Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.963
Filtrar
1.
Eur J Sport Sci ; 24(6): 682-692, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38874937

RESUMO

The aim of our study was to compare the effects of two different plyometric training programs (targeting knee extensors or plantar flexors) on jump height and strength of leg muscles. Twenty-nine male basketball players were assigned to the knee-flexed (KF), knee-extended (KE), or control groups. In addition to regular training, the KF group performed plyometric jumps (10 sets of 10 jumps, 3 sessions/week, 4 weeks) from 50 cm boxes with the knee flexed (90°-120°), whereas the KE group performed the jumps from 30 cm boxes with the knee much more extended (130°-170°). Jumping ability was evaluated with squat jumps (SJs), countermovement jumps (CMJs), and drop jumps from 20 cm (DJ20) and 40 cm (DJ40). Knee and ankle muscles were assessed during maximal isokinetic and isometric tests, and EMG activity was recorded from vastus lateralis and medial gastrocnemius. The KF group increased SJ (+10%, d = 0.86) and CMJ (+11%, d = 0.70) but decreased DJ40 height (-7%, d = -0.40). Conversely, the KE group increased DJ20 (+10%, d = 0.74) and DJ40 (+12%, d = 0.77) but decreased SJ height (-4%, d = -0.23). The reactivity index during DJs increased (+10% for DJ20, d = 0.47; +20% for DJ40, d = 0.91) for the KE group but decreased (-10%, d = -0.48) for the KF group during DJ40. Plantar flexor strength increased for the KE group (d = 0.72-1.00) but not for the KF group. Negative transfer across jumps is consistent with the principle of training specificity. Basketball players interested to perform fast rebounds in their training should avoid plyometric jumps with large knee flexions and long contact times.


Assuntos
Desempenho Atlético , Basquetebol , Eletromiografia , Força Muscular , Músculo Esquelético , Exercício Pliométrico , Humanos , Masculino , Basquetebol/fisiologia , Exercício Pliométrico/métodos , Desempenho Atlético/fisiologia , Adulto Jovem , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Joelho/fisiologia , Tornozelo/fisiologia , Adulto
2.
J Bodyw Mov Ther ; 39: 79-86, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876705

RESUMO

BACKGROUND: Strengthening the hip and trunk muscles may decrease foot pronation in upright standing due to expected increases in hip passive torque and lower-limb external rotation. However, considering the increased pronation caused by a more varus foot-ankle alignment, subjects with more varus may experience smaller or no postural changes after strengthening. OBJECTIVE: To investigate the effects of hip and trunk muscle strengthening on lower-limb posture during upright standing and hip passive torque of women with more and less varus alignment. METHODS: This nonrandomized controlled experimental study included 50 young, able-bodied women. The intervention group (n = 25) performed hip and trunk muscle strengthening exercises, and the control group (n = 25) maintained their usual activities. Each group was split into two subgroups: those with more and less varus alignment. Hip, shank, and rearfoot-ankle posture and hip passive external rotation torque were evaluated. Mixed analyses of variance and preplanned contrasts were used to assess prepost changes and between-group differences (α = 0.05). RESULTS: The less-varus subgroup of the intervention group had a reduced rearfoot eversion posture (P = 0.02). No significant changes were observed in the less-varus subgroup of the control group (P = 0.31). There were no significant differences in posture between the control and intervention groups when varus was not considered (P ≥ 0.06). The intervention group had increased hip passive torque (P = 0.001) compared to the control group, independent of varus alignment. CONCLUSION: Despite the increases in hip passive torque, the rearfoot eversion posture was reduced only in women with a less-varus alignment. Having more foot-ankle varus may prevent eversion reductions.


Assuntos
, Força Muscular , Postura , Humanos , Feminino , Postura/fisiologia , Adulto Jovem , Força Muscular/fisiologia , Pé/fisiologia , Pronação/fisiologia , Torque , Tornozelo/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Articulação do Tornozelo/fisiologia , Músculo Esquelético/fisiologia , Terapia por Exercício/métodos
3.
Cereb Cortex ; 34(6)2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38850217

RESUMO

This study aimed to investigate the effects of high-definition transcranial direct current stimulation on ankle force sense and underlying cerebral hemodynamics. Sixteen healthy adults (8 males and 8 females) were recruited in the study. Each participant received either real or sham high-definition transcranial direct current stimulation interventions in a randomly assigned order on 2 visits. An isokinetic dynamometer was used to assess the force sense of the dominant ankle; while the functional near-infrared spectroscopy was employed to monitor the hemodynamics of the sensorimotor cortex. Two-way analyses of variance with repeated measures and Pearson correlation analyses were performed. The results showed that the absolute error and root mean square error of ankle force sense dropped more after real stimulation than after sham stimulation (dropped by 23.4% vs. 14.9% for absolute error, and 20.0% vs. 10.2% for root mean square error). The supplementary motor area activation significantly increased after real high-definition transcranial direct current stimulation. The decrease in interhemispheric functional connectivity within the Brodmann's areas 6 was significantly correlated with ankle force sense improvement after real high-definition transcranial direct current stimulation. In conclusion, high-definition transcranial direct current stimulation can be used as a potential intervention for improving ankle force sense. Changes in cerebral hemodynamics could be one of the explanations for the energetic effect of high-definition transcranial direct current stimulation.


Assuntos
Tornozelo , Espectroscopia de Luz Próxima ao Infravermelho , Estimulação Transcraniana por Corrente Contínua , Humanos , Feminino , Masculino , Estimulação Transcraniana por Corrente Contínua/métodos , Adulto , Adulto Jovem , Tornozelo/fisiologia , Hemodinâmica/fisiologia , Circulação Cerebrovascular/fisiologia , Córtex Motor/fisiologia
4.
J Acupunct Meridian Stud ; 17(3): 94-99, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38898646

RESUMO

Importance: Neuromodulation may be one of the underlying mechanisms of dry needling (DN); however, the mechanism has not yet been fully clarified. Objective: This randomized controlled trial is designed to evaluate DN stimulation of the tibialis anterior and peroneus longus muscles in chronic ankle instability (CAI) and healthy subjects, employing functional magnetic resonance imaging (fMRI). Design: Clinical study protocol, SPIRIT compliant. Setting: Brain Mapping Laboratory. Population: A total of thirty participants aged between 18 and 40 years old will be included in this study. Twenty healthy participants will be randomized into 2 groups (real DN and sham DN). Ten patients with CAI will also be recruited to the third group and receive only real DN for comparison. Exposures: Real and sham DN. Main Outcomes and Measures: The voxel count, coordinates of peak activation, and peak intensity will be obtained as primary outcomes to report brain map activation. Measurements will be taken before, during, and after DN treatment. The strength of the ankle dorsiflexors, active dorsiflexion range of motion, and McGill pain questionnaire short-form will be used as secondary outcome measures. Results: The results from this study will be published in peer-reviewed journals and disseminated as presentations at national and international congresses. Conclusion: This trial will explore brain responses to real and sham DN in healthy participants and to real DN in CAI patients. Overall, our results will provide preliminary evidence of the neural mechanism of DN.


Assuntos
Agulhamento Seco , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Adulto , Adulto Jovem , Agulhamento Seco/métodos , Masculino , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Feminino , Adolescente , Tornozelo/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Mapeamento Encefálico/métodos , Instabilidade Articular/terapia , Instabilidade Articular/fisiopatologia , Instabilidade Articular/diagnóstico por imagem , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/fisiopatologia
5.
PLoS One ; 19(6): e0303397, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38848334

RESUMO

A novel powered ankle-foot prosthesis is designed. The effect of wearing the novel prosthesis and an energy-storage-and-return (ESAR) foot on lower-limb biomechanics is investigated to preliminarily evaluate the design. With necessary auxiliary materials, a non-amputated subject (a rookie at using prostheses) is recruited to walk on level ground with an ESAR and the novel powered prostheses separately. The results of the stride characteristics, the ground reaction force (GRF) components, kinematics, and kinetics in the sagittal plane are compared. Wearing the powered prosthesis has less prolongation of the gait cycle on the unaffected side than wearing the ESAR foot. Wearing ESAR or proposed powered prostheses influences the GRF, kinematics, and kinetics on the affected and unaffected sides to some extent. Thereinto, the knee moment on the affected side is influenced most. Regarding normal walking as the reference, among the total of 15 indexes, the influences of wearing the proposed powered prosthesis on six indexes on the affected side (ankle's/knee's/hip's angles, hip's moment, and Z- and X-axis GRF components) and five indexes on the unaffected side (ankle's/knee's/hip's angles and ankle's/hip's moments) are slighter than those of wearing the ESAR foot. The influences of wearing the powered prosthesis on two indexes on the unaffected side (knee's moment and X-axis GRF component) are similar to those of wearing the ESAR foot. The greatest improvement of wearing the powered prosthesis is to provide further plantarflexion after reaching the origin of the ankle joint before toe-off, which means that the designed powered device can provide further propulsive power for the lifting of the human body's centre of gravity during walking on level ground. The results demonstrate that wearing the novel powered ankle-foot prosthesis benefits the rookie in recovering the normal gait more than wearing the ESAR foot.


Assuntos
Membros Artificiais , , Desenho de Prótese , Humanos , Fenômenos Biomecânicos , Pé/fisiologia , Marcha/fisiologia , Caminhada/fisiologia , Masculino , Tornozelo/fisiologia , Articulação do Tornozelo/fisiologia , Adulto , Extremidade Inferior/fisiologia
6.
J Sports Sci Med ; 23(2): 418-424, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38841636

RESUMO

To determine how lateral shuffling/lateral shuffle (LS) -induced fatigue affects ankle proprioception and countermovement jump (CMJ) performance. Eighteen male college athletes performed 6 modes of a repeated LS protocol with 2 distances (2.5 and 5 m) and 3 speeds (1.6, 1.8, and 2.0 m/s). After LS, ankle inversion proprioception (AIP) was measured using the active movement extent discrimination apparatus (AMEDA). CMJ, blood lactate (BLa), heart rate (HR) and rating of perceived exertion (RPE) were measured before and after LS. The number of changes of direction (CODs) in each protocol was recorded. LS-induced fatigue was evident in BLa, HR and RPE (all p < 0.05), increasing with shorter shuffle distance and faster speed. RM-ANOVA showed a significant distance main effect on both AIP (p < 0.01) and CMJ (p < 0.05), but the speed main effect was only significant for CMJ (p ≤ 0.001), not AIP (p = 0.87). CMJ performance was correlated with BLa, HR and RPE (r values range from -0.62 to -0.32, all p ≤ 0.001). AIP was only correlated with CODs (r = -0.251, p < 0.01). These results suggested that in LS, shorter distance, regardless of speed, was associated with worse AIP, whereas subsequent CMJ performance was affected by both LS distance and speed. Hence, AIP performance was not related to physiological fatigue, but CMJ performance was. Results imply that LS affects processing proprioceptive input and producing muscular output differently, and that these two aspects of neuromuscular control are affected by physiological fatigue to varying degrees. These findings have implications for injury prevention and performance enhancement.


Assuntos
Tornozelo , Desempenho Atlético , Frequência Cardíaca , Ácido Láctico , Fadiga Muscular , Propriocepção , Humanos , Masculino , Propriocepção/fisiologia , Adulto Jovem , Frequência Cardíaca/fisiologia , Fadiga Muscular/fisiologia , Tornozelo/fisiologia , Desempenho Atlético/fisiologia , Ácido Láctico/sangue , Exercício Pliométrico , Esforço Físico/fisiologia
7.
J Foot Ankle Res ; 17(2): e12028, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38820170

RESUMO

BACKGROUND: The aim of this study was to compare the plantar pressure distribution and knee and ankle muscle architecture in women with and without knee osteoarthritis (OA). METHODS: Fifty women with knee OA (mean age = 52.11 ± 4.96 years, mean Body mass index (BMI) = 30.94 ± 4.23 kg/m2) and 50 healthy women as a control group (mean age = 50.93 ± 3.78 years, mean BMI = 29.06 ± 4.82 kg/m2) were included in the study. Ultrasonography was used to evaluate knee and ankle muscles architecture and femoral cartilage thickness. The plantar pressure distribution was evaluated using the Digital Biometry Scanning System and Milleri software (DIASU, Italy). Static foot posture was evaluated using the Foot Posture Index (FPI), and pain severity was assessed using the Visual Analog Scale. RESULTS: The OA group exhibited lower muscle thickness in Rectus Femoris (RF) (p = 0.003), Vastus Medialis (VM) (p = 0.004), Vastus Lateralis (p = 0.023), and Peroneus Longus (p = 0.002), as well as lower Medial Gastrocnemius pennation angle (p = 0.049) and higher Fat thickness (FT) in RF (p = 0.033) and VM (p = 0.037) compared to the control group. The OA group showed thinner femoral cartilage thickness (p = 0.001) and higher pain severity (p = 0.001) than the control groups. FPI scores were higher (p = 0.001) in OA group compared to the control group. The plantar pressure distribution results indicated an increase in total surface (p = 0.027), total load (p = 0.002), medial load (p = 0.005), and lateral load (p = 0.002) on dominant side in OA group compared to the control group. CONCLUSIONS: Knee and ankle muscle architecture, knee extensor muscle FT, and plantar pressure distribution in the dominant foot differed in individuals with knee OA compared to the control group.


Assuntos
, Músculo Esquelético , Osteoartrite do Joelho , Pressão , Ultrassonografia , Humanos , Feminino , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Pé/fisiopatologia , Pé/diagnóstico por imagem , Articulação do Tornozelo/fisiopatologia , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/patologia , Estudos de Casos e Controles , Articulação do Joelho/fisiopatologia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Postura/fisiologia , Tornozelo/fisiopatologia , Tornozelo/diagnóstico por imagem
8.
J Foot Ankle Res ; 17(2): e12027, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38812103

RESUMO

PURPOSE: Abnormal lower limb movement patterns have been observed during walking in individuals with limited ankle dorsiflexion. The purpose of this study was to investigate the relationships of peak ankle dorsiflexion angle during the stance phase of walking with the lower extremity biomechanics at the corresponding moment and to determine a cutoff value of functional limited ankle dorsiflexion during walking. METHODS: Kinematic and kinetic data of 70 healthy participants were measured during walking. Spearman's correlation coefficients were calculated to establish the association between peak ankle dorsiflexion and angle and moment of ankle, knee, and hip, ground reaction force, and pelvic movement at peak ankle dorsiflexion. All variables significantly related to peak ankle dorsiflexion were extracted as a common factor by factor analysis. Maximally selected Wilcoxon statistic was used to perform a cutoff value analysis. RESULTS: Peak ankle dorsiflexion positively correlated with ankle plantar flexion moment (r = 0.432; p = 0.001), ankle external rotation moment (r = 0.251; p = 0.036), hip extension angle (r = 0.281; p = 0.018), hip flexion moment (r = 0.341; p = 0.004), pelvic ipsilateral rotation angle (r = 0.284; p = 0.017), and medial, anterior, and vertical ground reaction force (r = 0.324; p = 0.006, r = 0.543; p = 0.001, r = 0.322; p = 0.007), negatively correlated with knee external rotation angle (r = -0.394; p = 0.001) and hip adduction angle (r = -0.256; p = 0.032). The cutoff baseline value for all 70 participants was 9.03°. CONCLUSIONS: There is a correlation between the peak ankle dorsiflexion angle and the lower extremity biomechanics during walking. If the peak ankle dorsiflexion angle is less than 9.03°, the lower limb movement pattern will change significantly.


Assuntos
Articulação do Tornozelo , Extremidade Inferior , Amplitude de Movimento Articular , Caminhada , Humanos , Fenômenos Biomecânicos/fisiologia , Masculino , Feminino , Articulação do Tornozelo/fisiologia , Caminhada/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto , Extremidade Inferior/fisiologia , Adulto Jovem , Articulação do Quadril/fisiologia , Articulação do Joelho/fisiologia , Tornozelo/fisiologia
9.
J Neuroeng Rehabil ; 21(1): 87, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38807221

RESUMO

BACKGROUND: The talocrural joint and the subtalar joint are the two major joints of the ankle-joint complex. The position and direction of the exosuit force line relative to these two joint axes can influence ankle motion. We aimed to understand the effects of different force-lines on ankle multidimensional motion. METHODS: In this article, three assistance force line schemes for ankle exosuits were proposed: perpendicular to the talocrural joint axis (PT), intersecting with the subtalar joint axis (IS), and parallel to the triceps surae (PTS). A theoretical model was proposed to calculate the exosuit's assistance moment. Seven participants completed four experimental tests of ankle plantarflexion, including three passive motions assisted by the PT, PTS and IS schemes, and one active motion without exosuit assistance (Active). RESULTS: The simulation results demonstrated that all three exosuits were able to produce significant moments of ankle plantarflexion. Among these, the PT scheme exhibited the highest moments in all dimensions, followed by the PTS and IS schemes. The experimental findings confirmed the effectiveness of all three exosuit schemes in assisting ankle plantarflexion. Additionally, as the assistive force lines approached the subtalar joint, there was a decrease in ankle motion assisted by the exosuits in non-plantarflexion directions, along with a reduction in the average distance of ankle angle curves relative to active ankle motion. Furthermore, the linear correlation coefficients between inversion and plantarflexion, adduction and plantarflexion, and adduction and inversion gradually converged toward active ankle plantarflexion motion. CONCLUSIONS: Our research indicates that the position of the exosuit force line to the subtalar joint has a significant impact on ankle inversion and adduction. Among all three schemes, the IS, which has the closest distance to the subtalar joint axes, has the greatest kinematic similarity to active ankle plantarflexion and might be a better choice for ankle assistance and rehabilitation.


Assuntos
Articulação do Tornozelo , Humanos , Articulação do Tornozelo/fisiologia , Masculino , Fenômenos Biomecânicos , Adulto , Exoesqueleto Energizado , Adulto Jovem , Amplitude de Movimento Articular/fisiologia , Feminino , Movimento/fisiologia , Modelos Teóricos , Tornozelo/fisiologia
10.
PLoS One ; 19(5): e0303070, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38809842

RESUMO

Tap dance generates forces and joint motions that can lead to injury; however, little is known about the magnitude of load across different tap steps. The purpose of this study was to calculate peak vertical forces, average vertical foot velocities, and maximum/minimum ankle angles produced by tap dancers with different levels of experience performing the toe cannon, heel cannon, flap, and cramp roll. This prospective cross-sectional study included 14 female tap dancers aged ≥18 years with varying tap experience. Participants were recorded by three cameras while performing a choreographed tap combination containing four steps of interest on a force platform. Adjusting for experience and dancer-level clustering, we identified the steps-cramp roll and toe cannon-that had the highest peak vertical ground reaction force, angles, and velocities compared to flap and heel cannon. There was no effect of experience. The results supported our hypothesis and provide new insights into step production. Over time, the larger forces associated with these steps could pose an increased risk of injury to bones and joints when compared to smaller forces, which may suggest the importance of adjusting routines to reduce or avoid injury.


Assuntos
Articulação do Tornozelo , Dança , Humanos , Feminino , Dança/fisiologia , Adulto , Estudos Transversais , Articulação do Tornozelo/fisiologia , Estudos Prospectivos , Adulto Jovem , Fenômenos Biomecânicos , Suporte de Carga/fisiologia , Tornozelo/fisiologia , Adolescente
11.
Clin Biomech (Bristol, Avon) ; 115: 106261, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38749329

RESUMO

BACKGROUND: Peripheral neuropathy due to chemotherapeutic drugs causes alterations in ankle movement during gait. This study aimed to describe the spatiotemporal parameters and ankle kinematics during gait in schoolchildren with acute lymphoblastic leukemia with clinically suspected peripheral neuropathy. METHODS: In children with acute lymphoblastic leukemia in the maintenance phase, we calculated spatiotemporal and kinematic parameters of the ankle during gait using Kinovea® software. Furthermore, we identified alterations in the parameters obtained considering the values of the normality data from a stereophotogrammetry system as the reference values. Finally, we represented the kinematic parameters of the ankles calculated with Kinovea® compared to the normality values of the stereophotogrammetry. FINDINGS: We evaluated 25 schoolchildren; 13 were male (52.0%) with a median age of 88.0months and a median of 60.0 weeks in the maintenance phase, and 54.8% were classified as standard risk. Spatiotemporal parameters: cadence (steps/min), bilateral step length (m), and average gait speed (m/s) in ALL children were significantly lower than reference values (p < 0.001). Except for right mid-stance and bilateral foot strike, initial swing showed that both ankles maintained plantar flexion values during gait, significantly lower in ALL patients (p < 0.05). INTERPRETATION: We identified spatiotemporal and kinematics alterations in schoolchildren with acute lymphoblastic leukemia during all phases of the gait suggestive of alteration in ankle muscles during movement, probably due to peripheral neuropathy; nevertheless, our results should be taken with caution until the accuracy and reliability of Kinovea® software as a diagnostic test compared to the stereophotogrammetric system in children with ALL and healthy peers is proven.


Assuntos
Marcha , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Masculino , Criança , Feminino , Estudos Transversais , Doenças do Sistema Nervoso Periférico/fisiopatologia , Fenômenos Biomecânicos , Tornozelo/fisiopatologia , Articulação do Tornozelo/fisiopatologia , Movimento , Adolescente
12.
PLoS One ; 19(5): e0302389, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38696428

RESUMO

BACKGROUND: Ankle-foot orthoses (AFOs) are commonly used to overcome mobility limitations related to lower limb musculoskeletal injury. Despite a multitude of AFOs to choose from, there is scant evidence to guide AFO prescription and limited opportunities for AFO users to provide experiential input during the process. To address these limitations in the current prescription process, this study evaluates a novel, user-centered and personalized 'test-drive' strategy using a robotic exoskeleton ('AFO emulator') to emulate commercial AFO mechanical properties (i.e., stiffness). The study will determine if brief, in-lab trials (with emulated or actual AFOs) can predict longer term preference, satisfaction, and mobility outcomes after community trials (with the actual AFOs). Secondarily, it will compare the in-lab experience of walking between actual vs. emulated AFOs. METHODS AND ANALYSIS: In this participant-blinded, randomized crossover study we will recruit up to fifty-eight individuals with lower limb musculoskeletal injuries who currently use an AFO. Participants will walk on a treadmill with three actual AFOs and corresponding emulated AFOs for the "in-lab" assessments. For the community trial assessment, participants will wear each of the actual AFOs for a two-week period during activities of daily living. Performance-based and user-reported measures of preference and mobility will be compared between short- and long-term trials (i.e., in-lab vs. two-week community trials), and between in-lab trials (emulated vs. actual AFOs). TRIAL REGISTRATION: The study was prospectively registered at www.clininicaltrials.gov (Clinical Trials Study ID: NCT06113159). Date: November 1st 2023. https://classic.clinicaltrials.gov/ct2/show/NCT06113159.


Assuntos
Órtoses do Pé , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tornozelo/fisiopatologia , Estudos Cross-Over , Exoesqueleto Energizado , Ensaios Clínicos Controlados Aleatórios como Assunto , Caminhada/fisiologia
13.
Clin Biomech (Bristol, Avon) ; 116: 106268, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38795609

RESUMO

BACKGROUND: Community ambulation involves complex walking adaptability tasks such as stepping over obstacles or taking long steps, which require adequate propulsion generation by the trailing leg. Individuals post-stroke often have an increased reliance on their trailing nonparetic leg and favor leading with their paretic leg, which can limit mobility. Ankle-foot-orthoses are prescribed to address common deficits post-stroke such as foot drop and ankle instability. However, it is not clear if walking with an ankle-foot-orthosis improves inter-limb propulsion symmetry during adaptability tasks. This study sought to examine this hypothesis. METHODS: Individuals post-stroke (n = 9) that were previously prescribed a custom fabricated plantarflexion-stop articulated ankle-foot-orthosis participated. Participants performed steady-state walking and adaptability tasks overground with and without their orthosis. The adaptability tasks included obstacle crossing and long-step tasks, leading with both their paretic and nonparetic leg. Inter-limb propulsion symmetry was calculated using trailing limb ground-reaction-forces. FINDINGS: During the obstacle crossing task, ankle-foot-orthosis use resulted in a significant improvement in inter-limb propulsion symmetry. The orthosis also improved ankle dorsiflexion during stance, reduced knee hyperextension, increased gastrocnemius muscle activity, and increased peak paretic leg ankle plantarflexor moment. In contrast, there were no differences in propulsion symmetry during steady-state walking and taking a long-step when using the orthosis. INTERPRETATION: Plantarflexion-stop articulated ankle-foot-orthoses can improve propulsion symmetry during obstacle crossing tasks in individuals post-stroke, promoting paretic leg use and reduced reliance on the nonparetic leg.


Assuntos
Órtoses do Pé , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Caminhada , Humanos , Caminhada/fisiologia , Masculino , Feminino , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/complicações , Pessoa de Meia-Idade , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Adaptação Fisiológica , Articulação do Tornozelo/fisiopatologia , Pé/fisiopatologia , Fenômenos Biomecânicos , Tornozelo/fisiopatologia , Marcha/fisiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/reabilitação , Transtornos Neurológicos da Marcha/etiologia , Paresia/fisiopatologia , Paresia/reabilitação , Paresia/etiologia
14.
Orthop Clin North Am ; 55(3): 383-392, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38782509

RESUMO

Although the impact that vitamin D has on bone healing is uncertain in foot and ankle (F&A) surgery, there is support for vitamin D supplementation (2000 IU/day) with calcium (1 g/day) to promote bone healing. Although orthopedic F&A surgeons are frequently the first provider to detect the harbingers of osteoporosis by the occurrence of fragility fractures, this should trigger referral to the appropriate specialist for assessment and treatment. There is circumstantial evidence suggesting a role of hypovitaminosis D in bone marrow edema syndrome and possibly osteochondritis dissecans. There should be a low threshold for assessing vitamin D levels in such patients.


Assuntos
Deficiência de Vitamina D , Vitamina D , Humanos , Vitamina D/uso terapêutico , Vitamina D/sangue , Vitamina D/administração & dosagem , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico , Suplementos Nutricionais , Procedimentos Ortopédicos/efeitos adversos , Pé/cirurgia , Tornozelo/cirurgia
15.
Anesthesiol Clin ; 42(2): 263-280, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38705675

RESUMO

Modern anesthetic management for foot and ankle surgery includes a variety of anesthesia techniques including general anesthesia, neuraxial anesthesia, or MAC in combination with peripheral nerve blocks and/or multimodal analgesic agents. The choice of techniques should be tailored to the nature of the procedure, patient comorbidities, anesthesiologist skill level, intensity of anticipated postoperative pain, and surgeon preference.


Assuntos
Anestesia , Tornozelo , , Humanos , Pé/cirurgia , Tornozelo/cirurgia , Anestesia/métodos , Procedimentos Ortopédicos/métodos , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico
16.
J Morphol ; 285(5): e21707, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38721681

RESUMO

Using finite element analysis on the astragali of five macropodine kangaroos (extant and extinct hoppers) and three sthenurine kangaroos (extinct proposed bipedal striders) we investigate how the stresses experienced by the ankle in similarly sized kangaroos of different hypothesized/known locomotor strategy compare under different simulation scenarios, intended to represent the moment of midstance at different gaits. These tests showed a clear difference between the performance of sthenurines and macropodines with the former group experiencing lower stress in simulated bipedal strides in all species compared with hopping simulations, supporting the hypothesis that sthenurines may have utilized this gait. The Pleistocene macropodine Protemnodon also performed differently from all other species studied, showing high stresses in all simulations except for bounding. This may support the hypothesis of Protemnodon being a quadrupedal bounder.


Assuntos
Análise de Elementos Finitos , Macropodidae , Animais , Macropodidae/fisiologia , Macropodidae/anatomia & histologia , Tornozelo/fisiologia , Fenômenos Biomecânicos , Marcha/fisiologia , Locomoção/fisiologia , Estresse Mecânico
17.
Sci Rep ; 14(1): 10282, 2024 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-38704481

RESUMO

During fatigued conditions, badminton players may experience adverse effects on their ankle joints during smash landings. In addition, the risk of ankle injury may vary with different landing strategies. This study aimed to investigate the influence of sport-specific fatigue factors and two backhand smash actions on ankle biomechanical indices. Thirteen female badminton players (age: 21.2 ± 1.9 years; height: 167.1 ± 4.1 cm; weight: 57.3 ± 5.1 kg; BMI: 20.54 ± 1.57 kg/m2) participated in this study. An 8-camera Vicon motion capture system and three Kistler force platforms were used to collect kinematic and kinetic data before and after fatigue for backhand rear-court jump smash (BRJS) and backhand lateral jump smash (BLJS). A 2 × 2 repeated measures analysis of variance was employed to analyze the effects of these smash landing actions and fatigue factors on ankle biomechanical parameters. Fatigue significantly affected the ankle-joint plantarflexion and inversion angles at the initial contact (IC) phase (p < 0.05), with both angles increasing substantially post-fatigue. From a kinetic perspective, fatigue considerably influenced the peak plantarflexion and peak inversion moments at the ankle joint, which resulted in a decrease the former and an increase in the latter after fatigue. The two smash landing actions demonstrated different landing strategies, and significant main effects were observed on the ankle plantarflexion angle, inversion angle, peak dorsiflexion/plantarflexion moment, peak inversion/eversion moment, and peak internal rotation moment (p < 0.05). The BLJS landing had a much greater landing inversion angle, peak inversion moment, and peak internal rotation moment compared with BRJS landing. The interaction effects of fatigue and smash actions significantly affected the muscle force of the peroneus longus (PL), with a more pronounced decrease in the force of the PL muscle post-fatigue in the BLJS action(post-hoc < 0.05). This study demonstrated that fatigue and smash actions, specifically BRJS and BLJS, significantly affect ankle biomechanical parameters. After fatigue, both actions showed a notable increase in IC plantarflexion and inversion angles and peak inversion moments, which may elevate the risk of lateral ankle sprains. Compared with BRJS, BLJS poses a higher risk of lateral ankle sprains after fatigue.


Assuntos
Articulação do Tornozelo , Esportes com Raquete , Humanos , Feminino , Esportes com Raquete/fisiologia , Fenômenos Biomecânicos , Articulação do Tornozelo/fisiologia , Adulto Jovem , Fadiga/fisiopatologia , Adulto , Fadiga Muscular/fisiologia , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/etiologia , Tornozelo/fisiologia , Amplitude de Movimento Articular/fisiologia , Atletas
18.
Foot (Edinb) ; 59: 102092, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38574631

RESUMO

Surgical site infections (SSI) constitute 31% of all hospital-acquired conditions, with ankle and foot surgical procedures showing an incidence of SSI ranging from 0.5% to 6.5%. This study aimed to assess the incidence of both superficial and deep surgical site infections in foot and ankle surgery, along with associated factors. Conducted as a retrospective cohort study, it included 2180 patients undergoing foot and ankle surgery in a private hospital between 2014 and 2020, encompassing elective and trauma cases. Outcome variables comprised SSI, while predictor variables encompassed sex, age, diabetes mellitus, systemic arterial hypertension, smoking, American Society of Anesthesiologists (ASA) score, and body mass index. Logistic regression models were employed to identify associations between study variables. The incidence of surgical site infections stood at 4% (83/2180), comprising a rate of 2.8% (57/2180) for superficial infections and 1.2% (26/2180) for deep infections. Smoking (OR 2.9, 95%CI 1.4-5.3) and ASA score >2 (OR 3.4, 95%CI 1.2-8.4) emerged as independent factors associated with surgical site infections. The group with deep infections exhibited higher proportions of smokers (p = 0.002), systemic arterial hypertension (p = 0.018), trauma surgery (p = 0.049), and an ASA score >2 (p = 0.011). Overall infection incidence in this cohort reached 4%, with trauma cases, smoking, hypertension, and an ASA score >2 independently linked to deep infections. Surgeons should be cognizant of these risk factors when managing prophylactic antibiotic regimens for patients.


Assuntos
, Infecção da Ferida Cirúrgica , Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Masculino , Feminino , Incidência , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Pé/cirurgia , Adulto , Idoso , Tornozelo/cirurgia , Estudos de Coortes , Procedimentos Ortopédicos/efeitos adversos
19.
Zhonghua Wai Ke Za Zhi ; 62(6): 514-519, 2024 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-38682620

RESUMO

The rapid development of technology has ushered in a new era of minimally invasive and intelligent surgery.Minimally invasive surgeries, such as small incision, percutaneous surgery, arthroscopic surgery, and endoscopic surgery, have contributed to less invasive surgical trauma, better cosmesis, and faster recovery. Furthermore, the recent adoption of artificial intelligence (AI) has introduced new assistances and tools for minimally invasive foot and ankle surgery. By the help of advanced AI algorithms, surgeons can accurately make diagnose and personalized treatment strategies. Applications of computer-assisted navigation systems and robotics have facilitated precise surgical procedures and real-time confirmation of surgical outcomes. Foot and ankle surgery has lagged behind other surgical specialties in adopting these advancements. Currently, the integration of various forms of minimally invasive surgery and AI technology stand as the main trend in the development of foot and ankle surgery. It is believed that in the near future, intelligent minimally invasive surgery will become the mainstream in the domain of foot and ankle.


Assuntos
Tornozelo , Inteligência Artificial , , Procedimentos Cirúrgicos Minimamente Invasivos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Pé/cirurgia , Tornozelo/cirurgia , Cirurgia Assistida por Computador/métodos
20.
J Neuroeng Rehabil ; 21(1): 67, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38689255

RESUMO

BACKGROUND: Foot and ankle unloading is essential in various clinical contexts, including ulcers, tendon ruptures, and fractures. Choosing the right assistive device is crucial for functionality and recovery. Yet, research on the impact of devices beyond crutches, particularly ankle-foot orthoses (AFOs) designed to unload the ankle and foot, is limited. This study investigates the effects of three types of devices-forearm crutches, knee crutch, and AFO-on biomechanical, metabolic, and subjective parameters during walking with unilateral ankle-foot unloading. METHODS: Twenty healthy participants walked at a self-selected speed in four conditions: unassisted able-bodied gait, and using three unloading devices, namely forearm crutches, iWalk knee crutch, and ZeroG AFO. Comprehensive measurements, including motion capture, force plates, and metabolic system, were used to assess various spatiotemporal, kinematic, kinetic, and metabolic parameters. Additionally, participants provided subjective feedback through questionnaires. The conditions were compared using a within-subject crossover study design with repeated measures ANOVA. RESULTS: Significant differences were found between the three devices and able-bodied gait. Among the devices, ZeroG exhibited significantly faster walking speed and lower metabolic cost. For the weight-bearing leg, ZeroG exhibited the shortest stance phase, lowest braking forces, and hip and knee angles most similar to normal gait. However, ankle plantarflexion after push-off using ZeroG was most different from normal gait. IWalk and crutches caused significantly larger center-of-mass mediolateral and vertical fluctuations, respectively. Participants rated the ZeroG as the most stable, but more participants complained it caused excessive pressure and pain. Crutches were rated with the highest perceived exertion and lowest comfort, whereas no significant differences between ZeroG and iWalk were found for these parameters. CONCLUSIONS: Significant differences among the devices were identified across all measurements, aligning with previous studies for crutches and iWalk. ZeroG demonstrated favorable performance in most aspects, highlighting the potential of AFOs in enhancing gait rehabilitation when unloading is necessary. However, poor comfort and atypical sound-side ankle kinematics were evident with ZeroG. These findings can assist clinicians in making educated decisions about prescribing ankle-foot unloading devices and guide the design of improved devices that overcome the limitations of existing solutions.


Assuntos
Tornozelo , , Caminhada , Humanos , Fenômenos Biomecânicos , Masculino , Caminhada/fisiologia , Feminino , Adulto , Tornozelo/fisiologia , Pé/fisiologia , Órtoses do Pé , Tecnologia Assistiva , Adulto Jovem , Muletas , Estudos Cross-Over , Marcha/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...