64 research outputs found
Preliminary Evidence That Taping Does Not Optimize Joint Coupling of the Foot and Ankle Joints in Patients with Chronic Ankle Instability
No full textBACKGROUND: Foot-ankle motion is affected by chronic ankle instability (CAI) in terms of altered kinematics. This study focuses on multisegmental foot-ankle motion and joint coupling in barefoot and taped CAI patients during the three subphases of stance at running. METHODS: Foot segmental motion data of 12 controls and 15 CAI participants during running with a heel strike pattern were collected through gait analysis. CAI participants performed running trials in three conditions: barefoot running, and running with high-dye and low-dye taping. Dependent variables were the range of motion (RoM) occurring at the different inter-segment angles as well as the cross-correlation coefficients between predetermined segments. RESULTS: There were no significant RoM differences for barefoot running between CAI patients and controls. In taped conditions, the first two subphases only showed RoM changes at the midfoot without apparent RoM reduction compared to the barefoot CAI condition. In the last subphase there was limited RoM reduction at the mid- and rearfoot. Cross-correlation coefficients highlighted a tendency towards weaker joint coupling in the barefoot CAI condition compared to the controls. Joint coupling within the taped CAI conditions did not show optimization compared to the barefoot CAI condition. CONCLUSIONS: RoM was not significantly changed for barefoot running between CAI patients and controls. In taped conditions, there was no distinct tendency towards lower mean RoM values due to the mechanical restraints of taping. Joint coupling in CAI patients was not optimized by taping.sponsorship: This research was funded in part by a clinical research Grant of the Belgische Vereniging voor Orthopedie en Traumatologie (BVOT). (clinical research Grant of the Belgische Vereniging voor Orthopedie en Traumatologie (BVOT))status: Publishe
Clinical Applicability of an Existing Proportionality Scheme in Three-Segment Kinetic Foot Models (vol 75, pg 871, 2019)
No full textThis article was updated to correct Giovanni A. Matricali's name.status: Publishe
Comparison of foot segmental mobility and coupling during gait between patients with diabetes mellitus with and without neuropathy and adults without diabetes
No full textReduction in foot mobility has been identified as a key factor of altered foot biomechanics in individuals with diabetes mellitus. This study aimed at comparing in vivo segmental foot kinematics and coupling in patients with diabetes with and without neuropathy to control adults.sponsorship: This prospective study was carried out under the financial support of the Agency for Innovation by Science and Technology Flanders (GRANT: 080659). The work of G.A. Matricali was partially funded by a clinical doctoral scholarship of the Research Foundation-Flanders (Belgium). (Agency for Innovation by Science and Technology Flanders|GRANT: 080659, Research Foundation-Flanders (Belgium))status: Publishe
Body of evidence supporting the clinical use of 3D multisegment foot models : a systematic review
No full textBackground: A critical component in the characterization of foot mechanics during clinical gait analysis is the quantitative measurement of foot kinematics. Currently, the use of 3-D multisegment foot models (3DMFMs) is popular in gait laboratories as it would seem to be an adequate tool for the in vivo analysis of dynamic foot kinematics. This systematic review identifies and evaluates current evidence for the use of 3DMFMs in clinical gait analysis.
Methods: A targeted search strategy traced full papers that fulfilled the inclusion and exclusion criteria. The papers were classified and evaluated for quality using a custom made quality appraisal form.
Findings: Forty-one manuscripts were included yielding a total number of fifteen 3DMFMs. Generally, study procedures and sample selection were adequately described; however, the methodological quality varied widely. Evidence regarding the repeatability of the identified models also varied widely. Models facing the highest level of scientific credibility were characterized by adequate repeatability indices obtained from between-trial, between-day and between and within assessor studies. Generally, the highest reliability indices were found for the sagittal plane kinematics. Within-subject variability was found to be the lowest, contrarily, between-subject and between-day variability were found to be highest.
Interpretation: Reported repeatability indices such as the coefficient of multiple correlation, standard deviation and standard error of measurement provide evidence for the continued use of 3DMFMs. While a number of published models exist, there is not adequate evidence available to support their clinical use. More reliability and validity studies are needed to confirm adequate measurement properties of 3DMFMs.sponsorship: This review work was carried out under the financial support of the Agency for Innovation by Science and Technology Flanders (Grant: 080659). The work of G.A. Matricali was partially funded by a clinical doctoral scholarship of the Research Foundation-Flanders (Belgium). (Agency for Innovation by Science and Technology Flanders|080659, Research Foundation-Flanders (Belgium))status: Publishe
Repeatability of a 3D multi-segment foot model protocol in presence of foot deformities
No full textRepeatability studies on 3D multi-segment foot models (3DMFMs) have mainly considered healthy participants which contrasts with the widespread application of these models to evaluate foot pathologies. The current study aimed at establishing the repeatability of the 3DMFM described by Leardini et al. [3] in presence of foot deformities. Foot kinematics of eight adult participants were analyzed using a repeated-measures design including two therapists with different levels of experience. The inter-trial variability was higher compared to the kinematics of healthy subjects. Consideration of relative angles resulted in the lowest inter-session variability. The absolute 3D rotations between the Sha-Cal and Cal-Met seem to have the lowest variability in both therapists. A general trend towards higher σ(sess)/σ(trial) ratios was observed when the midfoot was involved. The current study indicates that not only relative 3D rotations and planar angles can be measured consistently in patients, also a number of absolute parameters can be consistently measured serving as basis for the decision making process.sponsorship: The authors are grateful to the Agency for Innovation by Science and Technology Flanders for funding this project (GRANT: 080659). The work of G. Matricali was partially funded by a Clinical Doctoral Scholarship of the Research Foundation Flanders (Belgium). (Agency for Innovation by Science and Technology Flanders|GRANT: 080659, Research Foundation Flanders (Belgium))status: Publishe
Fracture of the posterior medial tubercle of the talus: a case report and review of the literature
No full textIsolated fracture of the posterior medial tubercle of the talus is a rare injury. To our knowledge the fracture has only been described by five different authors. We diagnosed lately a fracture after a direct trauma. Non-operative treatment with custom made insoles and counselling lead to a acceptable outcome
Venous malformation as source of a tarsal tunnel syndrome: treat the source or the cause of the complaints? A case report
No full textPainful tarsal tunnel syndrome is a compression neuropathy with a variety of possible sources. As it presents a challenging differential diagnostic problem, it is often under-diagnosed. Among the intrinsic and extrinsic factors, varicose veins are the main source in case of a venous etiology. We report a case of a 39-year old male patient who presented with complaints of paresthesia and excessive pain of the right foot, especially the medial side. Further work up by ultrasonography, magnetic resonance imaging and electromyography revealed an extensive congenital venous malformation of the right lower limb with subsequent compression of the tibial nerve in the tarsal tunnel. We did not treat the source, but the cause by open tarsal tunnel release. Excellent result with immediate full relieve of the patients complaints was achieved.status: Publishe
Charcot neuroarthropathy after simultaneous pancreas-kidney transplantation: risk factors, prevalence and outcome
No full textWe retrospectively analyzed outcome and risk factors of developing Charcot foot (CF) in 100 patients with type 1 diabetes mellitus who underwent a simultaneous pancreas-kidney (SPK) transplantation. Patients who developed CF after SPK transplantation had significantly higher mortality (56% vs. 18%) and more frequently graft failure (44% vs. 13%). Recipients with CF also experienced acute rejections more frequently (78% vs. 41%). They furthermore had higher pre-transplant values of HbA1c , received cyclosporine and azathioprine more often, and had significantly higher cumulative corticosteroid use. Patients transplanted in an earlier era (1992-1998) received cyclosporine and azathioprine more often and had a significantly higher cumulative corticosteroid use with the higher prevalence of CF. Conversely, patients with diabetes transplanted more recently (1999-2012) received lower doses of corticosteroids as part of their tacrolimus-based immunosuppressive therapy, resulting in fewer CF attacks. In conclusion, development of CF after SPK is associated with poor patient and graft outcome. Poor pre-transplant diabetic control and the use of high-dose corticosteroids are risk factors for the development of CF. We recommend reduction in or even total avoidance of corticosteroids after SPK transplantation. Given the importance of the diagnosis of CF on outcome, a systematic examination of SPK patients' feet is recommended.status: Publishe
The Biomechanical Behavior of Distal Foot Joints in Patients with Isolated, End-Stage Tibiotalar Osteoarthritis Is Not Altered Following Tibiotalar Fusion
No full textAnkle arthrodesis is considered to be an optimal treatment strategy to relieve pain during walking in patients with isolated, end-stage tibiotalar osteoarthritis. The aim of this study was to investigate the post-operative effect of an arthrodesis on the ankle and foot joint biomechanics. We included both patients (n = 10) and healthy reference data (n = 17). A multi-segment foot model was used to measure the kinematics and kinetics of the ankle, Chopart, Lisfranc, and first metatarsophalangeal joints during a three-dimensional (3D) gait analysis. These data, together with patient reported outcome measures, were collected at baseline (pre-operative) and one year post-operatively. Patients experienced a decrease in pain and an increase in general well-being after surgery. Compared to the baseline measurements, patients only demonstrated a significant average post-operative increase of 0.22 W/kg of power absorption in the ankle joint. No other significant differences were observed between baseline and post-operative measurements. Current findings suggest that the biomechanical behavior of distal foot joints is not altered one year after fusion. The pain relief achieved by the arthrodesis improved the loading patterns during walking. Clinical significance of this study dictates that patients do not have to fear a loss in biomechanical functionality after an ankle arthrodesis.sponsorship: This study was supported by the Clinical Research Grant of the BVOT (Belgian Society of Orthopaedics and Trauma Research). The sponsors had no involvement in the study. The Open Access publication was made possible through funding support of the KU Leuven Fund for Fair Open Access. (Clinical Research Grant of the BVOT (Belgian Society of Orthopaedics and Trauma Research), KU Leuven Fund)status: Publishe
Iatrogenic osteochondral kissing lesion after transmalleolar drilling of the talar dome
No full textAnkle injuries can lead to early osteoarthrosis when diagnosis is delayed. The clinical presentation of an osteochondral lesion of the talar dome is often difficult to diagnose in the initial setup of an ankle sprain or fracture. Once the lesion is adequately imaged and staged, open or arthroscopic treatment can be initiated. We discuss the arthroscopic treatment of a posteromedial talar dome lesion in this case report. Transmalleolar drilling was performed to treat an osteochondral lesion of the talar dome in a 24-year-old female. Her ankle evolved toward a severe clinical and radiologic condition in which a combined talar and tibial (kissing) lesion was seen during her follow-up. Therefore, we recommend the use of retrograde drilling or arthroscopic microfracture with minimal iatrogenic risk, instead of transmalleolar drilling, as the treatment of choice in these specific osteochondral lesion of the talar dome cases.status: Publishe
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