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2.
Medicine (Baltimore) ; 99(8): e19195, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080105

RESUMO

RATIONALE: Less-Invasive Stabilization System (LISS) plate is an internal fixation commonly used for the periprosthetic distal femur fractures. Failure associated with LISS plate has been rarely reported, and the reasons for LISS plate failure are multitudinous. Various advantages have been reported, but failures continue. PATIENT CONCERNS: We present 3 cases illustrating the failure of Less-Invasive Stabilization System (LISS) plating for periprosthetic distal femur fractures. The shaft screws of the LISS plate broke in 2 cases, and the plate placement was incorrect in 1 case. Early weight bearing, obesity, osteoporosis, and lateral collateral ligament injury due to incorrect plate placement constituted the etiologies of LISS plate failure. DIAGNOSIS: Failure of Less-Invasive Stabilization System (LISS) plating for periprosthetic distal femur fractures after Total knee arthroplasty. INTERVENTIONS: Three patients underwent Less-Invasive Stabilization System plates removal with replacement of the total knee arthroplasty revision surgery with rotating hinged knee prosthesis. OUTCOMES: After completing the total knee arthroplasty revision surgery, all patients underwent regular follow-up examinations. Case 2 could walk unaided, without pain, final union was confirmed for both case 1 and case 3. CONCLUSION: Less-Invasive Stabilization System (LISS) plate provides satisfactory results in periprosthetic fractures after Total knee arthroplasty (TKA). The LISS plate has many advantages, but failures continue to occur. The causes for failure were early weight bearing, obesity, osteoporosis, and lateral collateral ligament (LCL) injury due to incorrect plate placement in our series. We recommend that protection or properly delay of weight-bearing, active anti-osteoporosis treatment, and intraoperative fluoroscopy are the effective methods to avoid failure.


Assuntos
Placas Ósseas/efeitos adversos , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/métodos , Fraturas Periprotéticas/cirurgia , Idoso , Artroplastia do Joelho/métodos , Falha de Equipamento , Feminino , Fraturas do Fêmur/epidemiologia , Humanos , Obesidade/epidemiologia , Osteoporose/epidemiologia , Fraturas Periprotéticas/epidemiologia , Suporte de Carga/fisiologia
3.
PLoS One ; 15(2): e0219648, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32084138

RESUMO

BACKGROUND: External loading of the ligamentous tissues induces mechanical creep, which modifies neuromuscular response to perturbations. It is not well understood how ligamentous creep affects athletic performance and contributes to modifications of knee biomechanics during functional tasks. HYPOTHESIS/PURPOSE: The purpose of this study was to examine the mechanical and neuromuscular responses to single leg drop landing perturbations before and after passive loading of the knee joint. METHODS: Descriptive laboratory study. Male (n = 7) and female (n = 14) participants' (21.3 ± 2.1 yrs., 1.69 ± 0.09 m, 69.3 ± 13.0 kg) right hip, knee, and ankle kinematics were assessed during drop landings performed from a 30 cm height onto a force platform before and after a 10 min creep protocol. Electromyography (EMG) signals were recorded from rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), semimembranosus (SM), and biceps femoris (BF) muscles. The creep protocol involved fixing the knee joint at 35° during static loading with perpendicular loads of either 200 N (males) or 150 N (females). Maximum, minimum, range of motion (ROM), and angular velocities were assessed for the hip, knee, and ankle joints, while normalized EMG (NEMG), vertical ground reaction forces (VGRF), and rate of force development (RFD) were assessed at landing using ANOVAs. Alpha was set at 0.05. RESULTS: Maximum hip flexion velocity decreased (p < 0.01). Minimum knee flexion velocity increased (p < 0.02). Minimum knee ad/abduction velocity decreased (p < 0.001). Ankle ROM decreased (p < 0.001). aVGRF decreased (p < 0.02). RFD had a non-significant trend (p = 0.076). NAEMG was significant between muscle groups (p < 0.02). CONCLUSION: Distinct changes in velocity parameters are attributed to the altered mechanical behavior of the knee joint tissues and may contribute to changes in the loading of the leg during landing.


Assuntos
Fenômenos Biomecânicos/fisiologia , Eletromiografia/métodos , Articulações/fisiologia , Articulação do Tornozelo/fisiologia , Feminino , Articulação do Quadril/fisiologia , Humanos , Articulação do Joelho/fisiologia , Masculino , Músculo Esquelético/fisiologia , Amplitude de Movimento Articular , Suporte de Carga/fisiologia , Adulto Jovem
4.
Fisioter. Pesqui. (Online) ; 27(1): 16-21, jan.-mar. 2020. tab, graf
Artigo em Português | LILACS | ID: biblio-1090412

RESUMO

RESUMO O objetivo deste estudo foi verificar se a formação do arco longitudinal do pé interfere na distribuição da pressão plantar e na flexibilidade dos músculos posteriores da coxa. O método de estudo foi transversal e as impressões plantares foram obtidas usando o plantígrafo e analisadas segundo o método Viladot. A distribuição plantar e a flexibilidade foram avaliadas pela baropodometria e pelo banco de Wells, respectivamente. Foi observado que crianças com pés cavos apresentam maior flexibilidade quando comparadas às que têm o pé normal (p=0,02); e também que pés cavos apresentam maior pressão, ou seja, maior sobrecarga em calcâneo quando comparados àqueles com o arco plantar normal (p=0,02 membro inferior direito e p=0,03 membro inferior esquerdo). A avaliação do arco longitudinal medial mostra que crianças com pés cavos apresentam maior flexibilidade dos músculos posteriores de membro inferior. Os pés cavos também estão associados com maior descarga de peso em região de calcâneo.


RESUMEN El objetivo de este estudio fue verificar si la formación del arco longitudinal del pie interfiere con la distribución de la presión plantar y la flexibilidad de los músculos posteriores del muslo. El método de estudio fue transversal y las huellas plantar se obtuvieron utilizando el plantigraph y se analizaron según el método de Viladot. La distribución plantar y la flexibilidad se evaluaron mediante baropodometría y el banco de Wells, respectivamente. Se observó que los niños con pies huecos tienen mayor flexibilidad en comparación con aquellos con pies normales (p=0,02); y también que los pies huecos tienen una mayor presión, es decir, una mayor sobrecarga del talón en comparación con aquellos con arco plantar normal (p=0,02 miembro inferior derecho y p=0,03 miembro inferior izquierdo). La evaluación del arco longitudinal medial muestra que los niños con pies huecos tienen una mayor flexibilidad en los músculos posteriores de la extremidad inferior. Los pies huecos también están asociados con una mayor descarga de peso en la región del talón.


ABSTRACT Objective: To evaluate whether the formation of the longitudinal arch of the foot interferes with the distribution of plantar pressure and the pliability of the posterior thigh muscles. Methodology: a cross-sectional study and the footprints were obtained using the footprinting mat and analyzed according to the Viladot method. Plantar distribution and pliability were assessed by baropodometry and Wells' bank, respectively. Results: It was observed that children with cavus feet present greater pliability when compared to those with normal feet (p=0.02). Also, the cavus feet exhibit higher pressure, that is, a greater heel overload compared to those with normal plantar arch (p=0.02 lower right limb and p=0.03 lower left limb). Conclusions: The evaluation of the medial longitudinal arch shows that children with cavus feet have greater pliability of the lower limb posterior muscles. The cavus feet are also associated with higher pressure in the calcaneal region.


Assuntos
Humanos , Masculino , Feminino , Criança , Coxa da Perna/fisiologia , Amplitude de Movimento Articular/fisiologia , Músculo Esquelético/fisiologia , Pé/fisiologia , Fenômenos Biomecânicos/fisiologia , Estatura , Pesos e Medidas Corporais , Índice de Massa Corporal , Estudos Transversais , Suporte de Carga/fisiologia , Equilíbrio Postural/fisiologia , Pé Cavo/fisiopatologia
5.
PLoS One ; 15(1): e0227272, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31914159

RESUMO

Thorough preoperative planning in total knee arthroplasty is essential to reduce implant failure by proper implant sizing and alignment. The "gold standard" in conventional preoperative planning is based on anterior-posterior long-leg radiographs. However, the coronal component alignment is still an open discussion in literature, since studies have reported contradictory outcomes on survivorship, indicating that optimal individual alignment goals still need to be defined. Two-dimensional biomechanical models of the knee have the potential to predict joint forces and, therefore, objectify therapy planning. Previously published two-dimensional biomechanical models were evaluated and validated for the first time in this study by comparison of model predictions to corresponding in vivo measurements obtained from telemetric implants for a one- and two-leg stance. Model input parameters were acquired from weight-bearing anterior-posterior long-leg radiographs and statistical assumptions for patient-specific model adaptation. The overall time from initialization to load prediction was in the range of 7-8 minutes per patient for all models. However, no model could accurately predict the correct trend of knee joint forces over patients. Two dimensional biomechanical models of the knee have the potential to improve preoperative planning in total knee arthroplasty by providing additional individual biomechanical information to the surgeon. Although integration into the clinical workflow might be performed with acceptable costs, the models' accuracy is insufficient for the moment. Future work is needed for model optimization and more sophisticated modelling approaches.


Assuntos
Artroplastia do Joelho/instrumentação , Articulação do Joelho/fisiologia , Prótese do Joelho , Modelos Biológicos , Planejamento de Assistência ao Paciente , Idoso , Fenômenos Biomecânicos , Simulação por Computador , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Desenho de Prótese/métodos , Radiografia , Telemetria , Suporte de Carga/fisiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-31940987

RESUMO

The aim of this study was to evaluate the effect of additional load on postural-stability control in young women. To evaluate postural control in the 34 women in this study (mean age, 20.8 years), we measured postural sway (center of pressure, COP) in a neutral stance (with eyes open) in three trials of 30 s each. Three load conditions were used in the study: 0, 14, and 30 kg. In analysis, we used three COP parameters, variability (linear), mean sway velocity (linear), and entropy (nonlinear). Results suggested that a considerable load on a young woman's body (approximately 48% of body weight) had significant influence on stability. Specifically, heavy loads triggered random movements, increased the dynamics of postural-stability control, and required more attention to control standing posture. The results of our study indicate that inferior postural control mainly results from insufficient experience in lifting such a load.


Assuntos
Equilíbrio Postural , Posição Ortostática , Suporte de Carga/fisiologia , Adulto , Feminino , Humanos , Movimento/fisiologia , Adulto Jovem
7.
Int J Occup Saf Ergon ; 26(1): 15-19, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29553876

RESUMO

This study recruited 14 participants to examine the effects of load and height of the load's center of gravity (COG) on muscular activities of the brachioradialis, biceps brachii and erector spinae, and on box vibration acceleration (g) in manual holding tasks. Each participant was asked to hold a box in 12 conditions (4 loads × 3 heights of the load's COG). The results showed that muscular activities of the brachioradialis, biceps brachii and erector spinae significantly increased with load; however, they were not affected by the height of the load's COG. In addition, box vibration acceleration increased with load, and decreased with the height of the load's COG. The interaction effect of load and height of the load's COG on box vibration acceleration was also significant. This study recommends that the load magnitude should be decreased for the holding task that requires low vibration.


Assuntos
Remoção , Músculo Esquelético/fisiologia , Postura/fisiologia , Vibração , Suporte de Carga/fisiologia , Adolescente , Fenômenos Biomecânicos , Eletromiografia/métodos , Feminino , Humanos , Masculino , Análise e Desempenho de Tarefas , Adulto Jovem
8.
Gait Posture ; 75: 93-97, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31639614

RESUMO

BACKGROUND: Scoliosis is accepted as a 3-dimensional deformity involving axial, sagittal and frontal planes. RESEARCH QUESTION: To evaluate the correlation between baropodometric parameters and coronal balance status for idiopathic scoliosis. METHODS: 44 patients (7 males and 37 females) of Adolescent Idiopathic Scoliosis (AIS) were recruited. All participants should have scoliosis confirmed by a spine X-ray performed less than one month ahead of the baropodometric study. Radiographic studies including Cobb angle, offset between Central Sacral Vertical Line (CSVL) and C7 Vertebra Plumb Line (C7PL) (considered as global coronal balance, GCB), Apical Translation of the major curve (AT, considered as regional coronal balance) as well as Lateral Pelvic Tilt (LPT) were examined. A static baropodometry was performed for each patient. The contact surface and load ratio (to the entire load of both feet) were measured. RESULTS: On both sides, the surface of the forefoot was significantly larger than that of the rearfoot (P < 0.001) and the load ratio of the forefoot was significantly smaller than that of the rearfoot (P < 0.001). On the major curve side, GCB showed a positive correlation with the contact surface of the forefoot (r = 0.36, P = 0.019), as well as the load ratio (r = 0.40, P = 0.008). AT also showed a positive correlation with the load ratio of the forefoot (r = 0.331, P = 0.03) but no correlation with contact surface. SIGNIFICANCE: In scoliosis, coronal balance is correlated to plantar pressure distribution. Apical translation of the major curve and offset between CSVL and C7PL are the best describers of coronal balance.


Assuntos
Pé/fisiopatologia , Marcha/fisiologia , Escoliose/fisiopatologia , Adolescente , Criança , Feminino , Humanos , Masculino , Postura/fisiologia , Pressão , Radiografia , Estudos Retrospectivos , Escoliose/diagnóstico por imagem , Suporte de Carga/fisiologia
9.
Gait Posture ; 75: 129-136, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31678694

RESUMO

BACKGROUND: Task-specific loading of the limbs-termed as functional resistance training-is commonly used in gait rehabilitation; however, the biomechanical and neuromuscular effects of various forms of functional resistance training have not been studied systematically. This information is crucial for correctly selecting the appropriate mode of functional resistance training when treating individuals with gait disorders. RESEARCH QUESTION: To comprehensively evaluate the biomechanical (i.e., joint moment and power) and muscle activation changes with different forms of functional resistance training that are commonly used in clinics and research using biomechanical simulation-based analyses. METHODS: We developed simulations of functional resistance training during walking using OpenSim (Gait2354, 23 degrees of freedom and 54 muscles) and custom MATLAB scripts. We investigated five modes of functional resistance training that have been commonly used in clinics or in research: (1) a weight attached at the ankle, (2) an elastic band attached at the ankle, (3) a viscous device attached to the hip and knee, (4) a weight attached at the pelvis, and (5) a constant backwards pulling force at the pelvis. Lower-extremity joint moments and powers were computed using inverse dynamics and muscle activations were estimated using computed muscle control while walking with each device under multiple resistance levels: normal walking with no resistance, and walking with 30, 60, and 90 Newtons of resistance. RESULTS: The results indicate that the way in which resistance is applied during gait training differentially affects the internal joint moments, powers, and muscle activations as well as the joints and phase of the gait cycle where the resistance was experienced. SIGNIFICANCE: The results highlight the importance of understanding the joints and muscles that are targeted by various modes of functional resistance training and carefully choosing the best mode of training that meets the specific therapeutic needs of the patient.


Assuntos
Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Treinamento de Resistência/métodos , Caminhada/fisiologia , Fenômenos Biomecânicos , Simulação por Computador , Marcha/fisiologia , Humanos , Modelos Anatômicos , Suporte de Carga/fisiologia
10.
Clin Podiatr Med Surg ; 37(1): 23-37, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735267

RESUMO

Imaging with biomechanical analysis augments the clinical examination and improves outcomes by correlating imaging findings with the examination. Plain film radiographs are the gold standard to assess osseous alignment. The biomechanical examination provides information to formulate an accurate assessment. Weightbearing computed tomography scanning is a potentially valuable for functional information about joint biomechanics. True alignment of the lower extremity can be appreciated on weightbearing computed tomography scanning. Soft tissue structures can be assessed with diagnostic ultrasound examination. Acute and chronic injuries that compromise joint stability can be identified.


Assuntos
Deformidades do Pé/diagnóstico por imagem , Deformidades do Pé/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Radiografia , Amplitude de Movimento Articular/fisiologia , Ultrassonografia , Suporte de Carga/fisiologia
11.
Clin Sports Med ; 39(1): 1-12, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767101

RESUMO

The menisci are 2 fibrocartilaginous crescents anchored via bony and ligamentous attachments to surrounding structures. Their biochemical composition and multilayered structure make them ideal for converting compressive forces to tensile forces in addition to improving joint congruity and providing shock absorption to weight bearing. The medial meniscus maintains more attachments at both the horns and the midbody than the lateral meniscus, making it more susceptible to injury. Understanding of the gross anatomy, vascular anatomy, biochemical composition, and microstructure is key to understanding causes of meniscal pathology as well as treatment options for restoring its primary functions.


Assuntos
Meniscos Tibiais/anatomia & histologia , Meniscos Tibiais/fisiologia , Água Corporal/metabolismo , Colágeno Tipo I/metabolismo , Colágeno Tipo II/metabolismo , Glicosaminoglicanos/metabolismo , Humanos , Articulação do Joelho/anatomia & histologia , Articulação do Joelho/fisiologia , Propriocepção/fisiologia , Proteoglicanas/metabolismo , Líquido Sinovial/fisiologia , Lesões do Menisco Tibial/fisiopatologia , Suporte de Carga/fisiologia
12.
Bone Joint J ; 101-B(11): 1459-1463, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31674236

RESUMO

AIMS: Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for acetabular dysplasia. The purpose of this study was to investigate changes in muscle strength, gait speed, and clinical outcome in the operated hip after RAO over a one-year period using a standard protocol for rehabilitation. PATIENTS AND METHODS: A total of 57 patients underwent RAO for acetabular dysplasia. Changes in muscle strength of the operated hip, 10 m gait speed, Japanese Orthopaedic Association (JOA) hip score, and factors correlated with hip muscle strength after RAO were retrospectively analyzed. RESULTS: Three months postoperatively, the strength of the operated hip in flexion and abduction and gait speed had decreased from their preoperative levels. After six months, the strength of flexion and abduction had recovered to their preoperative level, as had gait speed. At one-year follow-up, significant improvements were seen in the strength of hip abduction and gait speed, but muscle strength in hip flexion remained at the preoperative level. The mean JOA score for hip function was 91.4 (51 to 100)) at one-year follow-up. Body mass index (BMI) showed a negative correlation with both strength of hip flexion (r = -0.4203) and abduction (r = -0.4589) one year after RAO. Although weak negative correlations were detected between strength of hip flexion one year after surgery and age (r = -0.2755) and centre-edge (CE) angle (r = -0.2989), no correlation was found between the strength of abduction and age and radiological evaluations of CE angle and acetabular roof obliquity (ARO). CONCLUSION: Hip muscle strength and gait speed had recovered to their preoperative levels six months after RAO. The clinical outcome at one year was excellent, although the strength of hip flexion did not improve to the same degree as that of hip abduction and gait speed. A higher BMI may result in poorer recovery of hip muscle strength after RAO. Radiologically, acetabular coverage did not affect the recovery of hip muscle strength at one year's follow-up. A more intensive rehabilitation programme may improve this. Cite this article: Bone Joint J 2019;101-B:1459-1463.


Assuntos
Acetábulo/cirurgia , Luxação do Quadril/fisiopatologia , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Osteotomia/métodos , Adulto , Feminino , Marcha/fisiologia , Luxação do Quadril/cirurgia , Articulação do Quadril/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia/reabilitação , Cuidados Pós-Operatórios/métodos , Estudos Retrospectivos , Resultado do Tratamento , Velocidade de Caminhada/fisiologia , Suporte de Carga/fisiologia , Adulto Jovem
13.
Rev Prat ; 69(6): 616-619, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31626416

RESUMO

The off-loading of diabetic foot ulcers is the most urgent and theoretically the easiest treatment to implement. Its effectiveness has been proven for decades by randomized controlled studies on neuropathic ulcers that heal with a cast in an average of 6 weeks with a high level of evidence. Total contact casts are not widely used throughout the world, although it is the standard treatment. Off-loading shoes are certainly effective but only if they are worn. It is the prescriber's challenge to obtain maximum compliance that makes it possible to avoid infections and secondary amputations that are totally avoidable most of the time and only related to the delay in optimal care, of which off loading is the essential part.


Assuntos
Pé Diabético , Suporte de Carga/fisiologia , Cicatrização , Amputação , Moldes Cirúrgicos , Pé Diabético/prevenção & controle , Pé Diabético/terapia , Humanos , Pressão , Sapatos
14.
BMC Musculoskelet Disord ; 20(1): 442, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604431

RESUMO

BACKGROUND: Insoles are often applied as preventive therapy of flatfoot deformity, but the therapeutic effects on obese individuals are still controversial. We aimed to investigate the effect of insole use on time-dependent changes in the foot arch during a repeated-loading simulation designed to represent 20,000 contiguous steps in individuals with a BMI value in the range of 30-40 kg/m2. METHODS: Eighteen cadaveric feet were randomly divided into the following three groups: normal, obese, and insole. Ten thousand cyclic loadings of 500 N (normal group) or 1000 N (obese and insole groups) were applied to the feet. We measured time-dependent change in arch height and calculated the bony arch index (BAI), arch flexibility, and energy absorption. RESULTS: The normal group maintained more than 0.21 BAI, which is the diagnostic criterion for a normal arch, throughout the 10,000 cycles; however, BAI was less than 0.21 at 1000 cycles in the obese group (mean, 0.203; 95% confidence interval [CI] 0.196-0.209) and at 6000 cycles in the insole group (mean, 0.200; 95% CI, 0.191-0.209). Although there was a significant time-dependent decrease in flexibility and energy absorption in both the obese and insole groups (P < 0.001), the difference between 1 and 10,000 cycles were significantly smaller in the insole group than in the obese group (P = 0.024). CONCLUSIONS: Use of insoles for obese individuals may help to slow time-dependent foot structural changes. However, the effect was not enough to maintain the foot structure against repeated hyper loadings.


Assuntos
Pé Chato/prevenção & controle , Órtoses do Pé , Pé/fisiopatologia , Obesidade/complicações , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Pé Chato/etiologia , Pé Chato/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Suporte de Carga/fisiologia
15.
Bone Joint J ; 101-B(10): 1256-1262, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564155

RESUMO

AIMS: Postoperative rehabilitation regimens following ankle arthrodesis vary considerably. A systematic review was conducted to determine the evidence for weightbearing recommendations following ankle arthrodesis, and to compare outcomes between different regimens. PATIENTS AND METHODS: MEDLINE, Web of Science, Embase, and Scopus databases were searched for studies reporting outcomes following ankle arthrodesis, in which standardized postoperative rehabilitation regimens were employed. Eligible studies were grouped according to duration of postoperative nonweightbearing: zero to one weeks (group A), two to three weeks (group B), four to five weeks (group C), or six weeks or more (group D). Outcome data were pooled and compared between groups. Outcomes analyzed included union rates, time to union, clinical scores, and complication rates. RESULTS: A total of 60 studies (2426 ankles) were included. Mean union rates for groups A to D were 93.2%, 95.5%, 93.0%, and 93.0%, respectively. Mean time to union was 10.4 weeks, 14.5 weeks, 12.4 weeks, and 14.4 weeks for groups A to D, respectively. Mean complication rates were 22.3%, 23.0%, 27.1%, and 28.7% for groups A to D, respectively. Reporting of outcome scores was insufficient to conduct meaningful analysis. CONCLUSION: Outcomes following ankle arthrodesis appear to be similar regardless of the duration of postoperative nonweightbearing, although the existing literature is insufficient to make definitive conclusions. Cite this article: Bone Joint J 2019;101-B:1256-1262.


Assuntos
Articulação do Tornozelo/cirurgia , Artrodese/métodos , Medição da Dor , Cuidados Pós-Operatórios/métodos , Suporte de Carga/fisiologia , Fatores Etários , Idoso , Articulação do Tornozelo/fisiopatologia , Artrodese/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Medição de Risco , Fatores Sexuais
16.
Gait Posture ; 74: 212-217, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31561119

RESUMO

BACKGROUND: A growing body of literature supports the promising effect of real-time feedback to re-train runners. However, no studies have comprehensively assessed the effects of foots trike and cadence modification using different forms of real-time feedback provided via wearable devices. RESEARCH QUESTION: The purpose of the present study was to determine if a change could be made in foot strike pattern and plantar loads using real-time visual, auditory and combined feedback provided using wearable devices. METHODS: Visual, auditory and combined feedback were provided using wearable devices as fifteen recreational runners ran on a treadmill at self-selected speed and increased cadence. Plantar loads and location of initial contact were measured with a flexible insole system. Repeated measures ANOVAs with Bonferroni adjusted pair-wise comparisons were used to assess statistical significance. RESULTS AND SIGNIFICANCE: A significant effect of condition was noted on location of center of pressure (p < 0.01). Bonferroni-adjusted post-hoc comparisons showed that feedback conditions differed from baseline as well as the new cadence conditions, however did not differ from each other. A significant interaction effect (region x feedback) was found for plantar loads (maximum force P < 0.001). Significant effects of feedback were noted at the heel (P < 0.001), medial midfoot (P < 0.001), lateral midfoot (P < 0.001), medial forefoot (P = 0.003), central forefoot (P = 0.003), and great toe (P = 0.004) but not at the lateral forefoot (P = 0.6) or lateral toes (P = 0.507). SIGNIFICANCE: The unique findings of our study showed that an anterior shift of the center of pressure, particularly when foot strike modification was combined with 10% increased cadence. We found lower heel and midfoot loads along with higher forefoot and great toe loads when foot strike modification using real-time feedback was combined with increased cadence. Our findings also suggest that auditory feedback might be more effective than visual feedback in foot-strike modification.


Assuntos
Pé/fisiologia , Feedback Formativo , Corrida/fisiologia , Dispositivos Eletrônicos Vestíveis , Suporte de Carga/fisiologia , Adulto , Análise de Variância , Teste de Esforço , Feminino , Calcanhar/fisiologia , Humanos , Masculino , Atividade Motora/fisiologia , Sapatos , Dedos do Pé/fisiologia , Adulto Jovem
17.
Gait Posture ; 74: 108-113, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31499404

RESUMO

BACKGROUND: Individuals with knee osteoarthritis (OA) show various dynamic sagittal-plane changes during the early stance phase of gait. However, the effect of these kinematic alterations on knee load during the early stance remains poorly understood. RESEARCH QUESTION: The purpose of this study was to examine the effect of altered sagittal- plane knee kinematics on knee load during the early stance. METHODS: A total of 13 healthy adult men underwent gait analysis trials using four conditions (baseline and three altered conditions). The three altered conditions were defined as follows: 1) Less flexion (LF): a gait that decreased knee flexion excursion (KFE) owing to a reduced peak knee flexion angle compared to baseline. 2) Initial flexion (IF): a gait with decreased KFE owing to an increased knee flexion angle at initial contact, during which the peak knee flexion angle did not differ from baseline. 3) Flexion gait (FG): a gait that increased the knee flexion angle at initial contact but did not reduce KFE compared with the baseline. Data analyzed included peak external knee flexion moment (KFM), KFM impulse (impulse was an integral value from initial contact to peak value), peak vertical ground reaction force (VGRF), and maximum loading rate. RESULTS: Both LF and IF conditions significantly decreased peak VGRF (p < 0.05) compared with the baseline. Peak KFM decreased in the LF condition and increased in the FG condition versus baseline (p < 0.05). A significantly increased KFM impulse was found in both IF and FG conditions when compared with baseline (p < 0.05). SIGNIFICANCE: An increase in knee flexion angle during early stance increased knee loading. Interventions are likely required for improving excessive knee flexion during early stance phase of gait in individuals with knee OA.


Assuntos
Marcha/fisiologia , Articulação do Joelho/fisiologia , Amplitude de Movimento Articular/fisiologia , Suporte de Carga/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino
18.
Gait Posture ; 74: 154-161, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31525653

RESUMO

BACKGROUND: Abnormal peak plantar pressure in neuropathic diabetic foot during walking activities is well managed through the use of appropriate design and material selection for the fabrication of custom made insoles (CMI). The redistribution of plantar pressure is possible by selecting an appropriate material for the fabrication of CMI. The walking activities may alter the plantar pressure distribution; which may differ while using CMI with different materials. OBJECTIVE: The objective of the study was to evaluate the effectiveness of CMI's materials on plantar pressure distribution during different walking activities, in diabetic feet with neuropathy. METHODS: The study was conducted on sixteen diabetic neuropathic subjects. The subjects were provided with two types of CMI; CMI-A (Plastazote® and microcellular rubber) and CMI-B (Multifoam, Plastazote® and microcellular rubber). Maximum peak plantar pressure and plantar pressure distribution were determined by Pedar-X® sensor insole during level walking, ramp walking and stair walking. RESULTS: The CMI-B lessened the maximum peak plantar pressure from the forefoot throughout the walking activities compared to CMI-A. The contact area was observed as lower using CMI-A compared to CMI-B, while performing walking activities. CONCLUSION: CMI-B, with multifoam as an additional top layer, provided more effective peak plantar pressure reduction at forefoot and it had better plantar pressure distribution compared to CMI-A during level walking and ramp ascending in diabetic foot with neuropathy.


Assuntos
Diabetes Mellitus/fisiopatologia , Pé Diabético/fisiopatologia , Órtoses do Pé , Pé/fisiopatologia , Caminhada/fisiologia , Suporte de Carga/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão , Sapatos
19.
Gait Posture ; 74: 182-186, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31539799

RESUMO

BACKGROUND: Injury rates are high in populations that regularly undertake weight-bearing physical activity, particularly military populations. Military training activities, that often include load carriage, have been associated with lower limb injury occurrence, specifically stress fractures. RESEARCH QUESTION: Recent work identified plantar loading variables as risk factors for lower limb stress fractures in Royal Marines recruits that were assessed during barefoot running. This study aimed to quantify how those plantar loading variables changed in Royal Marines recruits following a prolonged military load carriage activity, to further understand potential mechanisms for lower limb stress fractures. METHODS: Bilateral, synchronised plantar pressure and lower limb kinematic data were recorded during barefoot running at 3.6 m s-1 (±5%) pre- and post- a 12.8-km training activity (∼150 min). The training activity was completed with an average speed typical of walking (1.4 m.s-1), and 35.5 kg of additional load was carried throughout. Data were collected from 32 male Royal Marines recruits who completed the training activity in week-21 of the 32-week training programme. Plantar pressure variables and ankle dorsiflexion were compared between pre- and post-activity. RESULTS: Post-activity there was reduced loading under the forefoot and increased loading under the rearfoot and midfoot. There was no change in dorsiflexion touchdown angle, but an increase in peak dorsiflexion and range of motion post-activity. SIGNIFICANCE: The increased rearfoot loading, reduced forefoot loading and increased ankle dorsiflexion following a prolonged military load carriage activity suggest a reduced transfer of loading from the rearfoot to the forefoot during stance, which may have implications for the development of stress fractures, particularly of the metatarsals.


Assuntos
Pé/fisiologia , Militares , Corrida/fisiologia , Caminhada/fisiologia , Suporte de Carga/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Amplitude de Movimento Articular/fisiologia , Fatores de Risco , Adulto Jovem
20.
J Dance Med Sci ; 23(3): 104-111, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31500692

RESUMO

The aim of this study was to describe and compare the different character sub-types of Javanese dance from a biomechanical perspective. One professional dancer was asked to repeat a basic motion (standing-up) according to the movement rules that pertain to six character sub-types (humble-refined, proud-refined, humble-strong, proud-strong, monkey, and bird). A motion capture system consisting of seven infrared cameras with a sample rate of 100 Hz and two force plates with a sample rate of 1,000 Hz were used to capture kinematics and kinetics. There were significant differences in the bio-mechanical values we calculated for each character sub-type: range of motion, angular velocity, and ground reaction forces. The refined sub-types (humble-refined and proud-refined) showed the lowest values at the knee joint for range of motion and the lowest ankle, shoulder, and wrist angular velocities. This result suggests that low values in these measurements are related to the smooth movements of refined sub-types. These measurements help describe and contrast the motion patterns of Javanese dance, contributing both to the scientific analysis of Javanese dance and the application of biomechanics to the study of dance more generally.


Assuntos
Fenômenos Biomecânicos/fisiologia , Dança/fisiologia , Articulações/fisiologia , Amplitude de Movimento Articular/fisiologia , Suporte de Carga/fisiologia , Feminino , Humanos , Indonésia , Extremidade Inferior , Movimento/fisiologia
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