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1.
Microsurgery ; 44(5): e31209, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38970406

RESUMO

BACKGROUND: Instep flaps are commonly used for the reconstruction of weight-bearing areas of the foot. However, in cases of large defects or damage to the instep area, non-instep flaps such as reverse sural flaps (RSF) or free anterolateral thigh flaps (ALTF) can be employed. Previous studies have primarily focused on heel reconstruction when comparing different flaps, without considering the forefoot. This study aims to verify the clinical outcomes of these flaps and determine the appropriate donor site for weight-bearing areas of the foot including forefoot reconstruction. METHODS: In a retrospective study, 39 patients who had undergone flap reconstruction of weight-bearing area defects in the foot with a follow-up period of ≥1 year were included. The patients were categorized into two groups: Group A (n = 19) using instep flaps, and Group B (n = 20) using non-instep flap including RSFs and ALTFs. Surgical outcomes were assessed based on the success of the flap, the presence of partial necrosis, the number of additional surgeries, and complications related to the donor site. Clinical evaluation included visual analogue scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score, and the occurrence of ulcers. RESULTS: All flaps were successful, while partial necrosis occurred in one case in Group B. There were three reclosures after flap border debridement in both groups and one donor site debridement in Group A. The VAS scores during weight-bearing were 2.0 ± 1.1 and 2.2 ± 1.5 for Groups A and B, respectively (p = .716). The AOFAS scores were 52.8 ± 6.8 and 50.2 ± 12.7 for Groups A and B, respectively (p = .435). The occurrence of ulcers was 0.4 ± 0.9 times for Group A and 0.3 ± 0.7 times for Group B, with no significant difference between the two groups (p = .453). CONCLUSION: There was no difference in clinical outcomes between the types of flaps after reconstruction of the forefoot and hindfoot. Therefore, it is recommended to choose the appropriate flap based on factors such as the size of the defect, its location, and vascular status rather than the type of flap.


Assuntos
Traumatismos do Pé , Antepé Humano , Calcanhar , Procedimentos de Cirurgia Plástica , Suporte de Carga , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Calcanhar/cirurgia , Calcanhar/lesões , Adulto , Traumatismos do Pé/cirurgia , Antepé Humano/cirurgia , Retalhos Cirúrgicos/transplante , Lesões dos Tecidos Moles/cirurgia , Idoso , Retalhos de Tecido Biológico/transplante , Resultado do Tratamento , Adulto Jovem
2.
BMC Musculoskelet Disord ; 25(1): 533, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992608

RESUMO

BACKGROUND: The purpose of this study was to perform a biomechanical analysis to compare different medial column fixation patterns for valgus pilon fractures in a case-based model. METHODS: Based on the fracture mapping, 48 valgus pilon fracture models were produced and assigned into four groups with different medial column fixation patterns: no fixation (NF), K-wires (KW), intramedullary screws (IS), and locking compression plate (LCP). Each group contained wedge-in and wedge-out subgroups. After fixing each specimen on the machine, gradually increased axial compressive loads were applied with a load speed of one millimeter per minute. The maximum peak force was set at 1500 N. Load-displacement curves were generated and the axial stiffness was calculated. Five different loads of 200 N, 400 N, 600 N, 800 N, 1000 N were selected for analysis. The specimen failure was defined as resultant loading displacement over 3 mm. RESULTS: For the wedge-out models, Group-IS showed less displacement (p < 0.001), higher axial stiffness (p < 0.01), and higher load to failure (p < 0.001) than Group-NF. Group-KW showed comparable displacement under loads of 200 N, 400 N and 600 N with both Group-IS and Group-LCP. For the wedge-in models, no statistical differences in displacement, axial stiffness, or load to failure were observed among the four groups. Overall, wedge-out models exhibited less axial stiffness than wedge-in models (all p < 0.01). CONCLUSIONS: Functional reduction with stable fixation of the medial column is essential for the biomechanical stability of valgus pilon fractures and medial column fixation provides the enough biomechanical stability for this kind of fracture in the combination of anterolateral fixation. In detail, the K-wires can provide a provisional stability at an early stage. Intramedullary screws are strong enough to provide the medial column stability as a definitive fixation. In future, this technique can be recommended for medial column fixation as a complement for holistic stability in high-energy valgus pilon fractures.


Assuntos
Placas Ósseas , Fraturas da Tíbia , Humanos , Fenômenos Biomecânicos , Fraturas da Tíbia/cirurgia , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/fisiopatologia , Parafusos Ósseos , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/instrumentação , Fraturas do Tornozelo/cirurgia , Fraturas do Tornozelo/diagnóstico por imagem , Fraturas do Tornozelo/fisiopatologia , Fios Ortopédicos , Masculino , Suporte de Carga , Feminino , Adulto , Pessoa de Meia-Idade
3.
Int Wound J ; 21(7): e14957, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38994923

RESUMO

Prolonged mechanical loading of the skin and underlying soft tissue cause pressure ulceration. The use of special support surfaces are key interventions in pressure ulcer prevention. They modify the degree and duration of soft tissue deformation and have an impact on the skin microclimate. The objective of this randomized cross-over trial was to compare skin responses and comfort after lying for 2.5 h supine on a support surface with and without a coverlet that was intended to assist with heat and moisture removal at the patient/surface interface. In addition, physiological saline solution was administered to simulate an incontinence episode on the mattress next to the participants' skin surface. In total, 12 volunteers (mean age 69 years) with diabetes mellitus participated. After loading, skin surface temperature, stratum corneum hydration and skin surface pH increased, whereas erythema and structural stiffness decreased at the sacral area. At the heel skin area, temperature, erythema, and stratum corneum hydration increased. These results indicate occlusion and soft tissue deformation which was aggravated by the saline solution. The differences in skin response showed only minor differences between the support surface with or without the coverlet.


Assuntos
Leitos , Estudos Cross-Over , Calcanhar , Úlcera por Pressão , Humanos , Idoso , Úlcera por Pressão/prevenção & controle , Masculino , Feminino , Pessoa de Meia-Idade , Suporte de Carga/fisiologia , Idoso de 80 Anos ou mais , Temperatura Cutânea/fisiologia
4.
Bone Joint J ; 106-B: xxx, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38979634

RESUMO

Aims: Weightbearing instructions after musculoskeletal injury or orthopaedic surgery are a key aspect of the rehabilitation pathway and prescription. The terminology used to describe the weightbearing status of the patient is variable; many different terms are used, and there is recognition and evidence that the lack of standardized terminology contributes to confusion in practice. Methods: A consensus exercise was conducted involving all the major stakeholders in the patient journey for those with musculoskeletal injury. The consensus exercise primary aim was to seek agreement on a standardized set of terminology for weightbearing instructions. Results: A pre-meeting questionnaire was conducted. The one-day consensus meeting, including patient representatives, identified three agreed terms only to be used in defining the weightbearing status of the patient: 1) non-weightbearing; 2) limited weightbearing; and 3) unrestricted weightbearing. Conclusion: This study represents the first and only exercise in standardizing rehabilitation terminology in orthopaedics, as agreed by all major stakeholders in the patient pathway and the patients themselves. The standardization of language allows for higher-quality and more accurate research to be conducted, and is one small part of the bigger picture in increasing the mobility of patients after orthopaedic injury or surgery.


Assuntos
Terminologia como Assunto , Suporte de Carga , Humanos , Consenso , Procedimentos Ortopédicos , Inquéritos e Questionários
6.
J Biomech Eng ; 146(11)2024 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-38949883

RESUMO

This study sought to evaluate the effects of prolonged cyclic loading on the tissue-level mechanical properties of the spinal annulus fibrosus. Functional spinal units (FSUs) were obtained from porcine cervical spines at the C3-C4 and C5-C6 levels. Following a 15-min preload of 300 N of axial compression, the FSUs were split into three groups: the cyclic loading group cycled between 0.35 MPa and 0.95 MPa for 2 h (n = 8); the static loading group was compressed at 0.65 MPa for 2 h (n = 10); and a control group which only underwent the 300 N preload (n = 11). Following loading, samples of the annulus were excised to perform intralamellar tensile testing and interlamellar 180 deg peel tests. Variables analyzed from the intralamellar test were stress and strain at the end of the toe region, stress and strain at initial failure (yield point), Young's modulus, ultimate stress, and strain at ultimate stress. Variables evaluated from the interlamellar tests were lamellar adhesion strength, adhesion strength variability, and stiffness. The analysis showed no significant differences between conditions on any measured variable; however, there was a trend (p = 0.059) that cyclically loaded tissues had increased adhesion strength variability compared to the static and control conditions. The main finding of this study is that long-duration axial loading did not impact the intra- or interlamellar mechanical properties of the porcine annulus. A trend of increased adhesion strength variability in cyclically loaded samples could indicate a potential predisposition of the annulus to delamination.


Assuntos
Anel Fibroso , Estresse Mecânico , Suporte de Carga , Animais , Anel Fibroso/fisiologia , Suínos , Fenômenos Biomecânicos , Testes Mecânicos , Teste de Materiais , Resistência à Tração , Módulo de Elasticidade/fisiologia
7.
PLoS One ; 19(7): e0304606, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38990910

RESUMO

OBJECTIVE: To compare whole-body kinematics, leg muscle activity, and discomfort while performing a 10-min carrying task with and without a passive upper-body exoskeleton (CarrySuitⓇ), for both males and females. BACKGROUND: Diverse commercial passive exoskeletons have appeared on the market claiming to assist lifting or carrying task. However, evidence of their impact on kinematics, muscle activity, and discomfort while performing these tasks are necessary to determine their benefits and/or limitations. METHOD: Sixteen females and fourteen males carried a 15kg load with and without a passive exoskeleton during 10-min over a round trip route, in two non-consecutive days. Whole-body kinematics and leg muscle activity were evaluated for each condition. In addition, leg discomfort ratings were quantified before and immediately after the task. RESULTS: The gastrocnemius and vastus lateralis muscle activity remained constant over the task with the exoskeleton. Without the exoskeleton a small decrease of gastrocnemius median activation was observed regardless of sex, and a small increase in static vastus lateralis activation was observed only for females. Several differences in sagittal, frontal, and transverse movements' ranges of motion were found between conditions and over the task. With the exoskeleton, ROM in the sagittal plane increased over time for the right ankle and pelvis for both sexes, and knees for males only. Thorax ROMs in the three planes were higher for females only when using the exoskeleton. Leg discomfort was lower with the exoskeleton than without. CONCLUSION: The results revealed a positive impact on range of motion, leg muscle activity, and discomfort of the tested exoskeleton.


Assuntos
Exoesqueleto Energizado , Perna (Membro) , Músculo Esquelético , Humanos , Masculino , Feminino , Fenômenos Biomecânicos , Adulto , Músculo Esquelético/fisiologia , Perna (Membro)/fisiologia , Adulto Jovem , Amplitude de Movimento Articular/fisiologia , Eletromiografia , Suporte de Carga/fisiologia
8.
BMC Musculoskelet Disord ; 25(1): 527, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38982445

RESUMO

BACKGROUND: This study investigated the effects of changes in motor skills from an educational video program on the kinematic and kinetic variables of the lower extremity joints and knee ligament load. METHODS: Twenty male participants (age: 22.2 ± 2.60 y; height: 1.70 ± 6.2 m; weight: 65.4 ± 7.01 kg; BMI: 23.32 ± 2.49 [Formula: see text]) were instructed to run at 4.5 ± 0.2 m/s from a 5 m distance posterior to the force plate, land their foot on the force plate, and perform the cutting maneuver on the left. The educational video program for cutting maneuvers consisted of preparatory posture, foot landing orientation, gaze and trunk directions, soft landing, and eversion angle. The measured variables were the angle, angular velocity of lower extremity joints, ground reaction force (GRF), moment, and anterior cruciate ligament (ACL) and medial collateral ligament (MCL) forces through musculoskeletal modeling. RESULTS: After the video feedback, the hip joint angles increased in flexion, abduction, and external rotation (p < 0.05), and the angular velocity increased in extension (p < 0.05). The ankle joint angles increased in dorsiflexion (p < 0.05), and the angular velocity decreased in dorsiflexion (p < 0.05) but increased in abduction (p < 0.05). The GRF increased in the anterior-posterior and medial-lateral directions and decreased vertically (p < 0.05). The hip joint moments decreased in extension and external rotation (p < 0.05) but increased in adduction (p < 0.05). The knee joint moments were decreased in extension, adduction, and external rotation (p < 0.05). The abduction moment of the ankle joint decreased (p < 0.001). There were differences in the support zone corresponding to 64‒87% of the hip frontal moment (p < 0.001) and 32‒100% of the hip horizontal moment (p < 0.001) and differences corresponding to 32‒100% of the knee frontal moment and 21‒100% of the knee horizontal moment (p < 0.001). The GRF varied in the support zone at 44‒95% in the medial-lateral direction and at 17‒43% and 73‒100% in the vertical direction (p < 0.001). CONCLUSIONS: Injury prevention feedback reduced the load on the lower extremity joints during cutting maneuvers, which reduced the knee ligament load, mainly on the MCL.


Assuntos
Articulação do Joelho , Destreza Motora , Suporte de Carga , Humanos , Masculino , Adulto Jovem , Suporte de Carga/fisiologia , Articulação do Joelho/fisiologia , Fenômenos Biomecânicos/fisiologia , Destreza Motora/fisiologia , Gravação em Vídeo , Articulação do Quadril/fisiologia , Articulação do Tornozelo/fisiologia , Adulto , Corrida/fisiologia , Extremidade Inferior/fisiologia
9.
PeerJ ; 12: e17606, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38952989

RESUMO

Objective: To investigate the effects of 12-week weight-bearing dance aerobics (WBDA) on muscle morphology, strength and functional fitness in older women. Methods: This controlled study recruited 37 female participants (66.31y ± 3.83) and divided them into intervention and control groups according to willingness. The intervention group received 90-min WBDA thrice a week for 12 weeks, while the control group maintained normal activities. The groups were then compared by measuring muscle thickness, fiber length and pennation angle by ultrasound, muscle strength using an isokinetic multi-joint module and functional fitness, such as 2-min step test, 30-s chair stand, chair sit-and-reach, TUG and single-legged closed-eyed standing test. The morphology, strength, and functional fitness were compared using ANCOVA or Mann-Whitney U test to study the effects of 12 weeks WBDA. Results: Among all recruited participants, 33 completed all tests. After 12 weeks, the thickness of the vastus intermedius (F = 17.85, P < 0.01) and quadriceps (F = 15.62, P < 0.01) was significantly increased in the intervention group compared to the control group, along with a significant increase in the torque/weight of the knee flexor muscles (F = 4.47, P = 0.04). Similarly, the intervention group revealed a significant improvement in the single-legged closed-eyed standing test (z = -2.16, P = 0.03) compared to the control group. Conclusion: The study concluded that compared to the non-exercising control group, 12-week WBDA was shown to thicken vastus intermedius, increase muscle strength, and improve physical function in older women. In addition, this study provides a reference exercise program for older women.


Assuntos
Dança , Força Muscular , Suporte de Carga , Humanos , Feminino , Força Muscular/fisiologia , Idoso , Dança/fisiologia , Suporte de Carga/fisiologia , Aptidão Física/fisiologia , Extremidade Inferior/fisiologia , Extremidade Inferior/diagnóstico por imagem , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/diagnóstico por imagem , Exercício Físico/fisiologia , Músculo Quadríceps/fisiologia , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/anatomia & histologia
10.
Appl Ergon ; 120: 104340, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38964218

RESUMO

Augmented reality (AR) environments are emerging as prominent user interfaces and gathering significant attention. However, the associated physical strain on the users presents a considerable challenge. Within this background, this study explores the impact of movement distance (MD) and target-to-user distance (TTU) on the physical load during drag-and-drop (DND) tasks in an AR environment. To address this objective, a user experiment was conducted utilizing a 5× 5 within-subject design with MD (16, 32, 48, 64, and 80 cm) and TTU (40, 80, 120, 160, and 200 cm) as the variables. Physical load was assessed using normalized electromyography (NEMG) (%MVC) indicators of the upper extremity muscles and the physical item of NASA-Task load index (TLX). The results revealed significant variations in the physical load based on MD and TTU. Specifically, both the NEMG and subjective physical workload values increased with increasing MD. Moreover, NEMG increased with decreasing TTU, whereas the subjective physical workload scores increased with increasing TTU. Interaction effects of MD and TTU on NEMG were also significantly observed. These findings suggest that considering the MD and TTU when developing content for interacting with AR objects in AR environments could potentially alleviate user load.


Assuntos
Realidade Aumentada , Eletromiografia , Movimento , Músculo Esquelético , Análise e Desempenho de Tarefas , Extremidade Superior , Interface Usuário-Computador , Humanos , Extremidade Superior/fisiologia , Masculino , Adulto Jovem , Músculo Esquelético/fisiologia , Feminino , Movimento/fisiologia , Adulto , Carga de Trabalho , Suporte de Carga/fisiologia , Realidade Virtual
11.
BMC Musculoskelet Disord ; 25(1): 454, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851696

RESUMO

BACKGROUND: Ulnar impingement syndrome is a prevalent source of ulnar carpal pain; however, there is ongoing debate regarding the specific location of shortening, the method of osteotomy, the extent of shortening, and the resulting biomechanical alterations. METHOD: To investigate the biomechanical changes in the distal radioulnar joint (DRUJ) resulting from different osteotomy methods, a cadaveric specimen was dissected, and the presence of a stable DRUJ structure was confirmed. Subsequently, three-dimensional data of the specimen were obtained using a CT scan, and finite element analysis was conducted after additional processing. RESULTS: The DRUJ stress did not change significantly at the metaphyseal osteotomy of 2-3 mm but increased significantly when the osteotomy length reached 5 mm. When the osteotomy was performed at the diaphysis, the DRUJ stress increased with the osteotomy length, and the increase was greater than that of metaphyseal osteotomy. Stress on the DRUJ significantly increases when the position is changed to pronation dorsi-extension. Similarly, the increase in stress in diaphyseal osteotomy was greater than that in metaphyseal osteotomy. When the model was subjected to a longitudinal load of 100 N, neither osteotomy showed a significant change in DRUJ stress at the neutral position. However, the 100 N load significantly increased stress on the DRUJ when the position was changed to pronation dorsi-extension, and the diaphyseal osteotomy significantly increased stress on the DRUJ. CONCLUSIONS: For patients with distal oblique bundle, metaphyseal osteotomy result in a lower increase in intra-articular pressure in the DRUJ compared to diaphyseal osteotomy. However, it is crucial to note that regardless of the specific type of osteotomy employed, it is advisable to avoid a shortening length exceeding 5 mm.


Assuntos
Cadáver , Análise de Elementos Finitos , Osteotomia , Ulna , Articulação do Punho , Humanos , Osteotomia/métodos , Osteotomia/efeitos adversos , Articulação do Punho/cirurgia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/fisiopatologia , Ulna/cirurgia , Ulna/diagnóstico por imagem , Fenômenos Biomecânicos/fisiologia , Estresse Mecânico , Suporte de Carga/fisiologia , Masculino
12.
Sci Rep ; 14(1): 13215, 2024 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851842

RESUMO

Using a curved carbon-fiber plate (CFP) in running shoes may offer notable performance benefit over flat plates, yet there is a lack of research exploring the influence of CFP geometry on internal foot loading during running. The objective of this study was to investigate the effects of CFP mechanical characteristics on forefoot biomechanics in terms of plantar pressure, bone stress distribution, and contact force transmission during a simulated impact peak moment in forefoot strike running. We employed a finite element model of the foot-shoe system, wherein various CFP configurations, including three stiffnesses (stiff, stiffer, and stiffest) and two shapes (flat plate (FCFP) and curved plate (CCFP)), were integrated into the shoe sole. Comparing the shoes with no CFP (NCFP) to those with CFP, we consistently observed a reduction in peak forefoot plantar pressure with increasing CFP stiffness. This decrease in pressure was even more notable in a CCFP demonstrating a further reduction in peak pressure ranging from 5.51 to 12.62%, compared to FCFP models. Both FCFP and CCFP designs had a negligible impact on reducing the maximum stress experienced by the 2nd and 3rd metatarsals. However, they greatly influenced the stress distribution in other metatarsal bones. These CFP designs seem to optimize the load transfer pathway, enabling a more uniform force transmission by mainly reducing contact force on the medial columns (the first three rays, measuring 0.333 times body weight for FCFP and 0.335 for CCFP in stiffest condition, compared to 0.373 in NCFP). We concluded that employing a curved CFP in running shoes could be more beneficial from an injury prevention perspective by inducing less peak pressure under the metatarsal heads while not worsening their stress state compared to flat plates.


Assuntos
Corrida , Sapatos , Corrida/fisiologia , Humanos , Fenômenos Biomecânicos , Pressão , Fibra de Carbono/química , Antepé Humano/fisiologia , Análise de Elementos Finitos , Estresse Mecânico , Suporte de Carga/fisiologia , Carbono/química , Desenho de Equipamento , Pé/fisiologia
13.
Math Biosci Eng ; 21(4): 5394-5410, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38872540

RESUMO

Knee medial compartment osteoarthritis is effectively treated by a medial open-wedge high tibial osteotomy (MOWHTO). The feasibility and safety of MOWHTO for mild lateral meniscal tears are unknown. This study examined the feasibility and safety of knee joint weight-bearing line ratio (WBLr) adjustment during MOWHTO with lateral meniscal injuries. We used a healthy adult male's lower extremities computed tomography scans and knee joint magnetic resonance imaging images to create a normal fine element (FE) model. Based on this model, we generated nine FE models for the MOWHTO operation (WBLr: 40-80%) and 15 models for various lateral meniscal injuries. A compressive load of 650N was applied to all cases to calculate the von Mises stress (VMS), and the intact lateral meniscus' maximal VMS at 77.5% WBLr was accepted as the corrective upper limit stress. Our experimental results show that mild lateral meniscal tears can withstand MOWHTO, while severe tears cannot. Our findings expand the use of MOWHTO and provide a theoretical direction for practical decisions in patients with lateral meniscal injuries.


Assuntos
Análise de Elementos Finitos , Articulação do Joelho , Imageamento por Ressonância Magnética , Osteoartrite do Joelho , Osteotomia , Estresse Mecânico , Tíbia , Lesões do Menisco Tibial , Tomografia Computadorizada por Raios X , Suporte de Carga , Humanos , Masculino , Osteotomia/métodos , Tíbia/cirurgia , Tíbia/diagnóstico por imagem , Lesões do Menisco Tibial/cirurgia , Lesões do Menisco Tibial/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Articulação do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/fisiopatologia , Osteoartrite do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/fisiopatologia , Fenômenos Biomecânicos , Meniscos Tibiais/cirurgia , Meniscos Tibiais/diagnóstico por imagem
14.
J Bodyw Mov Ther ; 39: 43-49, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876663

RESUMO

OBJECTIVES: To investigate the relationship between predicted risk of injury based on the dichotomous classification of the weight-bearing lunge (WBL) test scores and variables related to jumping and sprinting ability in young athletes. Furthermore, to compare the impact of the classical dichotomous classification versus a more specific quartile subdivision of the WBL test scores on the explored variables. DESIGN: Cross-sectional study. PARTICIPANTS: 125 healthy athletes (mean age 10.38 (SD = 2.28) years) were recruited. MAIN OUTCOME MEASURES: Ankle dorsiflexion was evaluated with the WBL test, jumping distance with the standing long jump (SLJ) test, and maximal running speed with the 14-m and 28-m sprint test. RESULTS: Athletes with WBL test scores lower than 10 cm exhibited significantly poorer results for the SLJ test as well as lower 14-m and 28-m sprint times than those with WBL test scores higher than 10 cm (p < 0.05). Likewise, when WBL test scores were subdivided by quartiles, a positive trend between range of motion and improved performance was shown. CONCLUSIONS: Reduced ankle dorsiflexion mobility may affect sprinting and jumping ability in young athletes. In addition, a more detailed classification of ankle restriction by quartiles is proposed in this study in order to prevent injury and enhance athletic performance.


Assuntos
Articulação do Tornozelo , Amplitude de Movimento Articular , Corrida , Humanos , Estudos Transversais , Amplitude de Movimento Articular/fisiologia , Masculino , Corrida/fisiologia , Feminino , Articulação do Tornozelo/fisiologia , Adolescente , Criança , Suporte de Carga/fisiologia , Atletas , Desempenho Atlético/fisiologia
15.
J Bodyw Mov Ther ; 39: 441-446, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876666

RESUMO

BACKGROUND: Flatfoot is a structural and functional deformity of the foot that might change ground reaction force variables of gait. Evaluating the components of ground reaction force in three dimensions during gait is considered clinically important. This study aimed to investigate the components of ground reaction force, impulse, and loading rate during gait in people with flexible and rigid flatfoot compared to healthy subjects. 20 young women with flatfoot in two experimental groups (10 with rigid flatfoot and 10 with flexible flatfoot) and 10 healthy women in the control group participated in this study. Ground reaction force components during gait were measured using two force plates. The peak of ground reaction forces, impulse, and loading rate were then extracted. Data were processed and analyzed using MATLAB and SPSS software. One-way ANOVA with a significant level (P˂0.05) was used for statistical analysis. The results showed that peak braking force was higher in the rigid flatfoot group than in the control group (p = 0.016) and the flexible flatfoot group (p = 0.003). The posterior force loading rate was significantly higher in the rigid flatfoot group than in the flexible flatfoot group (P = 0.04). There was no significant difference in vertical loading rate between groups (P˃0.05). Since the maximal posterior ground reaction force was higher in the subjects with rigid flatfoot than in those with flexible flatfoot and healthy subjects, the increase in posterior ground reaction force is associated with an increase in anterior shear force at the knee.


Assuntos
Pé Chato , Marcha , Humanos , Pé Chato/fisiopatologia , Feminino , Fenômenos Biomecânicos , Marcha/fisiologia , Adulto Jovem , Adulto , Suporte de Carga/fisiologia , Estudos de Casos e Controles
16.
Clin Biomech (Bristol, Avon) ; 116: 106286, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38850881

RESUMO

BACKGROUND: The aim of this study was to test the hypothesis that proinflammatory cytokines correlate with knee loading mechanics during gait following a mechanical walking stimulus in subjects 2 years after anterior cruciate ligament reconstruction. Elevated systemic levels of proinflammatory cytokines can be sustained for years after injury. Considering roughly 50% of these patients progress to Osteoarthritis 10-15 years after injury, a better understanding of the role of proinflammatory cytokines such as tumor necrosis factor-α and Interleukin-1ß on Osteoarthritis risk is needed. METHODS: Serum proinflammatory cytokines concentrations were measured in 21 subjects 2 years after unilateral ACLR from blood drawn at rest and 3.5 h after 30 min of walking. An optoelectronic system and a force plate measured subjects' knee kinetics. Correlations were tested between inflammatory marker response and knee extension and knee adduction moments. FINDINGS: Changes in proinflammatory cytokines due to mechanical stimulus were correlated (R = 0.86) and showed substantial variation between subjects in both cytokines at 3.5 h post-walk. Knee loading correlated with 3.5-h changes in tumor necrosis factor-α concentration (Knee extension moment: R = -0.5, Knee adduction moment: R = -0.5) and Interleukin-1ß concentration (Knee extension moment: R = -0.44). However, no significant changes in concentrations were observed in tumor necrosis factor-α and Interleukin-1ß when comparing baseline and post walking stimulus conditions. INTERPRETATION: The significant associations between changes in serum proinflammatory markers following a mechanical stimulus and gait metrics in subjects at risk for developing Osteoarthritis underscore the importance of investigating the interaction between biomarkers and biomechanical factors in Osteoarthritis development.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Citocinas , Articulação do Joelho , Humanos , Masculino , Feminino , Citocinas/sangue , Adulto , Articulação do Joelho/fisiopatologia , Marcha , Lesões do Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Suporte de Carga , Interleucina-1beta/sangue , Caminhada , Fator de Necrose Tumoral alfa/sangue , Adulto Jovem , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/sangue , Osteoartrite do Joelho/cirurgia , Fenômenos Biomecânicos , Biomarcadores/sangue , Estresse Mecânico , Ligamento Cruzado Anterior/cirurgia
17.
Sci Rep ; 14(1): 14402, 2024 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-38909161

RESUMO

Intoeing in children is a common parental concern, but our understanding of the impact of foot progression angle (FPA) in these children leaves remains limited. This study examines the relationship between FPA and plantar loading pattern, as well as gait symmetry in children with intoeing. The sample included 30 children with intoeing caused by internal tibial torsion, uniformly divided into three groups: unilateral intoeing, bilateral mild intoeing, and bilateral mild-moderate intoeing. The relationship between FPA and plantar loading pattern, and gait symmetry within and among groups were assessed using dynamic pedobarographic and spatiotemporal data. Results indicated a significant correlation between FPA and peak pressure, maximum force, and plantar impulse in the medial and central forefoot, and also the medial and lateral heel zones for both bilateral intoeing groups. Significant differences were observed only in subdivided stance phase, including loading response, single support, and pre-swing phases, between the unilateral intoeing and bilateral mild intoeing groups. These findings suggest that FPA significantly affects the forefoot and heel zones, potentially increasing the load on the support structures and leading to transverse arch deformation. While children with intoeing demonstrate a dynamic self-adjustment capability to maintain gait symmetry, this ability begins to falter as intoeing becomes more pronounced.


Assuntos
, Marcha , Humanos , Criança , Marcha/fisiologia , Feminino , Masculino , Pé/fisiologia , Pé/anatomia & histologia , Suporte de Carga/fisiologia , Fenômenos Biomecânicos
18.
J Mech Behav Biomed Mater ; 156: 106575, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38824865

RESUMO

Articular cartilage tissue exhibits a spatial dependence in material properties that govern mechanical behaviour. A mathematical model of cartilage tissue under one dimensional confined compression testing is developed for normal tissue that takes account of these variations in material properties. Modifications to the model representative of a selection of mechanisms driving osteoarthritic cartilage are proposed, allowing application of the model to both physiological and pathophysiological, osteoarthritic tissue. Incorporating spatial variations into the model requires the specification of more parameters than are required in the absence of these variations. A global sensitivity analysis of these parameters is implemented to identify the dominant mechanisms of mechanical response, in normal and osteoarthritic cartilage tissue, to both static and dynamic loading. The most sensitive parameters differ between dynamic and static mechanics of the cartilage, and also differ between physiological and osteoarthritic pathophysiological cartilage. As a consequence changes in cartilage mechanics in response to alterations in cartilage structure are predicted to be contingent on the nature of loading and the health, or otherwise, of the cartilage. In particular the mechanical response of cartilage, especially deformation, is predicted to be much more sensitive to cartilage stiffness in the superficial zone given the onset of osteoarthritic changes to material properties, such as superficial zone increases in permeability and reductions in fixed charge. In turn this indicates that any degenerative changes in the stiffness associated with the superficial cartilage collagen mesh are amplified if other elements of osteoarthritic disease are present, which provides a suggested mechanism-based explanation for observations that the range of mechanical parameters representative of normal and osteoarthritic tissue can overlap substantially.


Assuntos
Cartilagem Articular , Osteoartrite , Fenômenos Biomecânicos , Osteoartrite/fisiopatologia , Fenômenos Mecânicos , Modelos Biológicos , Humanos , Estresse Mecânico , Teste de Materiais , Suporte de Carga , Testes Mecânicos
19.
J Orthop Traumatol ; 25(1): 30, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38850466

RESUMO

BACKGROUND: Rotator cuff disorders, whether symptomatic or asymptomatic, may result in abnormal shoulder kinematics (scapular rotation and glenohumeral translation). This study aimed to investigate the effect of rotator cuff tears on in vivo shoulder kinematics during a 30° loaded abduction test using single-plane fluoroscopy. MATERIALS AND METHODS: In total, 25 younger controls, 25 older controls and 25 patients with unilateral symptomatic rotator cuff tears participated in this study. Both shoulders of each participant were analysed and grouped on the basis of magnetic resonance imaging into healthy, rotator cuff tendinopathy, asymptomatic and symptomatic rotator cuff tears. All participants performed a bilateral 30° arm abduction and adduction movement in the scapular plane with handheld weights (0, 2 and 4 kg) during fluoroscopy acquisition. The range of upward-downward scapular rotation and superior-inferior glenohumeral translation were measured and analysed during abduction and adduction using a linear mixed model (loads, shoulder types) with random effects (shoulder ID). RESULTS: Scapular rotation was greater in shoulders with rotator cuff tendinopathy and asymptomatic rotator cuff tears than in healthy shoulders. Additional load increased upward during abduction and downward during adduction scapular rotation (P < 0.001 in all groups but rotator cuff tendinopathy). In healthy shoulders, upward scapular rotation during 30° abduction increased from 2.3° with 0-kg load to 4.1° with 4-kg load and on shoulders with symptomatic rotator cuff tears from 3.6° with 0-kg load to 6.5° with 4-kg load. Glenohumeral translation was influenced by the handheld weights only in shoulders with rotator cuff tendinopathy (P ≤ 0.020). Overall, superior glenohumeral translation during 30° abduction was approximately 1.0 mm with all loads. CONCLUSIONS: The results of glenohumeral translation comparable to control but greater scapular rotations during 30° abduction in the scapular plane in rotator cuff tears indicate that the scapula compensates for rotator cuff deficiency by rotating. Further analysis of load-dependent joint stability is needed to better understand glenohumeral and scapula motion. LEVEL OF EVIDENCE: Level 2. TRIAL REGISTRATION: Ethical approval was obtained from the regional ethics committee (Ethics Committee Northwest Switzerland EKNZ 2021-00182), and the study was registered at clinicaltrials.gov on 29 March 2021 (trial registration number NCT04819724, https://clinicaltrials.gov/ct2/show/NCT04819724 ).


Assuntos
Lesões do Manguito Rotador , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenômenos Biomecânicos , Estudos de Casos e Controles , Fluoroscopia , Imageamento por Ressonância Magnética , Amplitude de Movimento Articular/fisiologia , Rotação , Lesões do Manguito Rotador/fisiopatologia , Lesões do Manguito Rotador/diagnóstico por imagem , Articulação do Ombro/fisiopatologia , Articulação do Ombro/diagnóstico por imagem , Suporte de Carga/fisiologia
20.
J Orthop Surg Res ; 19(1): 327, 2024 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-38825673

RESUMO

BACKGROUND: Ankle fractures are frequent, and despite numerous publications on their treatment and outcome, there is a lack of precise data on the functional results in young, healthy and physically active patients. We hypothesized that patients who underwent open reduction and internal fixation (ORIF) for simple ankle fractures would have similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes. METHODS: A set of specific provocation tests was developed to evaluate the postoperative possibility of weight bearing, stop-and-go activities and range of motion. In combination with three questionnaires and a radiographic evaluation, the true functional outcome and the possibility of participating in sporting activities were investigated and compared with those of an age- and sex-matched control group. RESULTS: A significant impairment was found in unilateral and simple ankle fractures. This impairment increased in tests including stop-and-go activities in combination with load bearing and with the complexity of the fractures. Concerning the subjective outcome, there was a significant adverse effect for daily activities without any difference in preoperative or postoperative sporting activity between the groups. No difference was found in the radiological assessment. CONCLUSIONS: Both simple and complex ankle fractures treated with ORIF have a significant and long-lasting impact on functional outcome in young and active patients. The radiological result is not associated with a good functional outcome. TRIAL REGISTRATION: BASEC-Nr. 2018 - 01124.


Assuntos
Fraturas do Tornozelo , Fixação Interna de Fraturas , Humanos , Feminino , Fraturas do Tornozelo/cirurgia , Fraturas do Tornozelo/diagnóstico por imagem , Masculino , Fixação Interna de Fraturas/métodos , Adulto , Pessoa de Meia-Idade , Resultado do Tratamento , Radiografia , Suporte de Carga , Adulto Jovem , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Idoso
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