed with regression analyses to determine differences between groups in different measures, considering measures known to impact range and strength. Odds ratios (OR), 95% confidence intervals (CI) and p values were reported. RESULTS: Twenty-six children with ITW participated. Reduced weight bearing ankle range of motion, when measured with the knee bent, was associated with being in the ITW group (p = 0.009), being older (p < 0.001) and weighing less (p < 0.001). Reduced ankle plantar flexion range was only associated with being in the ITW group (p = 0.015). For all lower limb strength measures, excluding hip external rotation, children who displayed greater strength, did not toe walk (p < 0.002), were older (p < 0.001) and weighed more (p < 0.014). with ITW. CONCLUSION: Children with ITW displayed reduced overall plantar and dorsiflexion at the ankle, compared to non-toe walking children. Reduced plantarflexion is children with ITW has not been described before, however reduced dorsiflexion is commonly reported. Children with ITW were weaker in many lower limb measures, even when age and weight were considered. This should lead clinicians and researchers to pay greater attention to lower limb strength measures in this population.


Assuntos
Transtornos dos Movimentos , Dedos do Pé , Estudos de Casos e Controles , Criança , Pré-Escolar , Marcha/fisiologia , Humanos , Extremidade Inferior , Transtornos dos Movimentos/diagnóstico , Dedos do Pé/fisiologia , Caminhada/fisiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-36078206

RESUMO

Identifying potential gait deviations in patellofemoral instability (PI) can help with the development of effective rehabilitation strategies. The purpose of this systematic review was to examine whether there are specific gait alterations in subjects with PI. The present review followed the PRISMA guidelines and was initially registered at PROSPERO (CRD42021236765). The literature search was carried out in the databases of PubMed, the Cochrane library, Web of Science, ClinicalTrials.gov, and Medline. The search strategy resulted in the identification of seven relevant publications. Subjects with PI show decreased walking speed, stride length, and cadence. Some studies reported changes not only in knee kinematics and kinetics but also in hip and ankle kinematics and kinetics. There is evidence that most subjects with PI walk with a quadriceps avoidance gait and show increased genu valgum posture, but there is still great variability in the coping responses within individuals with PI. The discrepancy among the study results might underpin the fact that PI is a multifactorial problem, and subjects cope with the different underlying morphological as well as functional deficits using a variety of gait strategies, which makes the interpretation and understanding of the gait of subjects with PI a clinically challenging task.


Assuntos
Marcha , Velocidade de Caminhada , Articulação do Tornozelo , Fenômenos Biomecânicos/fisiologia , Marcha/fisiologia , Humanos , Articulação do Joelho , Caminhada/fisiologia , Velocidade de Caminhada/fisiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-36078509

RESUMO

This study aimed to determine the role of cognitive and affective responses to music cues in modulating the effects of familiarity with music on stride length and stride-to-stride variability in people with Parkinson's disease (PD). Using multilevel modeling, people with PD's spatiotemporal gait parameters and self-reported ratings of familiarity, enjoyment, cognitive and physical demand, beats salience of music cues after each walking trial, as well as music reward, were analyzed. Our findings indicate that (1) condition-varying perceived enjoyment and beat salience are positively associated with increased stride length; (2) participants with a greater music reward for mood regulation and emotion evocation show greater stride length changes compared with those with less music reward; (3) condition-varying perceived enjoyment is positively associated with decreases in stride-to-stride variability; and (4) participants with lower cognitive demand of walking with music cues and higher beat salience show lower stride-to-stride variability compared with those with higher cognitive demand and lower beat salience. These results provide behavioral evidence of independent and interactive influences of cognitive and affective responses to music cues on spatiotemporal gait parameters in people with PD.


Assuntos
Música , Doença de Parkinson , Estimulação Acústica/métodos , Sinais (Psicologia) , Marcha/fisiologia , Humanos , Caminhada/fisiologia
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 95-98, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36085891

RESUMO

Gait disturbances with falls are common among patients with Parkinson's disease. Falls commonly occur from slips while walking on pathways with turns. Gait phases namely Loading Response and Terminal Stance are linked with forward and backward slips. Also, postural deformities (connected with knee joint angles) are debilitating symptoms of Parkinson's patients and are related with falls. Here, we have focused on exploring the contribution of Loading Response and Terminal Stance to risk of fall along with the relevance of postural deformity (e.g., knee bending) while an individual walked overground on pathways (with 0° and 180° turn) under dual task condition. For this, we have used a wearable device consisting of a pair of Sensored shoes and Knee Bending Angle Recorder Units. The device was used to compute Coefficient of Variation of knee bending angle during different gait phases as an indicator of one's risk of fall that corroborated with clinical measure. Clinical Relevance- A study with age and gender matched healthy and Parkinson's individuals indicated the importance of Loading Response and pathway turn while assessing risk of fall. This can serve as important pre-clinical input while designing intervention paradigms.


Assuntos
Doença de Parkinson , Dispositivos Eletrônicos Vestíveis , Acidentes por Quedas/prevenção & controle , Marcha/fisiologia , Humanos , Articulação do Joelho , Doença de Parkinson/diagnóstico
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