Search Results (9)

Background/Objectives: This study aimed to provide preliminary normative data on intersegmental coordination patterns during heel rises at different knee joint positions and across various phases and periods. Methods: Twelve 21-year-old university students from the same cohort performed heel rises in knee-extended and knee-flexed conditions. Shank and foot kinematics were recorded using the VICON Oxford Foot Model, and intersegmental coordination was analyzed using a modified vector coding technique. Results: The results showed that coordination patterns varied significantly between the ascending and descending phases and across the early, middle, and late periods. In the early ascending phase, knee extension exhibited in-phase coordination (shank external rotation with hindfoot inversion), resembling propulsion-related coordination in gait, whereas knee flexion displayed greater anti-phase coordination between hindfoot plantar flexion and forefoot dorsiflexion. The middle and late periods demonstrated heel-rise-specific patterns, with coordination shifting from proximal to distal dominance. Knee flexion altered the coordination between the shank and hindfoot and between the hindfoot and forefoot in the sagittal plane compared to that during knee extension. Conclusions: These findings suggest that the knee position influences intersegmental coordination during heel rises, and the present results provide reference values that can enable future diagnostic validation and comparative studies in pathological populations. Full article

Background: Arthroereisis is a well-accepted and relatively easy procedure to treat the flexible flatfeet in children and adolescents. A mild calf-muscle shortening is not seldom an accompanying feature. The need for a gastrocnemius recession in addition to arthroereisis is controversial. Therefore, the objective of this study is to investigate the need for a gastrocnemius recession in mild cases of gastrocnemius shortening to improve ankle dorsiflexion in addition to arthroereisis. Methods: Twenty-seven patients (ages 9–15 years) who underwent arthroereisis for painful idiopathic flatfeet were included in this non-randomised retrospective study, approved by Friedrich-Alexander University, Erlangen-Nürnberg (22-86-Br). The gait data of 18 typically developed children in same age group was used as reference. Based on the intraoperative Silfverskjöld test, two groups could be identified in the collective, one with shortened of gastrocnemius who underwent gastrocnemius recession (FFGR) and one without (FF). A control group included 18 feet of 18 typically developing children. Outcomes were evaluated by comparing pre- and postoperative clinical assessments including pain scores, gait analysis using a multi-segmental foot model, and radiological imaging. The mean follow-up was 22.1 months, and statistical analysis included a two-factor ANOVA. Results: No statistically significant differences in anthropometric, clinical, and gait parameters were observed between the groups preoperatively. Improvements in ankle dorsiflexion and pain were seen in both groups without statistical significance. There was no loss of calf-muscle strength or ankle power. Conclusions: Arthroereisis effectively corrects an idiopathic flexible flatfoot and reduces pain in children and adolescents. The gastrocnemius muscle stretches following arthroereisis and therefore, no lengthening is necessary when mildly shortened. The major limitations of this study are its retrospective nature, non-randomisation, and small size of the study collective. Full article

Balance control in pirouettes has previously been characterized by constraint of the topple angle. However, there is a paucity of research using the margin of stability (MoS) as a dynamic measure of balance related to pirouettes. Therefore, this study aimed primarily to examine the MoS as a metric of balance during a single-turn en dehors pirouette in healthy female amateur ballet dancers. Four participants performed pirouettes until five successful pirouettes were achieved without hopping or loss of balance. Three-dimensional motion capture was used to record the motion trajectories of anatomical markers based on the Plug-in-Gait and Oxford Foot models. Motion synchronized with ground reaction forces was used to calculate the center of pressure (CoP), base of support (BoS), center of the pivot foot, center of mass (CoM), and extrapolated center of mass (XCoM) throughout the turn phase, using laboratory (LCS) and virtual left foot (LFT) coordinate systems. In the LCS and LFT coordinate system, the excursions and patterns of motion of both the CoM and XCoM relative to the CoP were similar, suggesting a neurological relationship. Two different measures of the margin of stability (MoS) in the LFT coordinate system were tabulated: the distance between the (1) XCoM and CoP and (2) XCoM and BoS center. The magnitude of both versions of the MoS was greatest at turn initiation and toe-touch, which was associated with two foot contacts. The MoS values were at a minimum approximately 50% of the stance during the turn phase: close to zero along the anteroposterior (A/P) axis and approximately 50 mm along the mediolateral (M/L) axis. On average, MoS magnitudes were reduced (mean across participants: approximately 20 mm) along the A/P axis, and larger MoS magnitudes (mean across participants: approximately 50 mm) along the M/L axis throughout the turn phase. Although all turns analyzed were completed successfully, the larger MoS values along the M/L axis suggest a fall potential. The variability between trials within a dancer and across participants and trials was documented and showed moderate inter-trial (16% to 51%) and across-participant CV% (range: 10% to 28%), with generally larger variations along the A/P axis. Although our results are preliminary, they suggest that the MoS may be useful for detecting faults in the control of dynamic balance in dehors pirouette performance, as a part of training and rehabilitation following injury. Full article

Background: Arthrodesis of the first metatarsophalangeal joint (MTP1) is a common intervention for hallux rigidus (HR). The procedure eliminates MTP1 motion but results in significant pain relief and high satisfaction rates, although MTP1 is eliminated. Less evidence is available regarding the effects on gait and the presence of compensatory mechanisms. The aim of this study is to investigate the effects of MTP1 arthrodesis on gait and patient-reported outcome measures (PROMs) compared with preoperative functioning and healthy individuals. Methods: In this prospective study, 10 patients (10 feet) with HR who underwent MTP1 arthrodesis were evaluated before and after surgery and compared with 15 healthy controls (30 feet). Gait analysis was performed with a motion capturing system using the multi-segment Oxford foot model. Spatiotemporal parameters and kinematics were quantitatively analyzed. PROMs were evaluated using validated questionnaires including the American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS-HMI) scale, the Numeric Pain Rating Scale (NPRS), and the Manchester–Oxford Foot Questionnaire (MOXFQ). Results: MTP1 joint motion was reduced in HR and further reduced after MTP1 arthrodesis compared with healthy controls. Furthermore, intersegmental ROM analysis revealed increased forefoot frontal plane motion (pronation and supination) in HR compared with healthy controls. This was also observed after MTP1 arthrodesis, while additionally increased frontal plane motion in the hindfoot (inversion and eversion) was observed compared with HR and healthy controls. PROM evaluation revealed improved AOFAS-HMI (from 55.7 to 79.1 points, p = 0.002) and NPRS (from 5.7 to 1.5 points, p = 0.004) scores after surgery. Additionally, improvements in the MOXFQ score (from 51.0 to 20.0 points, p = 0.002) were observed. Conclusions: Due to the loss of sagittal hallux motion, foot and ankle kinematics are changed in HR patients and after MTP1 arthrodesis compared with healthy controls. Loss of MTP1 motion results in increased frontal plane motion of the forefoot in HR, and increased frontal plane motion of the fore- and hindfoot after MTP1 arthrodesis. Additionally, substantial improvements in PROMs were recorded after surgery. Full article

Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage ball group (group A, n = 8) and an application-linked massage ball group (group B, n = 6). The application-linked massage ball sends information regarding the massages, such as the frequency and force of the massage on the foot, to the application on the patient’s smartphone. All clinical outcomes were evaluated at the beginning of the study and 1-, 2-, and 3-month follow-up. The primary outcome measure was the Manchester–Oxford Foot Questionnaire (MOXFQ) score. Results: At the beginning of the study, the initial MOXFQ score was not significantly different between the two groups (p = 0.948). At each time point, the MOXFQ score of the whole population did not improve significantly compared to that of the initial state (p = 0.131). Generalized estimating equation modeling demonstrated that there was no significant difference in the improvement of the MOXFQ score between groups A and B during follow-up (p = 0.826). In addition, no group-by-time interactions were observed (p = 0.457). Conclusions: The efficacy of an application-linked massage ball for the treatment of plantar fasciitis was not as definite as that of a traditional simple stretching ball in patients whose symptoms persisted for at least six months. Future studies that include patients with acute plantar fasciitis are required. Full article

Irish dance is growing in popularity, evolving to a more athletic and demanding dance style. The aim of this study is to conduct a systematic review, previously registered with PROSPERO, to identify the prevalence, incidence, and the injury pattern among Irish dancers and analyse the associated risk factors. Six online databases and two dance-specific science publications were searched systematically. Studies were included if the patterns of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Eleven articles were included, eight of Level 3c (cross-sectional) and three of Level 3b (prospective). Mean DB percentage score was 63% ± 7.2%. Prevalence ranged from 72.2% to 92.6%, affecting mostly the foot/ankle complex. Only two articles reported incidence, which ranged from 3.4 to 10.6 injuries/1000 h danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Injury prevalence and incidence is high in Irish dancers, with the foot and ankle being more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research. Full article

The squat, a fundamental functional movement, is prone to biomechanical inefficiencies. Several screening batteries utilize the Overhead Deep Squat (OHDS) to assess individuals for stability and mobility deficits. The purpose of this study was to create a comprehensive description of the three-dimensional (3D) kinematics and kinetics for normal, healthy participants during an overhead deep squat. This descriptive study containing 70 healthy young adults (31 male, 39 female; aged 18–35) utilized a video motion tracking system interfaced with force plates to obtain full-body 3D kinematics and kinetics. Seventy-three retro-reflective markers from the combined Plug-in Gait, Vicon upper limb, and Oxford Multi-segment foot models were used. Visual 3D software was used to determine joint kinematics and kinetics. Means and standard deviations of lower limb and trunk segment joint angles in the sagittal, transverse, and horizontal planes, as well as the ground reaction forces and net internal joint moments, were computed. The largest movements and joint moments occurred in the sagittal plane; however, the frontal and transverse plane appear crucial to providing stability and mobility. These results can be used as pilot normative data for both future studies and during assessments of biomechanical abnormalities in training and rehabilitation settings. Full article

Knowledge of ergonomics/human factors plays an important role in the creation and design of safety shoes and insoles, contributing to worker protection, comfort, and stability. The purpose of this study is to compare previous insole designs and analyze the plantar pressure and gait pattern kinematics using the Oxford foot model protocol. The tests were performed comparing the environments on the three rockers of the gait, represented by the heel, midfoot, and forefoot, according to the classification of foot type. The analysis of plantar pressure, regarding its total and maximum distribution, showed that the innovative insole presents a better load distribution in terms of the maximum plantar pressure exerted in the hindfoot and forefoot regions. In the biomechanical analysis of gait, the five variables studied did not show variation in the normal mechanics of the foot in any of the three environments considered. The hallux joint was the one that presented the greatest divergences with the barefoot in terms of amplitude and variability, as expected. Full article

Idiopathic toe walking (ITW) is a gait deviation characterized by forefoot contact with the ground, sometimes observed in children, that alters ankle kinematics, possibly leading to health-related issues. When studying foot and ankle gait deviations, the adoption of a single-segment foot model entails a significant simplification of foot and ankle movement, and thus may potentially mask some important foot dynamics. Differences in ankle kinematics between single- (conventional gait model, PiG, or Davis) and multi-segment (Oxford foot model, OFM) foot models were investigated in children with ITW. Fourteen participants were enrolled in the study and underwent instrumented gait analysis. Children were asked to walk barefoot and while wearing a foot orthosis that modified the ankle movement pattern toward a more physiological one without blocking foot intrinsic motion. ITW gait abnormalities, e.g., the absence of heel rocker and the presence of anticipated forefoot rocker, were found/not found according to the foot model. Walking conditions significantly interacted with the foot model effect. Finally, the different characterization of gait abnormalities led to a different classification of ITW, with a possible impact on the clinical evaluation. Due to its closer adhesion to ankle anatomy and to its sensitivity to ITW peculiarities, OFM may be preferable for instrumented gait analysis in this population. Full article