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1.
Sensors (Basel) ; 22(1)2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-35009893

RESUMO

To expand the potential use of in-shoe motion sensors (IMSs) in daily healthcare or activity monitoring applications for healthy subjects, we propose a real-time temporal estimation method for gait parameters concerning bilateral lower limbs (GPBLLs) that uses a single IMS and is based on a gait event detection approach. To validate the established methods, data from 26 participants recorded by an IMS and a reference 3D motion analysis system were compared. The agreement between the proposed method and the reference system was evaluated by the intraclass correlation coefficient (ICC). The results showed that, by averaging over five continuous effective strides, all time parameters achieved precisions of no more than 30 ms and agreement at the "excellent" level, and the symmetry indexes of the stride time and stance phase time achieved precisions of 1.0% and 3.0%, respectively, and agreement at the "good" level. These results suggest our method is effective and shows promise for wide use in many daily healthcare or activity monitoring applications for healthy subjects.


Assuntos
Marcha , Sapatos , Fenômenos Biomecânicos , , Voluntários Saudáveis , Humanos , Extremidade Inferior
2.
Sensors (Basel) ; 22(1)2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-35009915

RESUMO

Inertial measurement units (IMUs) fixed to the lower limbs have been reported to provide accurate estimates of stride lengths (SLs) during walking. Due to technical challenges, validation of such estimates in running is generally limited to speeds (well) below 5 m·s-1. However, athletes sprinting at (sub)maximal effort already surpass 5 m·s-1 after a few strides. The present study aimed to develop and validate IMU-derived SLs during maximal linear overground sprints. Recreational athletes (n = 21) completed two sets of three 35 m sprints executed at 60, 80, and 100% of subjective effort, with an IMU on the instep of each shoe. Reference SLs from start to ~30 m were obtained with a series of video cameras. SLs from IMUs were obtained by double integration of horizontal acceleration with a zero-velocity update, corrected for acceleration artefacts at touch-down of the feet. Peak sprint speeds (mean ± SD) reached at the three levels of effort were 7.02 ± 0.80, 7.65 ± 0.77, and 8.42 ± 0.85 m·s-1, respectively. Biases (±Limits of Agreement) of SLs obtained from all participants during sprints at 60, 80, and 100% effort were 0.01% (±6.33%), -0.75% (±6.39%), and -2.51% (±8.54%), respectively. In conclusion, in recreational athletes wearing IMUs tightly fixed to their shoes, stride length can be estimated with reasonable accuracy during maximal linear sprint acceleration.


Assuntos
, Corrida , Aceleração , Atletas , Fenômenos Biomecânicos , Humanos , Sapatos
3.
Neurosciences (Riyadh) ; 27(1): 31-39, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35017288

RESUMO

OBJECTIVES: To investigate the influence of repeated cervical mobilization (CM) on balance and plantar loading distribution in patients with Multiple Sclerosis (MS). METHODS: A total of 12 individuals were included in the cross over study designed as a cross sectional. The study was carried out from October 2019 until July 2020. Individuals received traditional treatment (TM) and cervical mobilization treatments (CM) 2 days a week for 4 weeks in a different order by random method. It was treated with joint traction and sliding techniques. Soft tissue mobilization techniques for myofascial relaxation were applied for CM in addition to TM. Romberg test (RT), Sharpened Romberg Test (SRT), and Functional Reach Test (FRT) were used to balance the assessment. Plantar loading distribution was evaluated with Pedobarography. The maximum and mean pressure in the foot, the percentages of pressure values in the fore and rear of the foot, and percentages of the bodyweight discharge onto right feet and left feet were recorded. RESULTS: The forefoot loading increased after treatment in the CM group (p<0.05). The duration of RT and SRT increased, and average pressure decreased in the cervical mobilization group (p<0.05). The body weight discharge onto right feet and left feet approached 50% after cervical mobilization (p<0.05). CONCLUSIONS: Cervical mobilization techniques can positively change the balance and plantar loading distribution compared to traditional treatment. Cervical mobilization applications could be used to support neurological rehabilitation.


Assuntos
Esclerose Múltipla , Estudos Cross-Over , Estudos Transversais , , Humanos , Esclerose Múltipla/terapia , Modalidades de Fisioterapia
4.
J Foot Ankle Res ; 15(1): 3, 2022 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-35057831

RESUMO

BACKGROUND: The plantar intrinsic foot muscles (PIFMs) have a role in dynamic functions, such as balance and propulsion, which are vital to walking. These muscles atrophy in older adults and therefore this population, which is at high risk to falling, may benefit from strengthening these muscles in order to improve or retain their gait performance. Therefore, the aim was to provide insight in the evidence for the effect of interventions anticipated to improve PIFM strength on dynamic balance control and foot function during gait in adults. METHODS: A systematic literature search was performed in five electronic databases. The eligibility of peer-reviewed papers, published between January 1, 2010 and July 8, 2020, reporting controlled trials and pre-post interventional studies was assessed by two reviewers independently. Results from moderate- and high-quality studies were extracted for data synthesis by summarizing the standardized mean differences (SMD). The GRADE approach was used to assess the certainty of evidence. RESULTS: Screening of 9199 records resulted in the inclusion of 11 articles of which five were included for data synthesis. Included studies were mainly performed in younger populations. Low-certainty evidence revealed the beneficial effect of PIFM strengthening exercises on vertical ground reaction force (SMD: - 0.31-0.37). Very low-certainty evidence showed that PIFM strength training improved the performance on dynamic balance testing (SMD: 0.41-1.43). There was no evidence for the effect of PIFM strengthening exercises on medial longitudinal foot arch kinematics. CONCLUSIONS: This review revealed at best low-certainty evidence that PIFM strengthening exercises improve foot function during gait and very low-certainty evidence for its favorable effect on dynamic balance control. There is a need for high-quality studies that aim to investigate the effect of functional PIFM strengthening exercises in large samples of older adults. The outcome measures should be related to both fall risk and the role of the PIFMs such as propulsive forces and balance during locomotion in addition to PIFM strength measures.


Assuntos
Acidentes por Quedas , , Acidentes por Quedas/prevenção & controle , Idoso , Marcha , Humanos , Força Muscular , Músculo Esquelético
5.
JAMA Netw Open ; 5(1): e2142354, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34985514

RESUMO

Importance: Deferred diabetic foot screening and delays in timely care of acute foot complications during the COVID-19 pandemic may have contributed to an increase in limb loss. Objective: To evaluate the association of the COVID-19 pandemic with diabetes-related care measures, foot complications, and amputation. Design, Setting, and Participants: This population-based cohort study included all adult residents of Ontario, Canada, with diabetes and compared the rates of selected outcomes from January 1, 2020, to February 23, 2021, vs January 1, 2019, to February 23, 2020. Main Outcomes and Measures: Comprehensive in-person diabetes care assessment, including foot examination; hemoglobin A1c (HbA1c) measurement; emergency department visit or hospitalization for diabetic foot ulceration, osteomyelitis, or gangrene; lower extremity open or endovascular revascularization; minor (toe or partial-foot) amputation; and major (above-ankle) leg amputation. Rates and rate ratios (RRs) comparing 2020-2021 vs 2019-2020 for each measure were calculated for 10-week periods, anchored relative to onset of the pandemic on March 11, 2020 (11th week of 2020). Results: On March 11, 2020, the study included 1 488 605 adults with diabetes (median [IQR] age, 65 [55-74] years; 776 665 [52.2%] men), and on March 11, 2019, the study included 1 441 029 adults with diabetes (median [IQR] age, 65 [55-74] years; 751 459 [52.1%] men). After the onset of the pandemic, rates of major amputation in 2020-2021 decreased compared with 2019-2020 levels. The RR for the prepandemic period from January 1 to March 10 was 1.05 (95% CI, 0.88-1.25), with RRs in the pandemic periods ranging from 0.86 (95% CI, 0.72-1.03) in May 20 to July 28 to 0.95 (95% CI, 0.80-1.13) in October 7 to December 15. There were no consistent differences in demographic characteristics or comorbidities of patients undergoing amputation in the 2020-2021 vs 2019-2020 periods. Rates of comprehensive in-person diabetes care assessment and HbA1c measurement declined sharply and remained below 2019-2020 levels (eg, in-person assessment, March 11 to May 19: RR, 0.28; 95% CI, 0.28-0.28). The rates of emergency department visits (eg, March 11 to May 19: RR, 0.67; 95% CI, 0.61-0.75), hospitalization (eg, March 11 to May 19: RR, 0.77; 95% CI, 0.68-0.87), open revascularization (eg, March 11 to May 19: RR, 0.66; 95% CI, 0.56-0.79), endovascular revascularization (March 11 to May 19: RR, 0.70; 95% CI, 0.61-0.81), and minor amputation (March 11 to May 19: RR, 0.70; 95% CI, 0.60-0.83) initially dropped but recovered to 2019-2020 levels over the study period. Conclusions and Relevance: In this population-based cohort study, disruptions in care related to the COVID-19 pandemic were not associated with excess leg amputations among people living with diabetes. As the pandemic ends, improved prevention and treatment of diabetic foot complications will be necessary to maintain these positive results.


Assuntos
Amputação , COVID-19 , Atenção à Saúde/métodos , Diabetes Mellitus , Pé Diabético/cirurgia , Pandemias , Idoso , COVID-19/epidemiologia , Estudos de Coortes , Comorbidade , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Pé Diabético/epidemiologia , Pé Diabético/terapia , Serviço Hospitalar de Emergência , Feminino , Pé/patologia , Pé/cirurgia , Hemoglobina A Glicada , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Exame Físico , SARS-CoV-2 , Procedimentos Cirúrgicos Vasculares
6.
BMC Musculoskelet Disord ; 23(1): 31, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983473

RESUMO

BACKGROUND: There has been a paucity of literature revealing the discrepancy between self-recognition about hallux valgus (HV) and radiographically-evaluated foot configuration. Knowing this discrepancy will help to make a comparative review of the findings of previous literatures about epidemiological studies about the prevalence of HV. QUESTIONS/PURPOSES: (1) Is there a discrepancy between radiographically-assessed and self-recognized HV in the general population? (2) What factors affect the self-recognition of HV in the general population? METHODS: The fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability study involved 1996 participants who had undergone anterior-posterior radiography of bilateral feet and answered a simple dichotomous questionnaire on self-recognition of HV. Measurements of the HV angle (HVA), interphalangeal angle of the hallux (IPA), and intermetatarsal angle between 1st and 2nd metatarsals (IMA) were performed using radiographs. Radiographic diagnosis of HV was done using the definition of hallux valgus angle of 20° or more. After univariate comparison of the participant backgrounds and radiographic measurements between participants with or without self-recognition of HV, multivariable logistic regression analysis was conducted in order to reveal independent factors affecting self-recognition. RESULTS: Significant difference was found between the prevalence of radiographically-assessed and self-recognized HV (29.8% vs. 16.5%, p <  0.0001). The prevalence of self-recognized HV increased with the progression of HV severity from a single-digit percentage (normal grade, HVA < 20°) up to 100% (severe grade, HVA ≥ 40°). A multivariable logistic regression analysis demonstrated that HVA, IMA, and female sex were independent positive factors for self-recognition of HV (HVA [per 1° increase]: OR, 1.18; 95% CI, 1.15-1.20; p <  0.0001; IMA [per 1° increase]: OR, 1.15; 95% CI, 1.09-1.20; p <  0.0001; and female sex [vs. male sex]: OR, 3.47; 95% CI, 2.35-5.18; p <  0.0001). CONCLUSIONS: There was a significant discrepancy between radiographically-assessed and self-recognized HV which narrowed with the progressing severity of HV. HVA, IMA, and female sex were independent positive factors for self-recognition of HV. Attention needs to be paid to potentially lowered prevalence of HV in epidemiological studies using self-reporting based on self-recognition.


Assuntos
Joanete , Hallux Valgus , Hallux , Ossos do Metatarso , Feminino , , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/epidemiologia , Humanos , Masculino , Estudos Retrospectivos
7.
Comput Methods Programs Biomed ; 213: 106507, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34794087

RESUMO

BACKGROUND: Foot collapse is primarily diagnosed and monitored using lateral weight-bearing foot x-ray images. There are several well-validated measurements which aid assessment. However, these are subject to inter- and intra-user variability. OBJECTIVE: To develop and validate a software system for the fully automatic assessment of radiographic changes associated with foot collapse; automatically generating measurements for calcaneal tilt, cuboid height and Meary's angle. METHODS: This retrospective study was approved by the Health Research Authority (IRAS 244852). The system was developed using lateral weight-bearing foot x-ray images, and evaluated against manual measurements from five clinical experts. The system has two main components: (i) a Random Forest-based point-finder to outline the bones of interest; and (ii) a geometry-calculator to generate the measurements based on the point positions from the point-finder. The performance of the point-finder was assessed using the point-to-point error (i.e. the mean absolute distance between each found point and the equivalent ground truth point, averaged over all points per image). For assessing the performance of the geometry-calculator, linear mixed models were fitted to estimate clinical inter-observer agreement and to compare the performance of the software system to that of the clinical experts. RESULTS: A total of 200 images were collected from 79 subjects (mean age: 56.4 years ±12.9 SD, 30/49 females/males). There was good agreement among all clinical experts with intraclass correlation estimates between 0.78 and 0.86. The point-finder achieved a median point-to-point error of 2.2 mm. There was no significant difference between the clinical and automatically generated measurements using the point-finder points, suggesting that the fully automatically obtained measurements are in agreement with the manually obtained measurements. CONCLUSIONS: The proposed system can be used to support and automate radiographic image assessment for diagnosing and managing foot collapse, saving clinician time, and improving patient outcomes.


Assuntos
, Feminino , Pé/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Radiografia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Suporte de Carga
8.
Appl Ergon ; 99: 103639, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34753097

RESUMO

This study compares human climbing performance, including climbing speed and movement and force patterns, between rail- and rung-climbing styles for a moderate aerial ladder slope (52.5°). Hand and foot movements and forces were recorded for 9 male and 10 female firefighters as they ascended and descended a 3.4-m ladder using elevated handrails (rail-climbing) or rungs (rung-climbing) for hand support. The results indicated that climbers used three or more points of contact 54% of the time for rung-climbing and 100% of the time for rail-climbing. Furthermore, rail-climbing was 10% faster than rung-climbing. In rail-climbing, the lateral hand forces were mostly directed away from the body; while during rung-climbing, they were alternated in lateral and medial directions. Overall, the results suggested that rail-climbing provides better control over body positioning and faster climbing speed. Furthermore, the continuous contact of both hands in rail-climbing may reduce the fall risk by facilitating the recovery from a slip or perturbation.


Assuntos
Bombeiros , , Fenômenos Biomecânicos , Feminino , Mãos , Humanos , Masculino , Movimento
9.
Clin Podiatr Med Surg ; 39(1): 1-14, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809788

RESUMO

Clubfoot or talipes equinovarus deformity is one of the most common anomalies affecting the lower extremities. This review provides an update on the outcomes of various treatment options used to correct clubfoot. The ultimate goal in the treatment of clubfoot is to obtain a fully functional and pain-free foot and maintain a long-term correction. The Ponseti method is now considered the gold standard of treatment for primary clubfoot. Relapse is common after primary treatment with the Ponseti method, and other interventions are discussed that are used to provide for long-term successful outcomes.


Assuntos
Pé Torto Equinovaro , Moldes Cirúrgicos , Pé Torto Equinovaro/terapia , , Humanos , Lactente , Recidiva , Resultado do Tratamento
10.
Clin Podiatr Med Surg ; 39(1): 113-127, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809790

RESUMO

Limb length inequality or discrepancy (LLD) occurs when there is a difference in length between 2 limbs or when deviation exists from a normally expected length for a given age. The magnitude of the discrepancy is defined as the difference between the 2 extremities. Aside from congenital etiologies, LLD can also arise from infection, paralysis, tumors/neoplasm, and surgery. Approximately 70% to 90% of the world's population has some elements of LLD with compensation allowing for tolerance and potentially masking the extent to which one limb could be significantly shorter either functionally or structurally. Components of functional LLD could include congenital shortening of soft tissues, joint contractures, axial skeleton malalignment, and abnormal pedal biomechanics (ie, posterior tibial tendonitis or equinovarus). In accordance with literature reports, most individuals can tolerate upwards of a 2 cm discrepancy. Although a constellation of symptoms such as joint pain, arthritis, alterations in oxygen consumption/heart rate, and low back pathology can occur later on in adulthood, the focus in this review will be with early diagnosis and management in the pediatric population.


Assuntos
Artrite , Pé Torto Equinovaro , Adulto , Fenômenos Biomecânicos , Criança , , Humanos , Desigualdade de Membros Inferiores
11.
Sports Biomech ; 21(1): 71-84, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31464161

RESUMO

There is an ongoing debate regarding the advantages and harms of different running striking patterns. The purpose of this study was to explore the kinematic differences between running with a midfoot- and rearfoot striking (RFS) pattern.Multi-segment foot kinematics of 12 students were assessed while running barefoot at 3.3 m/s (±10%) using a passive optoelectronic motion analysis system. Participants performed multiple running trials while landing on the rearfoot and midfoot. Comparison of the kinematic waveforms was performed using one-dimensional statistical parametric mapping (1DSPM) (paired t-test). The inter-segment angle between the shank and calcaneus was found to be significantly more plantar-flexed, more inverted and more adducted in the midfoot striking (MFS) condition compared to the RFS pattern. The calcaneus-midfoot inter-segment angle was found to be more plantar-flexed in the MFS condition. The downward angulation of the metatarsals and the medial longitudinal arch angle in the late swing phase was found to be more pronounced during MFS. Differences between midfoot and RFS patterns occur in the first sub-phase of stance (0-50% of the stance phase).These findings may be of interest for the kinesiopathological or pathokinesiological reasoning processes when facing foot- and lower limb-related running injuries.


Assuntos
, Corrida , Fenômenos Biomecânicos , Marcha , Humanos , Perna (Membro) , Amplitude de Movimento Articular
12.
J Pediatr Orthop B ; 31(1): e24-e30, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34028377

RESUMO

The impairments in motor performance could be related to the foot structure in children with attention-deficit/hyperactivity disorder (ADHD) while considering the close relationship between foot structure and lower extremity alignment. This study aimed to investigate the foot structure and its relationships between disease severity, physical activity and psychiatric traits in children with ADHD. Children with ADHD (n = 50; mean age: 12.02 ± 1.83 years) and typically developing peers (n = 30; mean age: 12.86 ± 2.56 years) were included. The static footprint analysis was collected by using digital images. The ImageJ program was used to calculate Clarke's angle, Staheli arch index (SAI) and Chippaux-Smirak index (CSI). The Turgay DSM-IV disruptive behavior disorders rating scale (T-DSM-IV-S), physical activity questionnaire for older children (PQ-C), children's depression inventory and state-trait anxiety inventory for children were all used to assess symptoms of ADHD, physical activity, depression, stress and anxiety, respectively. Approximately 52-53% of children with ADHD had mild to severe flatfoot, while only 8-13% of typically developing peers had flatfoot based on SAI and CSI (P = 0.01). Significant correlation was found between Clarke's angle and PQ-C (r = 0.21, P = 0.04). Besides, T-DSM-IV-S was significantly correlated with SAI (r = 0.24, P = 0.01) and CSI (r = 0.25, P = 0.01) in children with ADHD. Children with ADHD had a significantly greater tendency of flatfoot compared to typically developing peers. Besides, the deterioration of the foot structure of children with ADHD was associated with disease severity.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Pé Chato , Adolescente , Ansiedade , Estudos de Casos e Controles , Criança , , Humanos
13.
J Pediatr Orthop B ; 31(1): e17-e23, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34101678

RESUMO

The objectives of this study were to collect and analyze current diagnosis and treatment options of symptomatic flexible flatfoot (FFF), as well as to identify treatment expectations, among the members of the Italian Pediatric Orthopedics Society (SITOP). Diagnosis and treatment preferences were recorded according to a web-based survey. The survey was divided into six main sections: (1) general clinical parameters; (2) foot aspects; (3) X-ray angles (or lines); (4) expectations; (5) standard clinical assessment; (6) treatment options. One hundred and ten out of 248 SITOP members answered to the questionnaire. Age (85.5%), pain at the level of the plantar arch or fascia (61.8%), fatigue (59.1%) were the clinical parameters of crucial importance. Heel valgus (85.4%), flexibility (61.8%) and forefoot supination (47.3%) were identified as the most important foot aspects. Ninety-two responders (83.6%) identified the 'improved ability to walk longer without symptoms or discomfort' as the principal treatment expectation. Pain evaluated through the visual analog scale (VAS) was considered crucial in 31.8% of cases. All respondents confirmed they also treat patients with FFF surgically; in particular, 97.3% of SITOP affiliates declare to perform arthroereisis followed by lateral column lengthening (29.1%) and medializing calcaneal osteotomy (9.1%). Although in this survey heterogeneous findings for diagnosis and treatment of patients with symptomatic FFF within SITOP members were found, a large preference for age, heel valgus, flexibility as clinical aspects and parameters, as well as nonoperative treatment and arthroereisis, was reported.


Assuntos
Calcâneo , Pé Chato , Deformidades Adquiridas do Pé , Ortopedia , Criança , Pé Chato/diagnóstico por imagem , Pé Chato/epidemiologia , , Humanos , Osteotomia
14.
Br J Radiol ; 95(1129): 20210990, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34767489

RESUMO

OBJECTIVES: To accurately differentiate clumpy artifacts from tophi with foot and ankle DECT. METHODS AND MATERIALS: In session 1, 108 clumpy artifacts from 35 patients and 130 tophi images from 25 patients were analyzed. Reviewers classified green pixelation according to anatomic location, shape (linear, stippled, angular, oval), and height and width ratio. In session 2, green pixelation confined to the tendon was evaluated (shape, height and width ratio, occupied area in the tendon, accompanied peritendinous green pixelation). RESULTS: In session 1, while tophi were noted at various locations, almost all clumpy artifacts were located at the tendon (99%, p < 0.0001). Most clumpy artifacts were linear, stippled, and wide, while most tophi were angular and oval (p < 0.05). In session 2, the shape of green pixelation from clumpy artifacts and tophi was significantly different (p < 0.0001) and most clumpy artifacts occupied less than 50% of the tendon (p = 0.02), and most tophi were accompanied by peritendinous green pixelation (p < 0.0001). Univariant logistic regression showed that tophi were significantly correlated with peritendinous deposits, angular and oval shape, and more than 50% of the tendon (p < 0.05). CONCLUSION: Clumpy artifacts can be differentiated from tophi in DECT. Clumpy artifacts typically are located in the tendon with a linear or stippled shape, wide, and less than 50% of a tendon's cross-section. Tophi, on the other hand, typically are oval, larger than 50% of the tendon's cross-section, and associated with adjacent peritendinous green pixelation. ADVANCES IN KNOWLEDGE: Clumpy artifacts can be differentiated from tophi in image findings by their location and shape.


Assuntos
Articulação do Tornozelo/diagnóstico por imagem , Artrite Gotosa/diagnóstico por imagem , Artefatos , Pé/diagnóstico por imagem , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Tomografia Computadorizada por Raios X/métodos , Humanos , Estudos Retrospectivos , Tendões/diagnóstico por imagem
15.
Medicina (Kaunas) ; 57(12)2021 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-34946304

RESUMO

Background and Objectives: Smart wearable devices are effective in diabetic foot ulcer (DFU) prevention. However, factors determining their acceptance are poorly understood. This systematic review aims to examine the literature on patient and provider perspectives of smart wearable devices in DFU prevention. Materials and Methods: PubMed, Scopus, and Web of Science were systematically searched up to October 2021. The selected articles were assessed for methodological quality using the quality assessment tool for studies with diverse designs. Results: A total of five articles were identified and described. The methodological quality of the studies ranged from low to moderate. Two studies employed a quantitative study design and focused on the patient perspective, whereas three studies included a mixed, quantitative/qualitative design and explored patient or provider (podiatrist) perspectives. Four studies focused on an insole system and one included a smart sock device. The quantitative studies demonstrated that devices were comfortable, well designed and useful in preventing DFU. One mixed design study reported that patients did not intend to adopt an insole device in its current design because of malfunctions, a lack of comfort. and alert intrusiveness, despite the general perception that the device was a useful tool for foot risk monitoring. Two mixed design studies found that performance expectancy was a predictor of a podiatrist's behavioural intention to recommend an insole device in clinical practice. Disappointing participant experiences negatively impacted the podiatrists' intention to adopt a smart device. The need for additional refinements of the device was indicated by patients and providers before its use in this population. Conclusions: The current evidence about patient and provider perspectives on smart wearable technology is limited by scarce methodological quality and conflicting results. It is, thus, not possible to draw definitive conclusions regarding acceptability of these devices for the prevention of DFU in people with diabetes.


Assuntos
Diabetes Mellitus , Pé Diabético , Órtoses do Pé , Dispositivos Eletrônicos Vestíveis , Pé Diabético/prevenção & controle , , Humanos , Sapatos
16.
Acta Orthop Traumatol Turc ; 55(6): 518-526, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34967741

RESUMO

OBJECTIVE: The aim of this study was to compare pain, plantar foot sensation, postural control, fear of movement, and functional level between women patients with early-stage gonarthrosis and those with late-stage gonarthrosis. METHODS: A total of 62 women with gonarthrosis were included in the study. Patients were then divided into two groups: earlystage gonarthrosis group (31 women) and late-stage gonarthrosis group (31 women) according to Kellgren Lawrence criteria. Light touch-pressure sensation (Semmes Weinstein Monofilaments), two-point discrimination sensation (esthesiometer), and vibration sensation (128 Hz diapason) were used to evaluate plantar foot sensation. Pain intensity was assessed by the numeric rating scale, postural control by Berg balance scale, fear of movement by the Tampa kinesiophobia scale, functional mobility by the Timed Up and Go test and knee injury and osteoarthritis outcome score. RESULTS: Early-stage patients were found to have higher light-touch pressure sensation on 1st metatarsal head of dominant side, 5th metatarsal head of non-dominant side, heel of non-dominant side than late stage patients. Early-stage patients had a higher sensation of vibration than late stage patients. The patients in the early stage were found to have higher two-point discrimination sensation on middle of dominant side, heel of dominant side, trans-metatarsal of non-dominant side, middle of non-dominant side, heel of non-dominant side than late stage. Postural control of early-stage patients were found to be higher than late-stage patients. Early-stage patients had lower kinesophobia and higher functional levels than late-stage patients. CONCLUSION: The light touch sensation, vibration sensation, and two-point discrimination deteriorated by the progression of the disease should be important criteria in patients with gonarthrosis. LEVEL OF EVIDENCE: Level III, Therapeutic Study.


Assuntos
Osteoartrite do Joelho , Equilíbrio Postural , Feminino , , Humanos , Extremidade Inferior , Osteoartrite do Joelho/diagnóstico , Sensação , Estudos de Tempo e Movimento
17.
J Athl Train ; 56(12): 1362-1366, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34911076

RESUMO

CONTEXT: Three foot-strike techniques are common in runners. If these techniques generate different sounds at the point of impact with the ground, lower limb kinetics may be influenced. No previous authors have determined whether such relationships exist. OBJECTIVES: To determine foot-ground impact sound characteristics and compare the impact-sound characteristics across foot-strike techniques and the relationships between impact-sound characteristics and vertical loading rates. DESIGN: Cross-sectional study. SETTING: Gait analysis laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 30 runners (15 women, 15 men; age = 23.5 ± 4.0 years, height = 1.67 ± 0.1 m, mass = 58.1 ± 8.2 kg) completed overground running trials with rearfoot-strike, midfoot-strike (MFS), and forefoot-strike (FFS) techniques in a gait analysis laboratory. MAIN OUTCOME MEASURE(S): Impact sound was measured using a shotgun microphone, and the peak sound amplitude, median frequency, and sound duration were analyzed. Separate linear regressions, clustering participants due to repeated measures, were used to compare the sound characteristics across foot-strike techniques. Kinetic data were collected from a force plate, and the vertical loading rates were calculated. Pearson correlation was used to determine the relationship between sound characteristics and kinetics. RESULTS: Landing with an MFS or FFS resulted in greater peak sound amplitude (P < .001) and shorter sound duration (P < .001) than a rearfoot strike. The MFS exhibited the highest median frequency among the 3 foot-strike patterns, followed by the FFS (P < .001). We did not find a significant relationship between vertical loading rates and any impact sound characteristics (P > .115). CONCLUSIONS: The results suggest that impact-sound characteristics may be used to differentiate foot-strike patterns in runners. However, these did not relate to lower limb kinetics. Therefore, clinicians should not solely rely on impact sound to infer impact loading.


Assuntos
Marcha , Corrida , Adulto , Fenômenos Biomecânicos , Estudos Transversais , Feminino , , Humanos , Masculino , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-34948765

RESUMO

The purpose of this study was to examine differences in starting and kick-plate positions, pointing to an effect on kick-start performance with the dominant and non-dominant feet placed on the front edge of the OSB12 starting block. The sample included 20 female competitive swimmers whose average age was 16.1 ± 0.6 years. To assess swimmers' lower body explosive strength and determine leg dominance, a triple hop distance test was administered. We determined the swimmers' preferred starting position on a starting block in terms of the kick-plate setting and body position on the starting block. The results of our study demonstrate the importance of leg dominance and positioning on the OSB12 starting block. After the preferred starting position was determined, the optimal position for the kick start was selected. When the dominant leg was placed on the front edge of the starting block (p < 0.05; Cohen's d-large effect), swimmers produced shorter block times and times to 2 and 5 m. For most of the tested swimmers, the optimal basic position on the starting block included neutral- and rear-weighted positions with the kick plate set to positions 3-4 and the right leg placed on the front edge of the OSB12 starting block.


Assuntos
Perna (Membro) , Natação , Adolescente , Fenômenos Biomecânicos , Feminino , , Humanos , Postura
19.
Artigo em Inglês | MEDLINE | ID: mdl-34948877

RESUMO

Virtual reality (VR)-guided exercise therapy using mediVR KAGURA has been reported to improve gait function by extending the arm to spatial targets while sitting. We aimed to investigate toe and trunk-pelvic function and plantar sensation during gait in a postoperative patient with hallux valgus. A 60-year-old woman, whose foot deformities had improved 6 months earlier, participated in the study. The exercise therapy interventions were performed twice weekly for 15 min. This study used an A-B-A design: 1-week pre-phase, 3-week intervention phase, and 2-week post-phase. The plantar pressure distribution and thoracic and pelvic displacements during gait were recorded at the end of each phase. The tactile pressure thresholds of the foot were determined before and after each exercise. The maximum force and impulse under the hallux increased after the intervention. The sensory threshold of the hallux was reduced. The amplitude of the thoracic and pelvic displacement was shortened in lateral and extended in the vertical and progressional directions after the intervention. We found that a 3-week VR-guided exercise improved toe function, plantar sensation, and postural adjustment of the trunk and pelvis during gait in a patient who had undergone surgery for hallux valgus, and the effects continued for 2 weeks.


Assuntos
Hallux Valgus , Realidade Virtual , Feminino , , Marcha , Hallux Valgus/cirurgia , Humanos , Pessoa de Meia-Idade , Postura Sentada
20.
Artigo em Inglês | MEDLINE | ID: mdl-34949021

RESUMO

The purpose of this study was to explore the kinematical characteristics of jumping discus throwing. Eight male right-handed discus throwers who used to practice the jumping throwing technique were recruited as participants. Two high-speed digital cameras with 120 Hz sampling rate were synchronized to capture the movement. The captured images were processed using a motion analysis suite, and the markers attached to joints on images were digitized manually. Based on the results, throwers should keep smaller the shoulder-hip twisting and the right anterior superior iliac spine (abbreviated: ASIS) in front of the right acromion (for right-handed throwers) from the instant the right foot lands to the instant the left foot lands, before the instant of the right foot lands; keep the discus at a depressed position; and reduce the time before discus release, particularly the time of the non-support phase and the second single-support phase. Additionally, release velocity must be improved because throwing distance is directly proportional to squared release velocity. In conclusion, the current study demonstrated comprehensive kinematical analyses, which can be used to instruct the jumping discus throwing technique with duration and angle characteristics of throwing movement for athletes by coaches with videos.


Assuntos
Atletismo , Atletas , Fenômenos Biomecânicos , , Humanos , Masculino , Movimento
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