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2.
Zhongguo Zhen Jiu ; 41(3): 339-41, 2021 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-33798322

RESUMO

The origin and basis of wrist-ankle acupuncture were discussed based on the theory of huan in bamboo slip and silk medical book Mai Fa (Pulse Method), theory of maikou, "meridian points", and theory of origin, junction, branch and trunk. The huan in bamboo slip and silk medical book Pulse Method is the wrist and ankle, and the position of wrist-ankle acupuncture is close to the huan. The theory of maikou reflects the pulse method which could be used not only in diagnosis but also in treatment, and the acupuncture points of wrist-ankle acupuncture are corresponding to the position and the main indications of maikou. The acupuncture points of wrist-ankle acupuncture are close to the locations and indications of "meridian points", as well as the points of Liu, Zhu and Xiaru of the theory of origin, junction, branch and trunk. The acupuncture points of wrist-ankle acupuncture are distributed in the range of "ben" in the theory of origin, junction, branch and trunk and five-shu points. The operation of wrist-ankle acupuncture is consistent with the theory of shallow needling at defensive-qi.


Assuntos
Terapia por Acupuntura , Tornozelo , Pontos de Acupuntura , Livros , Seda , Punho
3.
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
4.
Eur J Radiol ; 138: 109674, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33798932

RESUMO

OBJECTIVES: We hypothesize that three-dimensional (3D) geometric analyses in weight bearing CT-images of the foot and ankle are more reproducible compared to two-dimensional (2D) analyses. Therefore, we compared 2D and 3D analyses on bones of weight-bearing and non weight-bearing cone-beam CT images of healthy volunteers. METHODS: Twenty healthy volunteers (10 male, 10 female, mean age 37.5 years) underwent weight-bearing and non weight-bearing cone-beam CT imaging of both feet. Clinically relevant height and angle measurements were performed in 2D and 3D (for example: cuboid height, calcaneal pitch, talo-calcaneal angle, Meary's angle, intermetatarsal angle). Three-dimensional measurements were obtained using automated software. Intra-observer and inter-observer agreement were evaluated for all 2D measurements. RESULTS: Overall intraclass correlation coefficients (ICC's) were higher than 0.750 for most 2D measurements, ranging from 0.352 to 0.995. Calcaneal pitch, angle between the first metatarsal (MT1) and proximal phalange 1, between the fifth metatarsal (MT5) and the calcaneus and heights of the sesamoid bones, navicular, cuboid and talus decreased during weight-bearing in both 2D and 3D results (p < 0.01). Meary's angle was not statistically different in 2D (p = 0.627) and 3D (p = 0.765). Higher coefficients of variation in 2D geometric analysis parameters (0.27 versus 0.16) indicate that 3D analyses are more precise compared to 2D (p < 0.01). Results of left and right feet are comparable for 2D and 3D analyses. CONCLUSION: Although 2D and 3D geometrical analyses are fundamentally different, automated 3D analyses are more reproducible and precise compared to 2D analyses. In addition, 3D evaluation better demonstrates differences in bone configurations between weight-bearing and non weight-bearing conditions, which may be of value to demonstrate pathology.


Assuntos
Tornozelo , Tomografia Computadorizada de Feixe Cônico , Adulto , Articulação do Tornozelo/diagnóstico por imagem , Feminino , Humanos , Masculino , Padrões de Referência , Suporte de Carga
5.
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
6.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 38(1): 97-104, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33899433

RESUMO

The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement-Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.


Assuntos
Ligamentos Laterais do Tornozelo , Tai Ji , Tornozelo , Articulação do Tornozelo , Fenômenos Biomecânicos , Humanos , Articulação do Joelho , Masculino
7.
Sensors (Basel) ; 21(5)2021 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-33800347

RESUMO

Falls are one of the leading causes of permanent injury and/or disability among the elderly. When these people live alone, it is convenient that a caregiver or family member visits them periodically. However, these visits do not prevent falls when the elderly person is alone. Furthermore, in exceptional circumstances, such as a pandemic, we must avoid unnecessary mobility. This is why remote monitoring systems are currently on the rise, and several commercial solutions can be found. However, current solutions use devices attached to the waist or wrist, causing discomfort in the people who wear them. The users also tend to forget to wear the devices carried in these positions. Therefore, in order to prevent these problems, the main objective of this work is designing and recollecting a new dataset about falls, falling risks and activities of daily living using an ankle-placed device obtaining a good balance between the different activity types. This dataset will be a useful tool for researchers who want to integrate the fall detector in the footwear. Thus, in this work we design the fall-detection device, study the suitable activities to be collected, collect the dataset from 21 users performing the studied activities and evaluate the quality of the collected dataset. As an additional and secondary study, we implement a simple Deep Learning classifier based on this data to prove the system's feasibility.


Assuntos
Acidentes por Quedas , Dispositivos Eletrônicos Vestíveis , Acelerometria , Acidentes por Quedas/prevenção & controle , Atividades Cotidianas , Idoso , Algoritmos , Tornozelo , Humanos , Redes Neurais de Computação
8.
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
9.
Sensors (Basel) ; 21(8)2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33923587

RESUMO

A lower-limb exoskeleton robot identifies the wearer's walking intention and assists the walking movement through mechanical force; thus, it is important to be able to identify the wearer's movement in real-time. Measurement of the angle of the knee and ankle can be difficult in the case of patients who cannot move the lower-limb joint properly. Therefore, in this study, the knee angle as well as the angles of the talocrural and subtalar joints of the ankle were estimated during walking by applying the neural network to two inertial measurement unit (IMU) sensors attached to the thigh and shank. First, for angle estimation, the gyroscope and accelerometer data of the IMU sensor were obtained while walking at a treadmill speed of 1 to 2.5 km/h while wearing an exoskeleton robot. The weights according to each walking speed were calculated using a neural network algorithm programmed in MATLAB software. Second, an appropriate weight was selected according to the walking speed through the IMU data, and the knee angle and the angles of the talocrural and subtalar joints of the ankle were estimated in real-time during walking through a feedforward neural network using the IMU data received in real-time. We confirmed that the angle estimation error was accurately estimated as 1.69° ± 1.43 (mean absolute error (MAE) ± standard deviation (SD)) for the knee joint, 1.29° ± 1.01 for the talocrural joint, and 0.82° ± 0.69 for the subtalar joint. Therefore, the proposed algorithm has potential for gait rehabilitation as it addresses the difficulty of estimating angles of lower extremity patients using torque and EMG sensors.


Assuntos
Exoesqueleto Energizado , Robótica , Articulação Talocalcânea , Tornozelo , Articulação do Tornozelo , Fenômenos Biomecânicos , Marcha , Humanos , Articulação do Joelho , Extremidade Inferior , Redes Neurais de Computação , Caminhada
10.
Ter Arkh ; 93(1): 87-93, 2021 Jan 10.
Artigo em Russo | MEDLINE | ID: mdl-33720632

RESUMO

Assesment of arterial stiffness the substantional prognostic factor for evaluating complications of cardiovascular diseases (CVD) in patients with atherosclerosis, hypertension and type 2 diabetes, may be performed using different parameters, including cardio-ankle vascular index (CAVI). The main purpose of this review is to analyze data from studies where CAVI is used to test the arterial wall stiffness in magistral vessels. CAVI measurement is non-invasive and performed by portable devices which makes it comfortable for ambulatory use in patients who come for a check-up and also in those who already are hospitalized. It does not require any special knowledge from investigator and the test lasts a couple of minutes long. CAVI does not depend on blood pressure changes and is more specific in structural changes of arterial wall assessment than brachial-ankle pulse wave velocity (baPWV). CAVI shows considerable correlation with markers of CVD like atherosclerotic plaques in vessels, diastolic disfunction of left ventricle and angina pectoris. CAVI may be used for early monitoring and assessing the lesions of target organs in patients with atherosclerosis, chronic hypertension and type 2 diabetes. Establishing CAVI as a standart parameter in assessing patients who are at risk of CVD can help to improve complications prevention, reduce mortality and prolong their lifespan.


Assuntos
Diabetes Mellitus Tipo 2 , Rigidez Vascular , Tornozelo , Índice Tornozelo-Braço , Pressão Sanguínea , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Humanos , Análise de Onda de Pulso
11.
Med Probl Perform Art ; 36(1): 45-53, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33647097

RESUMO

BACKGROUND: Dancing requires a high range of motion in the foot as well as a good shock-absorbing system formed by the foot and ankle joints. Although there is a broad consensus in dance that excessive calcaneal eversion can cause injury and should be avoided, calcaneal eversion is discussed controversially in the dance literature. An increased research focus on the biomechanics of dance, particularly research pertaining to the foot and ankle joints, might help to resolve this controversy. OBJECTIVES: The study's main purpose was to generate hitherto lacking kinematic data of calcaneal eversion in a dancer's demi-plié. METHODS: Thirty-two contemporary dancers performed three trials in two different conditions: demi-plié in parallel and in turned-out positions. The motion capture system FASTRAK was used to measure calcaneal eversion and foot and lower leg alignment during demi-plié. RESULTS: Maximal calcaneal eversion in turned-out demi-pliés was 3.36°±4° and total range of motion (i.e., maximal minus minimal angle) of calcaneal eversion was 3.73°±1.42°, where the large standard deviations indicate substantial variability across participants. Calcaneal eversion was significantly different between turned-out (3.36°±4°) and parallel (1.17°±4.06°) demi-pliés, as was the alignment of the lower leg and foot, where the lower leg tracked more medially relative to the foot during turned-out pliés. Crucially, both the magnitude of calcaneal eversion and its temporal coupling with ankle dorsiflexion were highly variable across participants. CONCLUSIONS: Average calcaneal eversion is a poor indicator of the role calcaneal eversion plays in the demi-plié of contemporary dancers. Rather, the temporal coupling between calcaneal eversion and ankle dorsiflexion needs to be considered.


Assuntos
Tornozelo , Dança , Articulação do Tornozelo , Fenômenos Biomecânicos , Humanos , Perna (Membro) , Amplitude de Movimento Articular
12.
Bone Joint J ; 103-B(3): 553-561, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641415

RESUMO

AIMS: The aims of the study were to analyze differences in surgical and oncological outcomes, as well as quality of life (QoL) and function in patients with ankle sarcomas undergoing three forms of surgical treatment, minor or major limb salvage surgery (LSS), or amputation. METHODS: A total of 69 patients with ankle sarcomas, treated between 1981 and 2017 at two tumour centres, were retrospectively reviewed (mean age at surgery: 46.3 years (SD 22.0); 31 females (45%)). Among these 69 patients 25 were analyzed prospectively (mean age at latest follow-up: 61.2 years (SD 20.7); 11 females (44%)), and assessed for mobility using the Prosthetic Limb Users Survey of Mobility (PLUS-M; for amputees only), the Toronto Extremity Salvage Score (TESS), and the University of California, Los Angeles (UCLA) Activity Score. Individual QoL was evaluated in these 25 patients using the five-level EuroQol five-dimension (EQ-5D-5L) and Fragebogen zur Lebenszufriedenheit/Questions on Life Satisfaction (FLZ). RESULTS: Of the total number of patients in the study, 22 (32%) underwent minor LSS and 22 (32%) underwent major LSS; 25 underwent primary amputation (36%). Complications developed in 26 (38%) patients, and were more common in those with major or minor LSS in comparison to amputation (59% vs 36% vs 20%; p = 0.022). A time-dependent trend towards higher complication risk following any LSS was present (relative risk: 0.204; 95% confidence interval (CI) 0.026 to 1.614; p = 0.095). In the prospective cohort, mean TESS was higher following minor LSS in comparison to amputation (91.0 vs 67.3; p = 0.006), while there was no statistically significant difference between major LSS and amputation (81.6 vs 67.3; p = 0.099). There was no difference in mean UCLA (p = 0.334) between the three groups (p = 0.334). None of the items in FLZ or EQ-5D-5L were different between the three groups (all p > 0.05), except for FLZ item "self-relation", being lower in amputees. CONCLUSION: Complications are common following LSS for ankle sarcomas. QoL is comparable between patients with LSS or amputation, despite better mobility scores for patients following minor LSS. We conclude that these results allow a decision for amputation to be made more easily in patients particularly where the principles of oncological surgery would otherwise be at risk. Cite this article: Bone Joint J 2021;103-B(3):553-561.


Assuntos
Amputação , Tornozelo , Salvamento de Membro/métodos , Qualidade de Vida , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Áustria/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia
13.
J Neurol Phys Ther ; 45(2): 112-196, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33675603

RESUMO

BACKGROUND: Level of ambulation following stroke is a long-term predictor of participation and disability. Decreased lower extremity motor control can impact ambulation and overall mobility. The purpose of this clinical practice guideline (CPG) is to provide evidence to guide clinical decision-making for the use of either ankle-foot orthosis (AFO) or functional electrical stimulation (FES) as an intervention to improve body function and structure, activity, and participation as defined by the International Classification of Functioning, Disability and Health (ICF) for individuals with poststroke hemiplegia with decreased lower extremity motor control. METHODS: A review of literature published through November 2019 was performed across 7 databases for all studies involving stroke and AFO or FES. Data extracted included time post-stroke, participant characteristics, device types, outcomes assessed, and intervention parameters. Outcomes were examined upon initial application and after training. Recommendations were determined on the basis of the strength of the evidence and the potential benefits, harm, risks, or costs of providing AFO or FES. RESULTS/DISCUSSION: One-hundred twenty-two meta-analyses, systematic reviews, randomized controlled trials, and cohort studies were included. Strong evidence exists that AFO and FES can each increase gait speed, mobility, and dynamic balance. Moderate evidence exists that AFO and FES increase quality of life, walking endurance, and muscle activation, and weak evidence exists for improving gait kinematics. AFO or FES should not be used to decrease plantarflexor spasticity. Studies that directly compare AFO and FES do not indicate overall superiority of one over the other. But evidence suggests that AFO may lead to more compensatory effects while FES may lead to more therapeutic effects. Due to the potential for gains at any phase post-stroke, the most appropriate device for an individual may change, and reassessments should be completed to ensure the device is meeting the individual's needs. LIMITATIONS: This CPG cannot address the effects of one type of AFO over another for the majority of outcomes, as studies used a variety of AFO types and rarely differentiated effects. The recommendations also do not address the severity of hemiparesis, and most studies included participants with varied baseline ambulation ability. SUMMARY: This CPG suggests that AFO and FES both lead to improvements post-stroke. Future studies should examine timing of provision, device types, intervention duration and delivery, longer term follow-up, responders versus nonresponders, and individuals with greater impairments. DISCLAIMER: These recommendations are intended as a guide for clinicians to optimize rehabilitation outcomes for people with poststroke hemiplegia who have decreased lower extremity motor control that impacts ambulation and overall mobility.A Video Abstract is available as supplemental digital content from the authors (available at: http://links.lww.com/JNPT/A335).


Assuntos
Terapia por Estimulação Elétrica , Órtoses do Pé , Transtornos Neurológicos da Marcha , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Tornozelo , Estimulação Elétrica , Humanos , Qualidade de Vida , Acidente Vascular Cerebral/complicações
14.
Artigo em Inglês | MEDLINE | ID: mdl-33669704

RESUMO

BACKGROUND: Foot-ankle motion is affected by chronic ankle instability (CAI) in terms of altered kinematics. This study focuses on multisegmental foot-ankle motion and joint coupling in barefoot and taped CAI patients during the three subphases of stance at running. METHODS: Foot segmental motion data of 12 controls and 15 CAI participants during running with a heel strike pattern were collected through gait analysis. CAI participants performed running trials in three conditions: barefoot running, and running with high-dye and low-dye taping. Dependent variables were the range of motion (RoM) occurring at the different inter-segment angles as well as the cross-correlation coefficients between predetermined segments. RESULTS: There were no significant RoM differences for barefoot running between CAI patients and controls. In taped conditions, the first two subphases only showed RoM changes at the midfoot without apparent RoM reduction compared to the barefoot CAI condition. In the last subphase there was limited RoM reduction at the mid- and rearfoot. Cross-correlation coefficients highlighted a tendency towards weaker joint coupling in the barefoot CAI condition compared to the controls. Joint coupling within the taped CAI conditions did not show optimization compared to the barefoot CAI condition. CONCLUSIONS: RoM was not significantly changed for barefoot running between CAI patients and controls. In taped conditions, there was no distinct tendency towards lower mean RoM values due to the mechanical restraints of taping. Joint coupling in CAI patients was not optimized by taping.


Assuntos
Articulação do Tornozelo , Instabilidade Articular , Tornozelo , Doença Crônica , Marcha , Humanos , Amplitude de Movimento Articular
15.
Artigo em Inglês | MEDLINE | ID: mdl-33669979

RESUMO

This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.


Assuntos
Traumatismos do Tornozelo , Basquetebol , Agulhamento Seco , Tornozelo , Articulação do Tornozelo , Eletromiografia , Feminino , Humanos , Masculino , Músculo Esquelético , Equilíbrio Postural
16.
Sensors (Basel) ; 21(4)2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33672161

RESUMO

The traditional systems used in the physiotherapy rehabilitation process are evolving towards more advanced systems that use virtual reality (VR) environments so that the patient in the rehabilitation process can perform various exercises in an interactive way, thus improving the patient's motivation and reducing the therapist's work. The paper presents a VR simulator for an intelligent robotic system of physiotherapeutic rehabilitation of the ankle of a person who has had a stroke. This simulator can interact with a real human subject by attaching a sensor that contains a gyroscope and accelerometer to identify the position and acceleration of foot movement on three axes. An electromyography (EMG) sensor is also attached to the patient's leg muscles to measure muscle activity because a patient who is in a worse condition has weaker muscle activity. The data collected from the sensors are taken by an intelligent module that uses machine learning to create new levels of exercise and control of the robotic rehabilitation structure of the virtual environment. Starting from these objectives, the virtual reality simulator created will have a low dependence on the therapist, this being the main improvement over other simulators already created for this purpose.


Assuntos
Terapia por Exercício , Procedimentos Cirúrgicos Robóticos , Realidade Virtual , Tornozelo , Articulação do Tornozelo , Humanos , Interface Usuário-Computador
17.
Zhongguo Gu Shang ; 34(2): 143-7, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33666001

RESUMO

OBJECTIVE: To explore clinical effects of single-tunnel pullout structure fixation and anatomical reconstruction of lateral ligament complex in treating chronic lateral ankle instability. METHODS: From January 2016 to December 2018, clinical data of 23 patients with chronic lateral malleolus instability who underwent anatomical reconstruction of lateral malleolus ligament complex with single-tunnel pullout structure fixation, were retrospectively studied. Among them, including 7 males and 16 females, aged from 17 to 33 years old with an avergae of (26.0±4.3) years old;16 patients classified to grage 0, and 7 patients classified to gradeⅠaccording to Kellgren-Lawrence(K-L) grading;the time of sprain ranged form 2 to 15 with an average of (5.7±2.9) times;the time from injury to operation ranged to 4 to 18 months with an average of (9.0±3.3) months. The range of movement of operative and uninjured ankle joints were measured at 24 months after opertaion, visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) were used to evaluate ankle joint function and improvement of pain, K-L grading and MRI scoring of osteoarthritis of ankle (MSOA) were used to evaluate degree of cartilage degeneration of ankle joint. RESULTS: All patients were followed up from 24 to 48 months with an average of (33.4±6.7) months. All the anterior talofibular ligaments and calcaneofibular ligaments were dissected and reconstructed by single-tunnel pullout structure fixation. The range of motion of dorsiflexion, plantarflexion, varus, and valgus on the operative side of ankle joint were smaller than those on the healthy side. There were no statistically differences in dorsiflexion and eversion between operative side and healthy side of ankle joint (P>0.05), while there were statistically differences in plantarflexion and varus (P<0.05). AOFAS score improved from 55.19±6.94 before surgery to 93.77±3.42 at 24 months after operation (P<0.05), and 23 patients were all excellent. VAS score reduced from 5.30±1.12 before opertaion to 1.10±0.81 at 24 months after operation (P<0.05). Forteen patients were grade 0, 8 patients were gradeⅠand 1 patient were gradeⅡaccording to K-L grading, and there were no differences between before and after operation (P>0.05). MSOA score increased from 3.74±2.54 before operation to 7.04±2.51 at 24 months after opertaion (P<0.05). CONCLUSION: Treatment of chronic lateral ankle instability with reconstruction of lateral ligament complex with single-tunnel pullout structure fixation could provide better tendon and bone healing conditions, improve surgical safety and could achieve satisfactory clinical outcomes.


Assuntos
Instabilidade Articular , Ligamentos Laterais do Tornozelo , Idoso , Tornozelo , Articulação do Tornozelo/cirurgia , Feminino , Humanos , Lactente , Instabilidade Articular/cirurgia , Ligamentos Laterais do Tornozelo/cirurgia , Masculino , Estudos Retrospectivos
18.
Sports Health ; 13(2): 128-135, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33560920

RESUMO

BACKGROUND: Single-leg vertical and horizontal hop tests are commonly used to assess performance of healthy athletes and as a measure of progress during rehabilitation from knee injury. It is unclear if they measure similar aspects of leg function, as the relative joint contributions of the hip, knee, and ankle joints during propulsion and landing are unknown. HYPOTHESIS: The proportion of work done by the hip, knee, and ankle will not be the same for these 2 jump types and will vary for propulsive and landing phases. STUDY DESIGN: Cross-sectional cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Twenty physically active participants completed instrumented single-leg hop analysis in both vertical and horizontal directions. Joint peak power, work generated or absorbed, and percentage contribution of each joint during propulsive and landing phases were compared between tasks using paired t tests. RESULTS: Vertical hop was performed with roughly similar contributions of the hip, knee, and ankle for both propulsion (31%, 34%, 35%, respectively) and landing (29%, 34%, 37%, respectively). Horizontal hop distance was mostly (87%) determined by the hip and ankle (44% and 43%), but landing was mostly (65%) performed by the knee with lesser contribution from the hip and ankle (24% and 11%). Propulsive phase showed a proximal-to-distal temporal sequence for both hop types, but landing was more complex. CONCLUSION: Performance during vertical and horizontal hops (jump height and jump distance, respectively) measures different aspects of hip, knee, and ankle function during the propulsive and landing phases. CLINICAL RELEVANCE: Assessment of knee joint function during rehabilitation should not be done using a horizontal hop. The knee contributes about a third to vertical hop height, but only about an eighth to horizontal hop distance. Practitioners carrying out performance testing using either vertical or horizontal hops should be mindful of the relative contributions for meaningful training inferences to be derived.


Assuntos
Tornozelo/fisiologia , Teste de Esforço/métodos , Quadril/fisiologia , Joelho/fisiologia , Exercício Pliométrico , Adulto , Fenômenos Biomecânicos , Estudos Transversais , Humanos , Traumatismos do Joelho/reabilitação , Masculino , Movimento , Força Muscular
19.
Sensors (Basel) ; 21(3)2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33540606

RESUMO

Previous research showed that an Inertial Measurement Unit (IMU) on the anterior side of the shank can accurately measure the Shank-to-Vertical Angle (SVA), which is a clinically-used parameter to guide tuning of ankle-foot orthoses (AFOs). However, in this context it is specifically important that differences in the SVA are detected during the tuning process, i.e., when adjusting heel height. This study investigated the validity of the SVA as measured by an IMU and its responsiveness to changes in AFO-footwear combination (AFO-FC) heel height in persons with incomplete spinal cord injury (iSCI). Additionally, the effect of heel height on knee flexion-extension angle and internal moment was evaluated. Twelve persons with an iSCI walked with their own AFO-FC in three different conditions: (1) without a heel wedge (refHH), (2) with 5 mm heel wedge (lowHH) and (3) with 10 mm heel wedge (highHH). Walking was recorded by a single IMU on the anterior side of the shank and a 3D gait analysis (3DGA) simultaneously. To estimate validity, a paired t-test and intraclass correlation coefficient (ICC) between the SVAIMU and SVA3DGA were calculated for the refHH. A repeated measures ANOVA was performed to evaluate the differences between the heel heights. A good validity with a mean difference smaller than 1 and an ICC above 0.9 was found for the SVA during midstance phase and at midstance. Significant differences between the heel heights were found for changes in SVAIMU (p = 0.036) and knee moment (p = 0.020) during the midstance phase and in SVAIMU (p = 0.042) and SVA3DGA (p = 0.006) at midstance. Post-hoc analysis revealed a significant difference between the ref and high heel height condition for the SVAIMU (p = 0.005) and knee moment (p = 0.006) during the midstance phase and for the SVAIMU (p = 0.010) and SVA3DGA (p = 0.006) at the instant of midstance. The SVA measured with an IMU is valid and responsive to changing heel heights and equivalent to the gold standard 3DGA. The knee joint angle and knee joint moment showed concomitant changes compared to SVA as a result of changing heel height.


Assuntos
Articulação do Tornozelo , Órtoses do Pé , Monitorização Fisiológica , Traumatismos da Medula Espinal , Tornozelo , Fenômenos Biomecânicos , Feminino , Marcha , Calcanhar , Humanos , Perna (Membro) , Masculino , Traumatismos da Medula Espinal/diagnóstico
20.
Am J Sports Med ; 49(3): 737-746, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33555910

RESUMO

BACKGROUND: Cartilage degeneration is a common issue in patients with chronic lateral ankle instability. However, there are limited studies regarding the effectiveness of lateral ligament surgery on preventing talar and subtalar joint cartilage from further degenerative changes. PURPOSE: To longitudinally evaluate talar and subtalar cartilage compositional changes using magnetic resonance imaging T2* mapping in anatomic anterior talofibular ligament (ATFL)-repaired and ATFL-reconstructed ankles and to compare them with measures in asymptomatic controls. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Between January 2015 and December 2016, patients with chronic lateral ankle instability who underwent anatomic ATFL repair (n = 19) and reconstruction (n = 20) were prospectively recruited. Patients underwent 3.0-T magnetic resonance imaging at baseline and 3-year follow-up. As asymptomatic controls, 21 healthy volunteers were recruited and underwent imaging at baseline. Talar dome cartilage was divided into (1) medial anterior, central, and posterior and (2) lateral anterior, central, and posterior. Posterior subtalar cartilage was divided into (1) central talus and calcaneus and (2) lateral talus and calcaneus. Ankle function was assessed using the American Orthopaedic Foot & Ankle Society scores. RESULTS: There were significant increases in T2* values in medial and lateral posterior and central talus cartilage from baseline to 3-year follow-up in patients who underwent repair. T2* values were significantly higher in ATFL-repaired ankles at follow-up for all cartilage regions of interest, except medial and lateral anterior and lateral central, compared with those in healthy controls. From baseline to 3-year follow-up, ATFL-reconstructed ankles had a significant increase in T2* values in lateral central and posterior cartilage. T2* values in ATFL-reconstructed ankles at follow-up were elevated in all cartilage regions of interest, except medial and lateral anterior, compared with those in healthy controls. ATFL-repaired ankles showed a greater decrease of T2* values from baseline to follow-up in lateral calcaneus cartilage than did ATFL-reconstructed ankles (P = .031). No significant differences in American Orthopaedic Foot & Ankle Society score were found between repair and reconstruction procedures (mean ± SD, 19.11 ± 7.45 vs 16.85 ± 6.24; P = .311). CONCLUSION: Neither anatomic ATFL repair nor reconstruction could prevent the progression of talar dome and posterior subtalar cartilage degeneration; however, ankle function and activity levels were not affected over a short period. Patients who underwent ATFL repair exhibited lower T2* values in the lateral calcaneus cartilage than did those who underwent reconstruction.


Assuntos
Instabilidade Articular , Ligamentos Laterais do Tornozelo , Articulação Talocalcânea , Tornozelo , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Cartilagem , Estudos de Coortes , Humanos , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/cirurgia , Ligamentos Laterais do Tornozelo/diagnóstico por imagem , Ligamentos Laterais do Tornozelo/cirurgia , Imagem por Ressonância Magnética , Articulação Talocalcânea/diagnóstico por imagem , Articulação Talocalcânea/cirurgia
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