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1.
Artigo em Inglês | MEDLINE | ID: mdl-33800119

RESUMO

Quantitative assessment is crucial for the evaluation of human postural balance. The force plate system is the key quantitative balance assessment method. The purpose of this study is to review the important concepts in balance assessment and analyze the experimental conditions, parameter variables, and application scope based on force plate technology. As there is a wide range of balance assessment tests and a variety of commercial force plate systems to choose from, there is room for further improvement of the test details and evaluation variables of the balance assessment. The recommendations presented in this article are the foundation and key part of the postural balance assessment; these recommendations focus on the type of force plate, the subject's foot posture, and the choice of assessment variables, which further enriches the content of posturography. In order to promote a more reasonable balance assessment method based on force plates, further methodological research and a stronger consensus are still needed.


Assuntos
Equilíbrio Postural , Postura , , Humanos , Posição Ortostática
2.
Artigo em Inglês | MEDLINE | ID: mdl-33801376

RESUMO

This study aimed to determine the influence of arch stiffness on running spatiotemporal parameters at a common speed for a wide range of endurance runners (i.e., 12 km·h-1). In total, 97 runners, 52 men and 45 women, completed a treadmill running protocol at 12 km·h-1. Spatiotemporal parameters were measured using the OptoGait system, and foot structure was assessed by determining arch stiffness. Since between-sex differences were found in anthropometric and foot structure variables, data analysis was conducted separately for men and women, and body mass and height were considered as covariates. For both sexes, a k-means cluster analysis grouped participants according to arch stiffness, by obtaining a group of low-arch stiffness (LAS group) and a group of high-arch stiffness (HAS group), with significant differences in arch stiffness (p < 0.001, for both men and women). No significant differences between LAS and HAS groups were found in running spatiotemporal parameters, regardless of sex (p ≥ 0.05). For both sexes, the partial correlation analysis reported no significant correlations (p ≥ 0.05) between foot structure variables and running spatiotemporal parameters. The results obtained show no differences in spatiotemporal gait characteristics during running at submaximal velocity between runners with low-arch stiffness and those with high-arch stiffness, regardless of sex. These findings may have important implications for clinicians and coaches by adding more evidence to the debate about the use of static foot classification measures when characterizing the foot and its biomechanics during running.


Assuntos
Corrida , Fenômenos Biomecânicos , Teste de Esforço , Feminino , , Marcha , Humanos , Masculino
3.
Artigo em Inglês | MEDLINE | ID: mdl-33809091

RESUMO

The main purpose of this study was to identify a dancer's body alignment while performing flamenco footwork to provide a detailed description that could be used by flamenco practitioners: teachers, instructors and students of different levels of advancement. The zapateado technique performed by a professional flamenco dancer was analyzed. The biomechanical analysis was based on 30 cycles composed of six repeating sequences of strikes. Kinematic recordings were performed using a Vicon system, while the measurement of the ground reaction forces (GRF) was accomplished with a Kistler force plate. The following parameters were analyzed: the time of each foot strike, the maximal value of the vertical component of GRF normalized to body weight (BW) for subsequent footwork steps, the impulse of the GRF and the kinematics of pelvis and lower limb joints, and an exemplary waveform view of the sound of footwork strikes was shown. The average values of the vertical component of GRF ranged between 0.6 and 2.7 BW. The maximal anterior pelvic tilt was 29°, with a 6° range of motion (RoM). This mobility was accompanied by 20° hip RoM and by ~40° knee RoM throughout flexion. The conclusions provide practical information that a teacher and flamenco student should receive.


Assuntos
, Extremidade Inferior , Fenômenos Biomecânicos , Humanos , Articulação do Joelho , Amplitude de Movimento Articular
4.
Artigo em Inglês | MEDLINE | ID: mdl-33809407

RESUMO

There are numerous programs worldwide adapted for alpine ski beginners and they all share the same primary goal-inclusion of skiing beginners in alpine ski schools. The final elements of ski school taught in the parallel skiing technique are parallel turn and short turn. Synchronized analysis of kinetic and kinematic parameters of the parallel turn (PT) and short turn (ST) was conducted to determine the main biomechanical differences from a standpoint of foot pressure and lower limb angles. Both elements were performed by nine male ski instructors (age 33.4 ± 8.62, height 179.52 ± 5.98 cm, weight 78.6 ± 8.88 kg). Kinetic and kinematic analysis was conducted on 180 turns, 90 for each element. Differences in kinetic and kinematic parameters between parallel and short turns were tested by a paired t-test. The main findings of our study are determined differences in the ratio of pressure distribution on the inside and the outside foot and differences in kinematic parameters of the outside leg between elements. The mentioned analysis can provide an objective insight into the complexity of each element and provide guidelines for teaching process of those elements. This study determined the reasons for higher complexity of ST compared to PT based on the objective evaluation of biomechanical factors.


Assuntos
Esqui , Fenômenos Biomecânicos , , Cinética , Masculino
5.
Artigo em Inglês | MEDLINE | ID: mdl-33809948

RESUMO

BACKGROUND: The analysis of the center of pressure (COP) is a method used to assess the foot function, but its reliability and repeatability have not been evaluated. COP can be altered by diverse conditions, like an excessive foot pronation. Low-Dye taping is commonly used for the treatment of symptoms related to an excessive pronation. To date, no study has evaluated the effects of the Low-Dye taping on COP and the duration of its effects. Thus, the main purpose of this manuscript was to assess the reliability and repeatability of the percentage of center of pressure locus area (%CLA) in feet with an excessive pronation, and secondarily, to assess that the Low-Dye taping modifies the %CLA during the immediate 48 h. METHODS: An observational study of the reliability and repeatability of the %CLA variable with the Low-Dye taping in feet with excessive pronation was carried out. We used the EPS-Platform to evaluate the results of the variable in 6 conditions in a first session to evaluate the reliability of the results. We compared the results of the first session with the results in a second session to evaluate the repeatability of the results. We also carried out an ANOVA test to evaluate the changes that the taping produced in the variable between without taping with the rest of the 6 conditions. RESULTS: For the %CLA, we observed a reliability greater than 0.80, measured by the interclass ratio index, both in the first session before taping, and in the second session before taping, thus being a repeatability variable. In the following times, with taping, at 10 min with tape, at 20 min with tape, at 24 h with tape and at 48 h with tape; an interclass ratio coefficient (ICC) higher than 0.80 was again obtained, thus being a reliable variable in all measurements made. The Low-Dye taping did not change %CLA from the time the tape was put in until 48 h (p-value = 1.000). CONCLUSIONS: The %CLA variable, in feet with excessive pronation, proved to be a reliable variable in all the measurements obtained before putting on the tape and during the following 48 h with the tape, and a repeatable variable. The Low-Dye taping did not change the %CLA from the time the tape was put in until 48 h.


Assuntos
Podiatria , , Pronação , Reprodutibilidade dos Testes
6.
Science ; 372(6540): 344-345, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33888627
7.
Artigo em Inglês | MEDLINE | ID: mdl-33801299

RESUMO

The aim of this study is to observe the morphological and postural changes to the foot that take place during pregnancy and the puerperium. Method: In this descriptive, observational, longitudinal study, we analysed 23 pregnant women, with particular attention to morphological and postural aspects of the foot, at three time points during and after pregnancy: in weeks 9-13 of gestation, weeks 32-35 of gestation and weeks 4-6 after delivery. The parameters considered were changes in foot length, the Foot Posture Index (FPI) and the Hernández Corvo Index, which were analysed using a pedigraph and taking into account the Body Mass Index (BMI). The same procedure was conducted in each review. Results: The statistical analyses obtained for each foot did not differ significantly between the three measurement times. A pronator-type footprint was most frequently observed during the third trimester of pregnancy; it was predominantly neutral during the postpartum period. Statistically significant differences between the measurement times were obtained in the right foot for cavus vs. neutral foot type (between the first and third trimesters and also between the first trimester and the puerperium) (in both cases, p < 0.0001). Conclusions: Foot length increases in the third trimester and returns to normal in the puerperium. According to FPI findings, the third trimester of pregnancy is characterised by pronation, while the posture returns to neutrality during the postpartum period. During pregnancy, the plantar arch flattens, and this persists during the puerperium. The incidence of cavus foot increases significantly in the third trimester and in the puerperium.


Assuntos
, Período Pós-Parto , Feminino , Pé/fisiologia , Humanos , Estudos Longitudinais , Postura , Gravidez , Terceiro Trimestre da Gravidez
8.
Sensors (Basel) ; 21(7)2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33804926

RESUMO

This work presents a revision of four different registration methods for thermal infrared and visible images captured by a camera-based prototype for the remote monitoring of diabetic foot. This prototype uses low cost and off-the-shelf available sensors in thermal infrared and visible spectra. Four different methods (Geometric Optical Translation, Homography, Iterative Closest Point, and Affine transform with Gradient Descent) have been implemented and analyzed for the registration of images obtained from both sensors. All four algorithms' performances were evaluated using the Simultaneous Truth and Performance Level Estimation (STAPLE) together with several overlap benchmarks as the Dice coefficient and the Jaccard index. The performance of the four methods has been analyzed with the subject at a fixed focal plane and also in the vicinity of this plane. The four registration algorithms provide suitable results both at the focal plane as well as outside of it within 50 mm margin. The obtained Dice coefficients are greater than 0.950 in all scenarios, well within the margins required for the application at hand. A discussion of the obtained results under different distances is presented along with an evaluation of its robustness under changing conditions.


Assuntos
Diabetes Mellitus , Pé Diabético , Algoritmos , Pé Diabético/diagnóstico por imagem , , Humanos , Monitorização Fisiológica , Termografia
9.
Sensors (Basel) ; 21(5)2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33806449

RESUMO

Flatfoot is a common musculoskeletal deformity. One of the most effective treatments is to wear individually customized plantar pressure-based insoles to help users change the abnormally distributed pressure on the pelma. However, most previous studies were divided only into several plantar areas without detailed plantar characteristic analysis. In this study, a new insole is designed which redistributes pressure following the analysis of characteristic points of plantar pressure, and practical evaluation during walking of subjects while wearing the insole. In total, 10 subjects with flexible flatfeet have participated in the performance of gait experiments by wearing flat insoles, orthotic insoles, and plantar pressure redistribution insoles (PPRI). The results showed that the stance time of PPRI was significantly lower than that of the flat insoles under slow gait. PPRI in the second to third metatarsal and medial heel area showed better unloading capabilities than orthotic insoles. In the metatarsal and heel area, the PPRI also had its advantage in percentage of contact area compared to flat insole and orthotic insole. The results prove that PPRI improves the plantar pressure distribution and gait efficiency of adults with flexible flatfeet, and can be applied into clinical application.


Assuntos
Pé Chato , Órtoses do Pé , Adulto , Desenho de Equipamento , Pé Chato/terapia , , Humanos , Pressão , Sapatos , Caminhada
10.
Artigo em Inglês | MEDLINE | ID: mdl-33807259

RESUMO

OBJECTIVE: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients, to determine the degree to which both feet were affected, primarily analyzing the severity of RA in both feet looking at structure and morphology, and secondly looking at the symmetry in terms of the anthropometrics and posture. METHOD: This cross-sectional study was conducted from January to December 2018. The data from 229 patients with RA and with foot pain and no RA recruited (Granada, Spain) were analyzed. Two researchers independently interviewed the patients to obtain the study data. The clinical data were obtained using specific foot health and quality of life questionnaires and a validated platform for foot measurement. Anthropometric measurements were obtained by means of a foot measurement platform and the Foot Posture Index (FPI). The bivariate analysis was performed with the Student's t test and the non-parametric Wilcoxon test. The level of significance was established at p < 0.05. RESULTS: In the RA group, anthropometric measurements revealed significant differences between the left and right feet in 13 of the 23 parameters considered, as follows: (non-load-bearing) foot length, length of the first metatarsophalangeal joint, maximum height of the internal longitudinal arch, and width of the midfoot (p < 0.001, p = 0.038, p < 0.001, and p = 0.037 respectively); and Foot Posture Index (p = 0.001). CONCLUSIONS: In patients with RA, statistically significant differences were found in the Foot Posture Index and in several parameters related to foot structure and morphology. From this, we conclude that from a morphological, structural, and postural standpoint, a pattern of symmetric joint involvement should not be viewed as a specific criterion for RA in the foot.


Assuntos
Artrite Reumatoide , Qualidade de Vida , Estudos Transversais , , Humanos , Espanha
11.
Sensors (Basel) ; 21(5)2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33807804

RESUMO

One important health problem that could affect diabetics is diabetic foot syndrome, as risk of ulceration, neuropathy, ischemia and infection. Unnoticed minor injuries, subsequent infection and ulceration may end in a foot amputation. Preliminary studies have shown a relationship between increased skin temperature and asymmetries between the same regions of both feet. In the preulceration phase, to develop a smart device able to control the temperature of these types of patients to avoid this risk might be very useful. A statistical analysis has been carried out with a sample of foot temperature data obtained from 93 individuals, of whom 44 are diabetics and 49 nondiabetics and among them 43% are men and 57% are women. Data obtained with a thermographic camera has been successful in providing a set of regions of interest, where the temperature could influence the individual, and the behavior of several variables that could affect these subjects provides a mathematical model. Finally, an in-depth analysis of existing sensors situated in those positions, namely, heel, medial midfoot, first metatarsal head, fifth metatarsal head, and first toe has allowed for the development of a smart sock to store temperatures obtained every few minutes in a mobile device.


Assuntos
Diabetes Mellitus , Pé Diabético , Dispositivos Eletrônicos Vestíveis , Pé Diabético/diagnóstico , Feminino , , Humanos , Masculino , Temperatura , Termografia
12.
Artigo em Inglês | MEDLINE | ID: mdl-33799795

RESUMO

Previous studies investigating the effect of excessive weight on the foot have commonly been cross-sectional; therefore, it is still unclear how the foot function gradually changes with the increased body mass that is physiologically gained over time. This study aimed to use a load transfer method to identify the mechanism of how the foot function changed with the increased excessive body mass over two years. Taking normal weight as the baseline, fifteen children became overweight or obese (group 1), and fifteen counterparts maintained normal weight (group 0) over the two years. Barefoot walking was assessed using a Footscan® plate system. A load transfer method was used based upon the relative force-time integral (FTI) to provide an insight into plantar load transference as children increased in weight. Significantly increased FTIs were found at the big toe (BT), medial metatarsal (MM), lateral metatarsal (LM), and lateral heel (HL) in group 1, while at BT, MM, medial heel (HM), and HL in group 0. Foot load showed a posterior to anterior transferal from midfoot (2.5%) and heel (7.0%) to metatarsal and big toe in group 1. The control group, however, shifted the loading within the metatarsal level from LM to HM (4.1%), and equally relieved weight from around the midfoot (MF) (3.0%) to BT, MM, HM and HL. Earlier weight loss intervention is required to prevent further adverse effects on foot functions caused by excessive weight-bearing.


Assuntos
, Caminhada , Criança , Estudos Transversais , Humanos , Estudos Longitudinais , Pressão
13.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(2): 279-285, 2021 Mar 26.
Artigo em Chinês | MEDLINE | ID: mdl-33879898

RESUMO

OBJECTIVE: To analyze characteristics and related factors of the plantar pressure during the level walking and single leg standing in the chronic ankle instability (CAI) individuals. METHODS: From April 2019, 75 CAI individuals and 40 healthy individuals were enrolled in this study. Both of the static and dynamic plantar pressure were measured during six times level walking and three times single leg standing testing. The data including peak force, time to peak force in various foot contact areas and the time to boundary (TTB) and velocity of center of pressure (COP) were measured and compared between the affected side and the unaffected side and between the CAI cases and the healthy individuals. The correlations between the plantar pressure and the gender, Beighton score, affected side and body mass index (BMI) were analyzed. RESULTS: The characteristics of plantar pressure distribution in the CAI individuals included: (1) During the level walking, the affected side showed the similar pressure contribution as the unaffected side (P>0.05). While compared with healthy individuals, there was a significantly higher peak force in the 5th metatarsal area (t=-3.86, P=0.03) of the affected side, lower peak force in the 1st (t=2.99, P=0.02), 2nd metatarsal head areas (t=2.09, P=0.01) of the affected side, medial hindfoot areas of both sides (affected, t=2.33, P=0.01; unaffected, t=3.74, P=0.02) and toes areass of both sides (affected, t=2.23, P=0.01; unaffected, t=3.28, P=0.02) and a delay to peak force in the 4th metatarsal head area (t=3.33, P=0.01) of the affected side. (2) During the single leg standing, the CAI individuals showed significantly worse balance control in the anterior/posterior direction (P < 0.05) and lateral/medial direction (P < 0.05) compared with the healthy controls, and the affected side had more severe balance control deficit in the lateral/medial direction (P < 0.05). (3) The women (P < 0.05) and the individuals with higher Beighton scores (P < 0.05) showed worse balance control deficit in the lateral/medial direction. CONCLUSION: CAI individuals showed significantly a more lateral shifted plantar distribution during the level walking compared with the healthy individuals and the tendency was worse on the affected sides, and showed worse balance control in the anterior/posterior direction and lateral/medial direction during the single leg standing. The women and those with generalized ligament laxity showed significantly worse balance control.


Assuntos
Tornozelo , Instabilidade Articular , Articulação do Tornozelo , Estudos de Casos e Controles , Feminino , , Humanos
14.
Sensors (Basel) ; 21(5)2021 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-33800949

RESUMO

The monitoring of some parameters, such as pressure loads, temperature, and glucose level in sweat on the plantar surface, is one of the most promising approaches for evaluating the health state of the diabetic foot and for preventing the onset of inflammatory events later degenerating in ulcerative lesions. This work presents the results of sensors microfabrication, experimental characterization and FEA-based thermal analysis of a 3D foot-insole model, aimed to advance in the development of a fully custom smart multisensory hardware-software monitoring platform for the diabetic foot. In this system, the simultaneous detection of temperature-, pressure- and sweat-based glucose level by means of full custom microfabricated sensors distributed on eight reading points of a smart insole will be possible, and the unit for data acquisition and wireless transmission will be fully integrated into the platform. Finite element analysis simulations, based on an accurate bioheat transfer model of the metabolic response of the foot tissue, demonstrated that subcutaneous inflamed lesions located up to the muscle layer, and ischemic damage located not below the reticular/fat layer, can be successfully detected. The microfabrication processes and preliminary results of functional characterization of flexible piezoelectric pressure sensors and glucose sensors are presented. Full custom pressure sensors generate an electric charge in the range 0-20 pC, proportional to the applied load in the range 0-4 N, with a figure of merit of 4.7 ± 1 GPa. The disposable glucose sensors exhibit a 0-6 mM (0-108 mg/dL) glucose concentration optimized linear response (for sweat-sensing), with a LOD of 3.27 µM (0.058 mg/dL) and a sensitivity of 21 µA/mM cm2 in the PBS solution. The technical prerequisites and experimental sensing performances were assessed, as preliminary step before future integration into a second prototype, based on a full custom smart insole with enhanced sensing functionalities.


Assuntos
Diabetes Mellitus , Pé Diabético , Dispositivos Eletrônicos Vestíveis , , Humanos , Sapatos , Suor
15.
Sensors (Basel) ; 21(5)2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33801346

RESUMO

Diabetic foot ulcers (DFUs) are a life-changing complication of diabetes that can lead to amputation. There is increasing evidence that long-term management with wearables can reduce incidence and recurrence of this condition. Temperature asymmetry measurements can alert to DFU development, but measurements of dynamic information, such as rate of temperature change, are under investigated. We present a new wearable device for temperature monitoring at the foot that is personalised to account for anatomical variations at the foot. We validate this device on 13 participants with diabetes (no neuropathy) (group name D) and 12 control participants (group name C), during sitting and standing. We extract dynamic temperature parameters from four sites on each foot to compare the rate of temperature change. During sitting the time constant of temperature rise after shoe donning was significantly (p < 0.05) faster at the hallux (p = 0.032, 370.4 s (C), 279.1 s (D)) and 5th metatarsal head (p = 0.011, 481.9 s (C), 356.6 s (D)) in participants with diabetes compared to controls. No significant differences at the other sites or during standing were identified. These results suggest that temperature rise time is faster at parts of the foot in those who have developed diabetes. Elevated temperatures are known to be a risk factor of DFUs and measurement of time constants may provide information on their development. This work suggests that temperature rise time measured at the plantar surface may be an indicative biomarker for differences in soft tissue biomechanics and vascularisation during diabetes onset and progression.


Assuntos
Diabetes Mellitus , Pé Diabético , Dispositivos Eletrônicos Vestíveis , , Humanos , Impressão Tridimensional , Temperatura
16.
Sensors (Basel) ; 21(5)2021 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-33803369

RESUMO

Depth cameras are developing widely. One of their main virtues is that, based on their data and by applying machine learning algorithms and techniques, it is possible to perform body tracking and make an accurate three-dimensional representation of body movement. Specifically, this paper will use the Kinect v2 device, which incorporates a random forest algorithm for 25 joints detection in the human body. However, although Kinect v2 is a powerful tool, there are circumstances in which the device's design does not allow the extraction of such data or the accuracy of the data is low, as is usually the case with foot position. We propose a method of acquiring this data in circumstances where the Kinect v2 device does not recognize the body when only the lower limbs are visible, improving the ankle angle's precision employing projection lines. Using a region-based convolutional neural network (Mask RCNN) for body recognition, raw data extraction for automatic ankle angle measurement has been achieved. All angles have been evaluated by inertial measurement units (IMUs) as gold standard. For the six tests carried out at different fixed distances between 0.5 and 4 m to the Kinect, we have obtained (mean ± SD) a Pearson's coefficient, r = 0.89 ± 0.04, a Spearman's coefficient, ρ = 0.83 ± 0.09, a root mean square error, RMSE = 10.7 ± 2.6 deg and a mean absolute error, MAE = 7.5 ± 1.8 deg. For the walking test, or variable distance test, we have obtained a Pearson's coefficient, r = 0.74, a Spearman's coefficient, ρ = 0.72, an RMSE = 6.4 deg and an MAE = 4.7 deg.


Assuntos
Tornozelo , Marcha , Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/diagnóstico por imagem , Fenômenos Biomecânicos , , Humanos
17.
Bone Joint J ; 103-B(4): 788-794, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33789469

RESUMO

AIMS: Tenosynovial giant cell tumour (TGCT) is one of the most common soft-tissue tumours of the foot and ankle and can behave in a locally aggressive manner. Tumour control can be difficult, despite the various methods of treatment available. Since treatment guidelines are lacking, the aim of this study was to review the multidisciplinary management by presenting the largest series of TGCT of the foot and ankle to date from two specialized sarcoma centres. METHODS: The Oxford Tumour Registry and the Leiden University Medical Centre Sarcoma Registry were retrospectively reviewed for patients with histologically proven foot and ankle TGCT diagnosed between January 2002 and August 2019. RESULTS: A total of 84 patients were included. There were 39 men and 45 women with a mean age at primary treatment of 38.3 years (9 to 72). The median follow-up was 46.5 months (interquartile range (IQR) 21.3 to 82.3). Localized-type TGCT (n = 15) predominantly affected forefoot, whereas diffuse-type TGCT (Dt-TGCT) (n = 9) tended to panarticular involvement. TGCT was not included in the radiological differential diagnosis in 20% (n = 15/75). Most patients had open rather than arthroscopic surgery (76 vs 17). The highest recurrence rates were seen with Dt-TGCT (61%; n = 23/38), panarticular involvement (83%; n = 5/8), and after arthroscopy (47%; n = 8/17). Three (4%) fusions were carried out for osteochondral destruction by Dt-TGCT. There were 14 (16%) patients with Dt-TGCT who underwent systemic treatment, mostly in refractory cases (79%; n = 11). TGCT initially decreased or stabilized in 12 patients (86%), but progressed in five (36%) during follow-up; all five underwent subsequent surgery. Side effects were reported in 12 patients (86%). CONCLUSION: We recommend open surgical excision as the primary treatment for TGCT of the foot and ankle, particularly in patients with Dt-TGCT with extra-articular involvement. Severe osteochondral destruction may justify salvage procedures, although these are not often undertaken. Systemic treatment is indicated for unresectable or refractory cases. However, side effects are commonly experienced, and relapses may occur once treatment has ceased. Cite this article: Bone Joint J 2021;103-B(4):788-794.


Assuntos
Tornozelo , , Tumor de Células Gigantes de Bainha Tendinosa/terapia , Neoplasias de Tecidos Moles/terapia , Adolescente , Adulto , Idoso , Artroscopia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/terapia
18.
Artigo em Inglês | MEDLINE | ID: mdl-33672908

RESUMO

We compared the hydrodynamic characteristics and pull-out strategies of four backstroke-to-breaststroke turning techniques in young swimmers. Eighteen 11 and 12-year-old swimmers participated in a 4 week intervention program including 16 contextual interference sessions. The hydrodynamic variables were assessed through inverse dynamics, and the pull-out strategy kinematics were assessed with tracking markers followed by 12 land cameras and 11 underwater cameras. Swimmers randomly completed sixteen 30 m maximal backstroke-to breaststroke-open, somersault, bucket and crossover turns (four in each technique) with a 3 min rest. The data showed higher drag force, cross-sectional area and drag coefficient values for the first (compared with the second) gliding position. The crossover turn revealed the highest push-off velocity (2.17 ± 0.05 m·s-1), and the somersault turn demonstrated the lowest foot plant index (0.68 ± 0.03; 68%), which could have affected the first gliding, transition and second gliding depths (0.73 ± 0.13, 0.86 ± 0.17 and 0.76 ± 0.17 m). The data revealed the consistency of the time spent (4.86 ± 0.98 s) and breakout distance (6.04 ± 0.94 m) among the four turning techniques, and no differences were observed between them regarding time and average velocity up to 7.5 m. The hydrodynamic characteristics and pull-out strategy of the backstroke-to-breaststroke turns performed by the age group swimmers were independent of the selected technique.


Assuntos
Desempenho Atlético , Hidrodinâmica , Fenômenos Biomecânicos , , Natação
19.
Bone Joint J ; 103-B(3): 562-568, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641425

RESUMO

METHODS: A multicentre retrospective study was carried out at two tertiary sarcoma centres. A database search identified all patients with a CS treated between January 1995 and January 2018. There were 810 CSs of which 76 (9.4%) were located in the fingers, toes, metacarpals, and metatarsal bones. RESULTS: The median age of the study population was 55 years (36 to 68) with a median follow-up of 52 months (22 to 87) months. Overall, 70% of the tumours were in the hand (n = 54) and 30% in the foot (n = 22). Predictors for LR were margin (p = 0.011), anatomical location (p = 0.017), and method of surgical management (p = 0.003). Anatomical location (p = 0.026), histological grade between 1 and 3 (p = 0.004) or 2 and 3 (p = 0.016), and surgical management (p = 0.001) were significant factors for LR-free survival. Disease-specific survival was affected by histological grade (p < 0.001), but not by LR (p = 0.397). CONCLUSION: Intralesional curettage of a low-grade CS is associated with an increased risk of LR, but LR does not affect disease-specific survival. Therefore, for low-grade CSs of the hands and feet, surgical management should aim to preserve function. In grade 2 CS, our study did not show any decreased disease-specific survival after recurrence; however, we suggest a more aggressive surgical approach to these tumours to prevent local recurrence, especially in the metacarpal and metatarsal bones. In high-grade tumours, the incidence of progressive disease is high and, therefore, the treatment of the primary tumour should be aggressive where possible, and patients observed closely for the development of metastatic disease. Cite this article: Bone Joint J 2021;103-B(3):562-568.


Assuntos
Neoplasias Ósseas/cirurgia , Condrossarcoma/cirurgia , , Mãos , Adulto , Idoso , Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Curetagem , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos
20.
BMC Geriatr ; 21(1): 166, 2021 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-33676395

RESUMO

BACKGROUND: Falls-related injuries are particularly serious for older people, causing pain, reduced community engagement and associated medical costs. Tripping is the leading cause of falls and the current study examined whether minimum ground clearance (MFC) of the swing foot, indicating high tripping risk, would be differentiated across cohorts of healthy 50-, 60- and 70-years old community residents in Japan. METHODS: A cross-sectional population comprising the three groups (50s, 60s and 70s) of 123 Konosu City residents consented to be recorded when walking on an unobstructed surface at preferred speed. Gait biomechanics was measured using high speed (100 Hz) motion capture (OptiTrack - Natural Point Inc.), including step length and width, double support, foot contact angle and MFC (swing toe height above the ground). Multivariate Analysis of Variance (MANOVA) was used to confirm ageing effects on MFC and fundamental gait parameters. Pearson's correlations were performed to identify the relationships between mean MFC and other MFC characteristics (SD and SI), step length, step width, double support time and foot contact angle. RESULTS: Compared to 50s, lower step length was seen (2.69 cm and 6.15 cm) for 60s and 70s, respectively. No other statistical effects were identified for spatio-temporal parameters between the three groups. The 50s cohort MFC was also significantly higher than 60s and 70s, while step-to-step MFC variability was greater in the 70s than 50s and 60s. Pearson's correlations demonstrated that more symmetrical gait patterns were associated with greater MFC height, as reflected in greater symmetry in step width (50s), MFC (60s) and foot contact angle (70s). In the 70s increased MFC height correlated with higher MFC variability and reduced foot contact angle. CONCLUSIONS: MFC height reduces from 60 years but more variable MFC appears later, from 70 years. While symmetrical gait was accompanied by increased MFC height, in the 70s group attempts to increase MFC height may have caused more MFC variability and lower foot contact angles, compromising foot-ground clearance. Assessments of swing foot mechanics may be a useful component of community falls prevention.


Assuntos
, Vida Independente , Acidentes por Quedas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Marcha , Humanos , Japão , Caminhada
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