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Sample records for ankle joint loading

  1. Ankle Joint Contact Loads and Displacement With Progressive Syndesmotic Injury.

    Science.gov (United States)

    Hunt, Kenneth J; Goeb, Yannick; Behn, Anthony W; Criswell, Braden; Chou, Loretta

    2015-09-01

    Ligamentous injuries to the distal tibiofibular syndesmosis are predictive of long-term ankle dysfunction. Mild and moderate syndesmotic injuries are difficult to stratify, and the impact of syndesmosis injury on the magnitude and distribution of forces within the ankle joint during athletic activities is unknown. Eight below-knee cadaveric specimens were tested in the intact state and after sequential sectioning of the following ligaments: anterior-inferior tibiofibular, anterior deltoid (1 cm), interosseous/transverse (IOL/TL), posterior-inferior tibiofibular, and whole deltoid. In each condition, specimens were loaded in axial compression to 700 N and then externally rotated to 20 N·m torque. During axial loading and external rotation, both the fibula and the talus rotated significantly after each ligament sectioning as compared to the intact condition. After IOL/TL release, a significant increase in posterior translation of the fibula was observed, although no syndesmotic widening was observed. Mean tibiotalar contact pressure increased significantly after IOL/TL release, and the center of pressure shifted posterolaterally, relative to more stable conditions, after IOL/TL release. There were significant increases in mean contact pressure and peak pressure along with a reduction in contact area with axial loading and external rotation as compared to axial loading alone for all 5 conditions. Significant increases in tibiotalar contact pressures occur when external rotation stresses are added to axial loading. Moderate and severe injuries are associated with a significant increase in mean contact pressure combined with a shift in the center of pressure and rotation of the fibula and talus. Considerable changes in ankle joint kinematics and contact mechanics may explain why moderate syndesmosis injuries take longer to heal and are more likely to develop long-term dysfunction and, potentially, ankle arthritis. © The Author(s) 2015.

  2. An in Silico Analysis of Ankle Joint Loads in Secondary Ankle Osteoarthritis. Case Study.

    Science.gov (United States)

    Lorkowski, Jacek; Mrzygłód, Mirosław W; Grzegorowska, Oliwia; Kotela, Ireneusz

    2015-01-01

    Secondary, post-traumatic, degenerative lesions of the ankle joint remain a serious clinical challenge. This paper presents the case of a 66-year-old patient with secondary, post-traumatic ankle osteoarthritis and subchondral cysts. The use of rapid computer modelling FEM 2D enabled optimization of surgical treatment. A FEM 2D model of biomechanical changes in bones may help in streamlining treatment as well as improve our understanding of the pathomechanism of osteoarthritis.

  3. Effects of changing speed on knee and ankle joint load during walking and running.

    Science.gov (United States)

    de David, Ana Cristina; Carpes, Felipe Pivetta; Stefanyshyn, Darren

    2015-01-01

    Joint moments can be used as an indicator of joint loading and have potential application for sports performance and injury prevention. The effects of changing walking and running speeds on joint moments for the different planes of motion still are debatable. Here, we compared knee and ankle moments during walking and running at different speeds. Data were collected from 11 recreational male runners to determine knee and ankle joint moments during different conditions. Conditions include walking at a comfortable speed (self-selected pacing), fast walking (fastest speed possible), slow running (speed corresponding to 30% slower than running) and running (at 4 m · s(-1) ± 10%). A different joint moment pattern was observed between walking and running. We observed a general increase in joint load for sagittal and frontal planes as speed increased, while the effects of speed were not clear in the transverse plane moments. Although differences tend to be more pronounced when gait changed from walking to running, the peak moments, in general, increased when speed increased from comfortable walking to fast walking and from slow running to running mainly in the sagittal and frontal planes. Knee flexion moment was higher in walking than in running due to larger knee extension. Results suggest caution when recommending walking over running in an attempt to reduce knee joint loading. The different effects of speed increments during walking and running should be considered with regard to the prevention of injuries and for rehabilitation purposes.

  4. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. The Effect of Backpack Load Carriage on the Kinetics and Kinematics of Ankle and Knee Joints During Uphill Walking.

    Science.gov (United States)

    Lee, Jinkyu; Yoon, Yong-Jin; Shin, Choongsoo S

    2017-12-01

    The purpose of this study was to investigate the effect of load carriage on the kinematics and kinetics of the ankle and knee joints during uphill walking, including joint work, range of motion (ROM), and stance time. Fourteen males walked at a self-selected speed on an uphill (15°) slope wearing military boots and carrying a rifle in hand without a backpack (control condition) and with a backpack. The results showed that the stance time significantly decreased with backpack carriage (p < .05). The mediolateral impulse significantly increased with backpack carriage (p < .05). In the ankle joints, the inversion-eversion, and dorsi-plantar flexion ROM in the ankle joints increased with backpack carriage (p < .05). The greater dorsi-plantar flexion ROM with backpack carriage suggested 1 strategy for obtaining high plantar flexor power during uphill walking. The result of the increased mediolateral impulse and inversion-eversion ROM in the ankle joints indicated an increase in body instability caused by an elevated center of mass with backpack carriage during uphill walking. The decreased stance time indicated that an increase in walking speed could be a compensatory mechanism for reducing the instability of the body during uphill walking while carrying a heavy backpack.

  6. Squeeze-Film Lubrication of the Human Ankle Joint Subjected to the Cyclic Loading Encountered in Walking

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2005-01-01

    Roč. 127, č. 1 (2005), s. 141-147 ISSN 0742-4787 R&D Projects: GA ČR(CZ) GA103/04/0150 Institutional research plan: CEZ:AV0Z20710524 Keywords : cyclic loading * human ankle joint * squeeze-film lubrication * synovial fluid filtration * synovial gel formation Subject RIV: JJ - Other Materials Impact factor: 0.682, year: 2005

  7. Arthroscopy of the ankle joint

    NARCIS (Netherlands)

    van Dijk, C. N.; Scholte, D.

    1997-01-01

    Ankle arthroscopy has become a standard procedure for a variety of indications. Joint distraction is applied by many authors. A recent retrospective multicentre study provoked the following questions. Is there an indication for diagnostic arthroscopy? Can arthroscopic surgery of the ankle joint be

  8. Joint angles of the ankle, knee, and hip and loading conditions during split squats.

    Science.gov (United States)

    Schütz, Pascal; List, Renate; Zemp, Roland; Schellenberg, Florian; Taylor, William R; Lorenzetti, Silvio

    2014-06-01

    The aim of this study was to quantify how step length and the front tibia angle influence joint angles and loading conditions during the split squat exercise. Eleven subjects performed split squats with an additional load of 25% body weight applied using a barbell. Each subject's movements were recorded using a motion capture system, and the ground reaction force was measured under each foot. The joint angles and loading conditions were calculated using a cluster-based kinematic approach and inverse dynamics modeling respectively. Increases in the tibia angle resulted in a smaller range of motion (ROM) of the front knee and a larger ROM of the rear knee and hip. The external flexion moment in the front knee/hip and the external extension moment in the rear hip decreased as the tibia angle increased. The flexion moment in the rear knee increased as the tibia angle increased. The load distribution between the legs changed squat execution was varied. Our results describing the changes in joint angles and the resulting differences in the moments of the knee and hip will allow coaches and therapists to adapt the split squat exercise to the individual motion and load demands of athletes.

  9. Osteoligamentous injuries of the medial ankle joint.

    Science.gov (United States)

    Lötscher, P; Lang, T H; Zwicky, L; Hintermann, B; Knupp, M

    2015-12-01

    Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ankle joint osteoarthritis.

  10. Functional Instability of the Ankle Joint: Etiopathogenesis

    Directory of Open Access Journals (Sweden)

    Aydan ÖRSÇELİK

    2016-09-01

    Full Text Available Ankle sprain is one of the most common sports injuries. Chronic ankle instability is a common complication of ankle sprains. Two causes of chronic ankle instability are mechanical instability and functional instability. It is important to understand functional instability etiopathogenesis of the ankle joint in order to guide diagnosis and treatment. This article aims to understand the etiopathogenesis of functional ankle instability.

  11. Hydrocolonotherapy ankle joints after injuries

    Directory of Open Access Journals (Sweden)

    Volodymyr Muchin

    2016-02-01

    Full Text Available Purpose: to improve efficiency of gydrokinesitherapy by means of specially designed devices and monolasts for patients after ankle joint injuries. Material & Methods: there are pedagogical methods, clinical and radiological methods, anthropometric measurements and goniometry were used. Results: the author's technique of hydrokinesitherapy with application hydrokinesimechanotherapy device in the program of physical rehabilitation which provides optimum conditions for the recovery process was developed. Conclusions: the specially designed hydrokinesomechanotherapeutic device and monolasts are allow strictly controlled movement in all planes of the ankle joint, which contributes to the acceleration of the recovery; the conducted anthropometric and goniometric studies were indicate more rapid elimination of edema, increase movement amplitude, carries opposition to the development of contractures and muscle atrophy.

  12. Arthrography of the ankle joint

    International Nuclear Information System (INIS)

    Crespi Porro, R.; Zellner, A.; Puricelli, G.; Quaglia, R.; Chelazzi, G.

    1984-01-01

    Arthrography of the ankle joint was first carried out by Johnson and Palmer at the Military Hospital in Stockholm in 1940. Arthrography can be used for judging the integrity of the articular cartilage, of osteochondritis dissecans, arthritis or adhesive capsulitis. The literature shows, however, that more than 95% of the patients on whom this examination has been performed has suffered from acute trauma. (orig.) [de

  13. Talofibular compartment of the ankle joint after recent ankle sprain

    International Nuclear Information System (INIS)

    Lindstrand, A.; Mortensson, W.; Norman, O.

    1978-01-01

    The validity of predicting the condition of the anterior talofibular ligament from the shape of the lateral compartment of the ankle joint was investigated in patients with recent ankle sprain. The diagnostic value of the method was found to be restricted. (Auth.)

  14. Ultrasonography of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jung Won; Lee, Sun Joo; Choo, Hye Jung; Kim, Sung Kwan; Gwak, Heui Chul [Inje University Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Lee, Sung Moon [Dept. of Radiology, Dae Kyung Imaging Center, Daegu (Korea, Republic of)

    2017-10-15

    Ankle disorders are a relatively common pathological condition, and ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various imaging modalities can be used to make a diagnosis in cases of ankle pain; however, ultrasound (US) has several benefits for the evaluation of ankle pain, especially in the tendons, ligaments, and nerves of the ankle. The purpose of this article is to review the common causes of ankle pathology, with particular reference to US features. In addition, the importance of a dynamic evaluation and a stress test with US is emphasized.

  15. Ultrasonography of the ankle joint

    International Nuclear Information System (INIS)

    Park, Jung Won; Lee, Sun Joo; Choo, Hye Jung; Kim, Sung Kwan; Gwak, Heui Chul; Lee, Sung Moon

    2017-01-01

    Ankle disorders are a relatively common pathological condition, and ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various imaging modalities can be used to make a diagnosis in cases of ankle pain; however, ultrasound (US) has several benefits for the evaluation of ankle pain, especially in the tendons, ligaments, and nerves of the ankle. The purpose of this article is to review the common causes of ankle pathology, with particular reference to US features. In addition, the importance of a dynamic evaluation and a stress test with US is emphasized

  16. Ball-and-socket ankle joint

    International Nuclear Information System (INIS)

    Pistoia, F.; Ozonoff, M.B.; Wintz, P.; Hartford Hospital, CT

    1987-01-01

    The ball-and-socket ankle joint is a malformation of the ankle in which the articular surface of the talus is hemispherical in both the anteroposterior and lateral projections and has a congruent, concave tibial articular surface. Fourteen patients with this condition were identified retrospectively. Thirteen patients were thought to have the congenital type of ball-and-socket ankle joint which in many was associated with tarsal coalition, short limb, and ray fusion and deletion anomalies. One case of the acquired type, demonstrating less geometric rounding of the talar margins, was seen in a patient with myelomeningocele, probably resulting from sensory and motor deficits. Although the exact etiology of the congenital type is unknown, its association with other malformations suggests that the ball-and-socket ankle joint results from an overall maldevelopment of the ankle and foot. (orig.)

  17. Relationship between viscosity of the ankle joint complex and functional ankle instability for inversion ankle sprain patients.

    Science.gov (United States)

    Lin, Che-Yu; Kang, Jiunn-Horng; Wang, Chung-Li; Shau, Yio-Wha

    2015-03-01

    Measurement of viscosity of the ankle joint complex is a novel method to assess mechanical ankle instability. In order to further investigate the clinical significance of the method, this study intended to investigate the relationship between ankle viscosity and severity of functional ankle instability. Cross-sectional study. 15 participants with unilateral inversion ankle sprain and 15 controls were recruited. Their ankles were further classified into stable and unstable ankles. Ankle viscosity was measured by an instrumental anterior drawer test. Severity of functional ankle instability was measured by the Cumberland Ankle Instability Tool. Unstable ankles were compared with stable ankles. Injured ankles were compared with uninjured ankles of both groups. The spearman's rank correlation coefficient was applied to determine the relationship between ankle viscosity and severity of functional ankle instability in unstable ankles. There was a moderate relationship between ankle viscosity and severity of functional ankle instability (r=-0.64, pankles exhibited significantly lower viscosity (pankle instability (pankles. Injured ankles exhibited significantly lower viscosity and more severe functional ankle instability than uninjured ankles (pankle viscosity and severity of functional ankle instability. This finding suggested that, severity of functional ankle instability may be partially attributed to mechanical insufficiencies such as the degenerative changes in ankle viscosity following the inversion ankle sprain. In clinical application, measurement of ankle viscosity could be a useful tool to evaluate severity of chronic ankle instability. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Minimum distraction gap: how much ankle joint space is enough in ankle distraction arthroplasty?

    Science.gov (United States)

    Fragomen, Austin T; McCoy, Thomas H; Meyers, Kathleen N; Rozbruch, S Robert

    2014-02-01

    The success of ankle distraction arthroplasty relies on the separation of the tibiotalar articular surfaces. The purpose of this study was to find the minimum distraction gap needed to ensure that the tibiotalar joint surfaces would not contact each other with full weight-bearing while under distraction. Circular external fixators were mounted to nine cadaver ankle specimens. Each specimen was then placed into a custom-designed load chamber. Loads of 0, 350, and 700N were applied to the specimen. Radiographic joint space was measured and joint contact pressure was monitored under each load. The external fixator was then sequentially distracted, and the radiographic joint space was measured under the three different loads. The experiment was stopped when there was no joint contact under 700N of load. The radiographic joint space was measured and the initial (undistracted) radiographic joint space was subtracted from it yielding the distraction gap. The minimum distraction gap (mDG) that would provide total unloading was calculated. The average mDG was 2.4 mm (range, 1.6 to 4.0 mm) at 700N of load, 4.4 mm (range, 3.7 to 5.8 mm) at 350N of load, and 4.9 mm (range, 3.7 to 7.0 mm) at 0N of load. These results suggest that if the radiographic joint space of on a standing X-ray of an ankle undergoing distraction arthroplasty shows a minimum of 5.8 mm of DG, then there will be no contact between joint surfaces during full weight-bearing. Therefore, 5 mm of radiographic joint space, as recommended historically, may not be adequate to prevent contact of the articular surfaces during weight-bearing.

  19. MR arthrography of the ankle joint

    International Nuclear Information System (INIS)

    Trattnig, S.; Rand, T.; Breitenseher, M.; Ba-Ssalamah, A.; Schick, S.; Imhof, H.

    1999-01-01

    Due to its superior soft tissue contrast conventional MRI is the imaging method of choice in the evaluation of ankle joint disorders. Conventional MR imaging can accurately demonstrate normal or acutely injured ligaments; however, in subacute and chronic injury joint fluid necessary for delineation of injured ligaments is absent and MR arthrography should be performed. MR arthrography uses the intraarticular injection of contrast material to distend the joint, yielding improved discrimination of intraarticular structures. This joint distension with MR arthrography is also helpful in the staging of osteochondritis dissecans, since in cases of unstable lesions tracking of contrast material into the interface can be more easily demonstrated. Finally, high contrast and joint distension by MR arthrography improves the detection of intraarticular loose bodies, which often require surgery. MR artrography, although invasive, may provide additional information in various ankle joint disorders. (orig.) [de

  20. Quantifying normal ankle joint volume: An anatomic study

    Directory of Open Access Journals (Sweden)

    Draeger Reid

    2009-01-01

    Full Text Available Background: Many therapeutic and diagnostic modalities such as intraarticular injections, arthrography and ankle arthroscopy require introduction of fluid into the ankle joint. Little data are currently available in the literature regarding the maximal volume of normal, nonpathologic, human ankle joints. The purpose of this study was to measure the volume of normal human ankle joints. Materials and Methods: A fluoroscopic guided needle was passed into nine cadaveric adult ankle joints. The needle was connected to an intracompartmental pressure measurement device. A radiopaque dye was introduced into the joint in 2 mL boluses, while pressure measurements were recorded. Fluid was injected into the joint until three consecutive pressure measurements were similar, signifying a maximal joint volume. Results: The mean maximum ankle joint volume was 20.9 ± 4.9 mL (range, 16-30 mL. The mean ankle joint pressure at maximum volume was 142.2 ± 13.8 mm Hg (range, 122-166 mm Hg. Two of the nine samples showed evidence of fluid tracking into the synovial sheath of the flexor hallucis longus tendon. Conclusion: Maximal normal ankle joint volume was found to vary between 16-30 mL. This study ascertains the communication between the ankle joint and the flexor hallucis longus tendon sheath. Exceeding maximal ankle joint volume suggested by this study during therapeutic injections, arthrography, or arthroscopy could potentially damage the joint.

  1. [Arthroscopic therapy of ankle joint impingement syndrome after operation of ankle joint fracture dislocation].

    Science.gov (United States)

    Feng, Zhibin; Mi, Kun; Wei, Renzhi; Liu, Wu; Wang, Bin

    2011-07-01

    To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, there were 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from -20 to -5 degrees (mean, -10.6 degrees), and the palmar flexion was 30-40 degrees (mean, 35.5 degrees). The total score was 48.32 +/- 9.24 and the pain score was 7.26 +/- 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25 degrees (mean, 19.6 degrees) and the palmar flexion was 35-45 degrees (mean, 40.7 degrees). Eight patients had mild limited ROM; the dorsal extension was 5-15 degrees (mean, 7.2 degrees) and the palmar flexion was 35-45 degrees (mean, 39.5 degrees). Four patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5 degrees (mean, 2.6 degrees) and the palmar flexion was 35-40 degrees (mean, 37.5 degrees). The total score was 89.45 +/- 9.55 and the pain score was 1.42 +/- 1.26 after

  2. Influence of ankle joint plantarflexion and dorsiflexion on lateral ankle sprain: A computational study.

    Science.gov (United States)

    Purevsuren, Tserenchimed; Kim, Kyungsoo; Batbaatar, Myagmarbayar; Lee, SuKyoung; Kim, Yoon Hyuk

    2018-05-01

    Understanding the mechanism of injury involved in lateral ankle sprain is essential to prevent injury, to establish surgical repair and reconstruction, and to plan reliable rehabilitation protocols. Most studies for lateral ankle sprain posit that ankle inversion, internal rotation, and plantarflexion are involved in the mechanism of injury. However, recent studies indicated that ankle dorsiflexion also plays an important role in the lateral ankle sprain mechanism. In this study, the contributions of ankle plantarflexion and dorsiflexion on the ankle joint were evaluated under complex combinations of internal and inversion moments. A multibody ankle joint model including 24 ligaments was developed and validated against two experimental cadaveric studies. The effects of ankle plantarflexion (up to 60°) and dorsiflexion (up to 30°) on the lateral ankle sprain mechanism under ankle inversion moment coupled with internal rotational moment were investigated using the validated model. Lateral ankle sprain injuries can occur during ankle dorsiflexion, in which the calcaneofibular ligament and anterior talofibular ligament tears may occur associated with excessive inversion and internal rotational moment, respectively. Various combinations of inversion and internal moment may lead to anterior talofibular ligament injuries at early ankle plantarflexion, while the inversion moment acts as a primary factor to tear the anterior talofibular ligament in early plantarflexion. It is better to consider inversion and internal rotation as primary factors of the lateral ankle sprain mechanism, while plantarflexion or dorsiflexion can be secondary factor. This information will help to clarify the lateral ankle sprain mechanism of injury.

  3. Does distal tibiofibular joint mobilization decrease limitation of ankle dorsiflexion?

    Science.gov (United States)

    Fujii, Misaki; Suzuki, Daisuke; Uchiyama, Eiichi; Muraki, Takayuki; Teramoto, Atsushi; Aoki, Mitsuhiro; Miyamoto, Shigenori

    2010-02-01

    Limitation of ankle motion is in many cases treated by joint mobilization (JM), a kind of manual physical therapy technique. Until now, the JM approach has mainly focused on the talocrural joint, with less attention to the distal tibiofibular joint. We applied cyclic loading to the lateral malleolus as in JM in order to clarify the relationship between the dorsiflexion angle and the excursion of the lateral malleolus. Seven normal, fresh-frozen cadaver legs were used. To each specimen, cyclic loading with a 30N force was applied 1000 times to the lateral malleolus at a speed of 15N/s. The displacement of the lateral malleolus was measured with a magnetic tracking system. The maximum dorsiflexion angle was measured before and after cyclic loading. After the first 100 and 1000 times of cyclic loading, the tibia was displaced 0.44+/-0.30mm and 0.75+/-0.36mm, respectively, and the fibula was displaced 0.44+/-0.28mm and 0.92+/-0.39mm, respectively. The average dorsiflexion angle increased from 14.36+/-7.51 degrees to 16.74+/-7.21 degrees after cyclic loading (Pankle dorsiflexion. These results suggest that tibiofibular JM would be effective for limitation of ankle dorsiflexion.

  4. Two ankle joint laxity testers: reliability and validity

    NARCIS (Netherlands)

    Kerkhoffs, Gino M. M. J.; Blankevoort, Leendert; Sierevelt, Inger N.; Corvelein, Ruby; Janssen, Guido H. W.; van Dijk, C. Niek

    2005-01-01

    Two test devices were manufactured to objectively measure ankle joint laxity: the dynamic anterior ankle tester (DAAT) and the quasi-static anterior ankle tester (QAAT). The primary aim was to analyse the reliability of both testers; The secondary aim was to assess validity in correlation with TELOS

  5. Expecting ankle tilts and wearing an ankle brace influence joint control in an imitated ankle sprain mechanism during walking.

    Science.gov (United States)

    Gehring, Dominic; Wissler, Sabrina; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    A thorough understanding of the functional aspects of ankle joint control is essential to developing effective injury prevention. It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking. Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24° inversion and 15° plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace. Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (-7%) and velocity (-4%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (-14%) and velocity (-11%) as well as reactive neuromuscular responses. The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing. Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Spontaneous resolution of posterior ankle joint loose bodies after total ankle replacement: A case report.

    Science.gov (United States)

    Lee, Raymond P; Cheng, Sally H S

    2017-06-01

    Late stage ankle osteoarthritis often presents with debilitating pain. It is common to find osteophytes and loose body formation around the joint. Total ankle arthroplasty can preserve joint mobility and pain relieve for such patient. However, when trying to remove the osteophytes and loose bodies at the posterior ankle joint, there is risk of damaging posterior structures such as the neurovascular bundle during the procedure. We are presenting a case where the posterior loose bodies remained untouched during the operation, and patient showed spontaneous resolution of the lesions with time. Patient enjoyed good function outcome after the surgery. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  7. [Advances on biomechanics and kinematics of sprain of ankle joint].

    Science.gov (United States)

    Zhao, Yong; Wang, Gang

    2015-04-01

    Ankle sprains are orthopedic clinical common disease, accounting for joint ligament sprain of the first place. If treatment is not timely or appropriate, the joint pain and instability maybe develop, and even bone arthritis maybe develop. The mechanism of injury of ankle joint, anatomical basis has been fully study at present, and the diagnostic problem is very clear. Along with the development of science and technology, biological modeling and three-dimensional finite element, three-dimensional motion capture system,digital technology study, electromyographic signal study were used for the basic research of sprain of ankle. Biomechanical and kinematic study of ankle sprain has received adequate attention, combined with the mechanism research of ankle sprain,and to explore the the biomechanics and kinematics research progress of the sprain of ankle joint.

  8. Differences in kinematic control of ankle joint motions in people with chronic ankle instability.

    Science.gov (United States)

    Kipp, Kristof; Palmieri-Smith, Riann M

    2013-06-01

    People with chronic ankle instability display different ankle joint motions compared to healthy people. The purpose of this study was to investigate the strategies used to control ankle joint motions between a group of people with chronic ankle instability and a group of healthy, matched controls. Kinematic data were collected from 11 people with chronic ankle instability and 11 matched control subjects as they performed a single-leg land-and-cut maneuver. Three-dimensional ankle joint angles were calculated from 100 ms before, to 200 ms after landing. Kinematic control of the three rotational ankle joint degrees of freedom was investigated by simultaneously examining the three-dimensional co-variation of plantarflexion/dorsiflexion, toe-in/toe-out rotation, and inversion/eversion motions with principal component analysis. Group differences in the variance proportions of the first two principal components indicated that the angular co-variation between ankle joint motions was more linear in the control group, but more planar in the chronic ankle instability group. Frontal and transverse plane motions, in particular, contributed to the group differences in the linearity and planarity of angular co-variation. People with chronic ankle instability use a different kinematic control strategy to coordinate ankle joint motions during a single-leg landing task. Compared to the healthy group, the chronic ankle instability group's control strategy appeared to be more complex and involved joint-specific contributions that would tend to predispose this group to recurring episodes of instability. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Ankle taping can reduce external ankle joint moments during drop landings on a tilted surface.

    Science.gov (United States)

    Sato, Nahoko; Nunome, Hiroyuki; Hopper, Luke S; Ikegami, Yasuo

    2017-09-20

    Ankle taping is commonly used to prevent ankle sprains. However, kinematic assessments investigating the biomechanical effects of ankle taping have provided inconclusive results. This study aimed to determine the effect of ankle taping on the external ankle joint moments during a drop landing on a tilted surface at 25°. Twenty-five participants performed landings on a tilted force platform that caused ankle inversion with and without ankle taping. Landing kinematics were captured using a motion capture system. External ankle inversion moment, the angular impulse due to the medio-lateral and vertical components of ground reaction force (GRF) and their moment arm lengths about the ankle joint were analysed. The foot plantar inclination relative to the ground was assessed. In the taping condition, the foot plantar inclination and ankle inversion angular impulse were reduced significantly compared to that of the control. The only component of the external inversion moment to change significantly in the taped condition was a shortened medio-lateral GRF moment arm length. It can be assumed that the ankle taping altered the foot plantar inclination relative to the ground, thereby shortening the moment arm of medio-lateral GRF that resulted in the reduced ankle inversion angular impulse.

  10. Fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma

    International Nuclear Information System (INIS)

    Wu Jun; Zhang Qiang

    2003-01-01

    Objective: To evaluate the fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma. Methods: Measure fracture line index of fibular stalk and the ankle joint in 217 adult cases of fracture and dislocation of ankle joint. And the cases were classified by the results of the measurement. Results: Measurement was unavailable in 9 cases of tearing fracture. In 31 cases, the lesions could not be particularly classified. And in the rest 176 cases the trauma were precisely classified. The over all successful rate was 81.6%. Conclusion: Fracture line index of fibular stalk and the ankle joint bone are valuable in classification of the trauma of the angle joint. While the specificity of this method is low in differentiating the adducting and abducting fracture of the medial angle, in which a combined investigation is recommended

  11. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint... ankle joint. The device limits translation and rotation: in one or more planes via the geometry of its...

  12. The relation between geometry and function of the ankle joint complex: a biomechanical review.

    Science.gov (United States)

    Kleipool, Roeland P; Blankevoort, Leendert

    2010-05-01

    This review deals with the relation between the anatomy and function of the ankle joint complex. The questions addressed are how high do the forces in the ankle joint get, where can the joints go (range of motion) and where do they go during walking and running. Finally the role of the ligaments and the articular surfaces is discussed, i.e. how does it happen. The magnitude of the loads on the ankle joint complex are primarily determined by muscle activity and can be as high as four times the body weight during walking. For the maximal range of motion, plantar and dorsiflexion occurs in the talocrural joint and marginally at the subtalar joint. In-eversion takes place at both levels. The functional range of motion is well within the limits of the maximal range of motion. The ligaments do not contribute to the forces for the functional range of motion but determine the maximal range of motion together with the articular surfaces. The geometry of the articular surfaces primarily determines the kinematics. Clinical studies must include these anatomical aspects to better understand the mechanism of injury, recovery, and interventions. Models can elucidate the mechanism by which the anatomy relates to the function. The relation between the anatomy and mechanical properties of the joint structures and joint function should be considered for diagnosis and treatment of ankle joint pathology.

  13. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle...

  14. Subspace methods for identification of human ankle joint stiffness.

    Science.gov (United States)

    Zhao, Y; Westwick, D T; Kearney, R E

    2011-11-01

    Joint stiffness, the dynamic relationship between the angular position of a joint and the torque acting about it, describes the dynamic, mechanical behavior of a joint during posture and movement. Joint stiffness arises from both intrinsic and reflex mechanisms, but the torques due to these mechanisms cannot be measured separately experimentally, since they appear and change together. Therefore, the direct estimation of the intrinsic and reflex stiffnesses is difficult. In this paper, we present a new, two-step procedure to estimate the intrinsic and reflex components of ankle stiffness. In the first step, a discrete-time, subspace-based method is used to estimate a state-space model for overall stiffness from the measured overall torque and then predict the intrinsic and reflex torques. In the second step, continuous-time models for the intrinsic and reflex stiffnesses are estimated from the predicted intrinsic and reflex torques. Simulations and experimental results demonstrate that the algorithm estimates the intrinsic and reflex stiffnesses accurately. The new subspace-based algorithm has three advantages over previous algorithms: 1) It does not require iteration, and therefore, will always converge to an optimal solution; 2) it provides better estimates for data with high noise or short sample lengths; and 3) it provides much more accurate results for data acquired under the closed-loop conditions, that prevail when subjects interact with compliant loads.

  15. Changes in ankle joint motion after Supramalleolar osteotomy: a cadaveric model.

    Science.gov (United States)

    Kim, Hak Jun; Yeo, Eui Dong; Rhyu, Im Joo; Lee, Soon-Hyuck; Lee, Yeon Soo; Lee, Young Koo

    2017-09-09

    Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers. They were harvested from five males (10 ankles)whose average age was 70 years. We assessed the motion of ankle joint as well as plantar pressure for SS(supra-syndesmotic) SMO and IS(intra-syndesmotic) SMO. After the osteotomy, each specimen was subjected to axial compression from 20 N preload to 350 N representing half-body weight. For the measurement of the motion of ankle joint, the changes in gap and point, angles in ankle joint were measured. The plantar pressure were also recorded using TekScan sensors. The changes in the various gap, point, and angles movements on SS-SMO and IS-SMO showed no statistically significant differences between the two groups. Regarding the shift of plantar center of force (COF) were noted in the anterolateral direction, but not statistically significant. SS-SMO and IS-SMO with intact fibula showed similar biomechanical effect on the ankle joint. We propose that IS-SMO should be considered carefully for the treatment of osteoarthrosis when fibular osteotomy is not performed because lateral cortex fracture was less likely using the intrasyndesmosis plane because of soft tissue support.

  16. The adult ball-and-socket ankle joint: surgical management of late ankle and subtalar arthritis.

    Science.gov (United States)

    Lewis, John S; DeOrio, James K

    2015-04-01

    We review the surgical management of 4 adult patients with ball-and-socket ankle deformity who developed end-stage subtalar and/or ankle joint arthritis. We retrospectively reviewed a series of 4 adult patients with ball-and-socket ankle configurations who underwent surgical treatment for either end-stage tibiotalar or subtalar arthritis, with either subtalar arthrodesis or total ankle replacement (TAR). Clinical outcome, including subjective pain assessment, limitation of activities, and difficulty with shoe wear, were assessed at follow-up. A total of 5 ankles in 4 patients were identified that met the inclusion criteria. There were 3 subtalar arthrodeses in 2 patients and 2 primary TARs in 2 patients. At an average follow-up of 30.5 (range = 17 to 59) months, there were no failures, although 1 patient who underwent TAR was considered an impending failure with aseptic component loosening. Of the 4 patients, 3 resumed normal activity with minimal pain and were very pleased with their overall outcome. Standard surgical interventions for ankle and subtalar arthritis, such as total ankle arthroplasty and subtalar arthrodesis, can be successfully performed in patients with ball-and-socket ankles; clinical outcome and survivorship, however, may be inferior to that in patients with normal ankle configurations. Therapeutic, Level IV: Case Series. © 2014 The Author(s).

  17. Mechanical instability destabilises the ankle joint directly in the ankle-sprain mechanism.

    Science.gov (United States)

    Gehring, Dominic; Faschian, Katrin; Lauber, Benedikt; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain. Thus, the purpose of this study was to evaluate whether individuals with MAI have deficits in stabilising their ankle joint in a close-to-injury situation compared with those with FAI and healthy controls. Ankle-joint control was assessed by means of three-dimensional motion analysis and electromyography in participants with FAI and MAI (n=19), in participants with pure FAI (n=9) and in healthy controls (n=18). Close-to-injury situations were simulated during standing, walking and jumping by means of a custom-made tilt platform. Individuals with FAI and MAI displayed significantly greater maximum ankle inversion angles (+5°) and inversion velocities (+50°/s) in the walking and jumping conditions compared to those with pure FAI and controls. Furthermore, individuals in the FAI and MAI group showed a significantly decreased pre-activation of the peroneus longus muscle during jumping compared to those with FAI. No differences between groups were found for plantar flexion and internal rotation, or for muscle activities following tilting of the platform. The present study demonstrates that MAI is characterised by impairments of ankle-joint control in close-to-injury situations. This could make these individuals more prone to recurrent ankle sprains, and suggests the need for additional mechanical support such as braces or even surgery. In addition, the study highlights the fact that dynamic experimental test conditions in the acting participant are needed to further unravel the mystery of chronic ankle instability.

  18. Radiology of chronic diseases of the ankle joint

    International Nuclear Information System (INIS)

    Rand, T.; Trattnig, S.; Breitenseher, M.; Imhof, H.; Wagesreither, S.

    1999-01-01

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or

  19. Analysis of the Effects of Normal Walking on Ankle Joint Contact Characteristics After Acute Inversion Ankle Sprain.

    Science.gov (United States)

    Bae, Ji Yong; Park, Kyung Soon; Seon, Jong Keun; Jeon, Insu

    2015-12-01

    To show the causal relationship between normal walking after various lateral ankle ligament (LAL) injuries caused by acute inversion ankle sprains and alterations in ankle joint contact characteristics, finite element simulations of normal walking were carried out using an intact ankle joint model and LAL injury models. A walking experiment using a volunteer with a normal ankle joint was performed to obtain the boundary conditions for the simulations and to support the appropriateness of the simulation results. Contact pressure and strain on the talus articular cartilage and anteroposterior and mediolateral translations of the talus were calculated. Ankles with ruptured anterior talofibular ligaments (ATFLs) had a higher likelihood of experiencing increased ankle joint contact pressures, strains and translations than ATFL-deficient ankles. In particular, ankles with ruptured ATFL + calcaneofibular ligaments and all ruptured ankles had a similar likelihood as the ATFL-ruptured ankles. The push off stance phase was the most likely situation for increased ankle joint contact pressures, strains and translations in LAL-injured ankles.

  20. Acute injury of the ankle joint

    International Nuclear Information System (INIS)

    Breitenseher, M.J.

    1999-01-01

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments. In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic. (orig.) [de

  1. Comparison of custom-moulded ankle orthosis with hinged joints and off-the-shelf ankle braces in preventing ankle sprain in lateral cutting movements.

    Science.gov (United States)

    Lee, Winson C C; Kobayashi, Toshiki; Choy, Barton T S; Leung, Aaron K L

    2012-06-01

    A custom moulded ankle orthosis with hinged joints potentially offers a better control over the subtalar joint and the ankle joint during lateral cutting movements, due to total contact design and increase in material strength. To test the above hypothesis by comparing it to three other available orthoses. Repeated measures. Eight subjects with a history of ankle sprains (Grade 2), and 11 subjects without such history performed lateral cutting movements in four test conditions: 1) non-orthotic, 2) custom-moulded ankle orthosis with hinges, 3) Sport-Stirrup, and 4) elastic ankle sleeve with plastic support. A VICON motion analysis system was used to study the motions at the ankle and subtalar joints. The custom-moulded ankle orthosis significantly lowered the inversion angle at initial contact (p = 0.006) and the peak inversion angle (p = 0.000) during lateral cutting movements in comparison to non-orthotic condition, while the other two orthoses did not. The three orthoses did not affect the plantarflexion motions, which had been suggested by previous studies to be important in shock wave attenuation. The custom-moulded ankle orthosis with hinges could better control inversion and thus expected to better prevent ankle sprain in lateral cutting movements. Custom-moulded ankle orthoses are not commonly used in preventing ankle sprains. This study raises the awareness of the use of custom-moulded ankle orthoses which are expected to better prevent ankle sprains.

  2. Injury of the ankle joint ligaments

    International Nuclear Information System (INIS)

    Breitenseher, M.J.

    2007-01-01

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.) [de

  3. Design of a simple, lightweight, passive-elastic ankle exoskeleton supporting ankle joint stiffness

    Science.gov (United States)

    Kim, Seyoung; Son, Youngsu; Choi, Sangkyu; Ham, Sangyong; Park, Cheolhoon

    2015-09-01

    In this study, a passive-elastic ankle exoskeleton (PEAX) with a one-way clutch mechanism was developed and then pilot-tested with vertical jumping to determine whether the PEAX is sufficiently lightweight and comfortable to be used in further biomechanical studies. The PEAX was designed to supplement the function of the Achilles tendon and ligaments as they passively support the ankle torque with their inherent stiffness. The main frame of the PEAX consists of upper and lower parts connected to each other by tension springs (N = 3) and lubricated hinge joints. The upper part has an offset angle of 5° with respect to the vertical line when the springs are in their resting state. Each spring has a slack length of 8 cm and connects the upper part to the tailrod of the lower part in the neutral position. The tailrod freely rotates with low friction but has a limited range of motion due to the stop pin working as a one-way clutch. Because of the one-way clutch system, the tension springs store the elastic energy only due to an ankle dorsiflexion when triggered by the stop pin. This clutch mechanism also has the advantage of preventing any inconvenience during ankle plantarflexion because it does not limit the ankle joint motion during the plantarflexion phase. In pilot jumping tests, all of the subjects reported that the PEAX was comfortable for jumping due to its lightweight (approximately 1 kg) and compact (firmly integrated with shoes) design, and subjects were able to nearly reach their maximum vertical jump heights while wearing the PEAX. During the countermovement jump, elastic energy was stored during dorsiflexion by spring extension and released during plantarflexion by spring restoration, indicating that the passive spring torque (i.e., supportive torque) generated by the ankle exoskeleton partially supported the ankle joint torque throughout the process.

  4. Effect of Complete Syndesmotic Disruption and Deltoid Injuries and Different Reduction Methods on Ankle Joint Contact Mechanics.

    Science.gov (United States)

    LaMothe, Jeremy; Baxter, Josh R; Gilbert, Susannah; Murphy, Conor I; Karnovsky, Sydney C; Drakos, Mark C

    2017-06-01

    Syndesmotic injuries can be associated with poor patient outcomes and posttraumatic ankle arthritis, particularly in the case of malreduction. However, ankle joint contact mechanics following a syndesmotic injury and reduction remains poorly understood. The purpose of this study was to characterize the effects of a syndesmotic injury and reduction techniques on ankle joint contact mechanics in a biomechanical model. Ten cadaveric whole lower leg specimens with undisturbed proximal tibiofibular joints were prepared and tested in this study. Contact area, contact force, and peak contact pressure were measured in the ankle joint during simulated standing in the intact, injured, and 3 reduction conditions: screw fixation with a clamp, screw fixation without a clamp (thumb technique), and a suture-button construct. Differences in these ankle contact parameters were detected between conditions using repeated-measures analysis of variance. Syndesmotic disruption decreased tibial plafond contact area and force. Syndesmotic reduction did not restore ankle loading mechanics to values measured in the intact condition. Reduction with the thumb technique was able to restore significantly more joint contact area and force than the reduction clamp or suture-button construct. Syndesmotic disruption decreased joint contact area and force. Although the thumb technique performed significantly better than the reduction clamp and suture-button construct, syndesmotic reduction did not restore contact mechanics to intact levels. Decreased contact area and force with disruption imply that other structures are likely receiving more loads (eg, medial and lateral gutters), which may have clinical implications such as the development of posttraumatic arthritis.

  5. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain.

    Science.gov (United States)

    Ju, Sung-Bum; Park, Gi Duck

    2017-02-01

    [Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function.

  6. Arthrography of the ankle joint in chronic instability

    Energy Technology Data Exchange (ETDEWEB)

    Dory, M.A.

    1986-05-01

    Papers on arthrography of injuries of the lateral ligaments of the ankle relate mainly to recent distortion of the joint. Arthrography performed at a later stage after injury generally is considered useless. In fact, changes in chronic instability are observed; they are subtle and consist either of small recesses adjacent to the lateral malleolus or communication of the joint with the peroneal tendon sheaths. Arthrography was assessed in 61 cases of recurrent lateral sprains of the ankle more than 2 weeks after acute injury; 38 were considered as positive. Twenty-five patients had operative evaluation, with four false negative and one false positive results. Small recesses adjacent to the lateral malleolus or opacification of the peroneal tendon sheaths are sequelae of an acute sprain with tear of the anterior talofibular and/or the calcaneofibular ligaments. Although false negative results occur, arthrography is useful in the preoperative assessment of chronic ankle instability.

  7. Arthrography of the ankle joint in chronic instability

    International Nuclear Information System (INIS)

    Dory, M.A.

    1986-01-01

    Papers on arthrography of injuries of the lateral ligaments of the ankle relate mainly to recent distortion of the joint. Arthrography performed at a later stage after injury generally is considered useless. In fact, changes in chronic instability are observed; they are subtle and consist either of small recesses adjacent to the lateral malleolus or communication of the joint with the peroneal tendon sheaths. Arthrography was assessed in 61 cases of recurrent lateral sprains of the ankle more than 2 weeks after acute injury; 38 were considered as positive. Twenty-five patients had operative evaluation, with four false negative and one false positive results. Small recesses adjacent to the lateral malleolus or opacification of the peroneal tendon sheaths are sequelae of an acute sprain with tear of the anterior talofibular and/or the calcaneofibular ligaments. Although false negative results occur, arthrography is useful in the preoperative assessment of chronic ankle instability. (orig.)

  8. 21 CFR 888.3120 - Ankle joint metal/polymer non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/polymer non-constrained cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3120 Ankle joint metal/polymer non-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer non...

  9. Lubrication of the Human Ankle Joint in Walking

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2010-01-01

    Roč. 132, č. 1 (2010), s. 1-8 ISSN 0742-4787 R&D Projects: GA ČR(CZ) GA103/07/0043 Institutional research plan: CEZ:AV0Z20710524 Keywords : articular cartilage * human ankle joint * lubrication * walking Subject RIV: JJ - Other Materials Impact factor: 0.449, year: 2010

  10. Lubrication of the human ankle joint in running

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2009-01-01

    Roč. 3, č. 5 (2009), s. 619-626 ISSN 1970-8734 R&D Projects: GA ČR(CZ) GA103/07/0043 Institutional research plan: CEZ:AV0Z20710524 Keywords : human ankle joint * lubrication * running Subject RIV: JJ - Other Materials

  11. Computed tomography in complex fractures of the ankle joint

    International Nuclear Information System (INIS)

    Friedburg, H.; Wimmer, B.; Hendrich, V.; Riede, U.N.

    1983-01-01

    Diagnostic value of conventional roentgen technique and computed tomography is proofed by examination of 50 patients with sprain fractures of the ankle joint. The dimension of destruction of the distal tibial joint surface is better documented by CT than by other radiological techniques. Additional informations like multifragmentation of the distal tibia or evaluation of reposition impedigment are found more frequently by CT. Therefore indication and planning of the traumatherapy can be assessed better by the traumatologist. (orig.)

  12. Computed tomography in complex fractures of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

    Friedburg, H.; Wimmer, B.; Hendrich, V.; Riede, U.N.

    1983-09-01

    Diagnostic value of conventional roentgen technique and computed tomography is proofed by examination of 50 patients with sprain fractures of the ankle joint. The dimension of destruction of the distal tibial joint surface is better documented by CT than by other radiological techniques. Additional informations like multiframentation of the distal tibia or evaluation of reposition impediment are found more frequently by CT. Therefore indication and planning of the traumatherapy can be assessed better by the traumatologist.

  13. A three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses.

    Science.gov (United States)

    Fatone, Stefania; Johnson, William Brett; Tucker, Kerice

    2016-04-01

    Misalignment of an articulated ankle-foot orthosis joint axis with the anatomic joint axis may lead to discomfort, alterations in gait, and tissue damage. Theoretical, two-dimensional models describe the consequences of misalignments, but cannot capture the three-dimensional behavior of ankle-foot orthosis use. The purpose of this project was to develop a model to describe the effects of ankle-foot orthosis ankle joint misalignment in three dimensions. Computational simulation. Three-dimensional scans of a leg and ankle-foot orthosis were incorporated into a link segment model where the ankle-foot orthosis joint axis could be misaligned with the anatomic ankle joint axis. The leg/ankle-foot orthosis interface was modeled as a network of nodes connected by springs to estimate interface pressure. Motion between the leg and ankle-foot orthosis was calculated as the ankle joint moved through a gait cycle. While the three-dimensional model corroborated predictions of the previously published two-dimensional model that misalignments in the anterior -posterior direction would result in greater relative motion compared to misalignments in the proximal -distal direction, it provided greater insight showing that misalignments have asymmetrical effects. The three-dimensional model has been incorporated into a freely available computer program to assist others in understanding the consequences of joint misalignments. Models and simulations can be used to gain insight into functioning of systems of interest. We have developed a three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses. The model has been incorporated into a freely available computer program to assist understanding of trainees and others interested in orthotics. © The International Society for Prosthetics and Orthotics 2014.

  14. Effect of kinesio-taping on ankle joint stability

    Directory of Open Access Journals (Sweden)

    Mervat A. Mohamed

    2016-05-01

    Full Text Available Ankle Instability is characterized by recurrent giving way and often develops after repeated lateral ankle sprains. Kinesiotape is more elastic than traditional athletic tape and is becoming increasingly popular. It is reported to decrease pain, improve muscle function, circulation and proprioception, however, research examining the effects of Kinesiotape in ankle instability is limited. The objective of this study was to determine if applying Kinesiotape to unstable ankle may improve performance in the Star Excursion Balance Test (SEBT, which has been shown to be a sensitive and reliable measure for quantifying dynamic balance. Thirty subjects with first degree ankle sprain were participated in this study. SEBT was used to test the subject dynamic balance under three conditions; without taping, with white athletic tape and with kinesiotape. One way repeated measure ANOVA using Greenhouse-Geisser corrections were conducted to evaluate differences in SEBT for the three conditions. Pairwise comparison of the outcome measures in the three occasions (without taping, with athletic taping, and with kinesio taping revealed statistically significant differences of all outcomes between occasion 1 (without taping and occasion 2 (with athletic taping favoring the athletic taping (p < 0.05. Also, a statistically significant difference between occasion 1 (without taping and occasion 3 (with kinesio taping were found (p < 0.05 favoring kinesio taping. Moreover, pairwise comparison of the ankle stability outcomes using athletic taping versus kinesio taping indicated a statistically significant difference (p < 0.05 in favor of kinesio taping measures. Conclusion: kinesiotape has superior effect than athletic tape in patients with first degree ankle sprain and can be used safely for improving ankle joint stability.

  15. Preventive lateral ligament tester (PLLT): a novel method to evaluate mechanical properties of lateral ankle joint ligaments in the intact ankle.

    Science.gov (United States)

    Best, Raymond; Böhle, Caroline; Mauch, Frieder; Brüggemann, Peter G

    2016-04-01

    To construct and evaluate an ankle arthrometer that registers inversion joint deflection at standardized inversion loads and that, moreover, allows conclusions about the mechanical strain of intact ankle joint ligaments at these loads. Twelve healthy ankles and 12 lower limb cadaver specimens were tested in a self-developed measuring device monitoring passive ankle inversion movement (Inv-ROM) at standardized application of inversion loads of 5, 10 and 15 N. To adjust in vivo and in vitro conditions, the muscular inactivity of the evertor muscles was assured by EMG in vivo. Preliminary, test-retest and trial-to-trial reliabilities were tested in vivo. To detect lateral ligament strain, the cadaveric calcaneofibular ligament was instrumented with a buckle transducer. After post-test harvesting of the ligament with its bony attachments, previously obtained resistance strain gauge results were then transferred to tensile loads, mounting the specimens with their buckle transducers into a hydraulic material testing machine. ICC reliability considering the Inv-ROM and torsional stiffness varied between 0.80 and 0.90. Inv-ROM ranged from 15.3° (±7.3°) at 5 N to 28.3° (±7.6) at 15 N. The different tests revealed a CFL tensile load of 31.9 (±14.0) N at 5 N, 51.0 (±15.8) at 10 N and 75.4 (±21.3) N at 15 N inversion load. A highly reliable arthrometer was constructed allowing not only the accurate detection of passive joint deflections at standardized inversion loads but also reveals some objective conclusions of the intact CFL properties in correlation with the individual inversion deflections. The detection of individual joint deflections at predefined loads in correlation with the knowledge of tensile ligament loads in the future could enable more individual preventive measures, e.g., in high-level athletes.

  16. Application of low field intensity joint MRI in ankle injury

    International Nuclear Information System (INIS)

    Zhang Zhenyu; Wang Wei

    2011-01-01

    Objective: To observe the diagnostic value of the low field intensity joint magnetic resonance imaging (MRI) in traumatic ankles. Methods: Through a retrospective examination and collection of 50 cases with complete information and checked by arthroscope or/and operated from Jan 2007 to Jun 2010, the diagnostic value ligament of the ankle joint, bone contusion,occult fracture, talus cartilage, and tendon could be evaluated. Cases of fracture for which could be diagnosed by X rays and CT were not included in this research. Results: The special low field intensity joint MRI had a high diagnostic sensitivity of 88.9% to ligamentum talofibulare anterius, but was only 50% sensitive to ligamentum calcaneofibulare. Its sensitivity to injury of ligamentum deltoideum and distal tibiofibular syndesmosis was up to 100%. Tendon injury, bone contusion and occult fracture could be exactly diagnosed. Its total sensitivity on talus cartilage traumatism was 70.6%. Its diagnosis sensitivity to talus cartilage traumatism at the 3rd-5th period by Mintz was 90%, with a lower one of 42.9% at the 1st-2nd period. Talus cartilage traumatism could be exactly predicted by osseous tissue dropsy below cartilage. Conclusion: The special low field intensity joint MRI is highly applicable to the diagnosis on ankle joint traumatism and facilitates clinical treatment. (authors)

  17. Long-term neuromuscular training and ankle joint position sense.

    Science.gov (United States)

    Kynsburg, A; Pánics, G; Halasi, T

    2010-06-01

    Preventive effect of proprioceptive training is proven by decreasing injury incidence, but its proprioceptive mechanism is not. Major hypothesis: the training has a positive long-term effect on ankle joint position sense in athletes of a high-risk sport (handball). Ten elite-level female handball-players represented the intervention group (training-group), 10 healthy athletes of other sports formed the control-group. Proprioceptive training was incorporated into the regular training regimen of the training-group. Ankle joint position sense function was measured with the "slope-box" test, first described by Robbins et al. Testing was performed one day before the intervention and 20 months later. Mean absolute estimate errors were processed for statistical analysis. Proprioceptive sensory function improved regarding all four directions with a high significance (pneuromuscular training has improved ankle joint position sense function in the investigated athletes. This joint position sense improvement can be one of the explanations for injury rate reduction effect of neuromuscular training.

  18. Altered neuromuscular control and ankle joint kinematics during walking in subjects with functional instability of the ankle joint.

    Science.gov (United States)

    Delahunt, Eamonn; Monaghan, Kenneth; Caulfield, Brian

    2006-12-01

    The ankle joint requires very precise neuromuscular control during the transition from terminal swing to the early stance phase of the gait cycle. Altered ankle joint arthrokinematics and muscular activity have been cited as potential factors that may lead to an inversion sprain during the aforementioned time periods. However, to date, no study has investigated patterns of muscle activity and 3D joint kinematics simultaneously in a group of subjects with functional instability compared with a noninjured control group during these phases of the gait cycle. To compare the patterns of lower limb 3D joint kinematics and electromyographic activity during treadmill walking in a group of subjects with functional instability with those observed in a control group. Controlled laboratory study. Three-dimensional angular velocities and displacements of the hip, knee, and ankle joints, as well as surface electromyography of the rectus femoris, peroneus longus, tibialis anterior, and soleus muscles, were recorded simultaneously while subjects walked on a treadmill at a velocity of 4 km/h. Before heel strike, subjects with functional instability exhibited a decrease in vertical foot-floor clearance (12.62 vs 22.84 mm; P joint before, at, and immediately after heel strike (1.69 degrees , 2.10 degrees , and -0.09 degrees vs -1.43 degrees , -1.43 degrees , and -2.78 degrees , respectively [minus value = eversion]; P < .05) compared with controls. Subjects with functional instability were also observed to have an increase in peroneus longus integral electromyography during the post-heel strike time period (107.91%.millisecond vs 64.53%.millisecond; P < .01). The altered kinematics observed in this study could explain the reason subjects with functional instability experience repeated episodes of ankle inversion injury in situations with only slight or no external provocation. It is hypothesized that the observed increase in peroneus longus activity may be the result of a change in

  19. Biomechanics of the natural, arthritic, and replaced human ankle joint

    Science.gov (United States)

    2014-01-01

    The human ankle joint complex plays a fundamental role in gait and other activities of daily living. At the same time, it is a very complicated anatomical system but the large literature of experimental and modelling studies has not fully described the coupled joint motion, position and orientation of the joint axis of rotation, stress and strain in the ligaments and their role in guiding and stabilizing joint motion, conformity and congruence of the articular surfaces, patterns of contact at the articular surfaces, patterns of rolling and sliding at the joint surfaces, and muscle lever arm lengths. The present review article addresses these issues as described in the literature, reporting the most recent relevant findings. PMID:24499639

  20. [Conservative therapy of cartilage defects of the upper ankle joint].

    Science.gov (United States)

    Smolenski, U C; Best, N; Bocker, B

    2008-03-01

    Cartilage defects of the upper ankle joint reflect the problem that great force is transmitted and balanced out over a relatively small surface area. As a pathophysiological factor, cartilage-bone contusions play a significant role in the development of cartilage defects of the upper ankle joint. Physiotherapeutic procedures belong to the standard procedures of conservative therapy. The use and selection of the type of therapy is based on empirical considerations and experience and investigations on effectiveness of particular therapies are relatively rare. At present a symptom-oriented therapy of cartilage defects of the upper ankle joint seems to be the most sensible approach. It can be assumed that it makes sense that the symptomatic treatment of cartilage defects or initial stages of arthritis also includes the subsequent symptoms of pain, irritated condition and limited function. This leads to starting points for physiotherapy with respect to pain therapy, optimisation of pressure relationships, avoidance of pressure points, improvement of diffusion and pressure release. In addition to the differential physiotherapeutic findings, the determination of a curative, preventive or rehabilitative procedure is especially important. In physical therapy special importance is placed on a scheduled serial application corresponding to the findings, employing the necessary methods, such as physiotherapy, sport therapy, medical mechanics, manual therapy, massage, electrotherapy and warmth therapy. From this the findings-related therapy is proposed as a practical therapy concept: locomotive apparatus pain therapy, optimisation of pressure relationships, improvement of diffusion and decongestion therapy. Therapy options have been selected base on the current literature and are summarised in tabular form. The art of symptomatic therapy of cartilage defects of the upper ankle joint does not lie in the multitude of sometimes speculative procedures, but in the targeted selection

  1. Influence of Passive Joint Stiffness on Proprioceptive Acuity in Individuals With Functional Instability of the Ankle.

    Science.gov (United States)

    Marinho, Hellen Veloso Rocha; Amaral, Giovanna Mendes; de Souza Moreira, Bruno; Araújo, Vanessa Lara; Souza, Thales Rezende; Ocarino, Juliana Melo; da Fonseca, Sérgio Teixeira

    2017-12-01

    Study Design Controlled laboratory study, cross-sectional. Background Deficits in ankle proprioceptive acuity have been reported in persons with functional instability of the ankle. Passive stiffness has been proposed as a possible mechanism underlying proprioceptive acuity. Objective To compare proprioceptive acuity and passive ankle stiffness in persons with and without functional ankle instability, and to assess the influence of passive joint stiffness on proprioceptive acuity in persons with functional ankle instability. Methods A sample of 18 subjects with and 18 without complaints of functional ankle instability following lateral ankle sprain participated. An isokinetic dynamometer was used to compare motion perception threshold, passive position sense, and passive ankle stiffness between groups. To evaluate the influence of passive stiffness on proprioceptive acuity, individuals in the lateral functional ankle instability group were divided into 2 subgroups: "high" and "low" passive ankle stiffness. Results The functional ankle instability group exhibited increased motion perception threshold when compared with the corresponding limb of the control group. Between-group differences were not found for passive position sense and passive ankle stiffness. Those in the functional ankle instability group with higher passive ankle stiffness had smaller motion perception thresholds than those with lower passive ankle stiffness. Conclusion Unlike motion perception threshold, passive position sense is not affected by the presence of functional ankle instability. Passive ankle stiffness appears to influence proprioceptive acuity in persons with functional ankle instability. J Orthop Sports Phys Ther 2017;47(12):899-905. Epub 7 Oct 2017. doi:10.2519/jospt.2017.7030.

  2. Ankle and subtalar synovitis in a ball-and-socket ankle joint causing posterolateral painful coarse crepitus: a case report.

    Science.gov (United States)

    Fan, Ka Yuk; Lui, Tun Hing

    2014-01-01

    A 17-year-old girl with bilateral ball-and-socket ankles reported left medial heel pain. Her left heel had gone into a varus position on tiptoeing, and a painful clunk had occurred when returning to normal standing. The clunk persisted after physiotherapy and treatment with an orthosis. Subtalar arthroscopy and peroneal tendoscopy showed mild diffuse synovitis of the ankle joint, especially over the posterior capsule, and a patch of inflamed and fibrotic synovium at the posterolateral corner of the subtalar joint. The clunk subsided immediately after arthroscopic synovectomy and had not recurred during 5 years of follow-up. We found no other reported cases of ankle and subtalar synovitis occurring in patients with a ball-and-socket ankle joint. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Comparison of Joint Loading in Badminton Lunging between Professional and Amateur Badminton Players

    Science.gov (United States)

    Fu, Lin

    2017-01-01

    The knee and ankle are the two most injured joints associated with the sport of badminton. This study evaluates biomechanical factors between professional and amateur badminton players using an injury mechanism model. The aim of this study was to investigate the kinematic motion and kinetic loading differences of the right knee and ankle while performing a maximal right lunge. Amateur players exhibited greater ankle range of motion (p badminton players presented a greater knee joint moment in the sagittal (p badminton players should account for these findings to reduce potential injury to the ankle and knee. PMID:28694684

  4. Ankle joint pressure changes in a pes cavovarus model: supramalleolar valgus osteotomy versus lateralizing calcaneal osteotomy.

    Science.gov (United States)

    Schmid, Timo; Zurbriggen, Sebastian; Zderic, Ivan; Gueorguiev, Boyko; Weber, Martin; Krause, Fabian G

    2013-09-01

    A fixed cavovarus foot deformity can be associated with anteromedial ankle arthrosis due to elevated medial joint contact stresses. Supramalleolar valgus osteotomies (SMOT) and lateralizing calcaneal osteotomies (LCOT) are commonly used to treat symptoms by redistributing joint contact forces. In a cavovarus model, the effects of SMOT and LCOT on the lateralization of the center of force (COF) and reduction of the peak pressure in the ankle joint were compared. A previously published cavovarus model with fixed hindfoot varus was simulated in 10 cadaver specimens. Closing wedge supramalleolar valgus osteotomies 3 cm above the ankle joint level (6 and 11 degrees) and lateral sliding calcaneal osteotomies (5 and 10 mm displacement) were analyzed at 300 N axial static load (half body weight). The COF migration and peak pressure decrease in the ankle were recorded using high-resolution TekScan pressure sensors. A significant lateral COF shift was observed for each osteotomy: 2.1 mm for the 6 degrees (P = .014) and 2.3 mm for the 11 degrees SMOT (P = .010). The 5 mm LCOT led to a lateral shift of 2.0 mm (P = .042) and the 10 mm LCOT to a shift of 3.0 mm (P = .006). Comparing the different osteotomies among themselves no significant differences were recorded. No significant anteroposterior COF shift was seen. A significant peak pressure reduction was recorded for each osteotomy: The SMOT led to a reduction of 29% (P = .033) for the 6 degrees and 47% (P = .003) for the 11 degrees osteotomy, and the LCOT to a reduction of 41% (P = .003) for the 5 mm and 49% (P = .002) for the 10 mm osteotomy. Similar to the COF lateralization no significant differences between the osteotomies were seen. LCOT and SMOT significantly reduced anteromedial ankle joint contact stresses in this cavovarus model. The unloading effects of both osteotomies were equivalent. More correction did not lead to significantly more lateralization of the COF or more reduction of peak pressure but a trend was

  5. Functional ankle instability as a risk factor for osteoarthritis: using T2-mapping to analyze early cartilage degeneration in the ankle joint of young athletes.

    Science.gov (United States)

    Golditz, T; Steib, S; Pfeifer, K; Uder, M; Gelse, K; Janka, R; Hennig, F F; Welsch, G H

    2014-10-01

    The aim of this study was to investigate, using T2-mapping, the impact of functional instability in the ankle joint on the development of early cartilage damage. Ethical approval for this study was provided. Thirty-six volunteers from the university sports program were divided into three groups according to their ankle status: functional ankle instability (FAI, initial ankle sprain with residual instability); ankle sprain Copers (initial sprain, without residual instability); and controls (without a history of ankle injuries). Quantitative T2-mapping magnetic resonance imaging (MRI) was performed at the beginning ('early-unloading') and at the end ('late-unloading') of the MR-examination, with a mean time span of 27 min. Zonal region-of-interest T2-mapping was performed on the talar and tibial cartilage in the deep and superficial layers. The inter-group comparisons of T2-values were analyzed using paired and unpaired t-tests. Statistical analysis of variance was performed. T2-values showed significant to highly significant differences in 11 of 12 regions throughout the groups. In early-unloading, the FAI-group showed a significant increase in quantitative T2-values in the medial, talar regions (P = 0.008, P = 0.027), whereas the Coper-group showed this enhancement in the central-lateral regions (P = 0.05). Especially the comparison of early-loading to late-unloading values revealed significantly decreasing T2-values over time laterally and significantly increasing T2-values medially in the FAI-group, which were not present in the Coper- or control-group. Functional instability causes unbalanced loading in the ankle joint, resulting in cartilage alterations as assessed by quantitative T2-mapping. This approach can visualize and localize early cartilage abnormalities, possibly enabling specific treatment options to prevent osteoarthritis in young athletes. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  6. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  7. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report.

    Science.gov (United States)

    O'Driscoll, Jeremiah; Kerin, Fearghal; Delahunt, Eamonn

    2011-06-09

    Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  8. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  9. The effect of kineziotape on ankle joint in patients with cerebrovascular accident - objectivisation by a footscan

    OpenAIRE

    Veličková, Barbora

    2013-01-01

    BACHELOR THESIS ABSTRACT Name and surname: Barbora Veličková Supervisor: Bc. Tereza Chalupská Opponent: Title: The effect of kineziotape on ankle joint in patients with cerebrovascular accident - objectivisation by a footscan Key words: kineziotaping, ankle joint, cerebrovascular accident, Footscan® Abstract: This bachelor thesis is focused on on the effect of kineziotape on ankle joint in patients with cerebrovascular accident. The bachelor thesis consists of theoretical and practical part. ...

  10. [Arthroscopy-guided fracture management. Ankle joint and calcaneus].

    Science.gov (United States)

    Schoepp, C; Rixen, D

    2013-04-01

    Arthroscopic fracture management of the ankle and calcaneus requires a differentiated approach. The aim is to minimize surgical soft tissue damage and to visualize anatomical fracture reduction arthroscopically. Moreover, additional cartilage damage can be detected and treated. The arthroscopic approach is limited by deep impressions of the joint surface needing cancellous bone grafting, by multiple fracture lines on the articular side and by high-grade soft tissue damage. An alternative to the minimally invasive arthroscopic approach is open arthroscopic reduction in conventional osteosynthesis. This facilitates correct assessment of surgical reduction of complex calcaneal fractures, otherwise remaining non-anatomical reduction might not be fluoroscopically detected during surgery.

  11. The effects of total ankle replacement on ankle joint mechanics during walking

    Directory of Open Access Journals (Sweden)

    Henry Wang

    2017-09-01

    Conclusion: Three months after surgeries, the STAA patients experienced improvements in ankle function and gait parameters. The STAA ankle demonstrated improved ankle mechanics during daily activities such as walking.

  12. Lower limb joint kinetics and ankle joint stiffness in the sprint start push-off.

    Science.gov (United States)

    Charalambous, Laura; Irwin, Gareth; Bezodis, Ian N; Kerwin, David

    2012-01-01

    Sprint push-off technique is fundamental to sprint performance and joint stiffness has been identified as a performance-related variable during dynamic movements. However, joint stiffness for the push-off and its relationship with performance (times and velocities) has not been reported. The aim of this study was to quantify and explain lower limb net joint moments and mechanical powers, and ankle stiffness during the first stance phase of the push-off. One elite sprinter performed 10 maximal sprint starts. An automatic motion analysis system (CODA, 200 Hz) with synchronized force plates (Kistler, 1000 Hz) collected kinematic profiles at the hip, knee, and ankle and ground reaction forces, providing input for inverse dynamics analyses. The lower-limb joints predominately extended and revealed a proximal-to-distal sequential pattern of maximal extensor angular velocity and positive power production. Pearson correlations revealed relationships (P push-off in different ways, depending on the phase of stance considered.

  13. Plantar impact causing midfoot fractures result in higher forces in Chopart's joint than in the ankle joint.

    Science.gov (United States)

    Richter, M; Wippermann, B; Thermann, H; Schroeder, G; Otte, D; Troeger, H D; Krettek, C

    2002-03-01

    Force effect (impact, extent of foot compartment deformation) and result (fracture pattern) for midfoot fractures in car occupants is known. An analysis of the processes in the foot was intended to improve car safety. Eleven fresh, unfrozen, unpreserved intact human cadavers (age: 36.8 (16-61) years, gender: male, race: Caucasian) were studied 24-72 h after death. In 3 cadavers (5 feet) the experimental design was established: entire cadaver fixed on a special tray in supine position, pendulum with bar impactor hitting the foot plantar to Lisfranc's joint. A custom-made pressure sensor was inserted in the ankle (A), talonavicular (TN) and calcaneocuboid (CC) joints (resolution: 1 cm2, sampling rate: 500/s). Sixteen feet were measured: midfoot fractures were induced in 11 feet. The maximum pressure amounted to 1.22-2.55 MPa (2.04+/-0.412) at 0.005 0.195 s (0.067+/-0.059) after impact. The maximum pressure occurred in 8 (50%) cases in the ankle, in 7 (44%) of the TN and 1 (6%) of the CC joints. A comparison of the first 200 pressure samples after impact of all sensor fields resulted in higher forces in Chopart's joint than in the ankle (t-test: p < 0.001). These force differences were higher in cases with midfoot fractures (mixed model analysis of variance: p = 0.003). Due to considerable forces in Chopart's joint we recommend a modification of the actual crash test dummy lower extremity model with an additional load cell that detects forces in the longitudinal direction of the foot axis.

  14. Lower extremity joint coupling variability during gait in young adults with and without chronic ankle instability.

    Science.gov (United States)

    Lilley, Thomas; Herb, Christopher C; Hart, Joseph; Hertel, Jay

    2018-06-01

    Chronic ankle instability (CAI) is a condition resulting from a lateral ankle sprain. Shank-rearfoot joint-coupling variability differences have been found in CAI patients; however, joint-coupling variability (VCV) of the ankle and proximal joints has not been explored. Our purpose was to analyse VCV in adults with and without CAI during gait. Four joint-coupling pairs were analysed: knee sagittal-ankle sagittal, knee sagittal-ankle frontal, hip frontal-ankle sagittal and hip frontal-ankle frontal. Twenty-seven adults participated (CAI:n = 13, Control:n = 14). Lower extremity kinematics were collected during walking (4.83 km/h) and jogging (9.66 km/h). Vector-coding was used to assess the stride-to-stride variability of four coupling pairs. During walking, CAI patients exhibited higher VCV than healthy controls for knee sagittal-ankle frontal in latter parts of stance thru mid-swing. When jogging, CAI patients demonstrated lower VCV with specific differences occurring across various intervals of gait. The increased knee sagittal-ankle frontal VCV in CAI patients during walking may indicate an adaptation to deal with the previously identified decrease in variability in transverse plane shank and frontal plane rearfoot coupling during walking; while the decreased ankle-knee and ankle-hip VCV identified in CAI patients during jogging may represent a more rigid, less adaptable sensorimotor system ambulating at a faster speed.

  15. A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco

    2016-01-01

    Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important.

  16. Association of Gastrocnemius Muscle Stiffness With Passive Ankle Joint Stiffness and Sex-Related Difference in the Joint Stiffness.

    Science.gov (United States)

    Chino, Kintaro; Takashi, Hideyuki

    2017-11-15

    Passive ankle joint stiffness is affected by all structures located within and over the joint, and is greater in men than in women. Localized muscle stiffness can be assessed by ultrasound shear wave elastography, and muscle architecture such as fascicle length and pennation angle can be measured by B-mode ultrasonography. Thus, we assessed localized muscle stiffness of the medial gastrocnemius (MG) with consideration of individual variability in the muscle architecture, and examined the association of the muscle stiffness with passive ankle joint stiffness and the sex-related difference in the joint stiffness. Localized muscle stiffness of the MG in 16 men and 17 women was assessed at 10° and 20° plantar flexion, neutral anatomical position, 10° and 20° dorsiflexion. Fascicle length and pennation angle of the MG were measured at these joint positions. Passive ankle joint stiffness was determined by the ankle joint angle-torque relationship. Localized MG muscle stiffness was not significantly correlated with passive ankle joint stiffness, and did not show significant sex-related difference, even when considering the muscle architecture. This finding suggest that muscle stiffness of the MG would not be a prominent factor to determine passive ankle joint stiffness and the sex-related difference in the joint stiffness.

  17. Model-Based Estimation of Ankle Joint Stiffness

    Directory of Open Access Journals (Sweden)

    Berno J. E. Misgeld

    2017-03-01

    Full Text Available We address the estimation of biomechanical parameters with wearable measurement technologies. In particular, we focus on the estimation of sagittal plane ankle joint stiffness in dorsiflexion/plantar flexion. For this estimation, a novel nonlinear biomechanical model of the lower leg was formulated that is driven by electromyographic signals. The model incorporates a two-dimensional kinematic description in the sagittal plane for the calculation of muscle lever arms and torques. To reduce estimation errors due to model uncertainties, a filtering algorithm is necessary that employs segmental orientation sensor measurements. Because of the model’s inherent nonlinearities and nonsmooth dynamics, a square-root cubature Kalman filter was developed. The performance of the novel estimation approach was evaluated in silico and in an experimental procedure. The experimental study was conducted with body-worn sensors and a test-bench that was specifically designed to obtain reference angle and torque measurements for a single joint. Results show that the filter is able to reconstruct joint angle positions, velocities and torque, as well as, joint stiffness during experimental test bench movements.

  18. Model-Based Estimation of Ankle Joint Stiffness.

    Science.gov (United States)

    Misgeld, Berno J E; Zhang, Tony; Lüken, Markus J; Leonhardt, Steffen

    2017-03-29

    We address the estimation of biomechanical parameters with wearable measurement technologies. In particular, we focus on the estimation of sagittal plane ankle joint stiffness in dorsiflexion/plantar flexion. For this estimation, a novel nonlinear biomechanical model of the lower leg was formulated that is driven by electromyographic signals. The model incorporates a two-dimensional kinematic description in the sagittal plane for the calculation of muscle lever arms and torques. To reduce estimation errors due to model uncertainties, a filtering algorithm is necessary that employs segmental orientation sensor measurements. Because of the model's inherent nonlinearities and nonsmooth dynamics, a square-root cubature Kalman filter was developed. The performance of the novel estimation approach was evaluated in silico and in an experimental procedure. The experimental study was conducted with body-worn sensors and a test-bench that was specifically designed to obtain reference angle and torque measurements for a single joint. Results show that the filter is able to reconstruct joint angle positions, velocities and torque, as well as, joint stiffness during experimental test bench movements.

  19. Model-Based Estimation of Ankle Joint Stiffness

    Science.gov (United States)

    Misgeld, Berno J. E.; Zhang, Tony; Lüken, Markus J.; Leonhardt, Steffen

    2017-01-01

    We address the estimation of biomechanical parameters with wearable measurement technologies. In particular, we focus on the estimation of sagittal plane ankle joint stiffness in dorsiflexion/plantar flexion. For this estimation, a novel nonlinear biomechanical model of the lower leg was formulated that is driven by electromyographic signals. The model incorporates a two-dimensional kinematic description in the sagittal plane for the calculation of muscle lever arms and torques. To reduce estimation errors due to model uncertainties, a filtering algorithm is necessary that employs segmental orientation sensor measurements. Because of the model’s inherent nonlinearities and nonsmooth dynamics, a square-root cubature Kalman filter was developed. The performance of the novel estimation approach was evaluated in silico and in an experimental procedure. The experimental study was conducted with body-worn sensors and a test-bench that was specifically designed to obtain reference angle and torque measurements for a single joint. Results show that the filter is able to reconstruct joint angle positions, velocities and torque, as well as, joint stiffness during experimental test bench movements. PMID:28353683

  20. Comparison of Joint Loading in Badminton Lunging between Professional and Amateur Badminton Players

    OpenAIRE

    Fu, Lin; Ren, Feng; Baker, Julien S.

    2017-01-01

    The knee and ankle are the two most injured joints associated with the sport of badminton. This study evaluates biomechanical factors between professional and amateur badminton players using an injury mechanism model. The aim of this study was to investigate the kinematic motion and kinetic loading differences of the right knee and ankle while performing a maximal right lunge. Amateur players exhibited greater ankle range of motion (p < 0.05, r = 0.89) and inversion joint moment (p < 0.05, r ...

  1. Effect of an ankle-foot orthosis on knee joint mechanics: a novel conservative treatment for knee osteoarthritis.

    Science.gov (United States)

    Fantini Pagani, Cynthia H; Willwacher, Steffen; Benker, Rita; Brüggemann, Gert-Peter

    2014-12-01

    Several conservative treatments for medial knee osteoarthritis such as knee orthosis and laterally wedged insoles have been shown to reduce the load in the medial knee compartment. However, those treatments also present limitations such as patient compliance and inconsistent results regarding the treatment success. To analyze the effect of an ankle-foot orthosis on the knee adduction moment and knee joint alignment in the frontal plane in subjects with knee varus alignment. Controlled laboratory study, repeated measurements. In total, 14 healthy subjects with knee varus alignment were analyzed in five different conditions: without orthotic, with laterally wedged insoles, and with an ankle-foot orthosis in three different adjustments. Three-dimensional kinetic and kinematic data were collected during gait analysis. Significant decreases in knee adduction moment, knee lever arm, and joint alignment in the frontal plane were observed with the ankle-foot orthosis in all three different adjustments. No significant differences could be found in any parameter while using the laterally wedged insoles. The ankle-foot orthosis was effective in reducing the knee adduction moment. The decreases in this parameter seem to be achieved by changing the knee joint alignment and thereby reducing the knee lever arm in the frontal plane. This study presents a novel approach for reducing the load in the medial knee compartment, which could be developed as a new treatment option for patients with medial knee osteoarthritis. © The International Society for Prosthetics and Orthotics 2013.

  2. Septic arthritis of the adult ankle joint secondary to Salmonella enteritidis: a case report.

    LENUS (Irish Health Repository)

    Munigangaiah, Sudarshan

    2011-09-01

    Salmonella septic arthritis in healthy individuals is a rare phenomenon. However, septic arthritis of the native adult ankle joint in healthy patients has not been previously described in the published data. This is a case report of a 70-year-old farmer who presented with a 2-week history of a painful, swollen right ankle and an inability to bear weight. He had no history of ankle injury or any predisposing conditions. Joint aspirations were positive for Salmonella enteritidis that was successfully treated with right ankle arthrotomy and washout, along with a 6-week course of intravenous antibiotic therapy.

  3. Roentgenofunctional investigation of the ankle joint in a long-term period after crural bone fracture

    International Nuclear Information System (INIS)

    Ignat'ev, Yu.T.; Novikov, V.P.

    1989-01-01

    On the basis of the results of clinicoroentgenological and tensographic investigations of 119 patients after traumas of the crural bones and ankle joint (2-36 yrs. ago) the authors showed the importance of roentgenofunctional investigation of the ankle joint. A specially designed footing was proposed. Of 77 patients after intra-articular fractures of the ankle bones various disorders in articular proportions, undetectable on routine roengenography, were diagnosed in 29 by functional roentgenography. Articular changes on roentgenofunctional investigation were revealed in one patient only out of 42 patients with extra-articular fractures of the crural bones. Tensography showed disorders of foot biomechanics in all patients with subluxations in the ankle

  4. The effects of load on system and lower-body joint kinetics during jump squats.

    Science.gov (United States)

    Moir, Gavin L; Gollie, Jared M; Davis, Shala E; Guers, John J; Witmer, Chad A

    2012-11-01

    To investigate the effects of different loads on system and lower-body kinetics during jump squats, 12 resistance-trained men performed jumps under different loading conditions: 0%, 12%, 27%, 42%, 56%, 71%, and 85% of 1-repetition maximum (1-RM). System power output was calculated as the product of the vertical component of the ground reaction force and the vertical velocity of the bar during its ascent. Joint power output was calculated during bar ascent for the hip, knee, and ankle joints, and was also summed across the joints. System power output and joint power at knee and ankle joints were maximized at 0% 1-RM (p < 0.001) and followed the linear trends (p < 0.001) caused by power output decreasing as the load increased. Power output at the hip was maximized at 42% 1-RM (p = 0.016) and followed a quadratic trend (p = 0.030). Summed joint power could be predicted from system power (p < 0.05), while system power could predict power at the knee and ankle joints under some of the loading conditions. Power at the hip could not be predicted from system power. System power during loaded jumps reflects the power at the knee and ankle, while power at the hip does not correspond to system power.

  5. Full Scale 3D Preoperative Planning System of the Ankle Joint Replacement Surgery with Multimedia System

    Directory of Open Access Journals (Sweden)

    Shuh-Ping Sun

    2014-05-01

    Full Text Available This study is intended to develop a computer-aided pre-surgical planning and simulating system in a multimedia environment for ankle joint replacement surgery. This system uses full-scale 3D reverse engineering techniques in design and development of the pre-surgical planning modules for ankle joint replacement surgery. This planning system not only develops the real-scale 3D image of the artificial ankle joint but also provides a detailed interior measurement of the ankle joint from various cutting planes. In this study, we apply the multimedia user interface to integrate different software functions into a surgical planning system with integrated functions. The functions include 3D model image acquisition, cutting, horizontal shifting and rotation of related bones (tibia and talus of the ankle joint in the predetermined time. For related bones of the ankle joint, it can also be used to design artificial ankle joints for adults in Taiwan. Those planning procedures can be recorded in this system for further research and investigation. Furthermore, since this system is a multimedia user interface, surgeons can use this system to plan and find a better and more efficient surgical approach before surgery. A database is available for this system to update and expand, which can provide different users with clinical cases as per their experience and learning.

  6. Effects of barefoot and barefoot inspired footwear on knee and ankle loading during running.

    Science.gov (United States)

    Sinclair, Jonathan

    2014-04-01

    Recreational runners frequently suffer from chronic pathologies. The knee and ankle have been highlighted as common injury sites. Barefoot and barefoot inspired footwear have been cited as treatment modalities for running injuries as opposed to more conventional running shoes. This investigation examined knee and ankle loading in barefoot and barefoot inspired footwear in relation to conventional running shoes. Thirty recreational male runners underwent 3D running analysis at 4.0m·s(-1). Joint moments, patellofemoral contact force and pressure and Achilles tendon forces were compared between footwear. At the knee the results show that barefoot and barefoot inspired footwear were associated with significant reductions in patellofemoral kinetic parameters. The ankle kinetics indicate that barefoot and barefoot inspired footwear were associated with significant increases in Achilles tendon force compared to conventional shoes. Barefoot and barefoot inspired footwear may serve to reduce the incidence of knee injuries in runners although corresponding increases in Achilles tendon loading may induce an injury risk at this tendon. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures

    NARCIS (Netherlands)

    Nosewicz, Tomasz L.; Beerekamp, M. Suzan H.; de Muinck Keizer, Robert-Jan O.; Schepers, Tim; Maas, Mario; Niek van Dijk, C.; Goslings, J. Carel

    2016-01-01

    Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative

  8. Joint contact loading in forefoot and rearfoot strike patterns during running.

    Science.gov (United States)

    Rooney, Brandon D; Derrick, Timothy R

    2013-09-03

    Research concerning forefoot strike pattern (FFS) versus rearfoot strike pattern (RFS) running has focused on the ground reaction force even though internal joint contact forces are a more direct measure of the loads responsible for injury. The main purpose of this study was to determine the internal loading of the joints for each strike pattern. A secondary purpose was to determine if converted FFS and RFS runners can adequately represent habitual runners with regards to the internal joint loading. Using inverse dynamics to calculate the net joint moments and reaction forces and optimization techniques to estimate muscle forces, we determined the axial compressive loading at the ankle, knee, and hip. Subjects consisted of 15 habitual FFS and 15 habitual RFS competitive runners. Each subject ran at a preferred running velocity with their habitual strike pattern and then converted to the opposite strike pattern. Plantar flexor muscle forces and net ankle joint moments were greater in the FFS running compared to the RFS running during the first half of the stance phase. The average contact forces during this period increased by 41.7% at the ankle and 14.4% at the knee joint during FFS running. Peak ankle joint contact force was 1.5 body weights greater during FFS running (pstrike pattern. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Value of special investigations of desion of the external tendon of the ankle joint

    International Nuclear Information System (INIS)

    Dengel, H.

    1982-01-01

    The advantage of special radiological investigations after damage of the external tendon of the ankle joint is absolutely certain. Clinical findings, functional X-ray pictures, and for some cases arthrography of the ankle joint render the correct diagnosis. Merely functional X-ray pictures will not always be sufficient, although sometimes this has been pretended. Experiences are described and indications for arthrography are pointed out. Arthrography certainly is the most accurate method for investigations of lesions of the external tendon of the ankle joint. Nevertheless is should only be performed for special cases and after critical interpretation of the functional X-ray pictures, because it is a rather invasive method. (orig.)

  10. Distraction arthroplasty with arthroscopic microfracture in a patient with rheumatoid arthritis of the ankle joint.

    Science.gov (United States)

    Nakasa, Tomoyuki; Adachi, Nobuo; Kato, Tomohiro; Ochi, Mitsuo

    2015-01-01

    We treated a 39-year-old female who had experienced destruction of her ankle joint owing to rheumatoid arthritis. This relatively young patient wished to avoid ankle fusion and joint replacement. Therefore, distraction arthroplasty with arthroscopic microfracture was performed to improve her symptoms and preserve motion. A microfracture procedure specifically for cartilage defects of the tibial plafond and talar dome was performed with the arthroscope, after which a hinged external fixator was applied to distract the ankle joint. The ankle joint space was enlarged by the external device and joint movement allowed. After 3 months, removal of the external device and repeat arthroscopy revealed newly formed fibrocartilage on the surfaces of both the tibia and the talus. At 2 years after the surgery, a radiograph showed that the joint space enlargement of the ankle had been maintained. The American Orthopaedic Foot and Ankle Society score improved from 37 points preoperatively to 82 points at 2 years postoperatively. Our findings suggest that good clinical results can be achieved with distraction arthroplasty and arthroscopic microfracture in a relatively young patient with rheumatoid arthritis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Effects of focal ankle joint cooling on unipedal static balance in individuals with and without chronic ankle instability.

    Science.gov (United States)

    Kim, Kyung-Min; Hart, Joseph M; Saliba, Susan A; Hertel, Jay

    2015-01-01

    Application of cryotherapy over an injured joint has been shown to improve muscle function, yet it is unknown how ankle cryotherapy affects postural control. Our purpose was to determine the effects of a 20-min focal ankle joint cooling on unipedal static stance in individuals with and without chronic ankle instability (CAI). Fifteen young subjects with CAI (9 males, 6 females) and 15 healthy gender-matched controls participated. All subjects underwent two intervention sessions on different days in which they had a 1.5L plastic bag filled with either crushed ice (active treatment) or candy corn (sham) applied to the ankle. Unipedal stance with eyes closed for 10s were assessed with a forceplate before and after each intervention. Center of pressure (COP) data were used to compute 10 specific dependent measures including velocity, area, standard deviation (SD), and percent range of COP excursions, and mean and SD of time-to-boundary (TTB) minima in the anterior-posterior (AP) and mediolateral directions. For each measure a three-way (Group-Intervention-Time) repeated ANOVAs found no significant interactions and main effects involving intervention (all Ps > 0.05). There were group main effects found for mean velocity (F(1,28) = 6.46, P = .017), area (F(1,28) = 12.83, P = .001), and mean of TTB minima in the AP direction (F(1,28) = 5.19, P = .031) indicating that the CAI group demonstrated greater postural instability compared to the healthy group. Postural control of unipedal stance was not significantly altered following focal ankle joint cooling in groups both with and without CAI. Ankle joint cryotherapy was neither beneficial nor harmful to single leg balance. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Varying negative work assistance at the ankle with a soft exosuit during loaded walking.

    Science.gov (United States)

    Malcolm, Philippe; Lee, Sangjun; Crea, Simona; Siviy, Christopher; Saucedo, Fabricio; Galiana, Ignacio; Panizzolo, Fausto A; Holt, Kenneth G; Walsh, Conor J

    2017-06-26

    Only very recently, studies have shown that it is possible to reduce the metabolic rate of unloaded and loaded walking using robotic ankle exoskeletons. Some studies obtained this result by means of high positive work assistance while others combined negative and positive work assistance. There is no consensus about the isolated contribution of negative work assistance. Therefore, the aim of the present study is to examine the effect of varying negative work assistance at the ankle joint while maintaining a fixed level of positive work assistance with a multi-articular soft exosuit. We tested eight participants during walking at 1.5 ms -1 with a 23-kg backpack. Participants wore a version of the exosuit that assisted plantarflexion via Bowden cables tethered to an off-board actuation platform. In four active conditions we provided different rates of exosuit bilateral ankle negative work assistance ranging from 0.015 to 0.037 W kg -1 and a fixed rate of positive work assistance of 0.19 W kg -1 . All active conditions significantly reduced metabolic rate by 11 to 15% compared to a reference condition, where the participants wore the exosuit but no assistance was provided. We found no significant effect of negative work assistance. However, there was a trend (p = .08) toward greater reduction in metabolic rate with increasing negative work assistance, which could be explained by observed reductions in biological ankle and hip joint power and moment. The non-significant trend of increasing negative work assistance with increasing reductions in metabolic rate motivates the value in further studies on the relative effects of negative and positive work assistance. There may be benefit in varying negative work over a greater range or in isolation from positive work assistance.

  13. Validity of an ankle joint motion and position sense measurement system and its application in healthy subjects and patients with ankle sprain.

    Science.gov (United States)

    Lin, Chueh-Ho; Chiang, Shang-Lin; Lu, Liang-Hsuan; Wei, Shun-Hwa; Sung, Wen-Hsu

    2016-07-01

    Ankle motion and proprioception in multiple axis movements are crucial for daily activities. However, few studies have developed and used a multiple axis system for measuring ankle motion and proprioception. This study was designed to validate a novel ankle haptic interface system that measures the ankle range of motion (ROM) and joint position sense in multiple plane movements, investigating the proprioception deficits during joint position sense tasks for patients with ankle instability. Eleven healthy adults (mean ± standard deviation; age, 24.7 ± 1.9 years) and thirteen patients with ankle instability were recruited in this study. All subjects were asked to perform tests to evaluate the validity of the ankle ROM measurements and underwent tests for validating the joint position sense measurements conducted during multiple axis movements of the ankle joint. Pearson correlation was used for validating the angular position measurements obtained using the developed system; the independent t test was used to investigate the differences in joint position sense task performance for people with or without ankle instability. The ROM measurements of the device were linearly correlated with the criterion standards (r = 0.99). The ankle instability and healthy groups were significantly different in direction, absolute, and variable errors of plantar flexion, dorsiflexion, inversion, and eversion (p ankle joint motion and position sense measurement system is valid and can be used for measuring the ankle ROM and joint position sense in multiple planes and indicate proprioception deficits for people with ankle instability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Comparison of Plain MRI and MR Arthrography in the Evaluation of Lateral Ligamentous Injury of the Ankle Joint

    Directory of Open Access Journals (Sweden)

    Mei-Chun Chou

    2006-01-01

    Conclusion: For evaluating ankle disability, using plain MRI alone is not adequate for correctly detecting lateral collateral ligamentous injury of the ankle joint. MR arthrography improves the sensitivity and the accuracy for ATaF and CF ligament injuries. It also helps in assessing coexisting pathologic lesions of ankle joints, especially impingement syndromes and osteochondral lesions, and provides more information for therapeutic decision making.

  15. Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

    Science.gov (United States)

    Yang, Yang; Fang, Ying; Zhang, Xini; He, Junliang; Fu, Weijie

    2017-01-01

    The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively) performed a weight-bearing dorsiflexion (WB-DF) maneuver, drop jumps (DJs), and lay-up jumps (LJs). Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041) was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028) and power (p = 0.022) were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion–extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane. Key points An increased shoe collar height effectively reduced ankle joint ROM in the sagittal plane in weight-bearing dorsiflexion maneuver. Shoe collar height did not affect sagittal plane ankle kinematics and had no effect on performance during realistic jumping. Shoe collar height can affect the ankle plantarflexion torque and peak power during the push-off phase in lay-up jump. PMID:29238255

  16. Application of the Superelastic NiTi Spring in Ankle Foot Orthosis (AFO to Create Normal Ankle Joint Behavior

    Directory of Open Access Journals (Sweden)

    Amirhesam Amerinatanzi

    2017-12-01

    Full Text Available Hinge-based Ankle Foot Orthosis (HAFO is one of the most common non-surgical solutions for the foot drop. In conventional HAFOs, the ankle joint is almost locked, and plantar flexion is restricted due to the high stiffness of the hinge mechanism. This often leads to a rigid walking gate cycle, poor muscle activity, and muscle atrophy. Since the ankle torque-angle loop has a non-linear profile, the use of a superelastic NiTi spring within the hinge, due to its nonlinear behavior, could recreate a close-to-normal stiffness of the normal ankle joint, which, in turn, could create a more natural walk. The focus of this study is to evaluate the performance of a superelastic NiTi spring versus a conventional Stainless Steel spring in a hinge mechanism of a custom-fit HAFO. To this aim, a custom-fit HAFO was fabricated via the fast casting technique. Then, motion analysis was performed for two healthy subjects (Case I and Case II: (i subjects with bare foot; (ii subjects wearing a conventional HAFO with no spring; (iii subjects wearing a conventional Stainless Steel-based HAFO; and (iv subjects wearing a NiTi spring-based HAFO. The data related to the ankle angle and the amount of moment applied to the ankle during walking were recorded using Cortex software and used for the evaluations. Finally, Finite Element Analysis (FEA was performed to evaluate the safety of the designed HAFO. The NiTi spring offers a higher range of motion (7.9 versus 4.14 degree and an increased level of moment (0.55 versus 0.36 N·m/kg. Furthermore, a NiTi spring offers an ankle torque-angle loop closer to that of the healthy subjects.

  17. Application of the Superelastic NiTi Spring in Ankle Foot Orthosis (AFO) to Create Normal Ankle Joint Behavior.

    Science.gov (United States)

    Amerinatanzi, Amirhesam; Zamanian, Hashem; Shayesteh Moghaddam, Narges; Jahadakbar, Ahmadreza; Elahinia, Mohammad

    2017-12-07

    Hinge-based Ankle Foot Orthosis (HAFO) is one of the most common non-surgical solutions for the foot drop. In conventional HAFOs, the ankle joint is almost locked, and plantar flexion is restricted due to the high stiffness of the hinge mechanism. This often leads to a rigid walking gate cycle, poor muscle activity, and muscle atrophy. Since the ankle torque-angle loop has a non-linear profile, the use of a superelastic NiTi spring within the hinge, due to its nonlinear behavior, could recreate a close-to-normal stiffness of the normal ankle joint, which, in turn, could create a more natural walk. The focus of this study is to evaluate the performance of a superelastic NiTi spring versus a conventional Stainless Steel spring in a hinge mechanism of a custom-fit HAFO. To this aim, a custom-fit HAFO was fabricated via the fast casting technique. Then, motion analysis was performed for two healthy subjects (Case I and Case II): (i) subjects with bare foot; (ii) subjects wearing a conventional HAFO with no spring; (iii) subjects wearing a conventional Stainless Steel-based HAFO; and (iv) subjects wearing a NiTi spring-based HAFO. The data related to the ankle angle and the amount of moment applied to the ankle during walking were recorded using Cortex software and used for the evaluations. Finally, Finite Element Analysis (FEA) was performed to evaluate the safety of the designed HAFO. The NiTi spring offers a higher range of motion (7.9 versus 4.14 degree) and an increased level of moment (0.55 versus 0.36 N·m/kg). Furthermore, a NiTi spring offers an ankle torque-angle loop closer to that of the healthy subjects.

  18. Joint stability characteristics of the ankle complex in female athletes with histories of lateral ankle sprain, part II: clinical experience using arthrometric measurement.

    Science.gov (United States)

    Kovaleski, John E; Heitman, Robert J; Gurchiek, Larry R; Hollis, J M; Liu, Wei; Pearsall, Albert W

    2014-01-01

    This is part II of a 2-part series discussing stability characteristics of the ankle complex. In part I, we used a cadaver model to examine the effects of sectioning the lateral ankle ligaments on anterior and inversion motion and stiffness of the ankle complex. In part II, we wanted to build on and apply these findings to the clinical assessment of ankle-complex motion and stiffness in a group of athletes with a history of unilateral ankle sprain. To examine ankle-complex motion and stiffness in a group of athletes with reported history of lateral ankle sprain. Cross-sectional study. University research laboratory. Twenty-five female college athletes (age = 19.4 ± 1.4 years, height = 170.2 ± 7.4 cm, mass = 67.3 ± 10.0 kg) with histories of unilateral ankle sprain. All ankles underwent loading with an ankle arthrometer. Ankles were tested bilaterally. The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness. Anterior displacement of the ankle complex did not differ between the uninjured and sprained ankles (P = .37), whereas ankle-complex rotation was greater for the sprained ankles (P = .03). The sprained ankles had less anterior and inversion end-range stiffness than the uninjured ankles (P ankle-complex laxity and end-range stiffness were detected in ankles with histories of sprain. These results indicate the presence of altered mechanical characteristics in the soft tissues of the sprained ankles.

  19. A numerical study on stress distribution across the ankle joint: Effects of material distribution of bone, muscle force and ligaments.

    Science.gov (United States)

    Mondal, Subrata; Ghosh, Rajesh

    2017-09-01

    The goal of this study is to develop a realistic three dimensional FE model of intact ankle joint. Three dimensional FE model of the intact ankle joint was developed using computed tomography data sets. The effect of muscle force, ligaments and proper material property distribution of bone on stress distribution across the intact ankle joint was studied separately. Present study indicates bone material property, ligaments and muscle force have influence on stress distribution across the ankle joint. Proper bone material, ligaments and muscle must be considered in the computational model for pre-clinical analysis of ankle prosthesis.

  20. The contribution of quasi-joint stiffness of the ankle joint to gait in patients with hemiparesis.

    Science.gov (United States)

    Sekiguchi, Yusuke; Muraki, Takayuki; Kuramatsu, Yuko; Furusawa, Yoshihito; Izumi, Shin-Ichi

    2012-06-01

    The role of ankle joint stiffness during gait in patients with hemiparesis has not been clarified. The purpose of this study was to determine the contribution of quasi-joint stiffness of the ankle joint to spatiotemporal and kinetic parameters regarding gait in patients with hemiparesis due to brain tumor or stroke and healthy individuals. Spatiotemporal and kinetic parameters regarding gait in twelve patients with hemiparesis due to brain tumor or stroke and nine healthy individuals were measured with a 3-dimensional motion analysis system. Quasi-joint stiffness was calculated from the slope of the linear regression of the moment-angle curve of the ankle joint during the second rocker. There was no significant difference in quasi-joint stiffness among both sides of patients and the right side of controls. Quasi-joint stiffness on the paretic side of patients with hemiparesis positively correlated with maximal ankle power (r=0.73, Phemiparesis. In contrast, healthy individuals might decrease quasi-joint stiffness to avoid deceleration of forward tilt of the tibia. Our findings might be useful for selecting treatment for increased ankle stiffness due to contracture and spasticity in patients with hemiparesis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Surgical treatment for diffused-type giant cell tumor (pigmented villonodular synovitis) about the ankle joint.

    Science.gov (United States)

    Li, Xingchen; Xu, Yang; Zhu, Yuan; Xu, Xiangyang

    2017-11-14

    Diffused-type giant cell tumor(Dt-GCT) is a rare, aggressive disorder of the joint synovium, bursa and tendon sheaths. Osseous erosions and subchondral cysts may develop as the result of synovium infiltration in Dt-GCT. We present a retrospective study of a series of patients who are diagnosed with Dt-GCT about the ankle joint, there clinical outcome is evaluated in this study. Fifteen patients with radiologically and histologically confirmed Dt-GCT about the ankle joint were identified in our foot and ankle department. Patients were managed with open synovectomy for the tumor tissue and bone grafting for bony erosions. X-rays and MRI scans were used for evaluation of the tumor and bony erosions pre- and post-operatively. Pre- and post-operative ankle function was assessed using the American Orthopedic Foot and Ankle Society -Ankle and Hindfoot (AOFAS-AH) score and the Muscularskeletal Tumor Society (MSTS) score. The mean follow-up duration was 37.4 months (range 25 to 50 months). There were 6 males and 9 females, with a mean age of 35 years old (range 18 to 65 years). All patients had talar erosion with the average size of 10.1*9.1*8.2 mm, distal tibia was affected in 5 patients with the average size of 6.2*5.6*5.8 mm. 7 patients had tendon involvement, 2 patients had recurrence and progression of ankle osteoarthritis. Both of them underwent ankle fusion. At the time of last follow-up, the mean AOFAS-AH score increased from 49 to 80 points (p ankle joint. Fusion is recommended for failed and severe cartilage destruction of the ankle joint.

  2. Management of chronic ankle pain using joint mobilization and ASTYM® treatment: a case report

    OpenAIRE

    Slaven, Emily J; Mathers, Jessie

    2011-01-01

    Treatment of ankle sprains predominately focuses on the acute management of this condition; less emphasis is placed on the treatment of ankle sprains in the chronic phase of recovery. Manual therapy, in the form of joint mobilization and manipulation, has been shown to be effective in the management of this condition, but the combination of joint mobilization and manipulation in tandem with ASTYM® treatment has not been explored. The purpose of this case report is to chronicle the management ...

  3. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis

    OpenAIRE

    Young, Rebekah; Nix, Sheree; Wholohan, Aaron; Bradhurst, Rachael; Reed, Lloyd

    2013-01-01

    Background Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Methods Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclu...

  4. Immediate Effects of Anterior-to-Posterior Talocrural Joint Mobilization after Prolonged Ankle Immobilization: A Preliminary Study

    OpenAIRE

    Landrum, Elizabeth L.; Kelln, Cdr. Brent M.; Parente, William R.; Ingersoll, Christopher D.; Hertel, Jay

    2008-01-01

    Ankle dorsiflexion range of motion (ROM) typically decreases after prolonged immobilization. Anterior-to-posterior talocrural joint mobilizations are purported to increase dorsiflexion ROM and decrease joint stiffness after immobilization. The purpose of this study was to determine if a single bout of Grade III anterior-to-posterior talocrural joint mobilizations immediately affected measures of dorsiflexion ROM, posterior ankle joint stiffness, and posterior talar translation in ankles of pa...

  5. Ankle Joint Intrinsic Dynamics is More Complex than a Mass-Spring-Damper Model.

    Science.gov (United States)

    Sobhani Tehrani, Ehsan; Jalaleddini, Kian; Kearney, Robert E

    2017-09-01

    This paper describes a new small signal parametric model of ankle joint intrinsic mechanics in normal subjects. We found that intrinsic ankle mechanics is a third-order system and the second-order mass-spring-damper model, referred to as IBK, used by many researchers in the literature cannot adequately represent ankle dynamics at all frequencies in a number of important tasks. This was demonstrated using experimental data from five healthy subjects with no voluntary muscle contraction and at seven ankle positions covering the range of motion. We showed that the difference between the new third-order model and the conventional IBK model increased from dorsi to plantarflexed position. The new model was obtained using a multi-step identification procedure applied to experimental input/output data of the ankle joint. The procedure first identifies a non-parametric model of intrinsic joint stiffness where ankle position is the input and torque is the output. Then, in several steps, the model is converted into a continuous-time transfer function of ankle compliance, which is the inverse of stiffness. Finally, we showed that the third-order model is indeed structurally consistent with agonist-antagonist musculoskeletal structure of human ankle, which is not the case for the IBK model.

  6. Diagnosis of ligament injuries in the superior ankle joint

    International Nuclear Information System (INIS)

    Gebing, R.; Fiedler, V.

    1991-01-01

    Nearly 40 years after ankle arthrography was first introduced, the anterior and inversion stress views of the ankle are still widely preferred as a noninvasive method of evaluating ligament injuries in the upper ankle. We consider the stress test, bilaterally performed using a standardized stress apparatus, as a basic examination by which to differentiate between slight and severe sprain. Intensive muscel splinting due to painful swelling can sometimes be treated by injection of local anesthetic. Like many authors, we perform ankle arthrography in cases where there is a significant difference between the clinical findings and the stress test. The technique of ankle arthrography can be readily learned and is extremely accurate in delineating the extent of ligamentous injury produced by moderate or severe ankle sprains. It can be performed in any X-ray department. (orig.) [de

  7. Effect of the sagittal ankle angle at initial contact on energy dissipation in the lower extremity joints during a single-leg landing.

    Science.gov (United States)

    Lee, Jinkyu; Song, Yongnam; Shin, Choongsoo S

    2018-05-01

    During landing, the ankle angle at initial contact (IC) exhibits relatively wide individual variation compared to the knee and hip angles. However, little is known about the effect of different IC ankle angles on energy dissipation. The purpose of this study was to investigate the relationship between individual ankle angles at IC and energy dissipation in the lower extremity joints. Twenty-seven adults performed single-leg landings from a 0.3-m height. Kinetics and kinematics of the lower extremity joints were measured. The relationship between ankle angles at IC and negative work, range of motion, the time to peak ground reaction force, and peak loading rate were analyzed. The ankle angle at IC was positively correlated with ankle negative work (r = 0.80, R 2  = 0.64, p angle was negatively correlated with hip negative work (r = -0.46, R 2  = 0.21, p = 0.01) and the contribution of the hip to total negative work (r = -0.61, R 2  = 0.37, p angle at IC. The ankle angle at IC was positively correlated with total negative work (r = 0.50, R 2  = 0.25, p angle at IC increased, such that the ankle energy dissipation increased and redistributed the energy dissipation in the ankle and hip joints. Further, these results suggest that increased ankle energy dissipation with a higher IC plantar flexion angle may be a potential landing technique for reducing the risk of injury to the anterior cruciate ligament and hip musculature. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Acute Ankle Sprain in a Mouse Model: Changes in Knee-Joint Space.

    Science.gov (United States)

    Hubbard-Turner, Tricia; Wikstrom, Erik A; Guderian, Sophie; Turner, Michael J

    2017-06-02

    Ankle sprains remain the most common orthopaedic injury. Conducting long-term studies in humans is difficult and costly, so the long-term consequences of an ankle sprain are not entirely known.   To measure knee-joint space after a single surgically induced ankle sprain in mice.   Randomized controlled trial.   University research laboratory.   Thirty male mice (CBA/2J) were randomly placed into 1 of 3 surgical groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament/CFL group, or a sham treatment group. The right ankle was operated on in all mice.   Three days after surgery, all of the mice were individually housed in cages containing a solid-surface running wheel, and daily running-wheel measurements were recorded. Before surgery and every 6 weeks after surgery, a diagnostic ultrasound was used to measure medial and lateral knee-joint space in both hind limbs.   Right medial (P = .003), right lateral (P = .002), left medial (P = .03), and left lateral (P = .002) knee-joint spaces decreased across the life span. The mice in the anterior talofibular ligament/CFL group had decreased right medial (P = .004) joint space compared with the sham and CFL groups starting at 24 weeks of age and continuing throughout the life span. No differences occurred in contralateral knee-joint degeneration among any of the groups.   Based on current data, mice that sustained a surgically induced severe ankle sprain developed greater joint degeneration in the ipsilateral knee. Knee degeneration could result from accommodation to the laxity of the ankle or biomechanical alterations secondary to ankle instability. A single surgically induced ankle sprain could significantly affect knee-joint function.

  9. Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures.

    Science.gov (United States)

    Nosewicz, Tomasz L; Beerekamp, M Suzan H; De Muinck Keizer, Robert-Jan O; Schepers, Tim; Maas, Mario; Niek van Dijk, C; Goslings, J Carel

    2016-08-01

    Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level IV, observational study. © The Author(s) 2016.

  10. Ankle replacement - discharge

    Science.gov (United States)

    ... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...

  11. Relevance of adjacent joint imaging in the evaluation of ankle fractures.

    Science.gov (United States)

    Antoci, Valentin; Patel, Shaun P; Weaver, Michael J; Kwon, John Y

    2016-10-01

    Routinely obtaining adjacent joint radiographs when evaluating patients with ankle fractures may be of limited clinical utility and an unnecessary burden, particularly in the absence of clinical suspicion for concomitant injuries. One thousand, three hundred and seventy patients who sustained ankle fractures over a 5-year period presenting to two level 1 trauma centers were identified. Medical records were retrospectively reviewed for demographics, physical examination findings, and radiographic information. Analyses included descriptive statistics along with sensitivity and predictive value calculations for the presence of adjacent joint fracture. Adjacent joint imaging (n=1045 radiographs) of either the knee or foot was obtained in 873 patients (63.7%). Of those, 75/761 patients (9.9%) demonstrated additional fractures proximal to the ankle joint, most commonly of the proximal fibula. Twenty-two of 284 (7.7%) demonstrated additional fractures distal to the ankle joint, most commonly of the metatarsals. Tenderness to palpation demonstrated sensitivities of 0.92 and 0.77 and positive predictive values of 0.94 and 0.89 for the presence of proximal and distal fractures, respectively. Additionally, 19/22 (86.4%) of patients sustaining foot fractures had their injury detectable on initial ankle X-rays. Overall, only 5.5% (75/1370) of patients sustained fractures proximal to the ankle and only 0.2% (3/1370) of patients had additional foot fractures not evident on initial ankle X-rays. The addition of adjacent joint imaging for the evaluation of patients sustaining ankle fractures is low yield. As such, patient history, physical examination, and clinical suspicion should direct the need for additional X-rays. Level IV. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Knee joint mobilization reduces secondary mechanical hyperalgesia induced by capsaicin injection into the ankle joint.

    Science.gov (United States)

    Sluka, K A; Wright, A

    2001-01-01

    Joint mobilization is a treatment approach commonly used by physical therapists for the management of a variety of painful conditions. However, the clinical effectiveness when compared to placebo and the neurophysiological mechanism of action are not known. The purpose of this study was to establish that application of a manual therapy technique will produce antihyperalgesia in an animal model of joint inflammation and that the antihyperalgesia produced by joint mobilization depends on the time of treatment application. Capsaicin (0.2%, 50 microl) was injected into the lateral aspect of the left ankle joint and mechanical withdrawal threshold assessed before and after capsaicin injection in Sprague-Dawley rats. Joint mobilization of the ipsilateral knee joint was performed 2 h after capsaicin injection for a total of 3 min, 9 min or 15 min under halothane anaesthesia. Control groups included animals that received halothane for the same time as the group that received joint mobilization and those whose limbs were held for the same duration as the mobilization (no halothane). Capsaicin resulted in a decreased mechanical withdrawal threshold by 2 h after injection that was maintained through 4 h. Both 9 and 15 min of mobilization, but not 3 min of mobilization, increased the withdrawal threshold to mechanical stimuli to baseline values when compared with control groups. The antihyperalgesic effect of joint mobilization lasted 30 min. Thus, joint mobilization (9 or 15 min duration) produces a significant reversal of secondary mechanical hyperalgesia induced by intra-articular injection of capsaicin. Copyright 2001 European Federation of Chapters of the International Association for the Study of Pain.

  13. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial.

    Science.gov (United States)

    Cruz-Díaz, David; Lomas Vega, Rafael; Osuna-Pérez, Maria Catalina; Hita-Contreras, Fidel; Martínez-Amat, Antonio

    2015-01-01

    To evaluate the effects of joint mobilization, in which movement is applied to the ankle's dorsiflexion range of motion, on dynamic postural control and on the self-reported instability of patients with chronic ankle instability (CAI). A double-blind, placebo-controlled, randomized trial with repeated measures and a follow-up period. Ninety patients with a history of recurrent ankle sprain, self-reported instability, and a limited dorsiflexion range of motion, were randomly assigned to either the intervention group (Joint Mobilizations, 3 weeks, two sessions per week) the placebo group (Sham Mobilizations, same duration as joint mobilization) or the control group, with a 6 months follow-up. Dorsiflexion Range of Motion (DFROM), Star Excursion Balance Test (SEBT) and CAI Tool (CAIT) were outcome measures. A separate 3 × 4 mixed model analysis of variance was performed to examine the effect of treatment conditions and time, and intention-to-treat (ITT) analysis was applied to evaluate the effect of the independent variable. The application of joint mobilization resulted in better scores of DFROM, CAIT, and SEBTs in the intervention group when compared with the placebo or the control groups (p ankle DFROM, postural control, and self-reported instability. These results suggest that joint mobilization could be applied to patients with recurrent ankle sprain to help restore their functional stability. Implications for Rehabilitation Functional instability is a very common sequela in patients with CAI, resulting in reduced quality of living due to the limitations it imposes on daily life activities. The mobilization with movement technique presented by Mulligan, and based on the joint mobilization accompanied by active movement, appears as a valuable tool to be employed by physical therapists to restore ankle function after a recurrent ankle sprain history. ROM restriction, subjective feeling of instability and dynamic postural control are benefiting from the joint

  14. Ankle instability

    NARCIS (Netherlands)

    Krips, Rover; de Vries, Jasper; van Dijk, C. Niek

    2006-01-01

    The ankle joint is the most congruent joint of the human body. Stability is provided by the bony configuration of the ankle mortise and the talar dome and by the ankle ligaments. During ankle motions, rotation and translation around and along the movement axes occur. Soft tissue stability is

  15. Effects of immobilization and remobilization on the ankle joint in Wistar rats

    International Nuclear Information System (INIS)

    Kunz, R.I.; Coradini, J.G.; Silva, L.I.; Bertolini, G.R.F.; Brancalhão, R.M.C.; Ribeiro, L.F.C.

    2014-01-01

    A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint

  16. Effects of immobilization and remobilization on the ankle joint in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Kunz, R.I. [Laboratório de Biologia Estrutural e Funcional, Universidade Estadual do Oeste do Paraná, Cascavel, PR (Brazil); Coradini, J.G.; Silva, L.I.; Bertolini, G.R.F. [Laboratório do Estudo das Lesões e Recursos Fisioterapêuticos, Universidade Estadual do Oeste do Paraná, Cascavel, PR (Brazil); Brancalhão, R.M.C.; Ribeiro, L.F.C. [Laboratório de Biologia Estrutural e Funcional, Universidade Estadual do Oeste do Paraná, Cascavel, PR (Brazil)

    2014-08-15

    A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint.

  17. The effect of ankle joint immobilization on lower limb venous flow.

    Science.gov (United States)

    Craik, Johnathan D; Clark, Amanda; Hendry, James; Sott, Andrea H; Hamilton, Paul D

    2015-01-01

    Below-knee cast immobilization is associated with an increased risk of developing deep vein thrombosis secondary to venous stasis. We investigated the effect of weight-bearing in a below-knee cast or pneumatic walking boot on lower limb venous blood flow. Duplex ultrasonography was used to measure venous blood flow in the popliteal vein of 10 healthy volunteers. Venous blood flow was measured while at rest, ambulating non-weight-bearing, partial weight-bearing, and full weight-bearing. Measurements were performed without ankle joint immobilization, with the ankle immobilized in a neutral cast, and with the ankle immobilized in a pneumatic walking boot in both neutral and equinus. There was no significant reduction in venous blood flow measurements between full weight-bearing without ankle joint immobilization and full weight-bearing in a neutral cast or neutral pneumatic walking boot. However, venous blood flow was reduced when partial weight-bearing (50%) and when full weight-bearing in a pneumatic walking boot in equinus. These results demonstrate that venous blood flow returned to normal levels when the subjects were permitted to fully bear weight in below-knee casts or walking boots, provided that the ankle joint was not in equinus. Weight-bearing status and ankle joint position should be appreciated during decisions for the provision of chemical thromboprophylaxis. © The Author(s) 2014.

  18. Dynamic Functional Stiffness Index of the Ankle Joint During Daily Living.

    Science.gov (United States)

    Argunsah Bayram, Hande; Bayram, Mehmed B

    2018-03-30

    Exploring ankle joint physiologic functional stiffness is crucial for improving the design of prosthetic feet that aim to mimic normal gait. We hypothesized that ankle joint stiffness would vary among the different activities of daily living and that the magnitude of the stiffness would indicate the degree of energy storage element sufficiency in terms of harvesting and returning energy. We examined sagittal plane ankle moment versus flexion angle curves from 12 healthy subjects during the daily activities. The slopes of these curves were assessed to find the calculated stiffness during the peak energy return and harvest phases. For the energy return and harvest phases, stiffness varied from 0.016 to 0.283 Nm/kg° and 0.025 and 0.858 Nm/kg°, respectively. The optimum stiffness during the energy return phase was 0.111 ± 0.117 Nm/kg° and during the energy harvest phase was 0.234 ± 0.327 Nm/kg°. Ankle joint stiffness varied significantly during the activities of daily living, indicating that an energy storage unit with a constant stiffness would not be sufficient in providing energy regenerative gait during all activities. The present study was directed toward the development of a complete data set to determine the torque-angle properties of the ankle joint to facilitate a better design process. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Residual load carrying capacity of timber joints

    NARCIS (Netherlands)

    Kuilen, J.W.G. van de

    1999-01-01

    Timber joints that have been preloaded for 2 to 8 years have been short term tested in accordance with EN 26891. The applied load levels varied between 30% and 50% of the average short term strength. The study comprised nailed, toothed-plate and split-ring joints. All joints were made of spruce and

  20. Comparison of Joint Loading in Badminton Lunging between Professional and Amateur Badminton Players

    Directory of Open Access Journals (Sweden)

    Lin Fu

    2017-01-01

    Full Text Available The knee and ankle are the two most injured joints associated with the sport of badminton. This study evaluates biomechanical factors between professional and amateur badminton players using an injury mechanism model. The aim of this study was to investigate the kinematic motion and kinetic loading differences of the right knee and ankle while performing a maximal right lunge. Amateur players exhibited greater ankle range of motion (p<0.05, r=0.89 and inversion joint moment (p<0.05, r=0.54 in the frontal plane as well as greater internal joint rotation moment (p<0.05, r=0.28 in the horizontal plane. In contrast, professional badminton players presented a greater knee joint moment in the sagittal (p<0.05, r=0.59 and frontal (p<0.05, r=0.37 planes, which may be associated with increased knee ligamentous injury risk. To avoid injury, the players need to forcefully extend the knee with internal rotation, strengthen the muscles around the ankle ligament, and maximise joint coordination during training. The injuries recorded and the forces responsible for the injuries seem to have developed during training activity. Training programmes and injury prevention strategies for badminton players should account for these findings to reduce potential injury to the ankle and knee.

  1. Syndesmotic ankle sprain.

    Science.gov (United States)

    Childs, Sharon G

    2012-01-01

    Ankle sprain injuries are the most common type of joint sprain. The prevalence of ankle joint sprains accounts for 21% of joint injuries in the body. Although somewhat rare, high-ankle or syndesmotic ankle sprains occur in up to 15% of ankle trauma. This article will present the pathomechanics of the high-ankle or syndesmotic sprain.

  2. The influence of muscle pennation angle and cross-sectional area on contact forces in the ankle joint.

    Science.gov (United States)

    Sopher, Ran S; Amis, Andrew A; Davies, D Ceri; Jeffers, Jonathan Rt

    2017-01-01

    Data about a muscle's fibre pennation angle and physiological cross-sectional area are used in musculoskeletal modelling to estimate muscle forces, which are used to calculate joint contact forces. For the leg, muscle architecture data are derived from studies that measured pennation angle at the muscle surface, but not deep within it. Musculoskeletal models developed to estimate joint contact loads have usually been based on the mean values of pennation angle and physiological cross-sectional area. Therefore, the first aim of this study was to investigate differences between superficial and deep pennation angles within each muscle acting over the ankle and predict how differences may influence muscle forces calculated in musculoskeletal modelling. The second aim was to investigate how inter-subject variability in physiological cross-sectional area and pennation angle affects calculated ankle contact forces. Eight cadaveric legs were dissected to excise the muscles acting over the ankle. The mean surface and deep pennation angles, fibre length and physiological cross-sectional area were measured. Cluster analysis was applied to group the muscles according to their architectural characteristics. A previously validated OpenSim model was used to estimate ankle muscle forces and contact loads using architecture data from all eight limbs. The mean surface pennation angle for soleus was significantly greater (54%) than the mean deep pennation angle. Cluster analysis revealed three groups of muscles with similar architecture and function: deep plantarflexors and peroneals, superficial plantarflexors and dorsiflexors. Peak ankle contact force was predicted to occur before toe-off, with magnitude greater than five times bodyweight. Inter-specimen variability in contact force was smallest at peak force. These findings will help improve the development of experimental and computational musculoskeletal models by providing data to estimate force based on both surface and deep

  3. Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

    Directory of Open Access Journals (Sweden)

    Yang Yang, Ying Fang, Xini Zhang, Junliang He, Weijie Fu

    2017-12-01

    Full Text Available The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively performed a weight-bearing dorsiflexion (WB-DF maneuver, drop jumps (DJs, and lay-up jumps (LJs. Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041 was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028 and power (p = 0.022 were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion–extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane.

  4. Does Shoe Collar Height Influence Ankle Joint Kinematics and Kinetics in Sagittal Plane Maneuvers?

    Science.gov (United States)

    Yang, Yang; Fang, Ying; Zhang, Xini; He, Junliang; Fu, Weijie

    2017-12-01

    The Objective of the study is to investigate the effects of basketball shoes with different collar heights on ankle kinematics and kinetics and athletic performance in different sagittal plane maneuvers. Twelve participants who wore high-top and low-top basketball shoes (hereafter, HS and LS, respectively) performed a weight-bearing dorsiflexion (WB-DF) maneuver, drop jumps (DJs), and lay-up jumps (LJs). Their sagittal plane kinematics and ground reaction forces were recorded using the Vicon motion capture system and Kistler force plates simultaneously. Moreover, ankle dorsiflexion and plantarflexion angles, moment, power, stiffness, and jump height were calculated. In the WB-DF test, the peak ankle dorsiflexion angle (p = 0.041) was significantly smaller in HS than in LS. Additionally, the peak ankle plantarflexion moment (p = 0.028) and power (p = 0.022) were significantly lower in HS than in LS during LJs but not during DJs. In both jumping maneuvers, no significant differences were found in the jump height or ankle kinematics between the two shoe types. According to the WB-DF test, increasing shoe collar height can effectively reduce the ankle range of motion in the sagittal plane. Although the HS did not restrict the flexion-extension performance of the ankle joint during two jumping maneuvers, an increased shoe collar height can reduce peak ankle plantarflexion moment and peak power during the push-off phase in LJs. Therefore, a higher shoe collar height should be used to circumvent effects on the partial kinetics of the ankle joint in the sagittal plane.

  5. [Observation on therapeutic effect of acupuncture at Yanglingquan (GB 34) on sprain of external ankle joint].

    Science.gov (United States)

    He, Xin-fang; Xu, Hai-bin

    2006-08-01

    To observe the increasing effect of Yanglingquan (GB 34) on sprain of external ankle joint. Seventy-nine cases of sprain of external ankle joint were semi-randomly divided into a treatment group (n = 46) and a control group (n = 33). The treatment group were treated with acupuncture at Yanglingquan (GB 34) and electro-magnetic therapy at local acupoints, and the control group with electro-magnetic therapy. The cured rate and the total effective rate were 67.4% and 91.3% in the treatment group, and 36.4% and 69.7% in the control group, respectively, with a significant difference between the two groups (Psprain of the external ankle joint.

  6. Bone scanning a useful addition in the diagnosis of ankle joint trauma

    International Nuclear Information System (INIS)

    Schmidt, C.

    1983-01-01

    A retrospective study of the indication in 169 scintigraphic examinations of the ankle joint was made. Usually joints respond to trauma with a generalized increase of the concentration of the radiopharmaceutical. By using a highly performed technique the focal hot spot caused by the fracture can be seen in the bone scan. The focal accumulation of the radioactive material must not correspond to a bone fracture in any case. The ligamentous avulsion of a bone chip and/or the periosteum can yield the same image but it cannot be diagnosed by radiographic techniques. Initially the routine radiograph and even the tomograph often are interpreted as normal or equivocal. In these cases of ankle trauma bone scanning completes the clinical evaluation. Although bone scanning is very important in the diagnosis of any traumatic lesion of the ankle joints it cannot replace the conventional X-ray technique. (orig.) [de

  7. Peripheral DXA measurement around ankle joint to diagnose osteoporosis as assessed by central DXA measurement.

    Science.gov (United States)

    Sung, Ki Hyuk; Choi, Young; Cho, Gyeong Hee; Chung, Chin Youb; Park, Moon Seok; Lee, Kyoung Min

    2018-02-05

    This study evaluated the correlation between central and peripheral bone mineral density (BMD) of the ankle joint, using dual-energy X-ray absorptiometry (DXA). We also investigated whether peripheral ankle BMD could be used to identify individuals who were diagnosed with osteoporosis, using central DXA. We recruited 134 volunteers aged 20-90 years who agreed to participate in this study. Central BMD of the lumbar spine and left femur, and peripheral BMD of the medial malleolus, distal tibia, lateral malleolus, and talus were measured with DXA. Among the peripheral sites of the ankle, the highest and lowest BMD were observed in the talus and lateral malleolus, respectively. All peripheral DXA measurements of the ankle joint were significantly correlated with central DXA measurements. There was a good correlation (r: 0.656-0.725) between peripheral and central BMD for the older age group (> 50 years), but fair-to-good correlation (r: 0.263-0.654) for the younger age group (ankle joint between osteoporosis and non-osteoporosis were 0.548 g/cm 2 (sensitivity, 89.0%; specificity, 69.0%) for the medial malleolus, 0.626 g/cm 2 (sensitivity, 83.3%; specificity, 82.8%) for the distal tibia, 0.47 g/cm 2 (sensitivity, 100.0%; specificity, 65.5%) for the lateral malleolus, and 0.973 g/cm 2 (sensitivity, 72.2%; specificity, 83.6%) for the talus (p ankle joint and central BMD for older age group. Further study is required to use the ankle DXA as a valid clinical tool for the diagnosis of osteoporosis and fracture risk assessment.

  8. Reliability of a Functional Test Battery Evaluating Functionality, Proprioception and Strength of the Ankle Joint

    OpenAIRE

    YILDIZ, Yavuz; ŞEKİR, Ufuk; HAZNECİ, Bülent

    2009-01-01

    Aim: In contrast to the one-sided evaluation methods used in the past, combining multiple tests allows one to obtain a global assessment of the ankle joint. Materials and Methods: Twenty healthy male volunteers participated in this study. One component of the test battery included five different functional ability tests, which included: single limb hopping course, one-legged and triple-legged hop for distance, and six-meter (6-m) and cross 6-m hop for time. Ankle joint position sense and on...

  9. High resolution ultrasonography in ankle joint pain: Where does it stand?

    Directory of Open Access Journals (Sweden)

    Mennatallah Hatem Shalaby

    2017-09-01

    Full Text Available Background: The ankle is frequently injured in trauma, overuse syndrome and inflammatory processes. Different imaging modalities assess the ankle, including plain radiography, computed tomography (CT, magnetic resonance imaging (MRI, and ultrasonography (US. Purpose: Our objective is to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain. Patients and methods: The study included 28 patients presented with ankle pain ranging in age from 17 to 60 years. They were examined by US and findings were correlated with MRI. Results: US was capable to detect various lesions (synovitis, arthritis, plantar fasciitis, tendon and ligamentous lesions. It had a sensitivity of 95.4%, a specificity of 83.3% and an overall accuracy of 92.8%. US had a limited value in detection of avascular necrosis (AVN, bone marrow oedema and fractures. Conclusion: US can be used as a first step diagnostic tool in cases of ankle pain. MRI should be spared to cases with negative or equivocal US findings. Keywords: High resolution ultrasound, Ankle joint pain, Tendons, Ligaments, Synovitis, Arthritis

  10. Comparison of Ankle Joint Visualization Between the 70° and 30° Arthroscopes: A Cadaveric Study.

    Science.gov (United States)

    Tonogai, Ichiro; Hayashi, Fumio; Tsuruo, Yoshihiro; Sairyo, Koichi

    2018-02-01

    Ankle arthroscopy is an important diagnostic and therapeutic tool. Arthroscopic ankle surgery for anterior ankle impingement or osteochondral lesions (OCLs) is mostly performed with a 30° arthroscope; however, visualization of lesions is sometimes difficult. This study sought to compare ankle joint visualization between 70° and 30° arthroscopes and clarify the effectiveness of 70° arthroscopy. Standard anterolateral and anteromedial portals were placed with 4-mm 70° or 30° angled arthroscopes in a fresh 77-year-old male cadaveric ankle. The medial ligament and surrounding tissue were dissected via a medial malleolar skin incision. Kirschner wires were inserted into the distal tibia anterior edge; 5-mm diameter OCLs were created on the medial talar gutter anteriorly, midway, and posteriorly. The talar dome and distal tibia anterior edge were visualized using both arthroscopes. The 70° arthroscope displayed the anterior edge of the distal tibia immediately in front of the arthroscope, allowing full visualization of the posterior OCL of the medial talar gutter more clearly than the 30° arthroscope. This study revealed better ankle joint visualization with the 70° arthroscope, and may enable accurate, safe, and complete debridement, especially in treatment of medial talar gutter posterior OCLs and removal of anterior distal tibial edge bony impediments. Level IV, Anatomic study.

  11. Ankle rehabilitation device with two degrees of freedom and compliant joint

    Science.gov (United States)

    Racu (Cazacu, C.-M.; Doroftei, I.

    2015-11-01

    We propose a rehabilitation device that we intend to be low cost and easy to manufacture. The system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg. To avoid injure of the ankle joint, this device is equipped with a compliant joint between the motor and mechanical transmission. The torque of this joint is intended to be adjustable, according to the degree of ankle joint damage. To choose the material and the dimensions of this compliant joint, in this paper we perform the first stress simulation. The minimum torque is calculated, while the maximum torque is given by the preliminary chosen actuator.

  12. Effects of joint alignment and type on mechanical properties of thermoplastic articulated ankle-foot orthosis.

    Science.gov (United States)

    Gao, Fan; Carlton, William; Kapp, Susan

    2011-06-01

    Articulated or hinged ankle-foot orthosis (AFO) allow more range of motion. However, quantitative investigation on articulated AFO is still sparse. The objective of the study was to quantitatively investigate effects of alignment and joint types on mechanical properties of the thermoplastic articulated AFO. Tamarack dorsiflexion assist flexure joints with three durometers (75, 85 and 95) and free motion joint were tested. The AFO joint was aligned with the center of the motor shaft (surrogate ankle joint), 10 mm superior, inferior, anterior and posterior with respect to the motor shaft center. The AFO was passively moved from 20° plantar flexion to 15° dorsiflexion at a speed of 10°/s using a motorized device. Mechanical properties including index of hysteresis, passive resistance torque and quasi-static stiffness (at neutral, 5°, 10° and 15° in plantar flexion) were quantified. Significant effects of joint types and joint alignment on the mechanical properties of an articulated thermoplastic AFO were revealed. Specifically, center alignment showed minimum resistance and stiffness while anterior and posterior alignment showed significantly higher resistance and stiffness. The dorsiflexion assist torques at neutral position ranged from 0.69 ± 0.09 to 1.88 ± 0.10 Nm. Anterior and posterior alignment should be avoided as much as possible. The current study suggested that anterior and posterior alignment be avoided as much as possible in clinical practice due to potential skin irritation and increase in stress around the ankle joint.

  13. Relationships between the center of pressure and the movements of the ankle and knee joints during the stance phase in patients with severe medial knee osteoarthritis.

    Science.gov (United States)

    Fukaya, Takashi; Mutsuzaki, Hirotaka; Okubo, Tomoyuki; Mori, Koichi; Wadano, Yasuyoshi

    2016-08-01

    The knee joint movement during the stance phase is affected by altered ankle movement and the center of pressure (COP). However the relationships between changes in the center of pressure (COP) and the altered kinematics and kinetics of the ankle and knee joints in patients with osteoarthritis (OA) of the knee are not well understood. The purpose of this study was to determine the relationships between changes in the COP and the altered kinematic and kinetic variables in ankle and knee joints during the stance phase in patients with medial knee OA. Fourteen patients with knee OA (21 knees) and healthy subjects were assessed by gait analysis using an eight-camera motion analysis system to record forward and lateral shifts in the COP and the angle and net internal moments of the knee and ankle joint. Spearman rank-correlation coefficients were used to determine the relationship between these results. In knees with medial OA, lateral shifts in the COP were correlated with knee flexion angle. Lateral shifts in the COP were correlated with the second peak of the knee extensor moment and correlated with the knee abductor moment. In patients with medial knee OA, lateral shifts in the COP were negatively correlated with the kinematic and kinetic variables in the sagittal plane of the knee joints. Controlling such lateral shifts in the COP may thus be an effective intervention for mechanical loads on the knee during the stance phase in patients with knee OA. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. The effect of the heel- to- toe rocker shoe on moments of ankle joint and temporal-spatial of gait in female student

    Directory of Open Access Journals (Sweden)

    masoomeh Veiskarami

    2015-01-01

    Full Text Available Background : Rocker shoes are the most commonly prescribed external therapeutic shoe modification and are used for treatment of the ankle and midfoot problems. The aim of this study was to assesse the effects of the heel- to-toe rocker shoes on temporal-spatial and ankle joint moments in sagital and frontal plane. Materials and Methods: In this quasi-exprimental study, three-dimentional gait analysis was carried out on 20 healthy university female students with normal normal gait pattern selected by convenience sampling method. A Vicon 470 system(Oxford Metrix, U.K. consisting of 6 cameras operating at 60Hz and kistler forceplate (A9286 was used.The paired samples T test was used to statistical analysis. Results: The results showed that there is no significant change in temporal-spatial parameters while wearing this modified shoe ,but the ankle moments while wearing rocker shoes in sagittal plane was significantly less than that while wearing traditional shoes(p=0.002 but in frontal plane significantly increased(p=0.007. Conclusion: Based on the current findings the major benefits of this modified shoe appear to be significantly restricted sagital plane moments with maintenance of walking speed so the loads on ankle joint and achilles tendon reduced, but increases frontal plain moments which leads to increase of mediolateral instability of ankle joint.

  15. Estimation of ligament strains and joint moments in the ankle during a supination sprain injury.

    Science.gov (United States)

    Wei, Feng; Fong, Daniel Tik-Pui; Chan, Kai-Ming; Haut, Roger C

    2015-01-01

    This study presents the ankle ligament strains and ankle joint moments during an accidental injury event diagnosed as a grade I anterior talofibular ligament (ATaFL) sprain. A male athlete accidentally sprained his ankle while performing a cutting motion in a laboratory setting. The kinematic data were input to a three-dimensional rigid-body foot model for simulation analyses. Maximum strains in 20 ligaments were evaluated in simulations that investigated various combinations of the reported ankle joint motions. Temporal strains in the ATaFL and the calcaneofibular ligament (CaFL) were then compared and the three-dimensional ankle joint moments were evaluated from the model. The ATaFL and CaFL were highly strained when the inversion motion was simulated (10% for ATaFL and 12% for CaFL). These ligament strains were increased significantly when either or both plantarflexion and internal rotation motions were added in a temporal fashion (up to 20% for ATaFL and 16% for CaFL). Interestingly, at the time strain peaked in the ATaFL, the plantarflexion angle was not large but apparently important. This computational simulation study suggested that an inversion moment of approximately 23 N m plus an internal rotation moment of approximately 11 N m and a small plantarflexion moment may have generated a strain of 15-20% in the ATaFL to produce a grade I ligament injury in the athlete's ankle. This injury simulation study exhibited the potentially important roles of plantarflexion and internal rotation, when combined with a large inversion motion, to produce a grade I ATaFL injury in the ankle of this athlete.

  16. Injury of the ankle joint ligaments; Bandverletzungen des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Institut fuer Radiologie, Landesklinikum Waldviertel Horn, Horn (Austria); Karl Landsteiner Institut, St. Poelten (Austria)

    2007-03-15

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.) [German] Die Diagnose einer lateralen Bandverletzung nach einem Sprunggelenktrauma basiert auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung hinsichtlich des Stellenwerts der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesondere fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird bei dieser Indikation zurzeit nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenkbaender erlaubt. Sie ist im besonderen Masse geeignet, akute und chronische Verletzungen des Sinus tarsi zu beurteilen. Bei chronischen Beschwerden nach Bandverletzung ist die MRT zur

  17. Can Ilizarov joint distraction delay the need for an arthrodesis of the ankle? A preliminary report

    NARCIS (Netherlands)

    van Valburg, A. A.; van Roermund, P. M.; Lammens, J.; van Melkebeek, J.; Verbout, A. J.; Lafeber, E. P.; Bijlsma, J. W.

    1995-01-01

    We applied joint distraction using an Ilizarov apparatus in 11 patients with post-traumatic osteoarthritis of the ankle to try to delay the need for an arthrodesis. Distraction for three months resulted in clinical improvement in pain and mobility for a mean of two years, with an increase in the

  18. Arthroscopic Findings of the Joint Distraction for the Patient With Chondrolysis of the Ankle

    OpenAIRE

    Katsuaki Kanbe; Atsushi Hasegawa; Kenji Takagishi; Hiroyuki Kaneko; Yasuyuki Nakajima

    1997-01-01

    This case report describes arthroscopic findings of the effect on articular distraction of ankle joint by means of external fixator for the patient with chondrolysis. Arthroscopy showed fibrocartilage tissue lying between the talus and tibia to protect damaged articular surfaces although apparent repair of surface cartilage failed to find.

  19. Dynamic Postural-Stability Deficits After Cryotherapy to the Ankle Joint.

    Science.gov (United States)

    Fullam, Karl; Caulfield, Brian; Coughlan, Garrett F; McGroarty, Mark; Delahunt, Eamonn

    2015-09-01

    Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however, its effects on postural stability remain unclear. To investigate the acute effects of a 15-minute ankle-joint cryotherapy application on dynamic postural stability. Controlled laboratory study. University biomechanics laboratory. A total of 29 elite-level collegiate male field-sport athletes (age = 20.8 ± 1.12 years, height = 1.80 ± 0.06 m, mass = 81.89 ± 8.59 kg) participated. Participants were tested on the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the Star Excursion Balance Test before and after a 15-minute ankle-joint cryotherapy application. Normalized reach distances; sagittal-plane kinematics of the hip, knee, and ankle joints; and associated mean velocity of the center-of-pressure path during performance of the ANT, PL, and PM reach directions of the Star Excursion Balance Test. We observed a decrease in reach-distance scores for the ANT, PL, and PM reach directions from precryotherapy to postcryotherapy (P .05). We noted a decrease in mean velocity of the center-of-pressure path from precryotherapy to postcryotherapy (P cryotherapy to the ankle joint.

  20. Identification of the contribution of the ankle and hip joints to multi-segmental balance control

    NARCIS (Netherlands)

    Boonstra, T.A.; Schouten, A.C.; Van der Kooij, H.

    2013-01-01

    Background Human stance involves multiple segments, including the legs and trunk, and requires coordinated actions of both. A novel method was developed that reliably estimates the contribution of the left and right leg (i.e., the ankle and hip joints) to the balance control of individual subjects.

  1. Foot and ankle compression improves joint position sense but not bipedal stance in older people

    NARCIS (Netherlands)

    Hijmans, J.M.; Zijlstra, W.; Geertzen, J.H.; Hof, A.L.; Postema, K.

    This study investigates the effects of foot and ankle compression on joint position sense (JPS) and balance in older people and young adults. 12 independently living healthy older persons (77-93 years) were recruited from a senior accommodation facility. 15 young adults (19-24 years) also

  2. Acute injury of the ankle joint; Akutes Trauma des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Univ. Klinik fuer Radiodiagnostik, Abt. fuer Osteologie und Besondere Klinische Einrichtung Magnet Resonanz, AKH, Wien (Austria)]|[Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)

    1999-01-01

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments. In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic. (orig.) [Deutsch] Die Diagnose einer lateralen Bandverletzung beim frischen Sprunggelenkstrauma fusst auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung fuer den Wert der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesonders fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird zur Zeit bei dieser Indikation nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenksbaende erlaubt. Bei knoecherner Sprunggelenksverletzungen ist die Verwendung des konventionellen Roentgen die etablierte Methode und meist

  3. Does ankle joint power reflect type of muscle action of soleus and gastrocnemius during walking in cats and humans?

    Science.gov (United States)

    Cronin, Neil J; Prilutsky, Boris I; Lichtwark, Glen A; Maas, Huub

    2013-04-26

    The main objective of this paper is to highlight the difficulties of identifying shortening and lengthening contractions based on analysis of power produced by resultant joint moments. For that purpose, we present net ankle joint powers and muscle fascicle/muscle-tendon unit (MTU) velocities for medial gastrocnemius (MG) and soleus (SO) muscles during walking in species of different size (humans and cats). For the cat, patterns of ankle joint power and MTU velocity of MG and SO during stance were similar: negative power (ankle moment×angular velocityankle joint power and fascicle velocity patterns were observed for MG muscle. In humans, like cats, the patterns of ankle joint power and MTU velocity of SO and MG were similar. Unlike the cat, there were substantial differences between patterns of fascicle velocity and ankle joint power during stance in both muscles. These results indicate that during walking, only a small fraction of mechanical work of the ankle moment is either generated or absorbed by the muscle fascicles, thus confirming the contribution of in-series elastic structures and/or energy transfer via two-joint muscles. We conclude that ankle joint negative power does not necessarily indicate eccentric action of muscle fibers and that positive power cannot be exclusively attributed to muscle concentric action, especially in humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. The efficacy of manual joint mobilisation/manipulation in treatment of lateral ankle sprains: a systematic review.

    Science.gov (United States)

    Loudon, Janice K; Reiman, Michael P; Sylvain, Jonathan

    2014-03-01

    Lateral ankle sprains are common and can have detrimental consequences to the athlete. Joint mobilisation/manipulation may limit these outcomes. Systematically summarise the effectiveness of manual joint techniques in treatment of lateral ankle sprains. This review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A computer-assisted literature search of MEDLINE, CINHAL, EMBASE, OVID and Physiotherapy Evidence Database (PEDro) (January 1966 to March 2013) was used with the following keywords alone and in combination 'ankle', 'sprain', 'injuries', 'lateral', 'manual therapy', and 'joint mobilisation'. The methodological quality of individual studies was assessed using the PEDro scale. After screening of titles, abstracts and full articles, eight articles were kept for examination. Three articles achieved a score of 10 of 11 total points; one achieved a score of 9; two articles scored 8; one article scored a 7 and the remaining article scored a 5. Three articles examined joint techniques for acute sprains and the remainder examined subacute/chronic ankle sprains. Outcome measures included were pain level, ankle range of motion, swelling, functional score, stabilometry and gait parameters. The majority of the articles only assessed these outcome measures immediately after treatment. No detrimental effects from the joint techniques were revealed in any of the studies reviewed. For acute ankle sprains, manual joint mobilisation diminished pain and increased dorsiflexion range of motion. For treatment of subacute/chronic lateral ankle sprains, these techniques improved ankle range-of-motion, decreased pain and improved function.

  5. Timber joints under long-term loading

    DEFF Research Database (Denmark)

    Feldborg, T.; Johansen, M.

    This report describes tests and results from stiffness and strength testing of splice joints under long-term loading. During two years of loading the spicimens were exposed to cyclically changing relative humidity. After the loading period the specimens were short-term tested. The connectors were...... integral nail-plates and nailed steel and plywood gussets. The report is intended for designers and researchers in timber engineering....

  6. Upper ankle joint space detection on low contrast intraoperative fluoroscopic C-arm projections

    Science.gov (United States)

    Thomas, Sarina; Schnetzke, Marc; Brehler, Michael; Swartman, Benedict; Vetter, Sven; Franke, Jochen; Grützner, Paul A.; Meinzer, Hans-Peter; Nolden, Marco

    2017-03-01

    Intraoperative mobile C-arm fluoroscopy is widely used for interventional verification in trauma surgery, high flexibility combined with low cost being the main advantages of the method. However, the lack of global device-to- patient orientation is challenging, when comparing the acquired data to other intrapatient datasets. In upper ankle joint fracture reduction accompanied with an unstable syndesmosis, a comparison to the unfractured contralateral site is helpful for verification of the reduction result. To reduce dose and operation time, our approach aims at the comparison of single projections of the unfractured ankle with volumetric images of the reduced fracture. For precise assessment, a pre-alignment of both datasets is a crucial step. We propose a contour extraction pipeline to estimate the joint space location for a prealignment of fluoroscopic C-arm projections containing the upper ankle joint. A quadtree-based hierarchical variance comparison extracts potential feature points and a Hough transform is applied to identify bone shaft lines together with the tibiotalar joint space. By using this information we can define the coarse orientation of the projections independent from the ankle pose during acquisition in order to align those images to the volume of the fractured ankle. The proposed method was evaluated on thirteen cadaveric datasets consisting of 100 projections each with manually adjusted image planes by three trauma surgeons. The results show that the method can be used to detect the joint space orientation. The correlation between angle deviation and anatomical projection direction gives valuable input on the acquisition direction for future clinical experiments.

  7. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis.

    Science.gov (United States)

    Young, Rebekah; Nix, Sheree; Wholohan, Aaron; Bradhurst, Rachael; Reed, Lloyd

    2013-11-14

    Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non-surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous. Twenty-three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM. Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non-surgical interventions, thus further research in this area is warranted.

  8. Management of chronic ankle pain using joint mobilization and ASTYM® treatment: a case report.

    Science.gov (United States)

    Slaven, Emily J; Mathers, Jessie

    2011-05-01

    Treatment of ankle sprains predominately focuses on the acute management of this condition; less emphasis is placed on the treatment of ankle sprains in the chronic phase of recovery. Manual therapy, in the form of joint mobilization and manipulation, has been shown to be effective in the management of this condition, but the combination of joint mobilization and manipulation in tandem with ASTYM® treatment has not been explored. The purpose of this case report is to chronicle the management of a patient with chronic ankle pain who was treated with manual therapy including manipulation and ASTYM treatment. As a result of a fall down stairs 6 months previously, the patient sustained a severe ankle sprain. The soft tissue damage was accompanied by bony disruptions which warranted the patient spending 3 weeks in a walking boot. At the initial evaluation, the patient reported difficulty with descending stairs reciprocally and not being able to run more than 4 minutes on the treadmill before the pain escalated to the level that she had to stop running. After five sessions of therapy consisting of joint mobilization, manipulation and ASTYM, the patient was able to descend stairs and run 40 minutes without pain.

  9. Assessment of Relationships Between Joint Motion Quality and Postural Control in Patients With Chronic Ankle Joint Instability.

    Science.gov (United States)

    Bączkowicz, Dawid; Falkowski, Krzysztof; Majorczyk, Edyta

    2017-08-01

    Study Design Controlled laboratory study, cross-sectional. Background Lateral ankle sprains are among the most common injuries encountered during athletic participation. Following the initial injury, there is an alarmingly high risk of reinjury and development of chronic ankle instability (CAI), which is dependent on a combination of factors, including sensorimotor deficits and changes in the biomechanical environment of the ankle joint. Objective To evaluate CAI-related disturbances in arthrokinematic motion quality and postural control and the relationships between them. Methods Sixty-three male subjects (31 with CAI and 32 healthy controls) were enrolled in the study. For arthrokinematic motion quality analysis, the vibroarthrographic signals were collected during ankle flexion/extension motion using an acceleration sensor and described by variability (variance of mean squares [VMS]), amplitude (mean of 4 maximal and 4 minimal values [R4]), and frequency (vibroarthrographic signal bands of 50 to 250 Hz [P1] and 250 to 450 Hz [P2]) parameters. Using the Biodex Balance System, single-leg dynamic balance was measured by overall, anteroposterior, and mediolateral stability indices. Results Values of vibroarthrographic parameters (VMS, R4, P1 and P2) were significantly higher in the CAI group than those in the control group (Pankle arthrokinematic motion and postural control were present. Therefore, physical therapy interventions focused on improving ankle neuromuscular control and arthrokinematic function are necessary in CAI patient care. J Orthop Sports Phys Ther 2017;47(8):570-577. Epub 4 Nov 2016. doi:10.2519/jospt.2017.6836.

  10. Resistance exercise recovers the structure of cartilage and synovial membrane of the ankle joint of rats after sciatic compression

    Directory of Open Access Journals (Sweden)

    Lizyana Vieira

    2017-08-01

    Full Text Available Abstract Aim to determine the effects of sciatic compression and treatment with resistance exercise on the morphology of the ankle joint of Wistar rats. Methods 32 male rats, aged 10 ± 1 week, weighing 376±22 grams were divided into the following four groups (n=8/group: CG (control, LG (lesion, EG (exercise and LEG (lesion and exercise. Three days after sciatic compression, the animals in the EG and LEG were submitted to resistance exercise by climbing stairs (five days/week for three weeks and a load of 100 grams was added. The exercise was carried out in two sets of ten consecutive ascents of the steps. The ankle joint tissues were analyzed for their morphometry and morphology using light microscopy. Results Regarding the number of chondrocytes, the LG and EG had more cells in the anterior articular cartilage in the tibia (62 and 43% and in the talus (57 and 45% when compared to the CG. In the LEG there was a 25% and 26% reduction of chondrocytes in the anterior cartilage in the tibia and talus when compared to the LG. Changes were observed in the tibia and talus in the LG, with the presence of flocculation, invagination of the subchondral bone, discontinuity of tidemark and pannus covering the subchondral bone in the talus, as well as changes in the synovial membrane. These alterations were minimized in the articular cartilage and synovial membrane in the LEG. Conclusions exercise restores the tissue morphology of ankle joint in Wistar rats after sciatic compression.

  11. Medial joint space widening of the ankle in displaced Tillaux and Triplane fractures in children.

    Science.gov (United States)

    Gourineni, Prasad; Gupta, Asheesh

    2011-10-01

    Tillaux and Triplane fractures occur in children predominantly from external rotation mechanism. We hypothesized that in displaced fractures, the talus would shift laterally along with the distal fibula and the distal tibial epiphyseal fragment increasing the medial joint space. Consecutive cases evaluated retrospectively. Level I and Level II centers. Twenty-two skeletally immature patients with 14 displaced Triplane fractures and eight displaced Tillaux fractures were evaluated for medial joint space widening. Measurement of fracture displacement and medial joint space widening before and after intervention. Thirteen Triplane and six Tillaux fractures (86%) showed medial space widening of 1 to 9 mm and equal to the amount of fracture displacement. Reduction of the fracture reduced the medial space to normal. There were no known complications. Medial space widening of the ankle may be a sign of ankle fracture displacement. Anatomic reduction of the fracture reduces the medial space and may improve the results in Tillaux and Triplane fractures.

  12. Measurement of gastrocnemius muscle elasticity by shear wave elastography: association with passive ankle joint stiffness and sex differences.

    Science.gov (United States)

    Chino, Kentaro; Takahashi, Hideyuki

    2016-04-01

    Passive joint stiffness is an important quantitative measure of flexibility, but is affected by muscle volume and all of the anatomical structures located within and over the joint. Shear wave elastography can assess muscle elasticity independent of the influences of muscle volume and the other nearby anatomical structures. We determined how muscle elasticity, as measured using shear wave elastography, is associated with passive joint stiffness and patient sex. Twenty-six healthy men (24.4 ± 5.9 years) and 26 healthy women (25.2 ± 4.8 years) participated in this study. The passive ankle joint stiffness and tissue elasticity of the medial gastrocnemius (MG) were quantified with the ankle in 30° plantar flexion (PF), a neutral anatomical position (NE), and 20° dorsiflexion (DF). No significant difference in passive joint stiffness by sex was observed with the ankle in PF, but significantly greater passive ankle joint stiffness in men than in women was observed in NE and DF. The MG elasticity was not significantly associated with joint stiffness in PF or NE, but it was significantly associated with joint stiffness in DF. There were no significant differences in MG elasticity by sex at any ankle position. Muscle elasticity, measured independent of the confounding effects of muscle volume and the other nearby anatomical structures, is associated with passive joint stiffness in the joint position where the muscle is sufficiently lengthened, but does not vary by sex in any joint position tested.

  13. Facilitation of Hoffmann reflexes of ankle muscles in prone but not standing positions by focal ankle-joint cooling.

    Science.gov (United States)

    Kim, Kyung-Min; Ingersoll, Christopher D; Hertel, Jay

    2015-05-01

    Focal ankle-joint cooling (FAJC) has been shown to increase Hoffmann (H) reflex amplitudes of select leg muscles while subjects lie prone, but it is unknown whether the neurophysiological cooling effects persist in standing. To assess the effects of FAJC on H-reflexes of the soleus and fibularis longus during 3 body positions (prone, bipedal, and unipedal stances) in individuals with and without chronic ankle instability (CAI). Crossover. Laboratory. 15 young adults with CAI (9 male, 6 female) and 15 healthy controls. All subjects received both FAJC and sham treatments on separate days in a randomized order. FAJC was accomplished by applying a 1.5-L plastic bag filled with crushed ice to the ankle for 20 min. Sham treatment involved room-temperature candy corn. Maximum amplitudes of H-reflexes and motor (M) waves were recorded while subjects lay prone and then stood in quiet bipedal and unipedal stances before and immediately after each treatment. Primary outcome measures were H(max):M(max) ratios for the soleus and fibularis longus. Three-factor (group × treatment condition × time) repeated-measures ANOVAs and Fisher LSD tests were performed for statistical analyses. Significant interactions of treatment condition by time for prone H(max):M(max) ratios were found in the soleus (P = .001) and fibularis longus (P = .003). In both muscles, prone H(max):M(max) ratios moderately increased after FAJC but not after sham treatment. The CAI and healthy groups responded similarly to FAJC. In contrast, there were no significant interactions or main effects in the bipedal and unipedal stances in either muscle (P > .05). FAJC moderately increased H-reflex amplitudes of the soleus and fibularis longus while subjects were prone but not during bipedal or unipedal standing. These results were not different between groups with and without CAI.

  14. The Effect of Joint Mobilization on Dynamic Postural Control in Patients With Chronic Ankle Instability: A Critically Appraised Topic.

    Science.gov (United States)

    Kosik, Kyle B; Gribble, Phillip A

    2018-01-01

    Clinical Scenario: Dorsiflexion range of motion is an important factor in the performance of the Star Excursion Balance Test (SEBT). While patients with chronic ankle instability (CAI) commonly experience decreased reach distances on the SEBT, ankle joint mobilization has been suggested to be an effective therapeutic intervention for targeting dorsiflexion range of motion. What is the evidence to support ankle joint mobilization for improving performance on the SEBT in patients with CAI? Summary of Key Findings: The literature was searched for articles examining the effects of ankle joint mobilization on scores of the SEBT. A total of 3 peer-reviewed articles were retrieved, 2 prospective individual cohort studies and 1 randomized controlled trial. Only 2 articles demonstrated favorable results following 6 sessions of ankle joint mobilization. Clinical Bottom Line: Despite the mixed results, the majority of the available evidence suggests that ankle joint mobilization improves dynamic postural control. Strength of Recommendation: In accordance with the Centre of Evidence Based Medicine, the inconsistent results and the limited high-quality studies indicate that there is level C evidence to support the use of ankle joint mobilization to improve performance on the SEBT in patients with CAI.

  15. [Conventional X-Rays of Ankle Joint Fractures in Older Patients are Not Always Predictive].

    Science.gov (United States)

    Jubel, A; Faymonville, C; Andermahr, J; Boxberg, S; Schiffer, G

    2017-02-01

    Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69.9 years. Operation reports and preoperative X-rays were analysed with respect to four relevant lesions: multifragmentary fracture pattern of the lateral malleolus, involvement of the medial malleolus, posterior malleolar fractures and bony avulsion of anterior syndesmosis. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and prevalence were calculated. Results: The prevalence of specific ankle lesions in the analyzed cohort was 24 % for the multifragmentary fracture pattern of the lateral malleolus, 38 % for fractures of the medial malleolus, 25 % for posterior malleolar fractures and 22.6 % for bony avulsions of the anterior syndesmosis. Multifragmentary fracture patterns of the lateral malleolus (sensitivity 0 %) and bony avulsions of the anterior syndesmosis (sensitivity 5 %) could not be detected in plain X-rays of the ankle joint at all. Fractures of the medial malleolus and involvement of the dorsal tibial facet were detected with a sensitivity of 96.8 % and 76.2 %, respectively, and specificity of 100 % in both cases. Conclusions: This study confirms that complex fracture patterns, such as multifragmentary involvement of the lateral malleolus, additional fracture of the medial malleolus, involvement of the dorsal tibial facet or bony avulsion of the anterior syndesmosis are common in ankle fractures of the elderly. Therefore, CT scans should be routinely considered for primary

  16. Six Sessions of Anterior-to-Posterior Ankle Joint Mobilizations Improve Patient-Reported Outcomes in Chronic Ankle Instability Patients: A Critically Appraised Topic.

    Science.gov (United States)

    Wikstrom, Erik A; Bagherian, Sajad; Cordero, Nicole B; Song, Kyeongtak

    2018-01-24

    Clinical Scenario: Chronic ankle instability (CAI) is a complex musculoskeletal condition that results in sensorimotor and mechanical alterations. Manual therapies, such as ankle joint mobilizations are known to improve clinician-oriented outcomes like dorsiflexion range of motion but their impact of patient-reported outcomes remains less clear. Focused Clinical Question: Do anterior-to-posterior ankle joint mobilizations improve patient reported outcomes in patients with CAI? Summary of Key Findings: Three studies (2 RCT, 1 Prospective cohort) quantified the effect of at least 2-weeks of anterior-to-posterior ankle joint mobilizations on improving patient reported outcomes immediately after the intervention and at a follow-up assessment. All three studies demonstrated significant improvements in at least one patient-reported outcome immediately after the intervention and at the follow-up assessment. Clinical Bottom Line: At least 2-weeks of ankle joint mobilization improves patient-reported outcomes in patients with CAI and these benefits are retained for at least a week following the termination of the intervention. Strength of Recommendation: Strength of recommendation is an A due to consistent good-quality patient-oriented evidence.

  17. Redistribution of Mechanical Work at the Knee and Ankle Joints During Fast Running in Minimalist Shoes.

    Science.gov (United States)

    Fuller, Joel T; Buckley, Jonathan D; Tsiros, Margarita D; Brown, Nicholas A T; Thewlis, Dominic

    2016-10-01

    Minimalist shoes have been suggested as a way to alter running biomechanics to improve running performance and reduce injuries. However, to date, researchers have only considered the effect of minimalist shoes at slow running speeds. To determine if runners change foot-strike pattern and alter the distribution of mechanical work at the knee and ankle joints when running at a fast speed in minimalist shoes compared with conventional running shoes. Crossover study. Research laboratory. Twenty-six trained runners (age = 30.0 ± 7.9 years [age range, 18-40 years], height = 1.79 ± 0.06 m, mass = 75.3 ± 8.2 kg, weekly training distance = 27 ± 15 km) who ran with a habitual rearfoot foot-strike pattern and had no experience running in minimalist shoes. Participants completed overground running trials at 18 km/h in minimalist and conventional shoes. Sagittal-plane kinematics and joint work at the knee and ankle joints were computed using 3-dimensional kinematic and ground reaction force data. Foot-strike pattern was classified as rearfoot, midfoot, or forefoot strike based on strike index and ankle angle at initial contact. We observed no difference in foot-strike classification between shoes (χ 2 1 = 2.29, P = .13). Ankle angle at initial contact was less (2.46° versus 7.43°; t 25 = 3.34, P = .003) and strike index was greater (35.97% versus 29.04%; t 25 = 2.38, P = .03) when running in minimalist shoes compared with conventional shoes. We observed greater negative (52.87 J versus 42.46 J; t 24 = 2.29, P = .03) and positive work (68.91 J versus 59.08 J; t 24 = 2.65, P = .01) at the ankle but less negative (59.01 J versus 67.02 J; t 24 = 2.25, P = .03) and positive work (40.37 J versus 47.09 J; t 24 = 2.11, P = .046) at the knee with minimalist shoes compared with conventional shoes. Running in minimalist shoes at a fast speed caused a redistribution of work from the knee to the ankle joint. This finding suggests that runners changing from conventional to minimalist

  18. Gymnasts and non-athletes muscle activation and torque production at the ankle joint

    Directory of Open Access Journals (Sweden)

    Natália Batista Albuquerque Goulart

    2014-07-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2014v16n5p555  Artistic Gymnasts (AG execute specific movements that require substantial movement control and force production at the ankle joint. This high demand might change the neuromechanical properties of the ankle joint muscles in these athletes compared to non-athlete girls (NAG. The aim of this study was to compare muscle activation and torque production at the ankle joint between AG and NAG. Ten AG (11.70 ± 1.06 years of age and 10 NAG (11.70 ± 1.49 years of age participated in the study. Electromyographic  (EMG signals of medial gastrocnemius (MG, soleus (SO and tibialis anterior (TA were obtained simultaneously to the maximal isometric plantarflexion (PFT and dorsiflexion (DFT torques of the dominant limb during a maximal voluntary isometric contraction (MVIC at five different joint angles (20°, 10°, 0°, -10° e -20°. Neuromuscular efficiency was also calculated by the Torque/EMG ratio. AG presented higher PFT (p0.05. In addition, AG showed higher values for plantar flexion neuromuscular efficiency and smaller values of dorsiflexion neuromuscular efficiency compared to the NAG (p<0.01. Higher sports demands of AG determined higher PFT, higher plantar flexor efficiency, smaller DFT but similar activation of MG, SO and TA compared to NAG.

  19. The correlation of the morphological changes of ankle point and ankle joint function after surgery on the Ruedi-Allgouer type III Pilon fracture: A case series study.

    Science.gov (United States)

    Zhou, Yifei; Cai, Leyi; Lu, Xiaolang; Yu, Yang; Hong, Jianjun

    2017-08-01

    To analyze the relationship between imaging findings and postoperative curative effect by measuring the morphology of the ankle mortise in patients with the Ruedi-Allgouer type III Pilon fractures. Forty-seven patients with Ruedi-Allgouer type III Pilon fractures who underwent surgical treatment from January 2011 to January 2015 were retrospectively analyzed. At the last follow-up, x-rays of the affected ankle and the healthy side were measured. According to the Kitaoka score of ankle joint function at the last follow-up. All patients were followed up for 18-24 months (mean 21 months). This study demonstrated that compared with the healthy side, the index of the width, depth, and coronal/sagittal angles of the ankle mortise were significantly different (P  0.05). According to the Kitaoka score, the difference between the affected and the healthy sides of each index of the ankle mortise was compared between the 3 groups. That is, the intraoperative treatment of the width and depth of the ankle mortise as well as the coronal and sagittal angles of the ankle mortise were significantly correlated with the postoperative curative effect. The intraoperative treatment of ankle mortise width, depth, and ankle coronal/sagittal angle in patients with severe Pilon fractures has a significant impact on postoperative efficacy. In order to prevent the occurrence of traumatic arthritis, the anatomical morphology of the ankle should be restored as much as possible in the course of surgery. Copyright © 2017. Published by Elsevier Ltd.

  20. Effect of linear polarized near-infrared light irradiation on flexibility of shoulder and ankle joints.

    Science.gov (United States)

    Demura, S; Yamaji, S; Ikemoto, Y

    2002-12-01

    There is a possibility that heat stimulus by linear polarized near-infrared light irradiation (PL: Super Lizer HA-30, Tokyo Medical Laboratory) improves the range of joint motion, because the flexibility of soft-part tissues, such as a muscle or a tendon, is improved by increasing the muscle temperature. The purpose of this study was to examine the influence of PL-irradiation on the ranges of shoulder and ankle motions. 30 healthy young adults (15 males: mean+/-SD, age 19.1+/-0.8 yrs, height 173.3+/-4.6 cm, body mass 68.5+/-8.0 kg and 15 females: mean+/-SD, age 19.2+/-0.7 yrs, height 162.3+/-4.5 cm, body mass 58.1+/-6.6 kg) participated in the experiment under PL-irradiation and no-irradiation (placebo) conditions. the angles of shoulder and ankle joint motions were measured twice, before and after the PL- and placebo-irradiations. The angle of a motion was defined as the angle connecting 3 points at linearity as follows: for the shoulder, the greater trochanter, acromion, and caput ulnare, and for the ankle, the knee joint, fassa of lateral malleolus and metacarpal bone. Each angle was measured when a subject extended or flexed maximally without support. The trial-to-trial reliability of each range of joint motion was very high. All parameters in PL-irradiation were significantly larger in postirradiation than pre-irradiation, and the value of postirradiation in PL-irradiation was significantly greater than that for placebo. The ranges of shoulder and ankle motions in placebo-irradiation were also significantly greater in postirradiation than pre-irradiation. Moreover, the change rate for each range of joint motion between pre- and postirradiations was significantly greater in PL-irradiation in both joints. In PL-irradiation, most subject's motions were greater in postirradiation than pre-irradiation, but not in the placebo-irradiation. The effect of PL-irradiation tended to be greater on subjects with a small range of a joint motion. It is considered from the

  1. In-vivo analysis of ankle joint movement for patient-specific kinematic characterization.

    Science.gov (United States)

    Ferraresi, Carlo; De Benedictis, Carlo; Franco, Walter; Maffiodo, Daniela; Leardini, Alberto

    2017-09-01

    In this article, a method for the experimental in-vivo characterization of the ankle kinematics is proposed. The method is meant to improve personalization of various ankle joint treatments, such as surgical decision-making or design and application of an orthosis, possibly to increase their effectiveness. This characterization in fact would make the treatments more compatible with the specific patient's joint physiological conditions. This article describes the experimental procedure and the analytical method adopted, based on the instantaneous and mean helical axis theories. The results obtained in this experimental analysis reveal that more accurate techniques are necessary for a robust in-vivo assessment of the tibio-talar axis of rotation.

  2. Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.

    Science.gov (United States)

    Hanlon, Shawn; Caccese, Jaclyn; Knight, Christopher A; Swanik, Charles Buz; Kaminski, Thomas W

    2016-02-01

    Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding. To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding. Cross-sectional study. Research laboratory. Thirty-three participants aged 20.2 ± 1.7 years were tested. The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded. Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV). Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversion-eversion motion was greater at 0° of knee flexion compared with 90° (P ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.

  3. Modeling and simulating the neuromuscular mechanisms regulating ankle and knee joint stiffness during human locomotion.

    Science.gov (United States)

    Sartori, Massimo; Maculan, Marco; Pizzolato, Claudio; Reggiani, Monica; Farina, Dario

    2015-10-01

    This work presents an electrophysiologically and dynamically consistent musculoskeletal model to predict stiffness in the human ankle and knee joints as derived from the joints constituent biological tissues (i.e., the spanning musculotendon units). The modeling method we propose uses electromyography (EMG) recordings from 13 muscle groups to drive forward dynamic simulations of the human leg in five healthy subjects during overground walking and running. The EMG-driven musculoskeletal model estimates musculotendon and resulting joint stiffness that is consistent with experimental EMG data as well as with the experimental joint moments. This provides a framework that allows for the first time observing 1) the elastic interplay between the knee and ankle joints, 2) the individual muscle contribution to joint stiffness, and 3) the underlying co-contraction strategies. It provides a theoretical description of how stiffness modulates as a function of muscle activation, fiber contraction, and interacting tendon dynamics. Furthermore, it describes how this differs from currently available stiffness definitions, including quasi-stiffness and short-range stiffness. This work offers a theoretical and computational basis for describing and investigating the neuromuscular mechanisms underlying human locomotion. Copyright © 2015 the American Physiological Society.

  4. Dynamic Postural-Stability Deficits After Cryotherapy to the Ankle Joint

    Science.gov (United States)

    Fullam, Karl; Caulfield, Brian; Coughlan, Garrett F.; McGroarty, Mark; Delahunt, Eamonn

    2015-01-01

    Context  Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however, its effects on postural stability remain unclear. Objective  To investigate the acute effects of a 15-minute ankle-joint cryotherapy application on dynamic postural stability. Design  Controlled laboratory study. Setting  University biomechanics laboratory. Patients or Other Participants  A total of 29 elite-level collegiate male field-sport athletes (age = 20.8 ± 1.12 years, height = 1.80 ± 0.06 m, mass = 81.89 ± 8.59 kg) participated. Intervention(s)  Participants were tested on the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the Star Excursion Balance Test before and after a 15-minute ankle-joint cryotherapy application. Main Outcome Measure(s)  Normalized reach distances; sagittal-plane kinematics of the hip, knee, and ankle joints; and associated mean velocity of the center-of-pressure path during performance of the ANT, PL, and PM reach directions of the Star Excursion Balance Test. Results  We observed a decrease in reach-distance scores for the ANT, PL, and PM reach directions from precryotherapy to postcryotherapy (P .05). We noted a decrease in mean velocity of the center-of-pressure path from precryotherapy to postcryotherapy (P cryotherapy to the ankle joint. PMID:26285088

  5. Changes in corticospinal transmission following 8 weeks of ankle joint immobilization

    DEFF Research Database (Denmark)

    Leukel, Christian; Taube, Wolfgang; Rittweger, Jörn

    2015-01-01

    ) of the primary motor cortex (Hcond). This method allows assessment of transmission in fast (monosynaptic) and slow(er) (polysynaptic) corticospinal pathways. METHODS: 9 subjects underwent 8weeks of unilateral ankle joint immobilization during daytime, 7 subjects served as controls. The measures obtained before...... and after immobilization included stretch- and H-reflexes assessing excitability of the spinal reflex circuitries, TMS recruitment curves estimating overall changes in corticospinal excitability, and Hcond. RESULTS: TMS recruitment curves showed an overall increase in corticospinal excitability following...

  6. The ankle joint - value of different radiological examinations especially in external ligament injuries

    International Nuclear Information System (INIS)

    Dengel, H.

    1984-01-01

    For a correct radiological positioning of the ankle joint the bimalleolar line is helpful as well for the A.P.-view as for the lateral view. For the examination of external ligament lacerations Radiography with functional test is not always sufficient. After critical comparison of functional radiographs, clinical symptoms and case history arthrography is necessary in certain cases to come to a final conclusion. Indications for arthrography are stated and explained. (orig.) [de

  7. Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Matthias Aurich

    2014-12-01

    Full Text Available Osteoarthritis (OA is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically and the cartilage lesions (arthroscopically of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients was performed, who were treated due to an injury of the knee and ankle joint. Statistical analysis was performed using SigmaStat 3.0 (SPSS Inc, Chicago, USA. There is a higher prevalence of injuries in the ankle as compared to the knee joint in this population from the same catchment area. In contrast, high-grade cartilage lesions are more prevalent in the knee, whereas low grade cartilage lesions are equally distributed between knee and ankle. From this data it can be concluded that the frequency of injuries and the injury pattern of knee versus ankle joints do not correlate with the severity of cartilage lesions and may therefore have no direct influence on the differential incidence of OA in those two joints.

  8. The effect of additional joint mobilization on neuromuscular performance in individuals with functional ankle instability.

    Science.gov (United States)

    Shih, Yi-Fen; Yu, Hsiang-Ting; Chen, Wen-Yin; Liao, Kwong-Kum; Lin, Hsiu-Chen; Yang, Yea-Ru

    2018-03-01

    To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI). A cross-sectional study. Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr). Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG. Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The value of spiral CT scan on fracture of ankle joint and tarsal bones

    International Nuclear Information System (INIS)

    Li Zhaoli; Liang Jingyin; Pan Zhifeng

    2009-01-01

    Objective: To study the value of spiral CT scan on the fracture of ankle joint and tarsal bones. Methods: 43 cases with the fracture of ankle joint and tarsal bones were collected and analyzed. All the cases were examined by plain film radiography and spiral CT thin slice scan. Multi-planar reformation (MPR), surface shaded display (SSD) and other techniques of image post-processing were performed in 35 cases of them. Results: Spiral CT scan could demonstrate more fractures than plain film radiography in 28 cases(65.1%). There are 15 cases (34.9%) which are normal in plain film radiography but abnormal in Spiral CT scan. Spiral CT could demonstrate the different length, width, direction and number of linear low density shadow. SSD and MPR were performed again in the cases with avulsion fracture and fragmental fracture to demonstrate the fracture direction and the shape, size and location of fragments more clearly. Conclusion: Spiral CT thin slice scan with image post-processing techniques can play an important role in fracture of ankle joint and tarsal bones. (authors)

  10. Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy.

    Science.gov (United States)

    Willerslev-Olsen, Maria; Lorentzen, Jakob; Nielsen, Jens Bo

    2014-01-01

    Foot drop and toe walking are frequent concerns in children with cerebral palsy (CP). Increased stiffness of the ankle joint muscles may contribute to these problems. Does four weeks of daily home based treadmill training with incline reduce ankle joint stiffness and facilitate heel strike in children with CP? Seventeen children with CP (4-14 years) were recruited. Muscle stiffness and gait ability were measured twice before and twice after training with an interval of one month. Passive and reflex-mediated stiffness were measured by a dynamometer which applied stretches below and above reflex threshold. Gait kinematics were recorded by 3-D video-analysis during treadmill walking. Foot pressure was measured by force-sensitive foot soles during treadmill and over-ground walking. Children with increased passive stiffness showed a significant reduction in stiffness following training (P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003) increased significantly following the training during both treadmill and over-ground walking. Daily intensive gait training may influence the elastic properties of ankle joint muscles and facilitate toe lift and heel strike in children with CP. Intensive gait training may be beneficial in preventing contractures and maintain gait ability in children with CP.

  11. One-degree-of-freedom spherical model for the passive motion of the human ankle joint.

    Science.gov (United States)

    Sancisi, Nicola; Baldisserri, Benedetta; Parenti-Castelli, Vincenzo; Belvedere, Claudio; Leardini, Alberto

    2014-04-01

    Mathematical modelling of mobility at the human ankle joint is essential for prosthetics and orthotic design. The scope of this study is to show that the ankle joint passive motion can be represented by a one-degree-of-freedom spherical motion. Moreover, this motion is modelled by a one-degree-of-freedom spherical parallel mechanism model, and the optimal pivot-point position is determined. Passive motion and anatomical data were taken from in vitro experiments in nine lower limb specimens. For each of these, a spherical mechanism, including the tibiofibular and talocalcaneal segments connected by a spherical pair and by the calcaneofibular and tibiocalcaneal ligament links, was defined from the corresponding experimental kinematics and geometry. An iterative procedure was used to optimize the geometry of the model, able to predict original experimental motion. The results of the simulations showed a good replication of the original natural motion, despite the numerous model assumptions and simplifications, with mean differences between experiments and predictions smaller than 1.3 mm (average 0.33 mm) for the three joint position components and smaller than 0.7° (average 0.32°) for the two out-of-sagittal plane rotations, once plotted versus the full flexion arc. The relevant pivot-point position after model optimization was found within the tibial mortise, but not exactly in a central location. The present combined experimental and modelling analysis of passive motion at the human ankle joint shows that a one degree-of-freedom spherical mechanism predicts well what is observed in real joints, although its computational complexity is comparable to the standard hinge joint model.

  12. [Case control study of fractures-dislocations of ankle joint with conservative and operative treatment].

    Science.gov (United States)

    Zhang, Song-Tu; Lin, Yi-Rong; Chen, Lian-Yuan

    2010-10-01

    To compare the clinical efficacy of grade III, IV supination-eversion fractures-dislocations of ankle joint between manipulative treatment and operative treatment. From September 2007 to December 2008, the clinical data of 60 patients with grade III, IV supination-eversion fractures-dislocations of ankle joint were retrospectively analyzed. There were 32 males and 28 females, ranging in age from 18 to 70 years with an average age of 38.17 years. All patients were respectively treated with manipulative treatment (conservative group, 30 cases) and operative treatment (operative group, 30 cases). The joint function was compared with Mazur standard; the reduction and shifting of fractures were observed with X-ray; the hospitalization day and the therapeutic cost were compared between two groups. All patients were followed up with an average of 15.27 months (ranged, 6 to 25 months). In conservative group, 16 cases got excellent result in joint function, 10 good, 3 fair, 1 poor; in operative group, 20 cases got excellent result, 8 good, 2 fair, 0 poor. In conservative group in the X-ray showed 25 cases obtained excellent and good reduction, 4 fair, 1 poor; and in operative group in the X-ray showed 28 cases obtained excellent and good reduction, 2 fair, 0 poor. There was no significant difference at the joint function and X-ray film after treatment between two groups (P > 0.05). The hospital day was respectively (7.87 +/- 3.34), (17.37 +/- 4.64) d in conservative group and operative group; and the therapeutic cost was respectively (2 506.67 +/- 649.10), (11 473.33 +/- 1 564.90) yuan. There was significant difference at hospital day and therapeutic cost between two groups (P fractures and dislocations of ankle joint. However, conservative treatment has advantage of high safety factor, low therapeutic cost, can reduce medical costs for patients.

  13. Inverse Dynamics Model for the Ankle Joint with Applications in Tibia Malleolus Fracture

    Science.gov (United States)

    Budescu, E.; Merticaru, E.; Chirazi, M.

    The paper presents a biomechanical model of the ankle joint, in order to determine the force and the torque of reaction into the articulation, through inverse dynamic analysis, in various stages of the gait. Thus, knowing the acceleration of the foot and the reaction force between foot and ground during the gait, determined by experimental measurement, there was calculated, for five different positions of the foot, the joint reaction forces, on the basis of dynamic balance equations. The values numerically determined were compared with the admissible forces appearing in the technical systems of osteosynthesis of tibia malleolus fracture, in order to emphasize the motion restrictions during bone healing.

  14. Feedback and feedforward locomotor adaptations to ankle-foot load in people with incomplete spinal cord injury.

    Science.gov (United States)

    Gordon, Keith E; Wu, Ming; Kahn, Jennifer H; Schmit, Brian D

    2010-09-01

    Humans with spinal cord injury (SCI) modulate locomotor output in response to limb load. Understanding the neural control mechanisms responsible for locomotor adaptation could provide a framework for selecting effective interventions. We quantified feedback and feedforward locomotor adaptations to limb load modulations in people with incomplete SCI. While subjects airstepped (stepping performed with kinematic assistance and 100% bodyweight support), a powered-orthosis created a dorisflexor torque during the "stance phase" of select steps producing highly controlled ankle-load perturbations. When given repetitive, stance phase ankle-load, the increase in hip extension work, 0.27 J/kg above baseline (no ankle-load airstepping), was greater than the response to ankle-load applied during a single step, 0.14 J/kg (P = 0.029). This finding suggests that, at the hip, subjects produced both feedforward and feedback locomotor modulations. We estimate that, at the hip, the locomotor response to repetitive ankle-load was modulated almost equally by ongoing feedback and feedforward adaptations. The majority of subjects also showed after-effects in hip kinetic patterns that lasted 3 min in response to repetitive loading, providing additional evidence of feedforward locomotor adaptations. The magnitude of the after-effect was proportional to the response to repetitive ankle-foot load (R(2) = 0.92). In contrast, increases in soleus EMG amplitude were not different during repetitive and single-step ankle-load exposure, suggesting that ankle locomotor modulations were predominately feedback-based. Although subjects made both feedback and feedforward locomotor adaptations to changes in ankle-load, between-subject variations suggest that walking function may be related to the ability to make feedforward adaptations.

  15. Radiology of chronic diseases of the ankle joint; Chronische Krankheitsbilder am Sprunggelenk

    Energy Technology Data Exchange (ETDEWEB)

    Rand, T. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie]|[Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Trattnig, S.; Breitenseher, M.; Imhof, H. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie; Kreuzer, S. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Wagesreither, S. [Vienna Univ. (Austria). Klinik fuer Zahn-, Mund- und Kieferheilkunde

    1999-01-01

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or

  16. Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity.

    Science.gov (United States)

    Kwon, O Y; Tuttle, L J; Johnson, J E; Mueller, M J

    2009-10-01

    Multiple factors may contribute to hammer toe deformity at the metatarsophalangeal joint. The purposes of this study were to (1) compare the ratio of toe extensor/flexor muscle strength in toes 2-4 among groups with and without hammer toe deformity, (2) to determine correlations between the ratio of toe extensor/flexor muscle strength in toes 2-4, and metatarsophalangeal joint deformity (3) to determine if other clinical measures differ between groups and if these measures are correlated with metatarsophalangeal joint angle. Twenty-seven feet with visible hammer toe deformity and 31 age matched feet without hammer toe deformity were tested. Toe muscle strength was measured using a dynamometer and the ratio of toe extensor muscle strength to flexor muscle strength was calculated. Metatarsophalangeal joint angle was measured from a computerized tomography image. Ankle and subtalar joint range of motion, and tibial torsion were measured using goniometry. Extensor/flexor toe muscle strength ratio was 2.3-3.0 times higher in the hammer toe group compared to the non-hammer toe group, in toes 2-4. The ratios of extensor/flexor toe muscle strength for toes 2-4 and metatarsophalangeal joint angle were highly correlated (r=0.69-0.80). Ankle dorsiflexion and metatarsophalangeal joint angle were negatively correlated for toes 2-4 (r=-0.38 to -0.56) as were eversion and metatarsophalangeal joint angle. These results provide insight into potential risk factors for the development of hammer toe deformity. Additional research is needed to determine the causal relationship between hammer toe deformity and the ratio of toe extensor/flexor muscle strength in toes 2-4.

  17. Differentiation between non-neural and neural contributors to ankle joint stiffness in cerebral palsy.

    Science.gov (United States)

    de Gooijer-van de Groep, Karin L; de Vlugt, Erwin; de Groot, Jurriaan H; van der Heijden-Maessen, Hélène C M; Wielheesen, Dennis H M; van Wijlen-Hempel, Rietje M S; Arendzen, J Hans; Meskers, Carel G M

    2013-07-23

    Spastic paresis in cerebral palsy (CP) is characterized by increased joint stiffness that may be of neural origin, i.e. improper muscle activation caused by e.g. hyperreflexia or non-neural origin, i.e. altered tissue viscoelastic properties (clinically: "spasticity" vs. "contracture"). Differentiation between these components is hard to achieve by common manual tests. We applied an assessment instrument to obtain quantitative measures of neural and non-neural contributions to ankle joint stiffness in CP. Twenty-three adolescents with CP and eleven healthy subjects were seated with their foot fixated to an electrically powered single axis footplate. Passive ramp-and-hold rotations were applied over full ankle range of motion (RoM) at low and high velocities. Subject specific tissue stiffness, viscosity and reflexive torque were estimated from ankle angle, torque and triceps surae EMG activity using a neuromuscular model. In CP, triceps surae reflexive torque was on average 5.7 times larger (p = .002) and tissue stiffness 2.1 times larger (p = .018) compared to controls. High tissue stiffness was associated with reduced RoM (p therapy.

  18. POSITION-SPECIFIC DEFICIT OF JOINT POSITION SENSE IN ANKLES WITH CHRONIC FUNCTIONAL INSTABILITY

    Directory of Open Access Journals (Sweden)

    Shigeki Yokoyama

    2008-12-01

    Full Text Available The present study was aimed to test a hypothesis that individuals with functional ankle instability (FAI underestimate the joint angle at greater plantarflexion and inversion. Seventeen males with unilateral FAI and 17 controls (males without FAI consented for participation in this IRB-approved, case-control study. Using a passive reproduction test, we assessed ankle joint position sense (JPS for test positions between 30 and -10 degrees plantarflexion with an inclement of 10 degrees with or without 20° inversion at each plantarflexion angle. The constant error (CE was defined as the value obtained by subtracting the true angle of a test position from the corresponding perceived angle. At plantarflexed and inverted test positions, the CE values were smaller in negative with greater in the FAI group than in the control group. That is, in the FAI group, the FAI group underestimated the true plantarflexion angle at combined 30° plantarflexion and 20° inversion. We conclude that the ankle with FAI underestimate the amount of plantarflexion, which increases the chance of reaching greater planterflexion and inversion than patients' intention at high risk situations of spraining such as landing

  19. Low-field MRI of the ankle joint-first experience in the pediatric age group

    International Nuclear Information System (INIS)

    Herber, S.; Kreitner, K.F.; Kalden, P.; Loew, R.; Thelen, M.; Berger, S.

    2000-01-01

    Purpose: To evaluate the feasibility and diagnostic confidence of MRI with an open low field System (Magnetom open trademark , Siemens, Germany) in children with predominantly traumatic disorders. Material and methods: Conventional X-rays and MRI examinations have been evaluated in 55 children. MRI was performed at an open 0.2 T MR-unit. The study protocol comprised coronal STIR-sequence, an angulated T 2 weighted TSE-sequence and T 1 weighted SE-sequence. Results: MRI showed ligamental ruptur in 33/50 (60%) cases. Injuries of the ATFL were most frequent (27/33); osseous ligamental tears occurred in approx. 50% of all cases. Fractures of the distal tibia and fibula were diagnosed in 28/55 children. 15/28 cases showed an involvement of the epiphysis. We found occult fractures in 11/28 children. Fractures, diagnosed by conventional X-rays, were excluded in 6 cases. Therapy changed in 35/55 patients on the basis of MRI-findings. Conclusion: Low-field MRI of the ankle joint in children and adolescents is able to show numerous pathological conditions. We recommend low-field MRI of the ankle in children with persistent or unclear pain of the ankle joint and inconspicuous conventional X-ray. (orig.) [de

  20. Anatomical predisposition of the ankle joint for lateral sprain or lateral malleolar fracture evaluated by radiographic measurements.

    Science.gov (United States)

    Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, SeungYeol; Kim, Tae Gyun; Choi, Young; Jung, Ki Jin; Kim, Yeon Ho; Koo, Seung Bum; Park, Moon Seok

    2015-01-01

    Injury mechanism and the amount of force are important factors determining whether a fracture or sprain occurs at the time of an ankle inversion injury. However, the anatomical differences between the ankle fracture and sprain have not been investigated sufficiently. This study was performed to investigate whether an anatomical predisposition of the ankle joint results in a lateral malleolar fracture or lateral ankle sprain. Two groups of consecutive patients, one with lateral malleolar fracture (274 patients, mean age 49.0 years) and the other with lateral ankle sprain (400 patients, mean age 38.4 years), were evaluated. Ankle radiographs were examined for 7 measures: distal tibial articular surface (DTAS) angle, bimalleolar tilt (BT), medial malleolar relative length (MMRL), lateral malleolar relative length (LMRL), medial malleolar slip angle (MMSA), anterior inclination of tibia (AI), and fibular position (FP). After an interobserver reliability test, the radiographic measurements were compared between the 2 groups. Linear regression analysis was performed to correct for age and sex effects between the groups. The fracture group and the sprain group showed significant differences in BT (P = .001), MMSA (P sprain groups showed a significant difference in BT (P = .001), MMRL (P ankle sprain group. Further 3-dimensional assessment of the bony structure and subsequent biomechanical studies are needed to elucidate the mechanism of injury according to the various types of ankle fractures and ankle sprain. Level III, retrospective comparative study. © The Author(s) 2014.

  1. [Endoprosthesis of the ankle joint. Indications and long-term results].

    Science.gov (United States)

    Endrich, B; Terbrüggen, D

    1991-10-01

    The treatment of a post-traumatic, progressively more painful ankle joint causes increasing disablement. It might require alternatives to conventional surgery if a patient does not consent to ankle arthrodesis to alleviate the pain. Therefore, we report on a retrospective study of 10 patients (age 25-73 years at the time of surgery). All of them refused arthrodesis; thus 10 total ankle arthroplasties were performed between 1982 and 1989. 5 women and 5 men were treated who have been suffering from severe post-traumatic arthrosis for 3-46 years. Since performance of a single-axis arthroplasty (ICLH prosthesis) in each patient, the mean follow-up has been 4.6 years. One year after surgery, the results could be considered good or excellent in 9 of the 10 patients; only 1 person experienced local wound infection, which led to removal of the implant 4 months later and ultimately to arthrodesis. Two years later, 7 patients are eligible for follow-up because 1 underwent surgery in February 1989. Another patient experienced aseptic loosening after 18 months; he was admitted to our hospital for arthrodesis. Three years after endoprosthetic surgery, all except 1 woman with occasional pain and stiffness were found to have satisfactory results on follow-up. The relief of pain was gratifying in all patients, with ankle function well maintained (at least 0-0-30 degrees). At present, the prosthesis is still functional in 6 patients (surgery 1.5-8 years ago). They can go about their usual daily business without apparent pain and with appropriate function; 2 of them, however, show radiolucent lines on standard X-rays of the ankle, suggesting some loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Concomitant Contracture of the Knee and Ankle Joint After Gastrocnemius Muscle Rupture: A Case Report.

    Science.gov (United States)

    Ryu, Dong Jin; Kim, Joon Mee; Kim, Bom Soo

    Injury of the medial head of the gastrocnemius, also called "tennis leg," is known to heal uneventfully in most cases with compression and immobilization therapy. Failure to heal or long-term complications, including ongoing pain and pes equinus, have been documented in only a limited number of case reports. To the best of our knowledge, a severe concomitant contracture of the knee and ankle joint as a consequence of a maltreated gastrocnemius muscle rupture has not been previously reported in English-language reports. The purpose of the present study was to report a serious complication of neglected tennis leg with a review of the published data. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Deformities and injuries of the ankle joint in children and adolescents

    International Nuclear Information System (INIS)

    Erlemann, R.; Just, A.; Peters, P.E.

    1991-01-01

    Knowledge of the normal development of the ankle joint is mandatory to understand the mechanism of injuries in children and adolescents. Some fractures (juvenile Tillaux's or two-fragment triplane fracture) occur only within a particular period of growth, which is determined by the degree of epiphyseal fusion. Tarsal coalitions are the deformities seen most frequently. Special radiographic techniques must be applied for the diagnosis. Ball and socket joint, tibiotalar slant and Trevor's disease are rare deformities, each of which is associated with a pathognomonic radiographic pattern. Some typical joint deformities may be seen in patients with neuromuscular disease. This has to be considered when nothing else is found in the clincial history. (orig.) [de

  4. Effects of balance training by knee joint motions on muscle activity in adult men with functional ankle instability.

    Science.gov (United States)

    Nam, Seung-Min; Kim, Won-Bok; Yun, Chang-Kyo

    2016-05-01

    [Purpose] This study examined the effects of balance training by applying knee joint movements on muscle activity in male adults with functional ankle instability. [Subjects and Methods] 28 adults with functional ankle instability, divided randomly into an experimental group, which performed balance training by applying knee joint movements for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Electromyographic values of the tibialis anterior, peroneus longus, peroneus brevis, and the lateral gastrocnemius muscles were obtained to compare and analyze muscle activity before and after the experiments in each group. [Results] The experimental group had significant increases in muscle activity in the tibialis anterior, peroneus longus, and lateral gastrocnemius muscles, while muscle activity in the peroneus brevis increased without significance. The control group had significant increases in muscle activity in the tibialis anterior and peroneus longus, while muscle activity in the peroneus brevis and lateral gastrocnemius muscles increased without significance. [Conclusion] In conclusion, balance training by applying knee joint movements can be recommended as a treatment method for patients with functional ankle instability.

  5. Restoration of ankle joint, quality of life dynamics and assessment of achilles tendon rupture consequences

    Directory of Open Access Journals (Sweden)

    V.V. Vitomskyi

    2017-11-01

    Full Text Available Aim: to investigate the dynamics of restoration of the amplitude of motion in the ankle joint, the quality of life and to assess the effects of the breakdown of the Achilles tendon. Material: patients (n=59, of which n=30 – the main group and n=29 – the control group were examined at 4, 8 and 16 weeks after surgery. Indicators registered with the help of: goniometry; the Achilles tendon Total Rupture Score; the scale of an assessment of consequences and results of Leppilahti implications. Results: the decrease of the total amplitude of the motion in the ankle joint takes place due to the deficiency of the amplitude of the dorsal flexion. At the end of the study the dorsal flexion rates were significantly better among the patients of main group. In particular, its deficit was 3.2 ± 1.85° in the main group and 6.8 ± 2.06° in the control group. The final total score Me (25; 75 was also better according to the questionnaire of the Achilles tendon Total Rupture Score: 82 (78; 84 points against 74 (72; 77 points (p <0.01. An assessment of consequences according to the Leppilahti score was 83.8 ± 8.58 points in the main group and 70.7 ± 10.58 points in the control group (p <0.01. Conclusions: means of physical rehabilitation help recover the amplitude of movement in the ankle joint, improve the quality of life and the effects after the rupture of the Achilles tendon. The correct methodological approach and combination of tools further improves the results.

  6. [Repair and reconstruction for severe fracture and dislocation of ankle joint].

    Science.gov (United States)

    Yin, Qingwei; Jiang, Yi; Xiao, Lianping; Li, Xiaodong; Fu, Jiaxin; Tian, Yonggang; Han, Liqiang; Liu, Zhi

    2008-06-01

    To summarize the technique and effect of the therapy for severe fracture and dislocation of ankle joint by operation. From March 2003 to February 2006, 76 cases were treated with primary open restoration and internal fixation for dislocated ankle joint fracture, with 47 males and 29 females, with the average age of 36.4 years (ranging from 18 years to 65 years). According to AO criterion, these fresh fractures were classified into 13 cases for type C3-1, 45 cases for type C3-2 and 18 cases for type C3-3. Based on the Gustilo-Anderson standard, 23 open fractures were classified into 17 cases for type II and 6 cases for type III A. The operation was delayed from 1 hours to 24 hours after the injury. All incisions healed at the first stage except 4 cases which delayed union because of simple infection by revision with ointment. A total of 72 cases were followed up, with the average time of 18.5 months (from 12 months to 35 months). The time of bone union was from 12 weeks to 24 weeks. The screws of fixation for lower tibia-fibula joint were found to be ruptured in 2 cases when further consultation was performed in the 16th and 20th week after the operation, respectively, and were broken within 1 year after the operation. These screws were taken out 12 weeks postoperative in 28 cases, while the whole internal fixations of the rest cases were taken out 1 year after the operation. The postoperative function of malleolus extended from 21.7 degrees to 26.8 degrees and flection from 38.5 degrees to 44.7 degrees. Assessed by the American Orthopaedic Foot and Ankle Society Clinical Rating Scales, 23 cases were excellent, 36 good, 13 fair, and the choiceness rate reached 81.94%. These procedures, together with reduction by twist after hospital, open and internal fixation in time, and parenchyma managed with internal fixation, are important to attain satisfactory effect for the treatment of severe fracture and dislocation of ankle joint.

  7. Long-term stress distribution patterns of the ankle joint in varus knee alignment assessed by computed tomography osteoabsorptiometry.

    Science.gov (United States)

    Onodera, Tomohiro; Majima, Tokifumi; Iwasaki, Norimasa; Kamishima, Tamotsu; Kasahara, Yasuhiko; Minami, Akio

    2012-09-01

    The stress distribution of an ankle under various physiological conditions is important for long-term survival of total ankle arthroplasty. The aim of this study was to measure subchondral bone density across the distal tibial joint surface in patients with malalignment/instability of the lower limb. We evaluated subchondral bone density across the distal tibial joint in patients with malalignment/instability of the knee by computed tomography (CT) osteoabsorptiometry from ten ankles as controls and from 27 ankles with varus deformity/instability of the knee. The quantitative analysis focused on the location of the high-density area at the articular surface, to determine the resultant long-term stress on the ankle joint. The area of maximum density of subchondral bone was located in the medial part in all subjects. The pattern of maximum density in the anterolateral area showed stepwise increases with the development of varus deformity/instability of the knee. Our results should prove helpful for designing new prostheses and determining clinical indications for total ankle arthroplasty.

  8. Charcot joint-like changes following ankle fracture in a patient with no underlying disease: report of a rare case.

    Science.gov (United States)

    Kumagai, Masaru; Yokota, Kiyoshi; Endoh, Toshiya; Takemoto, Hitoshi; Nagata, Kensei

    2002-01-01

    Charcot joint is a disease that often occurs in patients with diabetes mellitus, tabes dorsalis, syringomyelia, chronic alcoholism, leprosy, trauma, or infection after fractures and dislocations. The treatment for Charcot joint has various complications, such as skin lesions, infections, and delayed union. We present our experience with a male patient who developed Charcot joint-like changes without diabetes mellitus or any other disease after an ankle fracture due to minor trauma.

  9. [Arthroscopic treatment of chondral lesions of the ankle joint. Evidence-based therapy].

    Science.gov (United States)

    Thomas, M; Jordan, M; Hamborg-Petersen, E

    2016-02-01

    Ankle sprains are the most relevant injuries of the lower extremities and can lead to damage to ligaments and osteochondral lesions. Up to 50 % of patients with a sprained ankle later develop a lesion of the cartilage in the ankle joint or an osteochondral lesion of the talus. This can lead to osteoarthritis of the injured ankle joint. Spontaneous healing is possible in all age groups in cases of a bone bruise in the subchondral bone but in isolated chondral injuries is only useful in pediatric patients. In many cases chondral and osteochondral injuries lead to increasing demarcation of the affected area and can result in progressive degeneration of the joint if not recognized in time. There also exist a certain number of osteochondral changes of the articular surface of the talus without any history of relevant trauma, which are collectively grouped under the term osteochondrosis dissecans. Perfusion disorders are discussed as one of many possible causes of these alterations. Nowadays, chondral and osteochondral defects can be treated earlier due to detection using very sensitive magnetic resonance imaging (MRI) and computed tomography (CT) techniques. The use of conservative treatment only has a chance of healing in pediatric patients. Conservative measures for adults should only be considered as adjuvant treatment to surgery.Based on a comprehensive analysis of the current literature, this article gives an overview and critical analysis of the current concepts for treatment of chondral and osteochondral injuries and lesions of the talus. With arthroscopic therapy curettage and microfracture of talar lesions are the predominant approaches or retrograde drilling of the defect is another option when the chondral coating is retained. Implantation of autologous chondral cells or homologous juvenile cartilage tissue is also possible with arthroscopic techniques. Osteochondral fractures (flake fracture) are usually performed as a mini-open procedure supported by

  10. Design of a Robotic Ankle Joint for a Microspine-Based Robot

    Science.gov (United States)

    Thatte, Nitish

    2011-01-01

    Successful robotic exploration of near-Earth asteroids necessitates a method of securely anchoring to the surface of these bodies without gravitational assistance. Microspine grip- per arrays that can grasp rock faces are a potential solution to this problem. A key component of a future microspine-based rover will be the ankle used to attach each microspine gripper to the robot. The ankle's purpose is twofold: 1) to allow the gripper to conform to the rock so a higher percentage of microspines attach to the surface, and 2) to neutralize torques that may dislodge the grippers from the wall. Parts were developed using computer aided design and manufactured using a variety of methods including selective laser sintering, CNC milling, and traditional manual machining techniques. Upon completion of the final prototype, the gripper and ankle system was tested to demonstrate robotic engagement and disengagement of the gripper and to determine load bearing ability. The immediate application of this project is to out t the Lemur IIb robot so it can climb and hang from rock walls.

  11. Classification of fractures in the area of the ankle joint for practical surgical conceras

    International Nuclear Information System (INIS)

    Gay, B.

    1983-01-01

    For practical surgical concerns we require radiological diagnosis of all injuries, indication for conservative or operative therapy and prognostic evidence in order to classify fractures of the ankle joint. Due to the fact that joint stability is ensured by the fibula and syndesmosis, we prefer classification according to Weber. Fracture types A, B and C are classified according to radiological findings, the pertinent concomitant injuries introduced and differentiated from the special forms of the ''interligamentary fracture'' and ''flake fractures''. Due to the frequency of injury in children of the distal, tibial epiphyseal cartilage we select classification according to Aitken for practical purposes, which differentiates basically between separation and fracture of the epiphysis and makes for prognosis about disturbances in growth. Delimited from ''crush injury'' the Aitken classification is compared to other conventional forms of classification in tabular form. (orig.) [de

  12. Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography

    International Nuclear Information System (INIS)

    Schmid, M.R.; Pfirrmann, C.W.A.; Hodler, J.; Zanetti, M.; Vienne, P.

    2003-01-01

    To compare MR arthrography and CT arthrography for the evaluation of cartilage lesions in the ankle joint.Design and patients Thirty-six consecutive patients with clinically suspected cartilage lesions were prospectively included in the study. A 1:1 mixture of diluted gadoteridol (4 mmol/l) and iopamidol (300 mg iodine/ml) was injected. The articular cartilages of the talus, tibia, and fibula were analyzed separately by two musculoskeletal radiologists. A review panel consisting of two musculoskeletal radiologists and an orthopedic surgeon represented the standard of reference. For reader 1 accuracy of MR arthrography in the talus/tibia/fibula (88%/88%/94%) was slightly inferior to CT arthrography (90%/94%/92%). For reader 2, the accuracy was 76%/78%/83% for MR arthrography, and 92%/93%/92% for CT arthrography, respectively. Interobserver agreement for MR arthrography was 79%/74%/89% (kappa 0.47/0.34/0.27), while interobserver agreement for CT arthrography was 89%/90%/89% (kappa 0.69/0.54/0.54). CT arthrography appears to be more reliable than MR arthrography for the detection of cartilage lesions in the ankle joint. (orig.)

  13. Medial joint line bone bruising at MRI complicating acute ankle inversion injury: What is its clinical significance?

    International Nuclear Information System (INIS)

    Chan, V.O.; Moran, D.E.; Shine, S.; Eustace, S.J.

    2013-01-01

    Aim: To assess the incidence and clinical significance of medial joint line bone bruising following acute ankle inversion injury. Materials and methods: Forty-five patients who underwent ankle magnetic resonance imaging (MRI) within 2 weeks of acute ankle inversion injury were included in this prospective study. Integrity of the lateral collateral ligament complex, presence of medial joint line bone bruising, tibio-talar joint effusion, and soft-tissue swelling were documented. Clinical follow-up at 6 months was carried out to determine the impact of injury on length of time out of work, delay in return to normal walking, delay in return to sports activity, and persistence of medial joint line pain. Results: Thirty-seven patients had tears of the anterior talofibular ligament (ATFL). Twenty-six patients had medial joint line bone bruising with altered marrow signal at the medial aspect of the talus and congruent surface of the medial malleolus. A complete ATFL tear was seen in 92% of the patients with medial joint line bone bruising (p = 0.05). Patients with an ATFL tear and medial joint line bone bruising had a longer delay in return to normal walking (p = 0.0002), longer delay in return to sports activity (p = 0.0001), and persistent medial joint line pain (p = 0.0003). There was no statistically significant difference in outcome for the eight patients without ATFL tears. Conclusion: Medial joint line bone bruising following an acute ankle inversion injury was significantly associated with a complete ATFL tear, longer delay in the return to normal walking and sports activity, as well as persistent medial joint line pain. Its presence should prompt detailed assessment of the lateral collateral ligament complex, particularly the ATFL

  14. Mechanical stability of the subtalar joint after lateral ligament sectioning and ankle brace application: a biomechanical experimental study.

    Science.gov (United States)

    Kamiya, Tomoaki; Kura, Hideji; Suzuki, Daisuke; Uchiyama, Eiichi; Fujimiya, Mineko; Yamashita, Toshihiko

    2009-12-01

    The roles of each ligament supporting the subtalar joint have not been clarified despite several biomechanical studies. The effects of ankle braces on subtalar instability have not been shown. The ankle brace has a partial effect on restricting excessive motion of the subtalar joint. Controlled laboratory study. Ten normal fresh-frozen cadaveric specimens were used. The angular motions of the talus were measured via a magnetic tracking system. The specimens were tested while inversion and eversion forces, as well as internal and external rotation torques, were applied. The calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament were sectioned sequentially, and the roles of each ligament, as well as the stabilizing effects of the ankle brace, were examined. Complete sectioning of the ligaments increased the angle between the talus and calcaneus in the frontal plane to 51.7 degrees + or - 11.8 degrees compared with 35.7 degrees + or - 6.0 degrees in the intact state when inversion force was applied. There was a statistically significant difference in the angles between complete sectioning of the ligaments and after application of the brace (34.1 degrees + or - 7.3 degrees ) when inversion force was applied. On the other hand, significant differences in subtalar rotation were not found between complete sectioning of the ligaments and application of the brace when internal and external rotational torques were applied. The ankle brace limited inversion of the subtalar joint, but it did not restrict motion after application of internal or external rotational torques. In cases of severe ankle sprains involving the calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament injuries, application of an ankle brace might be less effective in limiting internal-external rotational instabilities than in cases of inversion instabilities in the subtalar joint. An improvement in the design of the brace is needed to restore

  15. Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers.

    Science.gov (United States)

    Wu, Wen-Te; Chen, Zhi-Wei; Zhou, Yu-Cheng

    2012-10-01

    To evaluate the clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. A retrospective study was carried out at the Department of Orthopedics, the First Hospital affiliated to Nanhua University, Hengyang, China from March 2005 to December 2011. Seventeen cases of anterior impingement syndrome of the ankle joint were confirmed, and treated through arthroscopy. All these patients conformed to regular follow-up postoperatively, and clinical details, as well as postoperative prognosis were retrieved and analyzed retrospectively. The efficacy was evaluated by the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot-ankle scoring system, and pain relief was assessed by visual analogue scoring (VAS). Anterolateral impingement syndrome was found in 11 patients, anteromedial impingement syndrome in 4, while anterior impingement syndrome in 2 via arthroscopic examination. The VAS was reduced from 5.2-1.1, and the AOFAS score was elevated from 76.4-95.8 postoperatively; both of which demonstrated statistical differences when compared to preoperative scores. It was also found that concomitant cartilage damage was an indicator of poor prognosis in arthroscopic treatment of impingement syndrome of the ankle joint. Satisfactory results could be achieved for physical workers with anterior impingement syndrome treated by arthroscopy. As the cartilage damage is an indicator of poor prognosis, an early operation is advocated when the prognosis of anterior impingement syndrome is confirmed.

  16. THERAPEUTIC EFFECTS OF ELECTROACUPUNCTURE PLUS POINT-PENETRATION FOR CHRONIC ANKLE JOINT SPRAIN

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yi-zao

    2005-01-01

    Objective: To observe clinical therapeutic effects of electroacupuncture plus point-penetration for chronic ankle joint sprain. Methods: 76 patients were randomly divided into treatment group (n=43) and control group (n=33).In teatment group, penetration needling from Qiuxu (丘墟 GB 40) to Zhaohai (照海 KI 6) was performed, combined with electrical stimulation for 30 min. Patients of control group were ordered to take Antinfan (50 mg,b.I.d.),supplemented with local external application of Votalin cream (b.I.d.).After 14 treatments (two courses), the therapeutic effect was assessed. Results: Following two courses of treatment, of the 43 cases and 33 cases in treatment and control groups,33 (76.7%) and 15 (45.5%) were cured, 4 (9.3%) and 7 (21.2%) had marked improvement in their symptoms, 3 (7.0%) and 2 (6.1%) had improvement, and 3 (7.0%) and 9(27.3%) failed, with the effective rates being 93.0% and 72.7% respectively. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). Conclusion: Penetrative needling plus EA is significantly superior to medication in relieving chronic ankle spain patient's clinical symptoms and signs.

  17. Foot loading with an ankle-foot orthosis: the accuracy of an integrated physical strain trainer.

    Science.gov (United States)

    Pauser, Johannes; Jendrissek, Andreas; Brem, Matthias; Gelse, Kolja; Swoboda, Bernd; Carl, Hans-Dieter

    2012-07-01

    To investigate the value of a built-in physical strain trainer for the monitoring of partial weight bearing with an ankle-foot orthosis. 12 healthy volunteers were asked to perform three trials. Plantar peak pressure values from normal gait (trial one) were defined as 100% (baseline). The following trials were performed with the Vacoped® dynamic vacuum ankle orthosis worn in a neutral position with full weight bearing (trial two) and a restriction to 10% body weight (BW) (trial three), as monitored with an integrated physical strain trainer. Peak plantar pressure values were obtained using the pedar® X system. Peak pressure values were statistically significantly reduced wearing the Vacoped® shoe with full weight bearing for the hindfoot to 68% of the baseline (normal gait) and for the midfoot and forefoot to 83% and 60%, respectively. Limited weight bearing with 10% BW as controlled by physical strain trainer further reduced plantar peak pressure values for the hindfoot to 19%, for the midfoot to 43% of the baseline and the forefoot to 22% of the baseline. The Vacoped® vacuum ankle orthosis significantly reduces plantar peak pressure. The integrated physical strain trainer seems unsuitable to monitor a limitation to 10% BW adequately for the total foot. The concept of controlling partial weight bearing with the hindfoot-addressing device within the orthosis seems debatable but may be useful when the hindfoot in particular must be off-loaded.

  18. Ankle sprain

    NARCIS (Netherlands)

    Struijs, Peter; Kerkhoffs, Gino

    2007-01-01

    Injury of the lateral ligament complex of the ankle joint occurs in about one per 10,000 people a day, accounting for a quarter of all sports injuries. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment strategies for acute ankle

  19. Ankle sprain

    NARCIS (Netherlands)

    Struijs, Peter Aa; Kerkhoffs, Gino Mmj

    2010-01-01

    Injury of the lateral ligament complex of the ankle joint occurs in about one in 10,000 people a day, accounting for a quarter of all sports injuries. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment strategies for acute ankle

  20. Sprained Ankles

    Science.gov (United States)

    ... away before the ligament is injured. Types of Sprains In young children, the ankle is the most commonly sprained joint, followed by ... A walking cast may be necessary if the ankle or foot injury has been severe. Most grade 1 sprains will heal within two weeks without subsequent complications. ...

  1. Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Lorentzen, Jakob; Nielsen, Jens Bo

    2014-01-01

    and facilitate heel strike in children with CP? METHODS: Seventeen children with CP (4-14 years) were recruited. Muscle stiffness and gait ability were measured twice before and twice after training with an interval of one month. Passive and reflex-mediated stiffness were measured by a dynamometer which applied...... in stiffness following training (P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003) increased significantly following the training during both treadmill and over-ground walking. CONCLUSIONS: Daily intensive gait training may influence the elastic properties of ankle joint muscles...... and facilitate toe lift and heel strike in children with CP. Intensive gait training may be beneficial in preventing contractures and maintain gait ability in children with CP....

  2. Intramuscular Pressure of Tibialis Anterior Reflects Ankle Torque but Does Not Follow Joint Angle-Torque Relationship

    Directory of Open Access Journals (Sweden)

    Filiz Ateş

    2018-01-01

    Full Text Available Intramuscular pressure (IMP is the hydrostatic fluid pressure that is directly related to muscle force production. Electromechanical delay (EMD provides a link between mechanical and electrophysiological quantities and IMP has potential to detect local electromechanical changes. The goal of this study was to assess the relationship of IMP with the mechanical and electrical characteristics of the tibialis anterior muscle (TA activity at different ankle positions. We hypothesized that (1 the TA IMP and the surface EMG (sEMG and fine-wire EMG (fwEMG correlate to ankle joint torque, (2 the isometric force of TA increases at increased muscle lengths, which were imposed by a change in ankle angle and IMP follows the length-tension relationship characteristics, and (3 the electromechanical delay (EMD is greater than the EMD of IMP during isometric contractions. Fourteen healthy adults [7 female; mean (SD age = 26.9 (4.2 years old with 25.9 (5.5 kg/m2 body mass index] performed (i three isometric dorsiflexion (DF maximum voluntary contraction (MVC and (ii three isometric DF ramp contractions from 0 to 80% MVC at rate of 15% MVC/second at DF, Neutral, and plantarflexion (PF positions. Ankle torque, IMP, TA fwEMG, and TA sEMG were measured simultaneously. The IMP, fwEMG, and sEMG were significantly correlated to the ankle torque during ramp contractions at each ankle position tested. This suggests that IMP captures in vivo mechanical properties of active muscles. The ankle torque changed significantly at different ankle positions however, the IMP did not reflect the change. This is explained with the opposing effects of higher compartmental pressure at DF in contrast to the increased force at PF position. Additionally, the onset of IMP activity is found to be significantly earlier than the onset of force which indicates that IMP can be designed to detect muscular changes in the course of neuromuscular diseases impairing electromechanical transmission.

  3. Vibrotactile stimulation of fast-adapting cutaneous afferents from the foot modulates proprioception at the ankle joint.

    Science.gov (United States)

    Mildren, Robyn L; Bent, Leah R

    2016-04-15

    It has previously been shown that cutaneous sensory input from across a broad region of skin can influence proprioception at joints of the hand. The present experiment tested whether cutaneous input from different skin regions across the foot can influence proprioception at the ankle joint. The ability to passively match ankle joint position (17° and 7° plantar flexion and 7° dorsiflexion) was measured while cutaneous vibration was applied to the sole (heel, distal metatarsals) or dorsum of the target foot. Vibration was applied at two different frequencies to preferentially activate Meissner's corpuscles (45 Hz, 80 μm) or Pacinian corpuscles (255 Hz, 10 μm) at amplitudes ∼3 dB above mean perceptual thresholds. Results indicated that cutaneous input from all skin regions across the foot could influence joint-matching error and variability, although the strongest effects were observed with heel vibration. Furthermore, the influence of cutaneous input from each region was modulated by joint angle; in general, vibration had a limited effect on matching in dorsiflexion compared with matching in plantar flexion. Unlike previous results in the upper limb, we found no evidence that Pacinian input exerted a stronger influence on proprioception compared with Meissner input. Findings from this study suggest that fast-adapting cutaneous input from the foot modulates proprioception at the ankle joint in a passive joint-matching task. These results indicate that there is interplay between tactile and proprioceptive signals originating from the foot and ankle. Copyright © 2016 the American Physiological Society.

  4. [Surgery of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws].

    Science.gov (United States)

    Zhang, P; Dong, Q R; Wang, Z Y; Chen, B; Wan, J H; Wang, L

    2016-11-08

    Objective: To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results. Method: From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31.5 years.The fractures occurred on the right side in 9 patients and on the left side in 4 patients.Three cases had the complication of medial malleolar fracture.Ten cases had the complication of medial and lateral malleolar fracture. Totally 11 cases were made calcaneal skeletal traction, and all the were made CT with three-dimensional image reconstruction.Two cases were treated with emergency operation.Eleven cases were treated with selective operation.The operation time was 5 hours-10 days after injury. The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS). Result: The average duration of follow-up was 22.6 months (range, 14-65 months). There was skin necrosis in one cases, no incision infection, malunion and nonunion of the fractures and loss of reduction. At final follow-up, AOFAS ankle score was 75.2 (range, 42 to 93), higher than preoperative 39.2 (range, 23 to 60), the difference was statistically significant ( P =0.023). The result was excellent in 4 cases, good in 5 cases, fair in 3 cases and 1 cases in poor, and the overall excellent or good rate was 69.2%. Avascular necrosis occurred in 3 cases (23.1%, 3/13). Traumatic arthritis was found in 5 cases (38.5%, 5/13), involved tibial astragaloid joint in 2 cases, involved subtalar joint in 1 case, involved tibial astragaloid joint and subtalar joint in 2 cases. Conclusion: The effect of surgical treatment for ipsilateral

  5. Immediate combined effect of gastrocnemius stretching and sustained talocrural joint mobilization in individuals with limited ankle dorsiflexion: A randomized controlled trial.

    Science.gov (United States)

    Kang, Min-Hyeok; Oh, Jae-Seop; Kwon, Oh-Yun; Weon, Jong-Hyuk; An, Duk-Hyun; Yoo, Won-Gyu

    2015-12-01

    Although gastrocnemius stretching and talocrural joint mobilization have been suggested as effective interventions to address limited ankle dorsiflexion passive range of motion (DF PROM), the effects of a combination of the two interventions have not been identified. The aim of the present study was to compare the effects of gastrocnemius stretching combined with joint mobilization and gastrocnemius stretching alone. A randomized controlled trial. In total, 24 individuals with limited ankle DF PROM were randomized to undergo gastrocnemius stretching combined with joint mobilization (12 feet in 12 individuals) or gastrocnemius stretching alone (12 feet in 12 individuals) for 5 min. Ankle kinematics during gait (time to heel-off and ankle DF before heel-off), ankle DF PROM, posterior talar glide, and displacement of the myotendinous junction (MTJ) of the gastrocnemius were assessed before and after the interventions. The groups were compared using two-way repeated measures analysis of variance. Greater increases in the time to heel-off and ankle DF before heel-off during gait and posterior talar glide were observed in the stretching combined with joint mobilization group versus the stretching alone group. Ankle DF PROM and displacement of the MTJ of the gastrocnemius were increased significantly after the interventions in both groups, with no significant difference between them. These findings suggest that gastrocnemius stretching with joint mobilization needs to be considered to improve ankle kinematics during gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Inter-joint coordination strategies during unilateral stance following first-time, acute lateral ankle sprain: A brief report.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Sweeney, Kevin; Delahunt, Eamonn

    2015-07-01

    This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants with an acute, first-time lateral ankle sprain injury in comparison to a control group. Sixty-six participants with an acute first-time lateral ankle sprain and 19 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-D kinematic data for similarity in the aim of establishing patterns of inter-joint coordination for these groups. Between-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2. Injured participants displayed increases in ankle-hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.12 [0.09] vs 0.06 [0.04]; η(2)=.16) and condition 2 (sagittal/frontal plane: 0.18 [0.13] vs 0.08 [0.06]; η(2)=0.37). Participants with acute first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Lower limb joint motion during a cross cutting movement differs in individuals with and without chronic ankle instability.

    Science.gov (United States)

    Koshino, Yuta; Yamanaka, Masanori; Ezawa, Yuya; Ishida, Tomoya; Kobayashi, Takumi; Samukawa, Mina; Saito, Hiroshi; Takeda, Naoki

    2014-11-01

    To compare the kinematics of lower limb joints between individuals with and without chronic ankle instability (CAI) during cross-turn and -cutting movements. Cross-sectional study. Motion analysis laboratory. Twelve subjects with CAI and twelve healthy controls. Hip flexion, adduction, and internal rotation, knee flexion, and ankle dorsiflexion and inversion angles were calculated in the 200 ms before initial ground contact and from initial ground contact to toe-off (stance phase) in a cross-turn movement during gait and a cross-cutting movement from a forward jump, and compared across the two groups. In the cross-cutting movement, the CAI group exhibited greater hip and knee flexion than the control group during the stance phase, and more hip abduction during the period before initial contact and the stance phase. In the cross-turn movement the joint kinematics were similar in the two groups. CAI subjects exhibited an altered pattern of the proximal joint kinematics during a cross-cutting movement. It is important for clinicians to assess the function of the hip and knee as well as the ankle, and to incorporate coordination training for the entire lower limb into rehabilitation after lateral ankle sprains. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Hip and knee joint loading during vertical jumping and push jerking.

    Science.gov (United States)

    Cleather, Daniel J; Goodwin, Jon E; Bull, Anthony M J

    2013-01-01

    The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. The knee experienced mean peak loadings of 2.4-4.6×body weight at the patellofemoral joint, 6.9-9.0×body weight at the tibiofemoral joint, 0.3-1.4×body weight anterior tibial shear and 1.0-3.1×body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4×body weight and the ankle 8.9-10.0×body weight. The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Ankle arthroscopy

    Science.gov (United States)

    Ankle surgery; Arthroscopy - ankle; Surgery - ankle - arthroscopy; Surgery - ankle - arthroscopic ... Arthroscopy may be recommended for these ankle problems: Ankle pain. Arthroscopy allows the surgeon to explore what ...

  10. Enhancing performance during inclined loaded walking with a powered ankle-foot exoskeleton.

    Science.gov (United States)

    Galle, Samuel; Malcolm, Philippe; Derave, Wim; De Clercq, Dirk

    2014-11-01

    A simple ankle-foot exoskeleton that assists plantarflexion during push-off can reduce the metabolic power during walking. This suggests that walking performance during a maximal incremental exercise could be improved with an exoskeleton if the exoskeleton is still efficient during maximal exercise intensities. Therefore, we quantified the walking performance during a maximal incremental exercise test with a powered and unpowered exoskeleton: uphill walking with progressively higher weights. Nine female subjects performed two incremental exercise tests with an exoskeleton: 1 day with (powered condition) and another day without (unpowered condition) plantarflexion assistance. Subjects walked on an inclined treadmill (15%) at 5 km h(-1) and 5% of body weight was added every 3 min until exhaustion. At volitional termination no significant differences were found between the powered and unpowered condition for blood lactate concentration (respectively, 7.93 ± 2.49; 8.14 ± 2.24 mmol L(-1)), heart rate (respectively, 190.00 ± 6.50; 191.78 ± 6.50 bpm), Borg score (respectively, 18.57 ± 0.79; 18.93 ± 0.73) and VO₂ peak (respectively, 40.55 ± 2.78; 40.55 ± 3.05 ml min(-1) kg(-1)). Thus, subjects were able to reach the same (near) maximal effort in both conditions. However, subjects continued the exercise test longer in the powered condition and carried 7.07 ± 3.34 kg more weight because of the assistance of the exoskeleton. Our results show that plantarflexion assistance during push-off can increase walking performance during a maximal exercise test as subjects were able to carry more weight. This emphasizes the importance of acting on the ankle joint in assistive devices and the potential of simple ankle-foot exoskeletons for reducing metabolic power and increasing weight carrying capability, even during maximal intensities.

  11. Treatment of peroneal tendon dislocation and coexisting medial and lateral ligamentous laxity in the ankle joint.

    Science.gov (United States)

    Ziai, Pejman; Sabeti-Aschraf, Manuel; Fehske, Kai; Dlaska, Constantin E; Funovics, Philipp; Wenzel, Florian; Graf, Alexandra; Buchhorn, Tomas

    2011-06-01

    Acute dislocation of the peroneal tendon is caused by massive combined flexion-torsion trauma supported by preexisting ligamentous laxity of the ankle joint. This study aimed to investigate the clinical outcome of combined treatment of peroneal tendon dislocation and lateral and medial ligamentous laxity. Between 2005 and 2007, forty-two patients with peroneal tendon dislocation and coexisting ligamentous laxity were treated. The superior extensor retinaculum was reconstructed using anchor technique and periosteal flap repair, whereas the preexisting ligamentous laxity with regard to the extensor inferior retinaculum was addressed using anchor reconstruction. All patients underwent arthroscopy prior to surgery. Thirty-eight of a total of 42 patients (aged 17-31) completed the 24-month follow-up. Clinical and arthroscopic examination was accomplished consistently by always the same two surgeons. Postoperative follow-up comprised clinical evaluation after 3, 6, 12 and 24 months. Clinical results showed a significant (Pankle joint following arthroscopy results in good clinical outcome and high patient satisfaction. Case series, Level IV.

  12. 99mTc-HDP SPECT-CT Aids Localization of Joint Injections in Degenerative Joint Disease of the Foot and Ankle.

    Science.gov (United States)

    Parthipun, Arum; Moser, Joanna; Mok, Wing; Paramithas, Anton; Hamilton, Paul; Sott, Andrea Helene

    2015-08-01

    Pain relating to degenerative joint disease within the foot and ankle can be difficult to localize with clinical examination alone due to the complex anatomy of the joints. The aim of this study was to determine whether single-photon emission computed tomography combined with conventional computed tomography (SPECT-CT) could be used to localize the site of degenerative joint disease for intra-articular injection and thereby improve the clinical success of the procedure. A prospective study was performed involving 203 patients who had undergone triple-phase (99m)Tc-hydroxymethylene diphosphonate bone scans with SPECT-CT of the foot and ankle for degenerative joint disease. Fifty-two patients went on to have joint injections for degenerative joint disease, with clinical follow-up. Correlation with the clinical diagnosis and the outcome of intra-articular injections with 0.5% bupivacaine and 80 mg of Depo-Medrone was performed. A successful outcome was determined by an improvement in the visual analog pain score of at least 50%. In 19 (37%) patients, the site of degenerative joint disease determined by SPECT-CT differed from the initial clinical assessment and resulted in a change in management. Overall, 46 (88%) patients showed an improvement in symptoms. The study demonstrated a high clinical success rate for SPECT-CT-guided joint injections. The technique was useful in localizing degenerative joint disease of the ankle, hindfoot, and midfoot as an adjunct to clinical examination. Level IV, case series. © The Author(s) 2015.

  13. One- and multi-segment foot models lead to opposite results on ankle joint kinematics during gait: Implications for clinical assessment.

    Science.gov (United States)

    Pothrat, Claude; Authier, Guillaume; Viehweger, Elke; Berton, Eric; Rao, Guillaume

    2015-06-01

    Biomechanical models representing the foot as a single rigid segment are commonly used in clinical or sport evaluations. However, neglecting internal foot movements could lead to significant inaccuracies on ankle joint kinematics. The present study proposed an assessment of 3D ankle kinematic outputs using two distinct biomechanical models and their application in the clinical flat foot case. Results of the Plug in Gait (one segment foot model) and the Oxford Foot Model (multisegment foot model) were compared for normal children (9 participants) and flat feet children (9 participants). Repeated measures of Analysis of Variance have been performed to assess the Foot model and Group effects on ankle joint kinematics. Significant differences were observed between the two models for each group all along the gait cycle. In particular for the flat feet group, opposite results between the Oxford Foot Model and the Plug in Gait were revealed at heelstrike, with the Plug in Gait showing a 4.7° ankle dorsal flexion and 2.7° varus where the Oxford Foot Model showed a 4.8° ankle plantar flexion and 1.6° valgus. Ankle joint kinematics of the flat feet group was more affected by foot modeling than normal group. Foot modeling appeared to have a strong influence on resulting ankle kinematics. Moreover, our findings showed that this influence could vary depending on the population. Studies involving ankle joint kinematic assessment should take foot modeling with caution. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

    Science.gov (United States)

    Wang, Chien-Shun; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; Huang, Ching-Kuei; Chang, Ming-Chau; Chiang, Chao-Ching

    2016-09-01

    The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. Level II, comparative study. © The Author(s) 2016.

  15. Plantar-flexion of the ankle joint complex in terminal stance is initiated by subtalar plantar-flexion: A bi-planar fluoroscopy study.

    Science.gov (United States)

    Koo, Seungbum; Lee, Kyoung Min; Cha, Young Joo

    2015-10-01

    Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects. The three-dimensional movements of the tibia, talus, and calcaneus were calculated with a three-dimensional/two-dimensional registration method. The skeletal kinematics were quantified from 9% to 86% of the full stance phase because of the limited camera speed of the X-ray system. At the beginning of terminal stance, plantar-flexion of the AJC was initiated in the subtalar joint on average at 75% ranging from 62% to 76% of the stance phase, and plantar-flexion of the ankle joint did not start until 86% of the stance phase. The earlier change to plantar-flexion in the AJC than the ankle joint due to the early plantar-flexion in the subtalar joint was observed in 8 of the 10 subjects. This phenomenon could be explained by the absence of direct muscle insertion on the talus. Preceding subtalar plantar-flexion could contribute to efficient and stable ankle plantar-flexion by locking the midtarsal joint, but this explanation needs further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Comparative X-ray investigation of lateral and anterior-posterior ankle-joint images - comparison with pathological and anatomical findings concerning lateral ankle-joint lesions and their clinical importance, studied in a special type of holding device

    International Nuclear Information System (INIS)

    John, F.

    1982-01-01

    The study reports on a possibility to interpret the relation of the different bone structures of the upper ankle-joint to one another in the X-ray picture without using contrast media. Modern funtional diagnostic methods increasingly make use of X-ray pictures taken in fixed position. It seems useful to standardize such X-ray images of the ankle-joint in order to make them reproducible. The author developed a device that would suit these purposes. A diagnosis required the reproduction of the accidental mechanism. The clinical symptoms do not permit to clearly state the extent of the lesion of the ligaments. The results of the post-operative follow-up examinations confirm the urgent necessity of the standardized diagnostic method presented and the success of the therapy applied. The presented X-ray method permits safe diagnosis of ruptures of the ligaments. Location of a certain rupture is not possible with the fixed-position X-ray screening. For a clear assessment of lesions of the ligaments at the lateral ankle-joint, X-ray pictures must be taken both in the anterior-posterior path of rays and in the lateral one. A normal result in the lateral path of rays does not exclude a pathologic result in the anterior-posterior path of rays, and vice versa. (orig./MG) [de

  17. Type 1 diabetes, sport practiced, and ankle joint mobility in young patients: What is the relationship?

    Science.gov (United States)

    Francia, Piergiorgio; Toni, Sonia; Iannone, Giulia; Seghieri, Giuseppe; Piccini, Barbara; Vittori, Alessandro; Santosuosso, Ugo; Casalini, Emilio; Gulisano, Massimo

    2018-03-01

    It is known that patients with diabetes can develop limited joint mobility (LJM) and that this can depend on the metabolic control maintained and the duration of the disease. The aims of this study were to verify the presence of ankle joint mobility (AJM) deficits in both plantar and dorsiflexion in young type 1 diabetic patients (T1D) considering also the possible role of sport practiced as a further factor, able to modify AJM. AJM was evaluated by an inclinometer in 82 T1D patients (M/F: 48/34), mean age 12.9 ± 2.6 years, body mass index (BMI) 19.7 ± 3.6 kg/m 2 , duration of diabetes 5.6 ± 3.3 years, mean HbA1c 7.5 ± 1.0% and in 226 healthy controls (M/F: 146/80), age-, gender-, and BMI-matched practicing different sports (soccer, volleyball, basketball, and dance). The patients' ankle range of motion was significantly lower than that in controls (132.7 ± 22.3° vs 126.1 ± 17.9°; P Soccer players showed lower AJM in both groups: patients (120.1 ± 15.9° vs 127.3 ± 18.1) and controls (119.4 ± 21.1° vs 142.0 ± 18.1; P < .0001) than subjects practicing other sports or who were sedentary. In both groups, patients and controls, age, sex, duration of disease, hemoglobin 1Ac, and BMI have not been shown to be correlated to the mobility assessed. The results of this study, in addition to confirming the negative effect of diabetes on AJM of young T1D patients, suggest that during these evaluations the sport-related effect should be considered because it can induce significant changes of AJM. © 2018 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.

  18. Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kuk Seon; Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Lee, Eil Seong; Min, Seon Jung; Han, You Mie [Dept. of Radiology, Hangang Scared Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Lee, Eil Seong [Dept.of Radiology, Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju (Korea, Republic of)

    2011-04-15

    A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

  19. Diagnosis of ligament injuries in the superior ankle joint. Roentgendiagnostik der Bandlaesionen des oberen Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Gebing, R.; Fiedler, V. (Staedtische Krankenanstalten Krefeld (Germany, F.R.). Inst. fuer Roentgendiagnostik)

    1991-12-01

    Nearly 40 years after ankle arthrography was first introduced, the anterior and inversion stress views of the ankle are still widely preferred as a noninvasive method of evaluating ligament injuries in the upper ankle. We consider the stress test, bilaterally performed using a standardized stress apparatus, as a basic examination by which to differentiate between slight and severe sprain. Intensive muscel splinting due to painful swelling can sometimes be treated by injection of local anesthetic. Like many authors, we perform ankle arthrography in cases where there is a significant difference between the clinical findings and the stress test. The technique of ankle arthrography can be readily learned and is extremely accurate in delineating the extent of ligamentous injury produced by moderate or severe ankle sprains. It can be performed in any X-ray department. (orig.).

  20. Lower extremity joint loads in habitual rearfoot and mid/forefoot strike runners with normal and shortened stride lengths.

    Science.gov (United States)

    Boyer, Elizabeth R; Derrick, Timothy R

    2018-03-01

    Our purpose was to compare joint loads between habitual rearfoot (hRF) and habitual mid/forefoot strikers (hFF), rearfoot (RFS) and mid/forefoot strike (FFS) patterns, and shorter stride lengths (SLs). Thirty-eight hRF and hFF ran at their normal SL, 5% and 10% shorter, as well as with the opposite foot strike. Three-dimensional ankle, knee, patellofemoral (PF) and hip contact forces were calculated. Nearly all contact forces decreased with a shorter SL (1.2-14.9% relative to preferred SL). In general, hRF had higher PF (hRF-RFS: 10.8 ± 1.4, hFF-FFS: 9.9 ± 2.0 BWs) and hip loads (axial hRF-RFS: -9.9 ± 0.9, hFF-FFS: -9.6 ± 1.0 BWs) than hFF. Many loads were similar between foot strike styles for the two groups, including axial and lateral hip, PF, posterior knee and shear ankle contact forces. Lateral knee and posterior hip contact forces were greater for RFS, and axial ankle and knee contact forces were greater for FFS. The tibia may be under greater loading with a FFS because of these greater axial forces. Summarising, a particular foot strike style does not universally decrease joint contact forces. However, shortening one's SL 10% decreased nearly all lower extremity contact forces, so it may hold potential to decrease overuse injuries associated with excessive joint loads.

  1. LATERAL ANKLE INJURY

    OpenAIRE

    Pollard, Henry; Sim, Patrick; McHardy, Andrew

    2002-01-01

    Background: Injury to the ankle joint is the most common peripheral joint injury. The sports that most commonly produce high ankle injury rates in their participating athletes include: basketball, netball, and the various codes of football. Objective: To provide an up to date understanding of manual therapy relevant to lateral ligament injury of the ankle. A discussion of the types of ligament injury and common complicating factors that present with lateral ankle pain is presented along with ...

  2. Quantitative evaluation of the viscoelastic properties of the ankle joint complex in patients suffering from ankle sprain by the anterior drawer test.

    Science.gov (United States)

    Lin, Che-Yu; Shau, Yio-Wha; Wang, Chung-Li; Chai, Huei-Ming; Kang, Jiunn-Horng

    2013-06-01

    Biological tissues such as ligaments exhibit viscoelastic behaviours. Injury to the ligament may induce changes of these viscoelastic properties, and these changes could serve as biomarkers to detect the injury. In the present study, a novel instrument was developed to non-invasive quantify the viscoelastic properties of the ankle in vivo by the anterior drawer test. The purpose of the study was to investigate the reliability of the instrument and to compare the viscoelastic properties of the ankle between patients suffering from ankle sprain and controls. Eight patients and eight controls participated in the present study. The reliability test was performed on three randomly chosen subjects. In patient and control test, both ankles of each subject were tested to evaluate the viscoelastic properties of the ankle. The viscosity index was defined for quantitatively evaluating the viscosity of the ankle. Greater viscosity index was associated with lower viscosity. Injured and uninjured ankles of patient and both ankles of controls were compared. The instrument exhibited excellent test-retest reliability (r > 0.9). Injured ankles exhibited significantly less viscosity than uninjured ankles, since injured ankles of patients had significantly higher viscosity index (8,148 ± 5,266) compared with uninjured ankles of patients (948 ± 617; p = 0.008) and controls (1,326 ± 613; p ankle can serve as sensitive and useful clinical biomarkers to differentiate between injured and uninjured ankles. The method may provide a clinical examination for objectively evaluating lateral ankle ligament injuries.

  3. An EMG-Controlled SMA Device for the Rehabilitation of the Ankle Joint in Post-Acute Stroke

    Science.gov (United States)

    Pittaccio, S.; Viscuso, S.

    2011-07-01

    The capacity of flexing one's ankle is an indispensible segment of gait re-learning, as imbalance, wrong compensatory use of other joints and risk of falling may depend on the so-called drop-foot. The rehabilitation of ankle dorsiflexion may be achieved through active exercising of the relevant musculature (especially tibialis anterior, TA). This can be troublesome for patients affected by weakness and flaccid paresis. Thus, as needs evolve during patient's improvements, a therapeutic device should be able to guide and sustain gradual recovery by providing commensurate aid. This includes exploiting even initial attempts at voluntary motion and turns those into effective workout. An active orthosis powered by two rotary actuators containing NiTi wire was designed to obtain ankle dorsiflexion. A computer routine that analyzes the electromyographic (sEMG) signal from TA muscle is used to control the orthosis and trigger its activation. The software also provides instructions and feed-back for the patient. Tests on the orthosis proved that it can produce strokes up to 36° against resisting torques exceeding 180 Ncm. Three healthy subjects were able to control the orthosis by modulating their TA sEMG activity. The movement produced in the preliminary tests is interesting for lower limb rehabilitation, and will be further improved by optimizing body-orthosis interface. It is hoped that this device will enhance early rehabilitation and recovery of ankle mobility in stroke patients.

  4. Ankle replacement

    Science.gov (United States)

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...

  5. A Novel Design for Adjustable Stiffness Artificial Tendon for the Ankle Joint of a Bipedal Robot: Modeling & Simulation

    Directory of Open Access Journals (Sweden)

    Aiman Omer

    2015-12-01

    Full Text Available Bipedal humanoid robots are expected to play a major role in the future. Performing bipedal locomotion requires high energy due to the high torque that needs to be provided by its legs’ joints. Taking the WABIAN-2R as an example, it uses harmonic gears in its joint to increase the torque. However, using such a mechanism increases the weight of the legs and therefore increases energy consumption. Therefore, the idea of developing a mechanism with adjustable stiffness to be connected to the leg joint is introduced here. The proposed mechanism would have the ability to provide passive and active motion. The mechanism would be attached to the ankle pitch joint as an artificial tendon. Using computer simulations, the dynamical performance of the mechanism is analytically evaluated.

  6. The Effect of Velocity of Joint Mobilization on Corticospinal Excitability in Individuals With a History of Ankle Sprain.

    Science.gov (United States)

    Fisher, Beth E; Piraino, Andrew; Lee, Ya-Yun; Smith, Jo Armour; Johnson, Sean; Davenport, Todd E; Kulig, Kornelia

    2016-07-01

    Study Design Controlled laboratory study. Background Joint mobilization and manipulation decrease pain and improve patient function. Yet, the processes underlying these changes are not well understood. Measures of corticospinal excitability provide insight into potential mechanisms mediated by the central nervous system. Objectives To investigate the differential effects of joint mobilization and manipulation at the talocrural joint on corticospinal excitability in individuals with resolved symptoms following ankle sprain. Methods Twenty-seven participants with a history of ankle sprain were randomly assigned to the control, joint mobilization, or thrust manipulation group. The motor-evoked potential (MEP) and cortical silent period (CSP) of the tibialis anterior and gastrocnemius were obtained with transcranial magnetic stimulation at rest and during active contraction of the tibialis anterior. The slopes of MEP/CSP input/output curves and the maximal MEP/CSP values were calculated to indicate corticospinal excitability. Behavioral measures, including ankle dorsiflexion and dynamic balance, were evaluated. Results A repeated-measures analysis of variance of the MEP slope showed a significant group-by-time interaction for the tibialis anterior at rest (P = .002) and during active contraction (P = .042). After intervention, the thrust manipulation group had an increase in corticospinal excitability, while the corticospinal excitability decreased in the mobilization group. The thrust manipulation group, but not other groups, also demonstrated a significant increase in the maximal MEP amplitude of the tibialis anterior after intervention. Conclusion The findings suggest that joint manipulation and mobilization have different effects on corticospinal excitability. The increased corticospinal excitability following thrust manipulation may provide a window for physical therapists to optimize muscle recruitment and subsequently movement. The trial was registered at

  7. Sprained ankle (image)

    Science.gov (United States)

    A sprain is caused by the twisting or bending of a joint into a position it was not designed to move. The ankle is the most commonly sprained joint. Some common symptoms of a sprain are pain around the joint, ...

  8. Effectiveness of joint mobilisation after cast immobilisation for ankle fracture: a protocol for a randomised controlled trial [ACTRN012605000143628

    Directory of Open Access Journals (Sweden)

    Haas Marion

    2006-05-01

    Full Text Available Abstract Background Passive joint mobilisation is a technique frequently used by physiotherapists to reduce pain, improve joint movement and facilitate a return to activities after injury, but its use after ankle fracture is currently based on limited evidence. The primary aim of this trial is to determine if adding joint mobilisation to a standard exercise programme is effective and cost-effective after cast immobilisation for ankle fracture in adults. Methods/Design Ninety participants will be recruited from the physiotherapy departments of three teaching hospitals and randomly allocated to treatment or control groups using a concealed procedure. All participants will perform an exercise programme. Participants in the treatment group will also receive joint mobilisation twice a week for four weeks. Blinded follow-up assessments will be conducted four, 12 and 24 weeks after randomisation. The primary outcome measures will be the Lower Extremity Functional Scale and the Assessment of Quality of Life. Secondary outcomes will include measures of impairments, activity limitation and participation. Data on the use of physiotherapy services and participants' out-of-pocket costs will be collected for the cost-effective and cost-utility analyses. To test the effects of treatment, between-group differences will be examined with analysis of covariance using a regression approach. The primary conclusions will be based on the four-week follow-up data. Discussion This trial incorporates features known to minimise bias. It uses a pragmatic design to reflect clinical practice and maximise generalisability. Results from this trial will contribute to an evidence-based approach for rehabilitation after ankle fracture.

  9. Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

    Science.gov (United States)

    Beytemür, Ozan; Albay, Cem; Adanır, Oktay; Yüksel, Serdar; Güleç, Mehmet Akif

    2016-12-01

    This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion. Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient. Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.

  10. Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial.

    Science.gov (United States)

    Plaza-Manzano, Gustavo; Vergara-Vila, Marta; Val-Otero, Sandra; Rivera-Prieto, Cristina; Pecos-Martin, Daniel; Gallego-Izquierdo, Tomás; Ferragut-Garcías, Alejandro; Romero-Franco, Natalia

    2016-12-01

    Recurrent ankle sprains often involve residual symptoms for which subjects often perform proprioceptive or/and strengthening exercises. However, the effectiveness of mobilization to influence important nerve structures due to its anatomical distribution like tibial and peroneal nerves is unclear. To analyze the effects of proprioceptive/strengthening exercises versus the same exercises and manual therapy including mobilizations to influence joint and nerve structures in the management of recurrent ankle sprains. A randomized single-blind controlled clinical trial. Fifty-six patients with recurrent ankle sprains and regular sports practice were randomly assigned to experimental or control group. The control group performed 4 weeks of proprioceptive/strengthening exercises; the experimental group performed 4 weeks of the same exercises combined with manual therapy (mobilizations to influence joint and nerve structures). Pain, self-reported functional ankle instability, pressure pain threshold (PPT), ankle muscle strength, and active range of motion (ROM) were evaluated in the ankle joint before, just after and one month after the interventions. The within-group differences revealed improvements in all of the variables in both groups throughout the time. Between-group differences revealed that the experimental group exhibited lower pain levels and self-reported functional ankle instability and higher PPT, ankle muscle strength and ROM values compared to the control group immediately after the interventions and one month later. A protocol involving proprioceptive and strengthening exercises and manual therapy (mobilizations to influence joint and nerve structures) resulted in greater improvements in pain, self-reported functional joint stability, strength and ROM compared to exercises alone. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Inter-joint coordination strategies during unilateral stance 6-months following first-time lateral ankle sprain.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Sweeney, Kevin; Delahunt, Eamonn

    2015-02-01

    Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants, 6-months after they sustained an acute, first-time lateral ankle sprain in comparison to a control group. Sixty-nine participants with a 6-month history of first-time lateral ankle sprain and 20 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-dimensional kinematic data for similarity in the aim of establishing patterns of lower-limb inter-joint coordination. The fractal dimension of the stance limb centre of pressure path was also calculated. Between-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2, and in the fractal dimension of the centre-of-pressure path for condition 2 only. Injured participants displayed increases in ankle-hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.15 [0.14] vs 0.06 [0.04]; η(2)=.19; sagittal/transverse plane: 0.14 [0.11] vs 0.09 [0.05]; η(2)=0.14) and condition 2 (sagittal/frontal plane: 0.15 [0.12] vs 0.08 [0.06]; η(2)=0.23), with an associated decrease in the fractal dimension of the centre-of-pressure path (injured limb: 1.23 [0.13] vs 1.36 [0.13]; η(2)=0.20). Participants with a 6-month history of first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Deformities and injuries of the ankle joint in children and adolescents. Missbildungen und Traumafolgen des kindlichen und jugendlichen Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, R. (Sankt-Johannes-Hospital, Duisburg (Germany, F.R.). Radiologische Klinik); Wuisman, P. (Muenster Univ. (Germany). Orthopaedische Klinik und Poliklinik (Huefferstiftung)); Just, A.; Peters, P.E. (Muenster Univ. (Germany, F.R.). Inst. fuer Klinische Radiologie)

    1991-12-01

    Knowledge of the normal development of the ankle joint is mandatory to understand the mechanism of injuries in children and adolescents. Some fractures (juvenile Tillaux's or two-fragment triplane fracture) occur only within a particular period of growth, which is determined by the degree of epiphyseal fusion. Tarsal coalitions are the deformities seen most frequently. Special radiographic techniques must be applied for the diagnosis. Ball and socket joint, tibiotalar slant and Trevor's disease are rare deformities, each of which is associated with a pathognomonic radiographic pattern. Some typical joint deformities may be seen in patients with neuromuscular disease. This has to be considered when nothing else is found in the clincial history. (orig.).

  13. In vivo facet joint loading of the canine lumbar spine.

    Science.gov (United States)

    Buttermann, G R; Schendel, M J; Kahmann, R D; Lewis, J L; Bradford, D S

    1992-01-01

    This study describes a technique to measure in vivo loads and the resultant load-contact locations in the facet joint of the canine lumbar spine. The technique is a modification of a previously described in vitro method that used calibrated surface strains of the lateral aspect of the right L3 cranial articular process. In the present study, strains were measured during various in vivo static and dynamic activities 3 days after strain gage implantation. The in vivo recording technique and its errors, which depend on the location of the applied facet loads, is described. The results of applying the technique to five dogs gave the following results. Relative resultant contact load locations on the facet tended to be in the central and caudal portion of the facet in extension activities, central and cranial in standing, and cranial and ventral in flexion or right-turning activities. Right-turning contact locations were ventral and cranial to left-turning locations. Resultant load locations at peak loading during walking were in the central region of the facet, whereas resultant load locations at minimum loading during walking were relatively craniad. This resultant load-contact location during a walk gait cycle typically migrated in an arc with a displacement of 4 mm from minimum to maximum loading. Static tests resulted in a range of facet loads of 0 N in flexion and lying to 185 N for two-legged standing erect, and stand resulted in facet loads of 26 +/- 15 N (mean +/- standard deviation [SD]). Dynamic tests resulted in peak facet loads ranging from 55 N while walking erect to 170 N for climbing up stairs. Maximum walk facet loads were 107 +/- 27 N. The technique is applicable to in vivo studies of a canine facet joint osteoarthritis model and may be useful for establishing an understanding of the biomechanics of low-back pain.

  14. Application of ankle joint adem position combined with foot inclined position in ankle sprain%踝关节正侧位联合足正斜位在足踝扭伤中的应用

    Institute of Scientific and Technical Information of China (English)

    施付强; 胡扬; 刘霞; 汪伟伟

    2015-01-01

    Objective To investigate X-ray examination technique and diagnosis of ankle joint sprain, in order to reduce misdiagnosis rate. Methods There were 8 patients with fractures caused by ankle joint sprain, and they all received ankle joint adem position examination and foot inclined position examination. Examination results were observed. Results Among the 8 patients, there was 1 case with lateral malleolus fracture, whose ankle joint adem position result was worse than foot inclined position, 1 case with lateral malleolus fracture, which was not showed by ankle joint adem position but was clearly showed by foot inclined position, and 1 case with fracture in basilar part of the fifth metatarsal bone, which had ankle joint adem position results better than foot inclined position. Conclusion Application of ankle joint adem position combined with foot inclined position examination can show the fracture line better than single examination by joint adem position or foot inclined position, thereby the coincidence rate of diagnosis can be improved.%目的:探讨踝关节扭伤的X线检查技术及诊断,以降低误诊漏诊率。方法8例足踝扭伤并致骨折的患者,均行踝关节正侧位检查及足正斜位检查,观察检查结果。结果8例患者中,有1例外踝骨折,踝关节正侧位显示不如足正斜位,1例外踝骨折踝关节正侧位未能显示,而足正斜位能清晰显示,1例第五跖骨基底部骨折足正斜位显示不如踝关节正侧位。结论踝关节扭伤患者行踝关节正侧位联合足正斜位检查比单纯踝关节正侧位检查或单纯足正斜位检查能更好的显示骨折线,从而提高诊断符合率。

  15. Ankle Injuries and Disorders

    Science.gov (United States)

    Your ankle bone and the ends of your two lower leg bones make up the ankle joint. Your ligaments, which connect bones to one ... muscles and tendons move it. The most common ankle problems are sprains and fractures. A sprain is ...

  16. Treadmill training with an incline reduces ankle joint stiffness and improves active range of movement during gait in adults with cerebral palsy

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Kirk, Henrik; Fernandez-Lago, Helena

    2017-01-01

    of gait were obtained before and after the intervention/control period. Intervention subjects trained 31.4 SD 10.1 days for 29.0 SD 2.3 min (total) 15.2 h. RESULTS: Passive ankle joint stiffness was reduced (F = 5.1; p = 0.031), maximal gait speed increased (F = 42.8, p ...PURPOSE: We investigated if 30 min of daily treadmill training with an incline for 6 weeks would reduce ankle joint stiffness and improve active range of movement in adults with cerebral palsy (CP). METHODS: The study was designed as a randomized controlled clinical trial including 32 adults...... prior to heel strike increased (F = 5.3, p reduces ankle joint stiffness and increases active ROM during...

  17. Shoulder joint loading and posture during medicine cart pushing task.

    Science.gov (United States)

    Xu, Xu; Lin, Jia-Hua; Boyer, Jon

    2013-01-01

    Excessive physical loads and awkward shoulder postures during pushing and pulling are risk factors for shoulder pain. Pushing a medicine cart is a major component of a work shift for nurses and medical assistants in hospitals and other health care facilities. A laboratory experiment was conducted to examine the effects of common factors (e.g., lane congestion, cart load stability, floor surface friction) on shoulder joint moment and shoulder elevation angle of participants during cart pushing. Participants pushed a medicine cart on straight tracks and turning around right-angle corners. Peak shoulder joint moments reached 25.1 Nm, 20.3 Nm, and 26.8 Nm for initial, transition, and turning phases of the pushing tasks, indicating that shoulder joint loading while pushing a medical cart is comparable to levels previously reported from heavy manual activities encountered in industry (e.g., garbage collection). Also, except for user experience, all other main study factors, including congestion level, cart load stability, location of transition strip, shoulder tendency, surface friction, and handedness, significantly influenced shoulder joint moment and shoulder elevation angle. The findings provide a better understanding of shoulder exposures associated with medicine cart operations and may be helpful in designing and optimizing the physical environment where medicine carts are used.

  18. Posttraumatic severe infection of the ankle joint - long term results of the treatment with resection arthrodesis in 133 cases

    Directory of Open Access Journals (Sweden)

    Kienast B

    2010-02-01

    Full Text Available Abstract Although there is a clear trend toward internal fixation for ankle arthrodesis, there is general consensus that external fixation is required for cases of posttraumatic infection. We retrospectively evaluated the technique and clinical long term results of external fixation in a triangular frame for cases of posttraumatic infection of the ankle. From 1993 to 2006 a consecutive series of 155 patients with an infection of the ankle was included in our study. 133 cases of the advanced "Gächter" stage III and IV were treated with arthrodesis. We treated the patients with a two step treatment plan. After radical debridement and sequestrectomy the malleoli and the joint surfaces were resected. An AO fixator was applied with two Steinmann-nails inserted in the tibia and in the calcaneus and the gap was temporary filled with gentamicin beads as the first step. In the second step we performed an autologous bone graft after a period of four weeks. The case notes were evaluated regarding trauma history, medical complaints, further injuries and illnesses, walking and pain status and occupational issues. Mean age at the index procedure was 49.7 years (18-82, 104 patients were male (67,1%. Follow up examination after mean 4.5 years included a standardised questionnaire and a clinical examination including the criteria of the AO-FAS-Score and radiographs. 92,7% of the cases lead to a stable arthrodesis. In 5 patients the arthrodesis was found partly-stable. In six patients (4,5% the infection was not controllable during the treatment process. These patients had to be treated with a below knee amputation. The mean AOFAS score at follow up was 63,7 (53-92. Overall there is a high degree of remaining disability. The complication rate and the reduced patient comfort reserve this method mainly for infection. Joint salvage is possible in the majority of cases with an earlier stage I and II infection.

  19. Inferring Muscle-Tendon Unit Power from Ankle Joint Power during the Push-Off Phase of Human Walking: Insights from a Multiarticular EMG-Driven Model.

    Science.gov (United States)

    Honert, Eric C; Zelik, Karl E

    2016-01-01

    Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs). However, such interpretations are confounded by multiarticular (multi-joint) musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions. The objective of this study was to investigate the degree to which ankle joint power overestimates net plantarflexor MTU power during the Push-off phase of walking, due to the behavior of the flexor digitorum and hallucis longus (FDHL)-multiarticular MTUs crossing the ankle and metatarsophalangeal (toe) joints. We performed a gait analysis study on six healthy participants, recording ground reaction forces, kinematics, and electromyography (EMG). Empirical data were input into an EMG-driven musculoskeletal model to estimate ankle power. This model enabled us to parse contributions from mono- and multi-articular MTUs, and required only one scaling and one time delay factor for each subject and speed, which were solved for based on empirical data. Net plantarflexing MTU power was computed by the model and quantitatively compared to inverse dynamics ankle power. The EMG-driven model was able to reproduce inverse dynamics ankle power across a range of gait speeds (R2 ≥ 0.97), while also providing MTU-specific power estimates. We found that FDHL dynamics caused ankle power to slightly overestimate net plantarflexor MTU power, but only by ~2-7%. During Push-off, FDHL MTU dynamics do not substantially confound the inference of net plantarflexor MTU power from inverse dynamics ankle power. However, other methodological limitations may cause inverse dynamics to overestimate net MTU power; for instance, due to rigid-body foot assumptions. Moving forward, the EMG-driven modeling approach presented

  20. Inferring Muscle-Tendon Unit Power from Ankle Joint Power during the Push-Off Phase of Human Walking: Insights from a Multiarticular EMG-Driven Model.

    Directory of Open Access Journals (Sweden)

    Eric C Honert

    Full Text Available Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs. However, such interpretations are confounded by multiarticular (multi-joint musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions. The objective of this study was to investigate the degree to which ankle joint power overestimates net plantarflexor MTU power during the Push-off phase of walking, due to the behavior of the flexor digitorum and hallucis longus (FDHL-multiarticular MTUs crossing the ankle and metatarsophalangeal (toe joints.We performed a gait analysis study on six healthy participants, recording ground reaction forces, kinematics, and electromyography (EMG. Empirical data were input into an EMG-driven musculoskeletal model to estimate ankle power. This model enabled us to parse contributions from mono- and multi-articular MTUs, and required only one scaling and one time delay factor for each subject and speed, which were solved for based on empirical data. Net plantarflexing MTU power was computed by the model and quantitatively compared to inverse dynamics ankle power.The EMG-driven model was able to reproduce inverse dynamics ankle power across a range of gait speeds (R2 ≥ 0.97, while also providing MTU-specific power estimates. We found that FDHL dynamics caused ankle power to slightly overestimate net plantarflexor MTU power, but only by ~2-7%.During Push-off, FDHL MTU dynamics do not substantially confound the inference of net plantarflexor MTU power from inverse dynamics ankle power. However, other methodological limitations may cause inverse dynamics to overestimate net MTU power; for instance, due to rigid-body foot assumptions. Moving forward, the EMG-driven modeling

  1. Effects of Ankle Arthrodesis on Biomechanical Performance of the Entire Foot.

    Directory of Open Access Journals (Sweden)

    Yan Wang

    Full Text Available Ankle arthrodesis is one popular surgical treatment for ankle arthritis, chronic instability, and degenerative deformity. However, complications such as foot pain, joint arthritis, and bone fracture may cause patients to suffer other problems. Understanding the internal biomechanics of the foot is critical for assessing the effectiveness of ankle arthrodesis and provides a baseline for the surgical plan. This study aimed to understand the biomechanical effects of ankle arthrodesis on the entire foot and ankle using finite element analyses. A three-dimensional finite element model of the foot and ankle, involving 28 bones, 103 ligaments, the plantar fascia, major muscle groups, and encapsulated soft tissue, was developed and validated. The biomechanical performances of a normal foot and a foot with ankle arthrodesis were compared at three gait instants, first-peak, mid-stance, and second-peak.Changes in plantar pressure distribution, joint contact pressure and forces, von Mises stress on bone and foot deformation were predicted. Compared with those in the normal foot, the peak plantar pressure was increased and the center of pressure moved anteriorly in the foot with ankle arthrodesis. The talonavicular joint and joints of the first to third rays in the hind- and mid-foot bore the majority of the loading and sustained substantially increased loading after ankle arthrodesis. An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray. The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes. Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery. These variations can provide

  2. Shoe collar height effect on athletic performance, ankle joint kinematics and kinetics during unanticipated maximum-effort side-cutting performance.

    Science.gov (United States)

    Lam, Gilbert Wing Kai; Park, Eun Jung; Lee, Ki-Kwang; Cheung, Jason Tak-Man

    2015-01-01

    Side-step cutting manoeuvres comprise the coordination between planting and non-planting legs. Increased shoe collar height is expected to influence ankle biomechanics of both legs and possibly respective cutting performance. This study examined the shoe collar height effect on kinematics and kinetics of planting and non-planting legs during an unanticipated side-step cutting. Fifteen university basketball players performed maximum-effort side-step cutting to the left 45° direction or a straight ahead run in response to a random light signal. Seven successful cutting trials were collected for each condition. Athletic performance, ground reaction force, ankle kinematics and kinetics of both legs were analysed using paired t-tests. Results indicated that high-collar shoes resulted in less ankle inversion and external rotation during initial contact for the planting leg. The high-collar shoes also exhibited a smaller ankle range of motion in the sagittal and transverse planes for both legs, respectively. However, no collar effect was found for ankle moments and performance indicators including cutting performance time, ground contact time, propulsion ground reaction forces and impulses. These findings indicated that high-collar shoes altered ankle positioning and restricted ankle joint freedom movements in both legs, while no negative effect was found for athletic cutting performance.

  3. Three-dimensional bone kinematics in an anterior laxity test of the ankle joint

    NARCIS (Netherlands)

    Kerkhoffs, G.; Blankevoort, L.; Kingma, I.; van Dijk, C.N.

    2007-01-01

    Questions addressed in this in-vitro study are (1) what are the actual three-dimensional kinematics of talus and calcaneus during an anterior drawer test as performed with the quasi-static anterior ankle tester (QAAT) (2) does laxity measurement with the QAAT represent the true anterior translation

  4. Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Kamizato Iwao

    2014-01-01

    Full Text Available Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament. Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire. Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

  5. Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants.

    Directory of Open Access Journals (Sweden)

    Ines Kutzner

    Full Text Available Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW. Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36-55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated

  6. Changes in Chopart joint load following tibiotalar arthrodesis: in vitro analysis of 8 cadaver specimen in a dynamic model

    Directory of Open Access Journals (Sweden)

    Herberts T

    2007-08-01

    Full Text Available Abstract Background In the current discussion of surgical treatment of arthroses in the ankle joint, arthrodesis is in competition with artificial joint replacement. Up until now, no valid biomechanical findings have existed on the changes in intraarticular loads following arthrodesis. One argument against tibiotalar arthrodesis is the frequently associated, long-term degeneration of the talonavicular joint, which can be attributed to changes in biomechanical stresses. Methods We used a dynamic model to determine the changes in intraarticular forces and peak-pressure in the talonavicular joint and in the calcaneocuboid joint on 8 cadaver feet under stress in a simulated stance phase following tibiotalar arthrodesis. Results The change seen after arthrodesis was a tendency of relocation of average force and maximum pressure from the lateral onto the medial column of the foot. The average force increased from native 92 N to 100 N upon arthrodesis in the talonavicular joint and decreased in the calcaneocuboid joint from 54 N to 48 N. The peak pressure increased from native 3.9 MPa to 4.4 MPa in the talonavicular joint and in the calcaneocuboid joint from 3.3 MPa to 3.4 MPa. The increase of force and peak pressure on the talonavicular joint and decrease of force on the calcaneocuboid joint is statistically significant. Conclusion The increase in imparted force and peak pressure on the medial column of the foot following tibiotalar arthrodesis, as was demonstrated in a dynamic model, biomechanically explains the clinically observed phenomenon of cartilage degeneration on the medial dorsum of the foot in the long term. As a clinical conclusion from the measurements, it would be desirable to reduce the force imparted on the medial column with displacement onto the lateral forefoot, say by suitable shoe adjustment, in order to achieve a more favourable long-term clinical result.

  7. Characteristics of solder joints under fatigue loads using piezomechanical actuation

    Science.gov (United States)

    Shim, Dong-Jin; Spearing, S. Mark

    2003-07-01

    Crack initiation and growth characteristics of solder joints under fatigue loads are investigated using piezomechanical actuation. Cracks in solder joints, which can cause failure in microelectronics components, are induced via piezoelectricity in piezo-ceramic bonded joints. Lead-zirconate-titanate ceramic plates and eutectic Sn-Pb solder bonded in a double-lap shear configuration are used in the investigation. Electric field across each piezo-ceramic plate is applied such that shear stresses/strains are induced in the solder joints. The experiments show that cracks initiate in the solder joints around defects such as voids and grow in length until they coalesce with other cracks from adjacent voids. These observations are compared with the similar thermal cycling tests from the literature to show feasibility and validity of the current method in investigating the fatigue characteristics of solder joints. In some specimens, cracks in the piezo-ceramic plates are observed, and failure in the specimens generally occurred due to piezo-ceramic plate fracture. The issues encountered in implementing this methodology such as low actuation and high processing temperatures are further discussed.

  8. Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction.

    Science.gov (United States)

    Kern, Andrew M; Anderson, Donald D

    2015-09-18

    Acute injury severity, altered joint kinematics, and joint incongruity are three important mechanical factors linked to post-traumatic osteoarthritis (PTOA). Finite element analysis (FEA) was previously used to assess the influence of increased contact stress due to joint incongruity on PTOA development. While promising agreement with PTOA development was seen, the inherent complexities of contact FEA limited the numbers of subjects that could be analyzed. Discrete element analysis (DEA) is a simplified methodology for contact stress computation, which idealizes contact surfaces as a bed of independent linear springs. In this study, DEA was explored as an expedited alternative to FEA contact stress exposure computation. DEA was compared to FEA using results from a previously completed validation study of two cadaveric human ankles, as well as a previous study of post-operative contact stress exposure in 11 patients with tibial plafond fracture. DEA-computed maximum contact stresses were within 19% of those experimentally measured, with 90% of the contact area having computed contact stress values within 1MPa of those measured. In the 11 fractured ankles, maximum contact stress and contact area differences between DEA and FEA were 0.85 ± 0.64 MPa and 22.5 ± 11.5mm(2). As a predictive measure for PTOA development, both DEA and FEA had 100% concordance with presence of OA (KL grade ≥ 2) and >95% concordance with KL grade at 2 years. These results support DEA as a reasonable alternative to FEA for computing contact stress exposures following surgical reduction of a tibial plafond fracture. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Loading nature of the interfacial cracks in a joint component under fusion-relevant thermal loads

    International Nuclear Information System (INIS)

    You, J.H.

    1998-01-01

    One of the standard design concepts for divertor components in a fusion reactor is the bonded joint structure. Understanding the loading nature of interfacial cracks are significant for the assessment of structural integrity of divertor joint components. In this paper, the thermomechanical loading nature of interfacial cracks is discussed. A bi-material joint element consisting of the CFC/TZM system is considered. A typical fusion operation condition is simulated assuming a pulsed high heat flux loading. Stress singularities near the interfacial crack tips are characterized quantitatively in terms of the fracture mechanical parameters. The evolution of the stress intensity factors and the energy release rate during the given transient thermal load are determined. The difference in loading characteristics between the edge crack and the center crack is discussed. High heat flux cycling tests are performed on brazed CFC/TZM divertor elements in an electron beam test facility. The microstructures of the damaged interface agree with the predicted fracture modes. The loading nature and possible failure mechanisms are discussed for a fusion-relevant thermal loading. (orig.)

  10. Mechanical Behaviour of Bolted Joints Under Impact Rates of Loading

    Science.gov (United States)

    2012-01-01

    M. (1995). Bearing Strength of Autoclave and oven cured kevlar / epoxy laminates under static and dynamic loading. Compostes, 451-456. Kretsis, G...Joints in Glass Fibre/ Epoxy Laminates. Composites, Volume 16. No 2. Kolsky, H. (1949). An Investigation of the Mechanical Properties of Materials at...elongating the pulse width. The responses are read by the strain gages bonded on the incident and transmission bar with Vishay AE-10 epoxy . The gages

  11. Current concepts: tissue engineering and regenerative medicine applications in the ankle joint.

    Science.gov (United States)

    Correia, S I; Pereira, H; Silva-Correia, J; Van Dijk, C N; Espregueira-Mendes, J; Oliveira, J M; Reis, R L

    2014-03-06

    Tissue engineering and regenerative medicine (TERM) has caused a revolution in present and future trends of medicine and surgery. In different tissues, advanced TERM approaches bring new therapeutic possibilities in general population as well as in young patients and high-level athletes, improving restoration of biological functions and rehabilitation. The mainstream components required to obtain a functional regeneration of tissues may include biodegradable scaffolds, drugs or growth factors and different cell types (either autologous or heterologous) that can be cultured in bioreactor systems (in vitro) prior to implantation into the patient. Particularly in the ankle, which is subject to many different injuries (e.g. acute, chronic, traumatic and degenerative), there is still no definitive and feasible answer to 'conventional' methods. This review aims to provide current concepts of TERM applications to ankle injuries under preclinical and/or clinical research applied to skin, tendon, bone and cartilage problems. A particular attention has been given to biomaterial design and scaffold processing with potential use in osteochondral ankle lesions.

  12. Squeeze-film Lubrication of the Human Ankle Joint with Synovial Fluid Filtrated by Articular Cartilage with the Superficial Zone Worn out

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

    Roč. 33, č. 11 (2000), s. 1415-1422 ISSN 0021-9290 R&D Projects: GA ČR GA103/00/0008 Keywords : human ankle joint * squeeze-film lubrication * synovial fluid filtration * worn-out cartilage superficial zone Subject RIV: BK - Fluid Dynamics Impact factor: 1.474, year: 2000

  13. Synovial Fluid Filtration by Articular Cartilage with a Worn-out Surface Zone in the Human Ankle Joint during Walking- II. Numerical Results for Steady Pure Sliding

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

    Roč. 45, č. 4 (2000), s. 375-396 ISSN 0001-7043 R&D Projects: GA ČR GA103/00/0008 Keywords : biphasic articular cartilage * biphasic synovial fluid * boundary lubrication * human ankle joint Subject RIV: BK - Fluid Dynamics

  14. Synovial Fluid Filtration by Articular Cartilage with a Worn-out Surface Zone in the Human Ankle Joint during Walking- I.A Mathematical Mixture Model

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

    Roč. 45, č. 3 (2000), s. 295-321 ISSN 0001-7043 R&D Projects: GA ČR GA103/00/0008 Keywords : asymptotic solution * biphasic articular cartilage * biphasic synovial fluid * human ankle joint Subject RIV: BK - Fluid Dynamics

  15. Relationship of medial gastrocnemius relative fascicle excursion and ankle joint power and work performance during gait in typically developing children: A cross-sectional study.

    Science.gov (United States)

    Martín Lorenzo, Teresa; Albi Rodríguez, Gustavo; Rocon, Eduardo; Martínez Caballero, Ignacio; Lerma Lara, Sergio

    2017-07-01

    Muscle fascicles lengthen in response to chronic passive stretch through in-series sarcomere addition in order to maintain an optimum sarcomere length. In turn, the muscles' force generating capacity, maximum excursion, and contraction velocity is enhanced. Thus, longer fascicles suggest a greater capacity to develop joint power and work. However, static fascicle length measurements may not be taking sarcomere length differences into account. Thus, we considered relative fascicle excursions through passive ankle dorsiflexion may better correlate with the capacity to generate joint power and work than fascicle length. Therefore, the aim of the present study was to determine if medial gastrocnemius relative fascicle excursions correlate with ankle joint power and work generation during gait in typically developing children. A sample of typically developing children (n = 10) were recruited for this study and data analysis was carried out on 20 legs. Medial gastrocnemius relative fascicle excursion from resting joint angle to maximum dorsiflexion was estimated from trigonometric relations of medial gastrocnemius pennation angle and thickness obtained from B-mode real-time ultrasonography. Furthermore, a three-dimensional motion capture system was used to obtain ankle joint work and power during the stance phase of gait. Significant correlations were found between relative fascicle excursion and peak power absorption (-) r(14) = -0.61, P = .012 accounting for 31% variability, positive work r(18) = 0.56, P = .021 accounting for 31% variability, and late stance positive work r(15) = 0.51, P = .037 accounting for 26% variability. The large unexplained variance may be attributed to mechanics of neighboring structures (e.g., soleus or Achilles tendon mechanics) and proximal joint kinetics which may also contribute to ankle joint power and work performance, and were not taken into account. Further studies are encouraged to provide greater insight

  16. Modelling the joint torques and loadings during squatting at the Smith machine.

    Science.gov (United States)

    Biscarini, Andrea; Benvenuti, Paolo; Botti, Fabio; Mastrandrea, Francesco; Zanuso, Silvano

    2011-03-01

    An analytical biomechanical model was developed to establish the relevant properties of the Smith squat exercise, and the main differences from the free barbell squat. The Smith squat may be largely patterned to modulate the distributions of muscle activities and joint loadings. For a given value of the included knee angle (θ(knee)), bending the trunk forward, moving the feet forward in front of the knees, and displacing the weight distribution towards the forefoot emphasizes hip and lumbosacral torques, while also reducing knee torque and compressive tibiofemoral and patellofemoral forces (and vice versa). The tibiofemoral shear force φ(t) displays more complex trends that strongly depend on θ(knee). Notably, for 180° ≥ θ(knee) ≥ 130°, φ(t) and cruciate ligament strain forces can be suppressed by selecting proper pairs of ankle and hip angles. Loading of the posterior cruciate ligament increases (decreases) in the range 180° ≥ θ(knee) ≥ 150° (θ(knee) ≤ 130°) with knee extension, bending the trunk forward, and moving the feet forward in front of the knees. In the range 150° > θ(knee) > 130°, the behaviour changes depending on the foot weight distribution. The conditions for the development of anterior cruciate ligament strain forces are explained. This work enables careful use of the Smith squat in strengthening and rehabilitation programmes.

  17. Bilateral Arthrodesis of the Ankle Joint: Self-Reported Outcomes in 35 Patients From the Swedish Ankle Registry.

    Science.gov (United States)

    Henricson, Anders; Kamrad, Ilka; Rosengren, Björn; Carlsson, Åke

    Bilateral ankle arthrodesis is seldom performed, and results concerning the outcome and satisfaction can only sparsely be found in published studies. We analyzed the data from 35 patients who had undergone bilateral ankle arthrodesis in the Swedish Ankle Registry using patient-reported generic and region-specific outcome measures. Of 36 talocrural arthrodeses and 34 tibio-talar-calcaneal arthrodeses, 6 ankles (9%) had undergone repeat arthrodesis because of nonunion. After a mean follow-up period of 47 ± 5 (range 12 to 194) months, the mean scores were as follows: self-reported foot and ankle score, 33 ± 10 (range 4 to 48); the EuroQol Group's EQ-5D ™ score, 0.67 ± 0.28 (range -0.11 to 1), the EuroQol Group's visual analog scale score, 70 ± 19 (range 20 to 95), 36-item Short Form Health Survey (SF-36) physical domain, 39 ± 11 (range 16 to 58); and SF-36 mental domain, 54 ± 14 (range 17 to 71). Patients with rheumatoid arthritis seemed to have similar self-reported foot and ankle scores but possibly lower EQ-5D ™ and SF-36 scores. Those with talocrural arthrodeses scored higher than did those with tibio-talar-calcaneal arthrodeses on the EQ5D ™ and SF-36 questionnaires (p = .03 and p = .04). In 64 of 70 ankles (91%), the patients were satisfied or very satisfied with the outcome. In conclusion, we consider bilateral ankle arthrodesis to be a reasonable treatment for symptomatic hindfoot arthritis, with high postoperative mid-term satisfaction and satisfactory scores on the patient-reported generic and region-specific outcome measures, when no other treatment option is available. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Evaluation of cartilage repair tissue in the knee and ankle joint using sodium magnetic resonance imaging at 7 Tesla

    International Nuclear Information System (INIS)

    Zbyn, S.

    2015-01-01

    Articular cartilage of adults shows no or very limited intrinsic capacity for self-repair. Since untreated chondral defects often progress to osteoarthritis, symptomatic defects should be treated. Different cartilage repair procedures have been developed with the goal to restore joint function and prevent further cartilage degeneration by providing repair tissue of the same structure, composition, and biomechanical properties as native cartilage. Various cartilage repair procedures have been developed; including bone marrow stimulation (BMS) techniques such as microfracture (MFX), cell-based techniques such as matrix-associated autologous chondrocyte transplantation (MACT), and others. Since biopsies of cartilage repair tissue are invasive and cannot be repeated, a noninvasive method is needed that could follow-up the quality of cartilage and repair tissue. Negatively charged glycosaminoglycans (GAG) are very important for cartilage function as they attract positive ions such as sodium. The high concentration of ions in cartilage is responsible for osmotic pressure providing cartilage its resilience to compression. Since GAGs are counterbalanced by sodium ions, sodium magnetic resonance imaging (MRI) was validated as a sensitive method for the in vivo evaluation of GAG concentration in native cartilage but not for repair tissue. Thus, the main goal of this thesis was to optimize and validate sodium 7 Tesla MRI for the evaluation of cartilage repair tissue quality in patients after different cartilage repair surgeries in the knee and ankle joint. In our studies, sodium MRI was used for the first time for the clinical evaluation of cartilage repair tissue. A strong correlation found between sodium imaging and dGEMRIC (another GAG-sensitive technique) in patients after MACT on femoral cartilage proved sensitivity of sodium MRI to GAG changes in native cartilage and repair tissue in vivo. Comparison between BMS and MACT patients showed significantly lower sodium values

  19. Simulated radiographic bone and joint modeling from 3D ankle MRI: feasibility and comparison with radiographs and 2D MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nordeck, Shaun M. [University of Texas Southwestern Medical College, Dallas, TX (United States); University of Texas Southwestern Medical Center, Musculoskeletal Radiology, Dallas, TX (United States); Koerper, Conrad E.; Adler, Aaron [University of Texas Southwestern Medical College, Dallas, TX (United States); Malhotra, Vidur; Xi, Yin [University of Texas Southwestern Medical Center, Musculoskeletal Radiology, Dallas, TX (United States); Liu, George T. [University of Texas Southwestern Medical Center, Orthopaedic Surgery, Dallas, TX (United States); Chhabra, Avneesh [University of Texas Southwestern Medical Center, Musculoskeletal Radiology, Dallas, TX (United States); University of Texas Southwestern Medical Center, Orthopaedic Surgery, Dallas, TX (United States)

    2017-05-15

    The purpose of this work is to simulate radiographs from isotropic 3D MRI data, compare relationship of angle and joint space measurements on simulated radiographs with corresponding 2D MRIs and real radiographs (XR), and compare measurement times among the three modalities. Twenty-four consecutive ankles were included, eight males and 16 females, with a mean age of 46 years. Segmented joint models simulating radiographs were created from 3D MRI data sets. Three readers independently performed blinded angle and joint space measurements on the models, corresponding 2D MRIs, and XRs at two time points. Linear mixed models and the intraclass correlation coefficient (ICC) was ascertained, with p values less than 0.05 considered significant. Simulated radiograph models were successfully created in all cases. Good agreement (ICC > 0.65) was noted among all readers across all modalities and among most measurements. Absolute measurement values differed between modalities. Measurement time was significantly greater (p < 0.05) on 2D versus simulated radiographs for most measurements and on XR versus simulated radiographs (p < 0.05) for nearly half the measurements. Simulated radiographs can be successfully generated from 3D MRI data; however, measurements differ. Good inter-reader and moderate-to-good intra-reader reliability was observed and measurements obtained on simulated radiograph models took significantly less time compared to measurements with 2D and generally less time than XR. (orig.)

  20. [Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint].

    Science.gov (United States)

    Qi, Yue-Feng; Chen, Fa-Lin; Bao, Shu-Ren; Li, Cheng-Huan; Zhao, Xing-Wei; Liu, Shi-Ming; Chen, Wen-Xue; Li, Ye; Wang, Peng

    2012-08-01

    To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism. From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment. All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary

  1. Sodium magnetic resonance imaging of ankle joint in cadaver specimens, volunteers, and patients after different cartilage repair techniques at 7 T: initial results.

    Science.gov (United States)

    Zbýň, Štefan; Brix, Martin O; Juras, Vladimir; Domayer, Stephan E; Walzer, Sonja M; Mlynarik, Vladimir; Apprich, Sebastian; Buckenmaier, Kai; Windhager, Reinhard; Trattnig, Siegfried

    2015-04-01

    The goal of cartilage repair techniques such as microfracture (MFX) or matrix-associated autologous chondrocyte transplantation (MACT) is to produce repair tissue (RT) with sufficient glycosaminoglycan (GAG) content. Sodium magnetic resonance imaging (MRI) offers a direct and noninvasive evaluation of the GAG content in native cartilage and RT. In the femoral cartilage, this method was able to distinguish between RTs produced by MFX and MACT having different GAG contents. However, it needs to be clarified whether sodium MRI can be useful for evaluating RT in thin ankle cartilage. Thus, the aims of this 7-T study were (1) to validate our sodium MRI protocol in cadaver ankle samples, (2) to evaluate the sodium corrected signal intensities (cSI) in cartilage of volunteers, (3) and to compare sodium values in RT between patients after MFX and MACT treatment. Five human cadaver ankle samples as well as ankles of 9 asymptomatic volunteers, 6 MFX patients and 6 MACT patients were measured in this 7-T study. Sodium values from the ankle samples were compared with histochemically evaluated GAG content. In the volunteers, sodium cSI values were calculated in the cartilages of ankle and subtalar joint. In the patients, sodium cSI in RT and reference cartilage were measured, morphological appearance of RT was evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system, and clinical outcome before and after surgery was assessed using the American Orthopaedic Foot and Ankle Society score and Modified Cincinnati Knee Scale. All regions of interest were defined on morphological images and subsequently transferred to the corresponding sodium images. Analysis of variance, t tests, and Pearson correlation coefficients were evaluated. In the patients, significantly lower sodium cSI values were found in RT than in reference cartilage for the MFX (P = 0.007) and MACT patients (P = 0.008). Sodium cSI and MOCART scores in RT did not differ between

  2. Effects of low frequency electromagnetic field on ankle joint swelling of ankle joint sprain and bruise%低频电磁场减轻踝关节扭挫伤患者肿胀疼痛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    姜乃明; 张宝芬; 祁欣; 范剑非

    2002-01-01

    Background: Main symptoms of ankle joint sprain and bruise are local swelling, pain and dysfunction. Aim of physical therapy is to reduce swelling and ease pain and resume walking function. Magnetic therapy has effects of reducing swelling and easing pain and promoting local blood circulation. Low frequency electromagnetic field has synthetic treatment function of magnetic heat and concussion massage. But the curative effects are different as the differences of working condition and shaking strength of magnetic head. Objective:To compare curative effects of low frequency full wave and half wave magnetic field on ankle joint swelling of ankle joint sprain and bruise. Unit: Department of Physical Therapy of General Hospital of Shenyang Military District.

  3. Magnetic resonance imaging of injuries to the ankle joint: can it predict clinical outcome?

    Science.gov (United States)

    Zanetti, M; De Simoni, C; Wetz, H H; Zollinger, H; Hodler, J

    1997-02-01

    To predict clinical outcome after ankle sprains on the basis of magnetic resonance (MR) findings. Twenty-nine consecutive patients (mean age 32.9 years, range 13-60 years) were examined clinically and with MR imaging both after trauma and following standardized conservative therapy. Various MR abnormalities were related to a clinical outcome score. There was a tendency for a better clinical outcome in partial, rather than complete, tears of the anterior talofibular ligament and when there was no fluid within the peroneal tendon sheath at the initial MR examination (P = 0.092 for either abnormality). A number of other MR features did not significantly influence clinical outcome, including the presence of a calcaneofibular ligament lesion and a bone bruise of the talar dome. Clinical outcome after ankle sprain cannot consistently be predicted by MR imaging, although MR imaging may be more accurate when the anterior talofibular ligament is only partially torn and there are no signs of injury to the peroneal tendon sheath.

  4. Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle

    NARCIS (Netherlands)

    Marijnissen, ACA; van Roermund, PM; van Melkebeek, J; Schenk, W; Verbout, AJ; Bijlsma, JWJ; Lafeber, FPJG

    Objective. Osteoarthritis, (OA) is a degenerative, disabling joint disease that affects >10% of the adult population. No effective disease-modifying treatment is available. In the present study, we used joint distraction, a relatively new treatment in Which mechanical contact between the articular

  5. An open 8-channel parallel transmission coil for static and dynamic 7T MRI of the knee and ankle joints at multiple postures.

    Science.gov (United States)

    Jin, Jin; Weber, Ewald; Destruel, Aurelien; O'Brien, Kieran; Henin, Bassem; Engstrom, Craig; Crozier, Stuart

    2018-03-01

    We present the initial in vivo imaging results of an open architecture eight-channel parallel transmission (pTx) transceive radiofrequency (RF) coil array that was designed and constructed for static and dynamic 7T MRI of the knee and ankle joints. The pTx coil has a U-shaped dual-row configuration (200 mm overall length longitudinally) that allows static and dynamic imaging of the knee and ankle joints at various postures and during active movements. This coil structure, in combination with B 1 shimming, allows flexible configuration of B 1 transmit profiles, with good homogeneity over 120-mm regions of interest. This coil enabled high-resolution gradient echo (e.g., 3D dual-echo steady state [DESS] and 3D multiecho data image combination [MEDIC]) and turbo spin echo (TSE) imaging (e.g., with proton density weighting [PDw], PDw with fat saturation, and T 1 and T 2 weightings) with local RF energy absorption rates well below regulatory limits. High-resolution 2D and 3D image series (e.g., 0.3 mm in-plane resolution for TSE, 0.47 mm isotropic for DESS and MEDIC) were obtained from the knee and ankle joints with excellent tissue contrast. Dynamic imaging during continuous knee and ankle flexion-extension cycles were successfully acquired. The new open pTx coil array provides versatility for high-quality static and dynamic MRI of the knee and ankle joints at 7T. Magn Reson Med 79:1804-1816, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  6. A Study of H-Reflexes in Subjects with Acute Ankle Inversion Injuries

    Science.gov (United States)

    1996-12-09

    stress to the injured ankle at heel- strike .(57) Any increased inversion stress by way of joint loading in the presence of compromised joint...the present study, may play a role in decreasing the degree of calcaneal inversion just prior to heel- strike and minimize the stress on the lateral...Presentation: * Significant edema/ecchymosis on lateral and medial aspects of ankle. * Possible pitting edema on forefoot (several days post- injury

  7. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    Science.gov (United States)

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  8. Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint

    Science.gov (United States)

    Migliore, A.; Bizzi, E.; De Lucia, O.; Delle Sedie, A.; Tropea, S.; Bentivegna, M.; Mahmoud, A.; Foti, C.

    2016-01-01

    OBJECTIVES The aim of the current study is to collect scientific data on all branded hyaluronic acid (HA) products in Italy that are in use for intra-articular (IA) injection in osteoarthritis (OA) compared with that reported in the leaflet. METHODS An extensive literature research was performed for all articles reporting data on the IA use of HA in OA. Selected studies were taken into consideration only if they are related to products based on HAs that are currently marketed in Italy with the specific joint indication for IA use in patients affected by OA. RESULTS Sixty-two HA products are marketed in Italy: 30 products are indicated for the knee but only 8 were proved with some efficacy; 9 products were effective for the hip but only 6 had hip indication; 7 products proved to be effective for the shoulder but only 3 had the indication; 5 products proved effective for the ankle but only one had the indication; 6 products were effective for the temporomandibular joint but only 2 had the indication; only 2 proved effective for vertebral facet joints but only 1 had the indication; and 5 products proved effective for the carpometacarpal joint but only 2 had the indication. CONCLUSIONS There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID:27279754

  9. Mobile ankle and knee perturbator.

    Science.gov (United States)

    Andersen, Jacob Buus; Sinkjaer, Thomas

    2003-10-01

    A mobile ankle and knee perturbator has been developed. It consists of a functional joint with an integrated clutch. Four Bowden wires connect the joint to a powerful motor and a double pneumatic cylinder. When needed during any time of the gait cycle, it is possible to impose an ankle rotation by engaging the clutch and rotating the ankle or knee joint with a predefined displacement. The system is designed to investigate electrophysiological and biomechanical features of the human ankle or knee joint during gait.

  10. Heel blood flow during loading and off-loading in bedridden older adults with low and normal ankle-brachial pressure index: a quasi-experimental study.

    Science.gov (United States)

    Masaki, Nami; Sugama, Junko; Okuwa, Mayumi; Inagaki, Misako; Matsuo, Junko; Nakatani, Tosio; Sanada, Hiromi

    2013-07-01

    The purpose of this study was to evaluate the differences in heel blood flow during loading and off-loading in bedridden adults older than 65 years. The patients were divided into three groups based on ankle-brachial pressure index (ABI) and transcutaneous oxygen tension (tcPO₂): (1) patients with an ABI ≥ 0.8 (Group A); (2) patients with an ABI < 0.8 and heel tcPO₂ ≥ 10 mmHg (Group B); and (3) patients with an ABI < 0.8 and heel tcPO₂ < 10 mmHg (Group C). Heel blood flow was monitored using tcPO₂ sensors. Data were collected with the heel (1) suspended above the bed surface (preload), (2) on the bed surface for 30 min (loading), and (3) again suspended above the bed surface for 60 min (off-loading). Heel blood flow during off-loading was assessed using three parameters: oxygen recovery index (ORI), total tcPO₂ for the first 10 min, and change in tcPO₂ after 60 min of off-loading. ORI in Group C (n = 8) was significantly shorter than in Groups A (n = 22) and B (n = 15). Total tcPO₂ for the first 10 min of off-loading in Group C was significantly less than that in Groups A and B. Change in tcPO₂ after 60 min of off-loading in Group C was less than in Group A. Based on these findings, additional preventive care against heel blood flow decrease in older adults with an ABI < 0.8 and heel tcPO₂ < 10 mmHg might be necessary after loading.

  11. Understanding acute ankle ligamentous sprain injury in sports

    Directory of Open Access Journals (Sweden)

    Fong Daniel TP

    2009-07-01

    Full Text Available Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms. Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms. The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative

  12. Ankle and knee biomechanics during normal walking following ankle plantarflexor fatigue.

    Science.gov (United States)

    Hunt, Michael A; Hatfield, Gillian L

    2017-08-01

    The purpose of this study was to investigate the immediate effects of unilateral ankle plantarflexor fatigue on bilateral knee and ankle biomechanics during gait. Lower leg kinematics, kinetics, and muscle activation were assessed before and after an ankle plantarflexor fatiguing protocol in 31 healthy individuals. Fatigue (defined as >10% reduction in maximal isometric ankle plantarflexor torque production and a downward shift in the median power frequency of both heads of the gastrocnemius muscle of the fatigued limb) was achieved in 18 individuals, and only their data were used for analysis purposes. Compared to pre-fatigue walking trials, medial gastrocnemius activity was significantly reduced in the study (fatigued) limb. Other main changes following fatigue included significantly more knee flexion during loading, and an associated larger external knee flexion moment in the study limb. At the ankle joint, participants exhibited significantly less peak plantarflexion (occurring at toe-off) with fatigue. No significant differences were observed in the contralateral (non-fatigued) limb. Findings from this study indicate that fatigue of the ankle plantarflexor muscle does not produce widespread changes in gait biomechanics, suggesting that small to moderate changes in maximal ankle plantarflexor force production capacity (either an increase or decrease) will not have a substantial impact on normal lower limb functioning during gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Differentiation between non-neural and neural contributors to ankle joint stiffness in cerebral palsy

    NARCIS (Netherlands)

    De Gooijer-van de Groep, K.L.; De Vlugt, E.; De Groot, J.H.; Van der Heijden-Maessen, H.C.M.; Wielheesen, D.H.M.; Van Wijlen-Hempel, R.M.S.; Arendzen, J.H.; Meskers, C.G.M.

    2013-01-01

    Background Spastic paresis in cerebral palsy (CP) is characterized by increased joint stiffness that may be of neural origin, i.e. improper muscle activation caused by e.g. hyperreflexia or non-neural origin, i.e. altered tissue viscoelastic properties (clinically: “spasticity” vs. “contracture”).

  14. A Subspace Approach to the Structural Decomposition and Identification of Ankle Joint Dynamic Stiffness.

    Science.gov (United States)

    Jalaleddini, Kian; Tehrani, Ehsan Sobhani; Kearney, Robert E

    2017-06-01

    The purpose of this paper is to present a structural decomposition subspace (SDSS) method for decomposition of the joint torque to intrinsic, reflexive, and voluntary torques and identification of joint dynamic stiffness. First, it formulates a novel state-space representation for the joint dynamic stiffness modeled by a parallel-cascade structure with a concise parameter set that provides a direct link between the state-space representation matrices and the parallel-cascade parameters. Second, it presents a subspace method for the identification of the new state-space model that involves two steps: 1) the decomposition of the intrinsic and reflex pathways and 2) the identification of an impulse response model of the intrinsic pathway and a Hammerstein model of the reflex pathway. Extensive simulation studies demonstrate that SDSS has significant performance advantages over some other methods. Thus, SDSS was more robust under high noise conditions, converging where others failed; it was more accurate, giving estimates with lower bias and random errors. The method also worked well in practice and yielded high-quality estimates of intrinsic and reflex stiffnesses when applied to experimental data at three muscle activation levels. The simulation and experimental results demonstrate that SDSS accurately decomposes the intrinsic and reflex torques and provides accurate estimates of physiologically meaningful parameters. SDSS will be a valuable tool for studying joint stiffness under functionally important conditions. It has important clinical implications for the diagnosis, assessment, objective quantification, and monitoring of neuromuscular diseases that change the muscle tone.

  15. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES - IMPLICATIONS FOR REHABILITATION STRATEGIES

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas

    2016-01-01

    BACKGROUND: A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important...... to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. PURPOSE: The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three commonly used...... balance devices (Airex®, BOSU® Ball and wobble board). DESIGN: Descriptive exploratory laboratory study. METHODS: Nineteen healthy subjects performed single-legged balance with eyes open on an Airex® mat, BOSU® Ball, wobble board, and floor (reference condition). Ankle kinematics were measured using...

  16. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES - IMPLICATIONS FOR REHABILITATION STRATEGIES

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas

    2016-01-01

    (MVC), and in addition amplitude probability distribution function (APDF) between 90 and 10% was calculated as a measure of muscle activation variability. RESULTS: Balancing on BOSU® Ball and wobble board generally resulted in increased ankle kinematic and muscle activity variables, compared......BACKGROUND: A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important...... to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. PURPOSE: The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three commonly used...

  17. The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability.

    Science.gov (United States)

    Powden, Cameron J; Hogan, Kathleen K; Wikstrom, Erik A; Hoch, Matthew C

    2017-05-01

    Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI). Examine the immediate effects of talocrural joint traction in those with CAI. Blinded, crossover. Laboratory. Twenty adults (14 females; age = 23.80 ± 4.02 y; height = 169.55 ± 12.38 cm; weight = 78.34 ± 16.32 kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous 3 mo, answering "yes" to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool. Subjects participated in 3 sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT), or a sham condition in a randomized order. Interventions consisted of four 30-s sets of traction with 1 min of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-s oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Preintervention and postintervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected. The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-posttreatment change scores for the WBLT (cm), normalized SEBTAR (%), and time-to-boundary (TTB) variables(s). Separate 1-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a priori at P manual therapies.

  18. A biologically-inspired multi-joint soft exosuit that can reduce the energy cost of loaded walking.

    Science.gov (United States)

    Panizzolo, Fausto A; Galiana, Ignacio; Asbeck, Alan T; Siviy, Christopher; Schmidt, Kai; Holt, Kenneth G; Walsh, Conor J

    2016-05-12

    Carrying load alters normal walking, imposes additional stress to the musculoskeletal system, and results in an increase in energy consumption and a consequent earlier onset of fatigue. This phenomenon is largely due to increased work requirements in lower extremity joints, in turn requiring higher muscle activation. The aim of this work was to assess the biomechanical and physiological effects of a multi-joint soft exosuit that applies assistive torques to the biological hip and ankle joints during loaded walking. The exosuit was evaluated under three conditions: powered (EXO_ON), unpowered (EXO_OFF) and unpowered removing the equivalent mass of the device (EXO_OFF_EMR). Seven participants walked on an instrumented split-belt treadmill and carried a load equivalent to 30 % their body mass. We assessed their metabolic cost of walking, kinetics, kinematics, and lower limb muscle activation using a portable gas analysis system, motion capture system, and surface electromyography. Our results showed that the exosuit could deliver controlled forces to a wearer. Net metabolic power in the EXO_ON condition (7.5 ± 0.6 W kg(-1)) was 7.3 ± 5.0 % and 14.2 ± 6.1 % lower than in the EXO_OFF_EMR condition (7.9 ± 0.8 W kg(-1); p = 0.027) and in the EXO_OFF condition (8.5 ± 0.9 W kg(-1); p = 0.005), respectively. The exosuit also reduced the total joint positive biological work (sum of hip, knee and ankle) when comparing the EXO_ON condition (1.06 ± 0.16 J kg(-1)) with respect to the EXO_OFF condition (1.28 ± 0.26 J kg(-1); p = 0.020) and to the EXO_OFF_EMR condition (1.22 ± 0.21 J kg(-1); p = 0.007). The results of the present work demonstrate for the first time that a soft wearable robot can improve walking economy. These findings pave the way for future assistive devices that may enhance or restore gait in other applications.

  19. The Relationship between Isokinetic Relative Torque of Hip, Knee and Ankle Joints and the Height of Guide Leg Jump in Young Men

    Directory of Open Access Journals (Sweden)

    Saeed Nikoukheslat

    2016-06-01

    Full Text Available Objective: The aim of this study was to investigate the relationship between isokinetic relative torques of hip, knee and ankle joints and the height of guide leg jump in young men. Methods: 27 college male athletes with mean age of 25±3.5 years, height 178.5±7.8 cm and weight of 75.7±10.7 kg voluntarily participated in this study. Isokinetic torque of hip, knee and ankle joints and the height of vertical jump were measured using BIODEX SYSTEM PRO 4 and digital vertical jumping tester systems respectively. Pearson correlation test at p<0.05 was used for statistical analysis. Results: Results showed that there were significant correlations between height of jump and hip joint flexion (p= 0.047 & r= 0.39 and extension (p= 0.003 & r= 0.55 torques of guide leg, hip joint extension torque of support leg (p= 0.020 & r=0.45 and knee joint flexion (p= 0.019 & r=0.45 and extension torques of support leg (p=0.006 & r=0.52. Conclusion: The results of this study show that flexion and extension torques of hip joint in guide leg and knee joint in support leg and also extension torque of hip joint in support leg have main effect on height of guide leg jump. Thus, in designing a specific training program for athletes in whom the nature of jump in their sports is guide leg jump, particular attention should be given to hip and knee joints strength.

  20. Effect of Ankle Joint Contact Angle and Ground Contact Time on Depth Jump Performance.

    Science.gov (United States)

    Phillips, Joshua H; Flanagan, Sean P

    2015-11-01

    Athletes often need to both jump high and get off the ground quickly, but getting off the ground quickly can decrease the vertical ground reaction force (VGRF) impulse, impeding jump height. Energy stored in the muscle-tendon complex during the stretch-shortening cycle (SSC) may mitigate the effects of short ground contact times (GCTs). To take advantage of the SSC, several coaches recommend "attacking" the ground with the foot in a dorsiflexed (DF) position at contact. However, the efficacy of this technique has not been tested. This investigation tested the hypotheses that shorter GCTs would lead to smaller vertical depth jump heights (VDJH), and that this difference could be mitigated by instructing the athletes to land in a DF as opposed to a plantar flexed (PF) foot position. Eighteen healthy junior college athletes performed depth jumps from a 45-cm box onto force platforms under instruction to achieve one of the 2 objectives (maximum jump height [hmax] or minimal GCT [tmin]), with one of the 2 foot conditions (DF or PF). These variations created 4 distinct jump conditions: DF-hmax, DF-tmin, PF-hmax, and PF-tmin. For all variables examined, there were no significant interactions. For all 4 conditions, the ankle was PF during landing, but the DF condition was 28.87% less PF than the PF condition. The tmin conditions had a 23.48% shorter GCT than hmax. There were no significant main effects for jump height. The peak impact force for tmin was 22.14% greater than hmax and 19.11% greater for DF compared with PF conditions. A shorter GCT did not necessitate a smaller jump height, and a less PF foot did not lead to improvements in jump height or contact time during a depth jump from a 45-cm box. The same jump height was attained in less PF and shorter GCT conditions by larger impact forces. To decrease contact time while maintaining jump height, athletes should be instructed to "get off the ground as fast as possible." This cue seems to be more important than foot

  1. Increased joint loads during walking--a consequence of pain relief in knee osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Simonsen, Erik B; Alkjaer, T

    2006-01-01

    Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis....... Although the patients walked with less compressive knee joint forces compared to the reference group, the effects of pain relief may accelerate the degenerative changes....

  2. The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking in individuals with incomplete spinal cord injury

    Directory of Open Access Journals (Sweden)

    Domingo Antoinette

    2006-02-01

    Full Text Available Abstract Background Powered lower limb orthoses could reduce therapist labor during gait rehabilitation after neurological injury. However, it is not clear how patients respond to powered assistance during stepping. Patients might allow the orthoses to drive the movement pattern and reduce their muscle activation. The goal of this study was to test the effects of robotic assistance in subjects with incomplete spinal cord injury using pneumatically powered ankle-foot orthoses. Methods Five individuals with chronic incomplete spinal cord injury (ASIA C-D participated in the study. Each subject was fitted with bilateral ankle-foot orthoses equipped with artificial pneumatic muscles to power ankle plantar flexion. Subjects walked on a treadmill with partial bodyweight support at four speeds (0.36, 0.54, 0.72 and 0.89 m/s under three conditions: without wearing orthoses, wearing orthoses unpowered (passively, and wearing orthoses activated under pushbutton control by a physical therapist. Subjects also attempted a fourth condition wearing orthoses activated under pushbutton control by them. We measured joint angles, electromyography, and orthoses torque assistance. Results A therapist quickly learned to activate the artificial pneumatic muscles using the pushbuttons with the appropriate amplitude and timing. The powered orthoses provided ~50% of peak ankle torque. Ankle angle at stance push-off increased when subjects walked with powered orthoses versus when they walked with passive-orthoses (ANOVA, p Two of the five subjects were able to control the orthoses themselves using the pushbuttons. The other three subjects found it too difficult to coordinate pushbutton timing. Orthoses assistance and maximum ankle angle at push-off were smaller when the subject controlled the orthoses compared to when the therapist-controlled the orthoses (p Conclusion Mechanical assistance from powered ankle-foot orthoses improved ankle push-off kinematics without

  3. Normal dynamic deformation characteristics of non-consecutive jointed rock masses under impact loads

    Science.gov (United States)

    Zeng, Sheng; Jiang, Bowei; Sun, Bing

    2017-08-01

    In order to study deformation characteristics of non-consecutive single jointed rock masses under impact loads, we used the cement mortar materials to make simulative jointed rock mass samples, and tested the samples under impact loads by the drop hammer. Through analyzing the time-history signal of the force and the displacement, first we find that the dynamic compression displacement of the jointed rock mass is significantly larger than that of the intact jointless rock mass, the compression displacement is positively correlated with the joint length and the impact height. Secondly, the vertical compressive displacement of the jointed rock mass is mainly due to the closure of opening joints under small impact loads. Finally, the peak intensity of the intact rock mass is larger than that of the non-consecutive jointed rock mass and negatively correlated with the joint length under the same impact energy.

  4. Directing clinical care using lower extremity biomechanics in patients with ankle osteoarthritis and ankle arthroplasty.

    Science.gov (United States)

    Queen, Robin

    2017-11-01

    Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach. Our recent studies have explored physical performance and energy recovery and revealed unexpected patterns and sequelae to treatment including incomplete restoration of gait function. These studies demonstrated for the first time the extreme levels and range of gait and balance dysfunction present in ankle osteoarthritis patients as well as quantifying the ways in which the affected joint alters movement and loading patterns not just in the painful joint, but throughout both the ipsilateral and contralateral lower extremity. Through this work, we determined that relieving pain alone through TAA is not enough to restore normal walking mechanics and balance due to underlying causes including limited ankle range of motion and balance deficits leading to long-term disability despite treatment. The results indicate the need to consider additional therapeutic interventions aimed at restoring balance, ankle range of motion, and movement symmetry in order to improve long-term health and function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2345-2355, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  5. The initial safe range of motion of the ankle joint after three methods of internal fixation of simulated fractures of the medial malleolus.

    Science.gov (United States)

    Shimamura, Yoshio; Kaneko, Kazuo; Kume, Kazuhiko; Maeda, Mutsuhiro; Iwase, Hideaki

    2006-07-01

    Previous studies have demonstrated the safe passive range of ankle motion for inter-bone stiffness after internal fixation under load but there is a lack of information about the safe range of ankle motion for early rehabilitation in the absence of loading. The present study was designed to assess the effect of ankle movement on inter-bone displacement characteristics of medial malleolus fractures following three types of internal fixation to determine the safe range of motion. Five lower legs obtained during autopsy were used to assess three types of internal fixation (two with Kirschner-wires alone; two with Kirschner-wires plus tension band wiring; and, one with an AO/ASIF malleolar screw alone). Following a simulated fracture by sawing through the medial malleolus the displacement between the fractured bone ends was measured during a passive range of movement with continuous monitoring using omega (Omega) shaped transducers and a biaxial flexible goniometer. Statistical analysis was performed with repeated measures analysis of variance. Inter-bone displacement was not proportional to the magnitude of movement throughout the range of ankle motion as, when separation exceeded 25 microm, there was increasingly wide separation as plantar-flexion or dorsal-flexion was increased. There was no statistical significant difference between the small amount of inter-bone displacement observed with three types of fixation within the safe range of dorsal-flexion and plantar-flexion for early rehabilitation. However the inter-bone separation when fixation utilized two Kirschner-wires alone tended to be greater than when using the other two types of fixation during dorsal-flexion and eversion. The present study revealed a reproducible range of ankle motion for early rehabilitation which was estimated to be within the range of 20 degrees of dorsal-flexion and 10 degrees of plantar-flexion without eversion. Also, internal fixation with two Kirschner-wires alone does not seem to

  6. Impact of the difference in the plantar flexor strength of the ankle joint in the affected side among hemiplegic patients on the plantar pressure and walking asymmetry.

    Science.gov (United States)

    You, Young Youl; Chung, Sin Ho; Lee, Hyung Jin

    2016-11-01

    [Purpose] This study was to examine the changes in the gait lines and plantar pressures in static and dynamic circumstances, according to the differences in the strengths of the plantar flexors in the ankle joints on the affected sides of hemiplegic patients, and to determine their impacts on walking symmetry. [Subjects and Methods] A total of thirty hospitalized stroke patients suffering from hemiplegia were selected in this study. The subjects had ankylosing patterns in the ankle joints of the affected sides. Fifteen of the patients had plantar flexor manual muscle testing scores between poor and fair, while fifteen of the patients had zero and trace. [Results] The contact pattern of the plantar surface with the ground is a reliable method for walking analysis, which is an important index for understanding the ankle mechanism and the relationship between the plantar surface and the ground. [Conclusion] The functional improvement of patients with stroke could be supported through a verification of the analysis methods of the therapy strategy and walking pattern.

  7. Three-dimensional kinematics of the knee and ankle joints for three consecutive push-offs during ice hockey skating starts.

    Science.gov (United States)

    Lafontaine, Dany

    2007-09-01

    Little biomechanical research has been conducted recently on hockey skating despite the sport's worldwide appeal. One reason for this lack of biomechanical knowledge stems from the difficulty of collecting data. The lack of accuracy, the disputable realism of treadmills, and the large field of view required are some of the technical challenges that have to be overcome. The main objective of the current study was to improve our knowledge of the joint kinematics during the skating stroke. A second objective was to improve the data collection system we developed and the third was to establish if a kinematic progression exists in the hockey skating stroke similar to that in speed skating. Relative motions at the knee and ankle joints were computed using a joint coordinate system approach. The differences at the knee joints in push-offs indicated that the skating skill was progressively changing with each push-off. The relative stability of the ankle angles can be attributed to the design of the skate boots, which have recently become very rigid. Further research on ice hockey skating is warranted and should include more skaters and investigate the effect various starting strategies and variations in equipment have on skaters' performance.

  8. Altered Knee and Ankle Kinematics During Squatting in Those With Limited Weight-Bearing–Lunge Ankle-Dorsiflexion Range of Motion

    Science.gov (United States)

    Dill, Karli E.; Begalle, Rebecca L.; Frank, Barnett S.; Zinder, Steven M.; Padua, Darin A.

    2014-01-01

    Context: Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee flexion. To our knowledge, researchers have not studied individuals with limited or normal ankle DF-ROM to investigate the relationship between those factors and the lower extremity movement patterns associated with anterior cruciate ligament injury. Objective: To determine, using 2 different measurement techniques, whether knee- and ankle-joint kinematics differ between participants with limited and normal ankle DF-ROM. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty physically active adults (20 with limited ankle DF-ROM, 20 with normal ankle DF-ROM). Main Outcome Measure(s): Ankle DF-ROM was assessed using 2 techniques: (1) nonweight-bearing ankle DF-ROM with the knee straight, and (2) weight-bearing lunge (WBL). Knee flexion, knee valgus-varus, knee internal-external rotation, and ankle DF displacements were assessed during the overhead-squat, single-legged squat, and jump-landing tasks. Separate 1-way analyses of variance were performed to determine whether differences in knee- and ankle-joint kinematics existed between the normal and limited groups for each assessment. Results: We observed no differences between the normal and limited groups when classifying groups based on nonweight-bearing passive-ankle DF-ROM. However, individuals with greater ankle DF-ROM during the WBL displayed greater knee-flexion and ankle-DF displacement and peak knee flexion during the overhead-squat and single-legged squat tasks. In addition, those individuals also demonstrated greater knee-varus displacement during the single-legged squat. Conclusions: Greater ankle DF-ROM assessed during the WBL was associated with greater knee-flexion and ankle-DF displacement during both squatting tasks as well as greater knee-varus displacement during

  9. The effect of tendon loading on in-vitro carpal kinematics of the wrist joint

    NARCIS (Netherlands)

    Foumani, M.; Blankevoort, L.; Stekelenburg, C.; Strackee, S. D.; Carelsen, B.; Jonges, R.; Streekstra, G. J.

    2010-01-01

    Measurements of in-vitro carpal kinematics of the wrist provide valuable biomechanical data. Tendon loading is often applied during cadaver experiments to simulate natural stabilizing joint compression in the wrist joint. The purpose of this study was to investigate the effect of tendon loading on

  10. Behavior of single lap composite bolted joint under traction loading: Experimental investigation

    Science.gov (United States)

    Awadhani, L. V.; Bewoor, Anand

    2018-04-01

    Composite bolted joints are preferred connection in the composite structures to facilitate the dismantling for the replacements/ maintenance work. The joint behavior under tractive forces has been studied in order to understand the safety of the structure designed. The main objective of this paper is to investigate the behavior of single-lap joints in carbon fiber reinforced epoxy composites under traction loading conditions. The experiments were designed to identify the effect of bolt diameter, stacking sequence and loading rate on the properties of the joint. The experimental results show that the parameters influence the joint performance significantly.

  11. Gain modulation of the middle latency cutaneous reflex in patients with chronic joint instability after ankle sprain.

    Science.gov (United States)

    Futatsubashi, Genki; Sasada, Shusaku; Tazoe, Toshiki; Komiyama, Tomoyoshi

    2013-07-01

    To investigate the neural alteration of reflex pathways arising from cutaneous afferents in patients with chronic ankle instability. Cutaneous reflexes were elicited by applying non-noxious electrical stimulation to the sural nerve of subjects with chronic ankle instability (n=17) and control subjects (n=17) while sitting. Electromyographic (EMG) signals were recorded from each ankle and thigh muscle. The middle latency response (MLR; latency: 70-120 ms) component was analyzed. In the peroneus longus (PL) and vastus lateralis (VL) muscles, linear regression analyses between the magnitude of the inhibitory MLR and background EMG activity showed that, compared to the uninjured side and the control subjects, the gain of the suppressive MLR was increased in the injured side. This was also confirmed by the pooled data for both groups. The degree of MLR alteration was significantly correlated to that of chronic ankle instability in the PL. The excitability of middle latency cutaneous reflexes in the PL and VL is modulated in subjects with chronic ankle instability. Cutaneous reflexes may be potential tools to investigate the pathological state of the neural system that controls the lower limbs in subjects with chronic ankle instability. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Relationship between activation of ankle muscles and quasi-joint stiffness in early and middle stances during gait in patients with hemiparesis.

    Science.gov (United States)

    Sekiguchi, Yusuke; Muraki, Takayuki; Tanaka, Naofumi; Izumi, Shin-Ichi

    2015-09-01

    It is unclear whether muscle contraction is necessary to increase quasi-joint stiffness (QJS) of the ankle joint during gait in patients with hemiparesis. The purpose of the present study was to investigate the relationship between QJS and muscle activation at the ankle joint in the stance phase during gait in patients with hemiparesis. Spatiotemporal and kinetic gait parameters and activation of the medial head of the gastrocnemius (MG), soleus (SOL), and tibialis anterior (TA) muscles were measured using a 3-dimensional motion analysis system and surface electromyography, in 21 patients with hemiparesis due to stroke and 10 healthy individuals. In the early stance, the QJS on the paretic side (PS) of patients was greater than that on the non-PS (phemiparesis, plantarflexor activation may not contribute to QJS in the early stance. On the other hand, QJS in the middle stance may be attributed to activation of the MG and SOL. Our findings suggest that activation of the MG and SOL in the middle stance on the PS may require to be enhanced to increase QJS during gait in patients with hemiparesis. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Differences of muscle co-contraction of the ankle joint between young and elderly adults during dynamic postural control at different speeds.

    Science.gov (United States)

    Iwamoto, Yoshitaka; Takahashi, Makoto; Shinkoda, Koichi

    2017-08-02

    Agonist and antagonist muscle co-contractions during motor tasks are greater in the elderly than in young adults. During normal walking, muscle co-contraction increases with gait speed in young adults, but not in elderly adults. However, no study has compared the effects of speed on muscle co-contraction of the ankle joint during dynamic postural control in young and elderly adults. We compared muscle co-contractions of the ankle joint between young and elderly subjects during a functional stability boundary test at different speeds. Fifteen young adults and 16 community-dwelling elderly adults participated in this study. The task was functional stability boundary tests at different speeds (preferred and fast). Electromyographic evaluations of the tibialis anterior and soleus were recorded. The muscle co-contraction was evaluated using the co-contraction index (CI). There were no statistically significant differences in the postural sway parameters between the two age groups. Elderly subjects showed larger CI in both speed conditions than did the young subjects. CI was higher in the fast speed condition than in the preferred speed condition in the young subjects, but there was no difference in the elderly subjects. Moreover, after dividing the analytical range into phases (acceleration and deceleration phases), the CI was larger in the deceleration phase than in the acceleration phase in both groups, except for the young subjects in the fast speed conditions. Our results showed a greater muscle co-contraction of the ankle joint during dynamic postural control in elderly subjects than in young subjects not only in the preferred speed condition but also in the fast speed condition. In addition, the young subjects showed increased muscle co-contraction in the fast speed condition compared with that in the preferred speed condition; however, the elderly subjects showed no significant difference in muscle co-contraction between the two speed conditions. This indicates

  14. Kinematic real-time feedback is more effective than traditional teaching method in learning ankle joint mobilisation: a randomised controlled trial.

    Science.gov (United States)

    González-Sánchez, Manuel; Ruiz-Muñoz, Maria; Ávila-Bolívar, Ana Belén; Cuesta-Vargas, Antonio I

    2016-10-06

    To analyse the effect of real-time kinematic feedback (KRTF) when learning two ankle joint mobilisation techniques comparing the results with the traditional teaching method. Double-blind randomized trial. Faculty of Health Sciences. undergraduate students with no experience in manual therapy. Each student practised intensely for 90 min (45 min for each mobilisation) according to the random methodology assigned (G1: traditional method group and G2: KRTF group). G1: an expert professor supervising the student's practice, the professorstudent ratio was 1:8. G2: placed in front of a station where, while they performed the manoeuvre, they received a KRTF on a laptop. total time of mobilisation, time to reach maximum amplitude, maximum angular displacement in the three axes, maximum and average velocity to reach the maximum angular displacement, average velocity during the mobilisation. Among the pre-post intervention measurements, there were significant differences within the two groups for all outcome variables, however, G2 (KRTF) achieved significantly greater improvements in kinematic parameters for the two mobilisations (significant increase in displacement, velocity and significant reduction in the mobilisations runtime) than G1. Ankle plantar flexion: G1's measurement stability (post-intervention) ranged between 0.491 and 0.687, while G2's measurement stability ranged between 0.899 and 0.984. Ankle dorsal flexion mobilisation: G1 the measurement stability (post-intervention) ranged from 0.543 and 0.684 while G2 ranged between 0.899 and 0.974. KRTF was proven to be more effective tool than traditional teaching method in the teaching - learning process of two joint mobilisation techniques. NCT02504710.

  15. STAMINA OF A GASKETED BOLTED FLANGED PIPE JOINT UNDER DYNAMIC LOADING

    Directory of Open Access Journals (Sweden)

    Muhammad Abid

    2016-11-01

    Full Text Available Gasketed bolted flange joints are the most critical components in pipelines for their sealing and strength under operating conditions. Most of the work available in literature is under static loading, whereas in industry, cyclic loads are applied due to the vibrating machinery such as motors, pumps, sloshing in offshore applications and in the ships etc. In this study a three dimensional finite element analysis of a gasketed joint is carried out using a spiral wound gasket under bolt up and dynamic operating conditions (internal pressure, axial and bending singly and in combination. The cyclic axial loads are concluded relatively more challenging for both the sealing and strength of the joint. Higher magnitudes of loads and frequencies are also observed more challenging to the joints performance.

  16. Peculiarities in Ankle Cartilage.

    Science.gov (United States)

    Kraeutler, Matthew J; Kaenkumchorn, Tanyaporn; Pascual-Garrido, Cecilia; Wimmer, Markus A; Chubinskaya, Susanna

    2017-01-01

    Posttraumatic osteoarthritis (PTOA) is the most common form of osteoarthritis (OA) of the ankle joint. PTOA occurs as a result of several factors, including the poor regenerative capacity of hyaline articular cartilage as well as increased contact stresses following trauma. The purpose of this article is to review the epidemiology, pathogenesis, and potential targets for treatment of PTOA in the ankle joint. Previous reviews primarily addressed clinical approaches to ankle PTOA, while the focus of the current article will be specifically on the newly acquired knowledge of the cellular mechanisms that drive PTOA in the ankle joint and means for potential targeted therapeutics that might halt the progression of cartilage degeneration and/or improve the outcome of surgical interventions. Three experimental treatment strategies are discussed in this review: (1) increasing the anabolic potential of chondrocytes through treatment with growth factors such as bone morphogenetic protein-7; (2) limiting chondrocyte cell death either through the protection of cell membrane with poloxamer 188 or inhibiting activity of intracellular proteases, caspases, which are responsible for cell death by apoptosis; and (3) inhibiting catabolic/inflammatory responses of chondrocytes by treating them with anti-inflammatory agents such as tumor necrosis factor-α antagonists. Future studies should focus on identifying the appropriate timing for treatment and an appropriate combination of anti-inflammatory, chondro- and matrix-protective biologics to limit the progression of trauma-induced cartilage degeneration and prevent the development of PTOA in the ankle joint.

  17. Investigation of load transfer efficiency in jointed plain concrete pavements (JPCP using FEM

    Directory of Open Access Journals (Sweden)

    Vahid Sadeghi

    2018-05-01

    Full Text Available Owing to heavy traffic loads, rigid pavements encounter various types of failures at transverse joints during their lifetime. Three-dimensional finite-element method (3D-FEM was used to assess the structural response of jointed concrete pavement under moving tandem axle loads. In this study, 3D FEM was verified using an existing numerical model and field measurement of the concrete slab traversed by a moving truck. This paper also investigated the effects of multiple parameters: material properties, slab geometry, load magnitude and frictional status of the slab and base layer on load transfer efficiency (LTE of the transverse joints. Further study has been done to investigate the slab performance without the dowel bars which occurs when parts of the pavement needed to be repaired using precast slabs. The aggregate interlock between the new slab and the existing slab is simulated by frictional interface. In 3D FEM model, the load transfer efficiency has been improved by increasing the elasticity modules of the concrete slab and the base layer or increasing the slab thickness. This can decrease the joints' deflections, reduces the damages on pavement joints. Removing dowel bars adversely affected the load transfer. Keywords: Concrete pavement, Load transfer, Finite-element method, Dowel bar, Structural behavior

  18. 针灸治疗踝关节扭伤的临床效果研究%The Study on Clinical Effects of Acupuncture Treatment for Ankle Joint Sprain

    Institute of Scientific and Technical Information of China (English)

    张祖安

    2015-01-01

    Objective To observe the clinical effects of acupuncture treatment for ankle joint sprain. Methods To adopt the acupuncture Kunlun Taixi Jiexi Zhaohai and Shenmai points on the 68 patients with ankle sprains. Results The effect to use the acupuncture treatment on ankle joint sprain is remarkable, the ankle joint swel ing and pain were disappeared, the patients can freely move. Conclusion The effect to use the acupuncture and moxibustion treatment on ankle sprains is remarkable, it is widely used in clinical practice.%目的:观察针灸治疗踝关节扭伤的临床效果。方法选取68例踝关节扭伤患者,针刺昆仑、太溪、解溪、照海以及申脉五大穴位。结果利用针灸治疗踝关节扭伤的效果显著,患者的踝关节部位肿胀感、疼痛感全部消失,患者行动自如。结论在治疗踝关节扭伤时,利用针灸予以治疗,临床效果显著。

  19. The Effect of Ankle, Knee and Hip Isokinetic Fatigue on Shock Absorption and Rate of Loading during Pair-leg Landing

    Directory of Open Access Journals (Sweden)

    Hamideh Khodaveisi

    2016-12-01

    Conclusion: Findings of this study indicate that the fatigue protocol using Isokinetic devices with uniform speed, increases muscle strength due to generating stress at all the joints, thereby, compensating the active and passive joints for shock absorption, and load distribution on the lower extremities. 

  20. The Effects of Load Carriage and Muscle Fatigue on Lower-Extremity Joint Mechanics

    Science.gov (United States)

    Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L.

    2013-01-01

    Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. Purpose: To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Method: Eighteen men performed the following tasks: unloaded…

  1. Analysis of an adhesively bonded single lap joint subjected to eccentric loading

    DEFF Research Database (Denmark)

    Anyfantis, Konstantinos; Tsouvalis, N. G.

    2013-01-01

    is benchmarking of computational tools. The test is based on a Single Lap Joint subjected to Eccentric Loading (SLJ-EL). The basic concept that lies behind this configuration is that the applied in-plane tensile load leads the adhesive layer to develop normal stresses, in-plane and out-of-plane shear stresses...

  2. Loading Analysis of Composite Wind Turbine Blade for Fatigue Life Prediction of Adhesively Bonded Root Joint

    Science.gov (United States)

    Salimi-Majd, Davood; Azimzadeh, Vahid; Mohammadi, Bijan

    2015-06-01

    Nowadays wind energy is widely used as a non-polluting cost-effective renewable energy resource. During the lifetime of a composite wind turbine which is about 20 years, the rotor blades are subjected to different cyclic loads such as aerodynamics, centrifugal and gravitational forces. These loading conditions, cause to fatigue failure of the blade at the adhesively bonded root joint, where the highest bending moments will occur and consequently, is the most critical zone of the blade. So it is important to estimate the fatigue life of the root joint. The cohesive zone model is one of the best methods for prediction of initiation and propagation of debonding at the root joint. The advantage of this method is the possibility of modeling the debonding without any requirement to the remeshing. However in order to use this approach, it is necessary to analyze the cyclic loading condition at the root joint. For this purpose after implementing a cohesive interface element in the Ansys finite element software, one blade of a horizontal axis wind turbine with 46 m rotor diameter was modelled in full scale. Then after applying loads on the blade under different condition of the blade in a full rotation, the critical condition of the blade is obtained based on the delamination index and also the load ratio on the root joint in fatigue cycles is calculated. These data are the inputs for fatigue damage growth analysis of the root joint by using CZM approach that will be investigated in future work.

  3. Ankle Problems

    Science.gov (United States)

    ... Read MoreDepression in Children and TeensRead MoreBMI Calculator Ankle ProblemsFollow this chart for more information about problems that can cause ankle pain. Our trusted Symptom Checker is written and ...

  4. Ankle Sprains

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Ankle Sprains KidsHealth / For Teens / Ankle Sprains What's in this ... How Do I Know if I Have a Sprain? If your ankle hurts enough after an injury that you need ...

  5. Dynamic strength of rock with single planar joint under various loading rates at various angles of loads applied

    Directory of Open Access Journals (Sweden)

    Pei-Yun Shu

    2018-06-01

    Full Text Available Intact rock-like specimens and specimens that include a single, smooth planar joint at various angles are prepared for split Hopkinson pressure bar (SHPB testing. A buffer pad between the striker bar and the incident bar of an SHPB apparatus is used to absorb some of the shock energy. This can generate loading rates of 20.2–4627.3 GPa/s, enabling dynamic peak stresses/strengths and associated failure patterns of the specimens to be investigated. The effects of the loading rate and angle of load applied on the dynamic peak stresses/strengths of the specimens are examined. Relevant experimental results demonstrate that the failure pattern of each specimen can be classified as four types: Type A, integrated with or without tiny flake-off; Type B, slide failure; Type C, fracture failure; and Type D, crushing failure. The dynamic peak stresses/strengths of the specimens that have similar failure patterns increase linearly with the loading rate, yielding high correlations that are evident on semi-logarithmic plots. The slope of the failure envelope is the smallest for slide failure, followed by crushing failure, and that of fracture failure is the largest. The magnitude of the plot slope of the dynamic peak stress against the loading rate for the specimens that are still integrated after testing is between that of slide failure and crushing failure. The angle of application has a limited effect on the dynamic peak stresses/strengths of the specimens regardless of the failure pattern, but it affects the bounds of the loading rates that yield each failure pattern, and thus influences the dynamic responses of the single jointed specimen. Slide failure occurs at the lowest loading rate of any failure, but can only occur in single jointed specimen that allows sliding. Crushing failure is typically associated with the largest loading rate, and fracture failure may occur when the loading rate is between the boundaries for slide failure and crushing

  6. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    Directory of Open Access Journals (Sweden)

    Robert Rasnick

    Full Text Available Total knee replacement (TKR is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05. No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups.

  7. Effects of slip-induced changes in ankle movement on muscle activity and ground reaction forces during running acceleration

    DEFF Research Database (Denmark)

    Ketabi, Shahin; Kersting, Uwe G.

    2013-01-01

    Ground contact in running is always linked to a minimum amount of slipping, e.g., during the early contact phase when horizontal forces are high compared to vertical forces. Studies have shown altered muscular activation when expecting slips [2-4]. It is not known what the mechanical effect of su...... of such slip episodes are on joint loading or performance. The aim of the present study was to examine the effect of changes in ankle movement on ankle joint loading, muscle activity, and ground reaction forces during linear acceleration....

  8. Ankle Arthrodesis Following Trauma, a Useful Salvage Procedure ...

    African Journals Online (AJOL)

    progressive loss of ankle-joint motion, weight-bearing pain, and functional disability. ... of patients after the reconstructionof ankle malunions.[6] ... Three patients with severe open ankle ... diabetic nor was he known to be on any steroid medication. He was .... Charnley J. Compression arthrodesis of the ankle and shoulder.

  9. To Explore X-ray Examination in the Diagnosis of Ankle Joint Fracture%X线检查在踝关节骨折诊断中的临床应用

    Institute of Scientific and Technical Information of China (English)

    马微

    2015-01-01

    Objective Clinical value of X-ray examination in the diagnosis of ankle joint fracture.Methods 50 patients with ankle sprain suspected surgical bone fractures in our hospital from 2013 January to 2014 January were examined by X-ray combined with multislice spiral CT scan for contrast research.Results X-ray examination found 42 cases of ankle fracture in the 50 patients, diagnosis rate was 84%, 7 cases of around the ankle soft tissue swelling associated with swelling of the joint, the diagnosis of occult fracture of ankle joint of the correct rate was 87.5% . ConclusionX-ray examination of the ankle injury and fracture has higher diagnosis rate, and X-ray examination is prompted to may have occult fracture of ankle joint if the display around the ankle soft tissue swelling associated with swelling of the joint.%目的:针对X线检查在踝关节骨折在诊断中的临床价值。方法选择我院2013年1月~2014年1月骨外科收治的踝关节扭伤怀疑骨折患者50例,行X线检查并同期做多层螺旋CT扫描作对比研究。结果50例患者中,通过X线检查发现踝关节骨折42例,诊断率为84%,踝关节周围软组织肿胀合并关节囊肿胀7例,其对踝关节隐匿性骨折的诊断正确率为87.5%。结论 X线检查对踝关节损伤及骨折有较高的诊断率,且X线检查若显示踝关节周围软组织肿胀合并关节囊肿胀则提示很大可能有踝关节隐匿性骨折。

  10. Ankle sprain - aftercare

    Science.gov (United States)

    Lateral ankle sprain - aftercare; Medial ankle sprain - aftercare; Medial ankle injury - aftercare; Ankle syndesmosis sprain - aftercare; Syndesmosis injury - aftercare; ATFL injury - aftercare; CFL injury - ...

  11. Reliability of sagittal plane hip, knee, and ankle joint angles from a single frame of video data using the GAITRite camera system.

    Science.gov (United States)

    Ross, Sandy A; Rice, Clinton; Von Behren, Kristyn; Meyer, April; Alexander, Rachel; Murfin, Scott

    2015-01-01

    The purpose of this study was to establish intra-rater, intra-session, and inter-rater, reliability of sagittal plane hip, knee, and ankle angles with and without reflective markers using the GAITRite walkway and single video camera between student physical therapists and an experienced physical therapist. This study included thirty-two healthy participants age 20-59, stratified by age and gender. Participants performed three successful walks with and without markers applied to anatomical landmarks. GAITRite software was used to digitize sagittal hip, knee, and ankle angles at two phases of gait: (1) initial contact; and (2) mid-stance. Intra-rater reliability was more consistent for the experienced physical therapist, regardless of joint or phase of gait. Intra-session reliability was variable, the experienced physical therapist showed moderate to high reliability (intra-class correlation coefficient (ICC) = 0.50-0.89) and the student physical therapist showed very poor to high reliability (ICC = 0.07-0.85). Inter-rater reliability was highest during mid-stance at the knee with markers (ICC = 0.86) and lowest during mid-stance at the hip without markers (ICC = 0.25). Reliability of a single camera system, especially at the knee joint shows promise. Depending on the specific type of reliability, error can be attributed to the testers (e.g. lack of digitization practice and marker placement), participants (e.g. loose fitting clothing) and camera systems (e.g. frame rate and resolution). However, until the camera technology can be upgraded to a higher frame rate and resolution, and the software can be linked to the GAITRite walkway, the clinical utility for pre/post measures is limited.

  12. Experimental Investigation on the Fatigue Mechanical Properties of Intermittently Jointed Rock Models Under Cyclic Uniaxial Compression with Different Loading Parameters

    Science.gov (United States)

    Liu, Yi; Dai, Feng; Dong, Lu; Xu, Nuwen; Feng, Peng

    2018-01-01

    Intermittently jointed rocks, widely existing in many mining and civil engineering structures, are quite susceptible to cyclic loading. Understanding the fatigue mechanism of jointed rocks is vital to the rational design and the long-term stability analysis of rock structures. In this study, the fatigue mechanical properties of synthetic jointed rock models under different cyclic conditions are systematically investigated in the laboratory, including four loading frequencies, four maximum stresses, and four amplitudes. Our experimental results reveal the influence of the three cyclic loading parameters on the mechanical properties of jointed rock models, regarding the fatigue deformation characteristics, the fatigue energy and damage evolution, and the fatigue failure and progressive failure behavior. Under lower loading frequency or higher maximum stress and amplitude, the jointed specimen is characterized by higher fatigue deformation moduli and higher dissipated hysteresis energy, resulting in higher cumulative damage and lower fatigue life. However, the fatigue failure modes of jointed specimens are independent of cyclic loading parameters; all tested jointed specimens exhibit a prominent tensile splitting failure mode. Three different crack coalescence patterns are classified between two adjacent joints. Furthermore, different from the progressive failure under static monotonic loading, the jointed rock specimens under cyclic compression fail more abruptly without evident preceding signs. The tensile cracks on the front surface of jointed specimens always initiate from the joint tips and then propagate at a certain angle with the joints toward the direction of maximum compression.

  13. Catenary Action in Rebars Crossing a Casting Joint Loaded in Shear

    DEFF Research Database (Denmark)

    Sørensen, Jesper Harrild; Hoang, Linh Cao; Olesen, John Forbes

    2016-01-01

    Reinforcement crossing a casting joint loaded in shear exhibits catenary action as the shear displacement increases. The load carrying capacity of such a joint is in practice often calculated by use of empirical methods to account for shear friction effects or by a first order plastic analysis...... if dowel action is included. The strength increase/reserve due to catenary action in the rebars is often neglected; however in some cases it may be necessary to utilize the effect in order to ensure overall structural robustness. This paper presents results of a study, where the increased shear capacity...... and theory is found when reasonable material properties are assumed....

  14. Rotational stiffness of American football shoes affects ankle biomechanics and injury severity.

    Science.gov (United States)

    Button, Keith D; Braman, Jerrod E; Davison, Mark A; Wei, Feng; Schaeffer, Maureen C; Haut, Roger C

    2015-06-01

    While previous studies have investigated the effect of shoe-surface interaction on injury risk, few studies have examined the effect of rotational stiffness of the shoe. The hypothesis of the current study was that ankles externally rotated to failure in shoes with low rotational stiffness would allow more talus eversion than those in shoes with a higher rotational stiffness, resulting in less severe injury. Twelve (six pairs) cadaver lower extremities were externally rotated to gross failure while positioned in 20 deg of pre-eversion and 20 deg of predorsiflexion by fixing the distal end of the foot, axially loading the proximal tibia, and internally rotating the tibia. One ankle in each pair was constrained by an American football shoe with a stiff upper, while the other was constrained by an American football shoe with a flexible upper. Experimental bone motions were input into specimen-specific computational models to examine levels of ligament elongation to help understand mechanisms of ankle joint failure. Ankles in flexible shoes allowed 6.7±2.4 deg of talus eversion during rotation, significantly greater than the 1.7±1.0 deg for ankles in stiff shoes (p = 0.01). The significantly greater eversion in flexible shoes was potentially due to a more natural response of the ankle during rotation, possibly affecting the injuries that were produced. All ankles failed by either medial ankle injury or syndesmotic injury, or a combination of both. Complex (more than one ligament or bone) injuries were noted in 4 of 6 ankles in stiff shoes and 1 of 6 ankles in flexible shoes. Ligament elongations from the computational model validated the experimental injury data. The current study suggested flexibility (or rotational stiffness) of the shoe may play an important role in both the severity of ankle injuries for athletes.

  15. Mathematical modelling as a tool to assessment of loads in volleyball player's shoulder joint during spike.

    Science.gov (United States)

    Jurkojć, Jacek; Michnik, Robert; Czapla, Krzysztof

    2017-06-01

    This article deals with kinematic and kinetic conditions in volleyball attack and identifies loads in the shoulder joint. Joint angles and velocities of individual segments of upper limb were measured with the use of the motion capture system XSENS. Muscle forces and loads in skeletal system were calculated by means of mathematical model elaborated in AnyBody system. Spikes performed by players in the best and worst way were compared with each other. The relationships were found between reactions in shoulder joint and flexion/extension, abduction/adduction and rotation angles in the same joint and flexion/extension in the elbow joint. Reactions in shoulder joint varied from 591 N to 2001 N (in relation to body weight [BW] 83-328%). The analysis proved that hand velocity at the moment of the ball hit (which varied between 6.8 and 13.3 m s -1 ) influences on the value of reaction in joints, but positions of individual segments relative to each other are also crucial. It was also proved in objective way, that position of the upper limb during spike can be more or less harmful assuming that bigger reaction increases possibility of injury, what can be an indication for trainers and physiotherapists how to improve injury prevention.

  16. The behavior of welded joint in steel pipe members under monotonic and cyclic loading

    International Nuclear Information System (INIS)

    Chang, Kyong-Ho; Jang, Gab-Chul; Shin, Young-Eui; Han, Jung-Guen; Kim, Jong-Min

    2006-01-01

    Most steel pipe members are joined by welding. The residual stress and weld metal in a welded joint have the influence on the behavior of steel pipes. Therefore, to accurately predict the behavior of steel pipes with a welded joint, the influence of welding residual stress and weld metal on the behavior of steel pipe must be investigated. In this paper, the residual stress of steel pipes with a welded joint was investigated by using a three-dimensional non-steady heat conduction analysis and a three-dimensional thermal elastic-plastic analysis. Based on the results of monotonic and cyclic loading tests, a hysteresis model for weld metal was formulated. The hysteresis model was proposed by the authors and applied to a three-dimensional finite elements analysis. To investigate the influence of a welded joint in steel pipes under monotonic and cyclic loading, three-dimensional finite elements analysis considering the proposed model and residual stress was carried out. The influence of a welded joint on the behavior of steel pipe members was investigated by comparing the analytical result both steel pipe with a welded joint and that without a welded joint

  17. Load Variation Influences on Joint Work During Squat Exercise in Reduced Gravity

    Science.gov (United States)

    DeWitt, John K.; Fincke, Renita S.; Logan, Rachel L.; Guilliams, Mark E.; Ploutz-Snyder, Lori L.

    2011-01-01

    Resistance exercises that load the axial skeleton, such as the parallel squat, are incorporated as a critical component of a space exercise program designed to maximize the stimuli for bone remodeling and muscle loading. Astronauts on the International Space Station perform regular resistance exercise using the Advanced Resistive Exercise Device (ARED). Squat exercises on Earth entail moving a portion of the body weight plus the added bar load, whereas in microgravity the body weight is 0, so all load must be applied via the bar. Crewmembers exercising in microgravity currently add approx.70% of their body weight to the bar load as compensation for the absence of the body weight. This level of body weight replacement (BWR) was determined by crewmember feedback and personal experience without any quantitative data. The purpose of this evaluation was to utilize computational simulation to determine the appropriate level of BWR in microgravity necessary to replicate lower extremity joint work during squat exercise in normal gravity based on joint work. We hypothesized that joint work would be positively related to BWR load.

  18. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

    Science.gov (United States)

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A.; Cates, Harold E.

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (pknee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

  19. The friction coefficient of shoulder joints remains remarkably low over 24 h of loading.

    Science.gov (United States)

    Jones, Brian K; Durney, Krista M; Hung, Clark T; Ateshian, Gerard A

    2015-11-05

    The frictional response of whole human joints over durations spanning activities of daily living has not been reported previously. This study measured the friction of human glenohumeral joints during 24 h of reciprocal loading in a pendulum testing device, at moderate (0.2 mm/s, 4320 cycles) and low (0.02 mm/s, 432 cycles) sliding speeds, under a 200 N load. The effect of joint congruence was also investigated by testing human humeral heads against significantly larger mature bovine glenoids. Eight human joints and six bovine joints were tested in four combinations: human joints tested at moderate (hHCMS, n=6) and low speed (hHCLS, n=3), human humeral heads tested against bovine glenoids at moderate speed (LCMS, n=3), and bovine joints tested at moderate speed (bHCMS, n=3). In the first half hour the mean±standard deviation of the friction coefficient was hHCMS: 0.0016±0.0011, hHCLS: 0.0012±0.0002, LCMS: 0.0008±0.0002 and bHCMS: 0.0024±0.0008; in the last four hours it was hHCMS: 0.0057±0.0025, hHCLS: 0.0047±0.0017, LCMS: 0.0012±0.0003 and bHCMS: 0.0056±0.0016. The initial value was lower than the final value (pfriction coefficient of natural human shoulders remains remarkably low (averaging as little as 0.0015 and no greater than 0.006) for up to 24 h of continuous loading. The sustained low friction coefficients observed in incongruent joints (~0.001) likely represent rolling rather than sliding friction. Copyright © 2015. Published by Elsevier Ltd.

  20. The Friction Coefficient of Shoulder Joints Remains Remarkably Low Over 24 h of Loading

    Science.gov (United States)

    Jones, Brian K.; Durney, Krista M.; Hung, Clark T.; Ateshian, Gerard A.

    2015-01-01

    The frictional response of whole human joints over durations spanning activities of daily living has not been reported previously. This study measured the friction of human glenohumeral joints during 24 h of reciprocal loading in a pendulum testing device, at moderate (0.2 mm/s, 4320 cycles) and low (0.02 mm/s, 432 cycles) sliding speeds, under a 200 N load. The effect of joint congruence was also investigated by testing human humeral heads against significantly larger mature bovine glenoids. Six human joints and six bovine joints were tested in four combinations: human joints tested at moderate (hHCMS, n=6) and low speed (hHCLS, n=3), human humeral heads tested against bovine glenoids at moderate speed (LCMS, n=3), and bovine joints tested at moderate speed (bHCMS, n=3). In the first half hour the mean ± standard deviation of the friction coefficient was hHCMS: 0.0016±0.0011, hHCLS: 0.0012±0.0002, LCMS: 0.0008±0.0002 and bHCMS: 0.0024±0.0008; in the last four hours it was hHCMS: 0.0057±0.0025, hHCLS: 0.0047±0.0017, LCMS: 0.0012±0.0003 and bHCMS: 0.0056±0.0016. The initial value was lower than the final value (pfriction coefficient of natural human shoulders remains remarkably low (averaging as little as 0.0015 and no greater than 0.006) for up to 24 h of continuous loading. The sustained low friction coefficients observed in incongruent joints (~0.001) likely represent rolling rather than sliding friction. PMID:26472306

  1. Incidence of hockey ankle injuries in Kwa-Zulu Natal, South Africa ...

    African Journals Online (AJOL)

    ankle injuries amongst hockey players was 26.41%. The most frequent ankle injury sustained by male adolescent hockey players was an inversion ankle sprain (84.62% of the 26.41% injured subjects of the sample cohort). The mechanisms of ankle injuries were attributed to rapid rotational movements of the ankle joint ...

  2. A computational parametric study on edge loading in ceramic-on-ceramic total hip joint replacements.

    Science.gov (United States)

    Liu, Feng; Feng, Li; Wang, Junyuan

    2018-07-01

    Edge loading in ceramic-on-ceramic total hip joint replacement is an adverse condition that occurs as the result of a direct contact between the head and the cup rim. It has been associated with translational mismatch in the centres of rotation of the cup and head, and found to cause severe wear and early failure of the implants. Edge loading has been considered in particular in relation to dynamic separation of the cup and head centres during a gait cycle. Research has been carried out both experimentally and computationally to understand the mechanism including the influence of bearing component positioning on the occurrence and severity of edge loading. However, it is experimentally difficult to measure both the load magnitude and duration of edge loading as it occurs as a short impact within the tight space of hip joints. Computationally, a dynamic contact model, for example, developed using the MSC ADAMS software for a multi-body dynamics simulation can be particularly useful for calculating the loads and characterising the edge loading. The aim of the present study was to further develop the computational model, and improve the predictions of contact force and the understanding of mechanism in order to provide guidance on design and surgical factors to avoid or to reduce edge loading and wear. The results have shown that edge loading can be avoided for a low range of translational mismatch in the centres of rotation of the cup and head during gait at the level of approximately 1.0 mm for a cup at 45° inclination, keeping a correct cup inclination at 45° is important to reduce the edge loading severity, and edge loading can be avoided for a certain range of translational mismatch of the cup and head centres with an increased swing phase load. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Ankle sprain (image)

    Science.gov (United States)

    An ankle sprain is a common injury to the ankle. The most common way the ankle is injured is when ... swelling, inflammation, and bruising around the ankle. An ankle sprain injury may take a few weeks to many ...

  4. The influence of ankle joint mobility when using an orthosis on stability in patients with spinal cord injury: a pilot study.

    Science.gov (United States)

    Arazpour, M; Bani, M A; Hutchins, S W; Curran, S; Javanshir, M A

    2013-10-01

    Perceived risk of falling is an important factor for people with spinal cord injury (SCI). This study investigated the influence of ankle joint motion on postural stability and walking in people with SCI when using an orthosis. Volunteer subjects with SCI (n=5) participated in this study. Each subject was fitted with an advanced reciprocating gait orthosis (ARGO) equipped with either solid or dorsiflexion-assist type ankle-foot orthosis (AFOs) and walked at their self-selected speed along a flat walkway to enable the comparison of walking speed, cadence and endurance. A force plate system and a modified Falls Efficacy Scale (MFES) were utilized to measure postural sway and the perceived fear of falling, respectively. There were significant differences in the mean MFES scores between two types of orthosis (P=0.023). When using two crutches, there was no significant difference in static standing postural sway in the medio-lateral (M/L) direction (P=0.799), but significant difference in the antero-posterior (A/P) direction (P=0.014). However, during single crutch support, there was a significant difference in both M/L (P=0.019) and A/P (P=0.022) directions. Walking speed (7%) and endurance (5%) significantly increased when using the ARGO with dorsi flexion assisted AFOs. There was no significant deference between two types of orthoses in cadence (P=0.54). Using an ARGO with dorsiflexion-assisted AFOs increased the fear of falling, but improved static postural stability and increased walking speed and endurance, and should therefore be considered as an effective orthosis during the rehabilitation of people with SCI.

  5. Moving dynamic loads caused by bridge deck joint unevenness - a case study

    CSIR Research Space (South Africa)

    Steyn, WJV

    2004-11-01

    Full Text Available This paper focus on the general guidelines regarding maximum unevenness from bridge deck joints for typical South African heavy vehicles, in order to minimize the generation of moving variable loads. In a recent investigation it was found that areas...

  6. Estimation of the mechanical loading of the shoulder joint in daily conditions

    NARCIS (Netherlands)

    De Vries, W.H.K.

    2015-01-01

    The goal of this thesis is to assemble a method to estimate shoulder joint reaction forces, in daily conditions, based on long term collection of ambulatory measurable variables, to obtain the desired long term mechanical load profile of the shoulder. Chapter 2 examines, and discusses one of the

  7. Failure Predictions of Out-of-Autoclave Sandwich Joints with Delaminations Under Flexure Loads

    Science.gov (United States)

    Nordendale, Nikolas A.; Goyal, Vinay K.; Lundgren, Eric C.; Patel, Dhruv N.; Farrokh, Babak; Jones, Justin; Fischetti, Grace; Segal, Kenneth N.

    2015-01-01

    An analysis and a test program was conducted to investigate the damage tolerance of composite sandwich joints. The joints contained a single circular delamination between the face-sheet and the doubler. The coupons were fabricated through out-of-autoclave (OOA) processes, a technology NASA is investigating for joining large composite sections. The four-point bend flexure test was used to induce compression loading into the side of the joint where the delamination was placed. The compression side was chosen since it tends to be one of the most critical loads in launch vehicles. Autoclave cure was used to manufacture the composite sandwich sections, while the doubler was co-bonded onto the sandwich face-sheet using an OOA process after sandwich panels were cured. A building block approach was adopted to characterize the mechanical properties of the joint material, including the fracture toughness between the doubler and face-sheet. Twelve four-point-bend samples were tested, six in the sandwich core ribbon orientation and six in sandwich core cross-ribbon direction. Analysis predicted failure initiation and propagation at the pre-delaminated location, consistent with experimental observations. A building block approach using fracture analyses methods predicted failure loads in close agreement with tests. This investigation demonstrated a small strength reduction due to a flaw of significant size compared to the width of the sample. Therefore, concerns of bonding an OOA material to an in-autoclave material was mitigated for the geometries, materials, and load configurations considered.

  8. Ankle ligament injuries

    Directory of Open Access Journals (Sweden)

    Per A.F.H. Renström

    1998-06-01

    that is refractory to conservative measures and bracing as outlined above, surgical treatment must address the subtalar joint as well. Subtalar ligament injury and instability are probably more common than appreciated. Definition and diagnosis of this entity are difficult, however. Fortunately, it appears that in the majority of the acute injuries healing occurs with the same functional rehabilitation program as that for lateral ankle ligament sprains. For chronic subtalar instability an intial attempt at functional rehabilitation with ankle proprioceptive training and bracing should be attempted. If this program fails primary repair or reconstruction can be beneficial. Reconstructive procedures must address the subtalar joint. Subtalar instability often occurs in conjunction with talocrural instability, so careful diagnosis is critical in anyone with chronic ankle instability. If either is not addressed, the patient will continue to have problems. Deltoid ligament injuries most often occur in association with ankle fractures. They are rare as isolated injuries. If no fracture is evident on radiographs, particular attention must be paid to the syndesmosis to ensure there is not an associated syndesmosis disruption. True isolated deltoid injuries seem to do well with non-operative functional treatment as for lateral ankle ligament injuries. Deltoid ruptures associated with ankle fractures appear to heal well by addressing the other injuries and allowing the deltoid to heal on its own. It is vital to correct any syndesmosis injury and to obtain correct bony alignment. Syndesmosis injuries can be debilitating if not treated properly. Careful physical exam and interpretation of radiographs is necessary to obtain a correct diagnosis. Partial injuries appear to do well with functional rehabilitation. However, complete tears, if widening is not corrected, can lead to chronic ankle pain and early degenerative changes. Widening of the syndesmosis with a tear of the inferior

  9. Development of an Active Ankle Foot Orthosis to Prevent Foot Drop and Toe Drag in Hemiplegic Patients: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Jungyoon Kim

    2011-01-01

    Full Text Available We developed an active ankle-foot orthosis (AAFO that controls dorsiflexion/plantarflexion of the ankle joint to prevent foot drop and toe drag during hemiplegic walking. To prevent foot slap after initial contact, the ankle joint must remain active to minimize forefoot collision against the ground. During late stance, the ankle joint must also remain active to provide toe clearance and to aid with push-off. We implemented a series elastic actuator in our AAFO to induce ankle dorsiflexion/plantarflexion. The activator was controlled by signals from force sensing register (FSR sensors that detected gait events. Three dimensional gait analyses were performed for three hemiplegic patients under three different gait conditions: gait without AFO (NAFO, gait with a conventional hinged AFO that did not control the ankle joint (HAFO, and gait with the newly-developed AFO (AAFO. Our results demonstrate that our newly-developed AAFO not only prevents foot drop by inducing plantarflexion during loading response, but also prevents toe drag by facilitating plantarflexion during pre-swing and dorsiflexion during swing phase, leading to improvement in most temporal-spatial parameters. However, only three hemiplegic patients were included in this gait analysis. Studies including more subjects will be required to evaluate the functionality of our newly developed AAFO.

  10. Experimental investigation on the failure of T-joints at elevated temperature under unaxial loading

    Science.gov (United States)

    Bahri, N. F.; Afendi, M.; Razlan, Z. M.; Nor, A.; Baharuddin, S. A.

    2017-09-01

    In this study, the mechanical properties and maximum failure load of a bulk and T-joints subjected to tensile loading were investigated experimentally. A bulk and the T-joint specimens were fabricated and tested in order to investigate the effects of temperature conditions on the failure of the joints. The adherent and adhesive used for T-joint are 304 L stainless steel and Hysol E 214 HP with the adhesive thickness of 1.0 mm. The tensile test of the bulk specimen and adhesively T-joint were conducted by using a universal testing machine (UTM) at room temperature (RT), 55 °C, 75 °C, 100 °C and 120 °C, respectively. It was found that as the temperature increases, the failure force strength decreases for bulk and T-joint specimen. Data obtained from the tests at 120 °C showed the failure force of the bulk adhesive decreased by approximately 44 % compared to the specimen tested at RT. Next, the bulk of Hysol failure force result was compared with Araldite at RT and 100 °C. Araldite data was taken from the previous study [1]. It has also been found that the bulk for Hysol has higher failure force compared to Araldite at RT and 100 °C.

  11. FLANGE-ORNL, Flanged Pipe Joint Stress Analysis, Internal Pressure, Moment Loads, Temperature

    International Nuclear Information System (INIS)

    Rodabaugh, E.C.; Moore, S.E.

    1979-01-01

    1 - Description of problem or function: FLANGE-ORNL calculates appropriate loads, stresses, and displacements for the flanges, bolts, and gaskets that comprise a flanged piping joint for internal pressure or moment loading on the pipe, temperature difference between the flange hub and ring, and variations in bolt load that result from pressure, hub-ring temperature gradient and/or bolt-ring temperature differences. Flanges considered may be tapered-hub, straight or blind. 2 - Method of solution: The solution is based on discontinuity analysis and the theory of plates and shells

  12. Analysis of movement axes of the ankle and subtalar joints: relationship with the articular surfaces of the talus.

    Science.gov (United States)

    Cho, Ho-Jung; Kwak, Dai-Soon; Kim, In-Beom

    2014-10-01

    Bone shape varies among human populations, and in the case of articular joints, the shape of the articulating surfaces strongly influences joint movement. In this study, we aimed to analyse the axes of the talocrural and subtalar joints, using the talar articular surface method, and compare these results with those of the previous studies. We used three-dimensional reconstruction models of tali among Korean individuals. The axes of the talocrural and subtalar joints were calculated by using the least-square sphere fitting method, and the principal axis was used for reference coordination. The shape of the talus was classified based on the shape of its anterior, middle, and posterior calcaneal facets, and the talar shape was compared with the movement axes. The movement axes did not differ according to the type of calcaneal facets of the talus. Interestingly, we also noted that the axes of the talocrural and subtalar joints in this study differed significantly from those reported in the previous studies; these differences may be due to variations in the shape of the bones. © IMechE 2014.

  13. Evaluation of new composite rigid joint under cyclic loading and its effect on one-floor composite frame

    Directory of Open Access Journals (Sweden)

    Azadeh Haghighat

    2017-08-01

    Full Text Available In order to improve the performance of structure against lateral and gravity loads, new systems known as composite systems consisting of the reinforced concrete columns and steel beams (RCS can be used and thereby the advantages of concrete beside steel are acquired. RCS joints can be implemented as either through-beam-type joint or through-column-type joint. In this paper, a concrete joint as standard reference joint and a proposed composite joint through-column‎ with new details were built and tested under cyclic loading. Then, using numerical analysis by finite element method, the behavior of composite joint under cyclic loading has been studied and the behavior and performance of proposed composite joint has been studied by comparing the results with that of concrete joint. The results showed that the joint composition in this way resulted in decreasing of the compressive and tensile damages of concrete and increasing in loading capacity, ductility, stiffness and energy absorption. General results of application of composite joint at the one floor-one span composite frame indicating that lateral loading capacity of frame was increased and the performance of frame was improved.

  14. Effects of an intensive weight loss program on knee joint loading in obese adults with knee osteoarthritis

    DEFF Research Database (Denmark)

    Aaboe, J; Bliddal, H; Messier, S P

    2011-01-01

    To determine the effect of an intensive weight loss program on knee joint loads during walking in obese patients with knee osteoarthritis (OA).......To determine the effect of an intensive weight loss program on knee joint loads during walking in obese patients with knee osteoarthritis (OA)....

  15. Anterior ankle arthroscopy, distraction or dorsiflexion?

    Science.gov (United States)

    de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

    2010-05-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

  16. Complications in ankle fracture surgery

    OpenAIRE

    Ovaska, Mikko

    2015-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  17. Predictive Simulations of Neuromuscular Coordination and Joint-Contact Loading in Human Gait.

    Science.gov (United States)

    Lin, Yi-Chung; Walter, Jonathan P; Pandy, Marcus G

    2018-04-18

    We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot-ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data. The data-tracking solutions accurately reproduced joint motion, ground forces and knee contact loads measured for two total knee arthroplasty patients walking at their preferred speeds. RMS errors in joint kinematics were joint kinematics, ground forces, knee contact loads and muscle activation patterns measured for slow and fast walking. The results demonstrate the feasibility of performing computationally-efficient, predictive, dynamic optimization simulations of movement using full-body, muscle-actuated models with realistic representations of joint function.

  18. Air acupuncture therapy combined with manipulation on 90 cases of acute sprain and bruising of ankle joint%气针加手法治疗急性踝关节扭挫伤90例

    Institute of Scientific and Technical Information of China (English)

    王永红; 李斌

    2003-01-01

    @@ BACKGROUND: Air acupuncture therapy is to make use of time and space stimuli of air in acupoint and promote blood circulation to remove blood stasis, relieve swelling and pain through interstitial osmosis and absorption. Manipulation to acute sprain and bruising of ankle joint can achieve anatomic reduction as soon as possible, clear incarceration of synovium, promote circulation of qi and relieve pain and increase blood circulation of affected tissue.

  19. Ankle Fractures: The Operative Outcome

    Directory of Open Access Journals (Sweden)

    Ahmad Hafiz Z

    2011-03-01

    Full Text Available Ankle fractures are commonly seen in orthopaedic practice. This retrospective study of patients with ankle fractures who underwent surgical treatment in our institution from January 2000 to December 2003 was undertaken to analyze the common causes and patterns of ankle fractures; and the functional outcome of operative treatment for these fractures. Eighty patients were identified and reviewed. There were 65 male (81.3% and 15 female patients (18.7% with age ranging from 13 to 71 years old (mean, 32.3y. Common causes of ankle fractures were trauma (especially motor vehicle accidents, sports injuries and the osteoporotic bones in the elderly. Weber C (64.0% was the most common pattern of fracture at presentation. The most common operative treatment for ankle fractures was open reduction and internal fixation (73 patients, 91.2%. Excellent and good outcomes were achieved in 93.8% of cases when measured using the Olerud and Molander scoring system for foot and ankle. In conclusion, operative treatment for ankle fractures restores sufficient stability and allowed mobility of the ankle joint.

  20. Effect of hoof angle on joint contact area in the equine metacarpophalangeal joint following simulated impact loading ex vivo.

    Science.gov (United States)

    McCarty, C A; Thomason, J J; Gordon, K; Hurtig, M; Bignell, W

    2015-11-01

    To add to the existing data on impact loading of the metacarpophalangeal (MCP) joint as a precursor to assessing the potential role of impact in joint disease. To examine the effect of impact loading on contact areas of the first phalanx (P1) and proximal sesamoids (PS) with the third metacarpal (McIII) under 3 hoof-strike conditions (toe-first, flat, heel-first). Randomised, repeated controlled experiment using cadaver material. Eight cadaver limbs were subjected to randomised, repeated controlled trials where the hoof was struck by a pendulum impact machine (impact velocity 3.55 m/s) under 3 strike conditions. Data from pressure sensitive film placed over medial and lateral McIII condyles and lateromedially across the dorsal aspect of McIII were quantified: total areas of P1 and PS contact (cm(2) ) at maximum recorded pressure; centroid locations of contact areas relative to the sagittal ridge (cm) and transverse ridge (cm) and dispersion of pixels (cm(4) ) for each McIII condyle (medial/lateral). The effect of the strike conditions on each variable were statistically tested using repeated-measures ANOVA (α = 0.05). Contact area between P1 and McIII condyles fell in well-defined areas bounded by the sagittal and transverse ridge, contact areas from PS were smaller and widely dispersed across McIII palmar border. Ratio of contact area of P1 to PS was 2.83 (Pcontact area (P>0.54) CONCLUSIONS: Contact at impact (primarily from P1 and distally situated on McIII), contrasts with contact areas at midstance from both P1 and PS, symmetrically placed. Under impact, the greatest contact area was on the dorsal aspect of the medial condyle and coincides with the area subjected to the greatest increase in subchondral bone stiffening in joint disease. © 2014 EVJ Ltd.

  1. Limit load solution for electron beam welded joints with single edge weld center crack in tension

    Science.gov (United States)

    Lu, Wei; Shi, Yaowu; Li, Xiaoyan; Lei, Yongping

    2012-05-01

    Limit loads are widely studied and several limit load solutions are proposed to some typical geometry of weldments. However, there are no limit load solutions exist for the single edge crack weldments in tension (SEC(T)), which is also a typical geometry in fracture analysis. The mis-matching limit load for thick plate with SEC(T) are investigated and the special limit load solutions are proposed based on the available mis-matching limit load solutions and systematic finite element analyses. The real weld configurations are simplified as a strip, and different weld strength mis-matching ratio M, crack depth/width ratio a/ W and weld width 2H are in consideration. As a result, it is found that there exists excellent agreement between the limit load solutions and the FE results for almost all the mis-matching ration M, a/ W and ligament-to-weld width ratio ( W-a)/ H. Moreover, useful recommendations are given for evaluating the limit loads of the EBW structure with SEC(T). For the EBW joints with SEC(T), the mis-matching limit loads can be obtained assuming that the components are wholly made of base metal, when M changing from 1.6 to 0.6. When M decreasing to 0.4, the mis-matching limit loads can be obtained assuming that the components are wholly made of base metal only for large value of ( W-a)/ H. The recommendations may be useful for evaluating the limit loads of the EBW structures with SEC(T). The engineering simplifications are given for assessing the limit loads of electron beam welded structure with SEC(T).

  2. Effect of boot shaft stiffness on stability joint energy and muscular co-contraction during walking on uneven surface.

    Science.gov (United States)

    Böhm, Harald; Hösl, Matthias

    2010-09-17

    Increased boot shaft stiffness may have a noticeable impact on the range of motion of the ankle joint. Therefore, the ability of the ankle joint to generate power for propulsion might be impaired. This might result in compensatory changes at the knee and hip joint. Besides, adaptability of the subtalar joint to uneven surface might be reduced, which could in turn affect stability. The aim of the study was therefore to investigate the influence of boot shaft stiffness on biomechanical gait parameters. Fifteen healthy young adults walked over coarse gravel wearing two different hiking boots that differed by 50% in passive shaft stiffness. Leg kinematics, kinetics and electromyography were measured. Gait velocity and indicators for stability were not different when walking with the hard and soft boot shaft over the gravel surface. However, the hard boot shaft decreased the ankle range of motion as well as the eccentric energy absorbed at the ankle joint. As a consequence, compensatory changes at the knee joint were observed. Co-contraction was increased, and greater eccentric energy was absorbed. Therefore, the efficiency of gait with hard boots might be decreased and joint loading at the knee might be increased, which might cause early fatigue of knee muscles during walking or hiking. The results of this study suggest that stiffness and blocking of joint motion at the ankle should not be equated with safety. A trade-off between lateral stiffness and free natural motion of the ankle joint complex might be preferable.

  3. Mean load effect on fatigue of welded joints using structural stress and fracture mechanics approach

    International Nuclear Information System (INIS)

    Kim, Jong Sung; Kim, Cheol; Jin, Tae Eun; Dong, P.

    2006-01-01

    In order to ensure the structural integrity of nuclear welded structures during design life, the fatigue life has to be evaluated by fatigue analysis procedures presented in technical codes such as ASME B and PV Code Section III. However, existing fatigue analysis procedures do not explicitly consider the presence of welded joints. A new fatigue analysis procedure based on a structural stress/fracture mechanics approach has been recently developed in order to reduce conservatism by erasing uncertainty in the analysis procedure. A recent review of fatigue crack growth data under various mean loading conditions using the structural stress/fracture mechanics approach, does not consider the mean loading effect, revealed some significant discrepancies in fatigue crack growth curves according to the mean loading conditions. In this paper, we propose the use of the stress intensity factor range ΔK characterized with loading ratio R effects in terms of the structural stress. We demonstrate the effectiveness in characterizing fatigue crack growth and S-N behavior using the well-known data. It was identified that the S-N data under high mean loading could be consolidated in a master S-N curve for welded joints

  4. Reliability Analysis for Adhesive Bonded Composite Stepped Lap Joints Loaded in Fatigue

    DEFF Research Database (Denmark)

    Kimiaeifar, Amin; Sørensen, John Dalsgaard; Lund, Erik

    2012-01-01

    -1, where partial safety factors are introduced together with characteristic values. Asymptotic sampling is used to estimate the reliability with support points generated by randomized Sobol sequences. The predicted reliability level is compared with the implicitly required target reliability level defined......This paper describes a probabilistic approach to calculate the reliability of adhesive bonded composite stepped lap joints loaded in fatigue using three- dimensional finite element analysis (FEA). A method for progressive damage modelling is used to assess fatigue damage accumulation and residual...... by the wind turbine standard IEC 61400-1. Finally, an approach for the assessment of the reliability of adhesive bonded composite stepped lap joints loaded in fatigue is presented. The introduced methodology can be applied in the same way to calculate the reliability level of wind turbine blade components...

  5. Anterior ankle arthroscopy, distraction or dorsiflexion?

    OpenAIRE

    de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, where...

  6. Behaviour of hybrid fibre reinforced concrete beam–column joints under reverse cyclic loads

    International Nuclear Information System (INIS)

    Ganesan, N.; Indira, P.V.; Sabeena, M.V.

    2014-01-01

    Highlights: • Developed a high performance hybrid fibre reinforced cementitious composite. • Exterior beam-column joints have been tested under reversed cyclic loading. • Ductility factor, energy dissipation and stiffness degradation have been evaluated. • Contribution to reduce congestion of reinforcement in beam column joints. - Abstract: An experimental investigation was carried out to study the effect of hybrid fibres on the strength and behaviour of High performance concrete beam column joints subjected to reverse cyclic loads. A total of 12 reinforced concrete beams column joints were cast and tested in the present investigation. High performance concrete of M60 grade was designed using the modified ACI method suggested by Aïtcin. Crimped steel fibres and polypropylene fibres were used in hybrid form. The main variables considered were the volume fraction of (i) crimped steel fibres viz. 0.5% (39.25 kg/m 3 ) and 1.0% (78.5 kg/m 3 ) and (ii) polypropylene fibres viz. 0.1% (0.9 kg/m 3 ), 0.15% (1.35 kg/m 3 ), and 0.2% (1.8 kg/m 3 ). Addition of fibres in hybrid form improved many of the engineering properties such as the first crack load, ultimate load and ductility factor of the composite. The combination of 1% (78.5 kg/m 3 ) volume fraction of steel fibres and 0.15% (1.35 kg/m 3 ) volume fraction of polypropylene fibres gave better performance with respect to energy dissipation capacity and stiffness degradation than the other combinations

  7. Methods for Solving a Stress Behaviour of Welded Joints under Repeated Loads

    Directory of Open Access Journals (Sweden)

    Semrád K.

    2016-05-01

    Full Text Available The article processes issue of strength of cyclically loaded welded joints with a focus on fillet welds. The data for used steels and basic information were obtained at U.S. Steel Research Laboratory and from articles by Lehigh University and the University of Illinois in USA. The practical application of the solution is presented for crane car body to crawler connection.

  8. Alterations in knee joint laxity during the menstrual cycle in healthy women leads to increases in joint loads during selected athletic movements.

    Science.gov (United States)

    Park, Sang-Kyoon; Stefanyshyn, Darren J; Ramage, Barbara; Hart, David A; Ronsky, Janet L

    2009-06-01

    It has been speculated that the hormonal cycle may be correlated with higher incidence of ACL injury in female athletes, but results have been very contradictory. Knee joint loads are influenced by knee joint laxity (KJL) during the menstrual cycle. Controlled laboratory study. Serum samples and KJL were assessed at the follicular, ovulation, and luteal phases in 26 women. Knee joint mechanics (angle, moment, and impulse) were measured and compared at the same intervals. Each of the 26 subjects had a value for knee laxity at each of the 3 phases of their cycle, and these were ordered and designated low, medium, and high for that subject. Knee joint mechanics were then compared between low, medium, and high laxity. No significant differences in knee joint mechanics were found across the menstrual cycle (no phase effect). However, an increase in KJL was associated with higher knee joint loads during movement (laxity effect). A 1.3-mm increase in KJL resulted in an increase of approximately 30% in adduction impulse in a cutting maneuver, an increase of approximately 20% in knee adduction moment, and a 20% to 45% increase in external rotation loads during a jumping and stopping task (P knee joint loading during movements. Clinical Relevance Our findings will be beneficial for researchers in the development of more effective ACL injury prevention programs.

  9. Influence of Elastic Bandage and Neoprene Ankle Support on Ankle Position Sense and Pain in Subjects with Ankle Sprain (Grade I & II

    Directory of Open Access Journals (Sweden)

    Basir Majdoleslami

    2004-06-01

    Full Text Available Objective: to investigate whether a neoprene ankle support and elastic bandage around the ankle joint of subjects with ankle sprain (grade I&II would , in short term (a reduce pain (b improve ankle joint position sense and comparison of their effect with each other if they have. Materials & Methods: In a semi-experimental study, 30 subjects (16men, 14 women, age between 16-52 with ankle sprain grade I&II. Subjects had to have at least 2cm from 10cm visual analogue scale (VAS of ankle pain for study entry. All patients were randomly assigned to either an elastic bandage or a neoprene ankle support. One week later they were assigned to the opposite selection. Joint position sense was assessed in the sitting position using an electrogoniometer and pain by VAS where 0cm equals no pain and 10 cm equals worst pain. ankle pain and JPS were assessed for each selection one week apart. During each visit assessment were performed at baseline and after 20 min of bandage/neoprene ankle support application. Results: the mean of scores for ankle variables JPS and VAS was taken and paired-t test and Wilcoxon signed rank test was employed to calculate the different between two trails. Neoprene ankle support had significant effect on ankle JPS (P=0.034. But elastic bandage had no effect (P=0.539. Both of them had significantly reduced ankle pain. (P=0.000  Conclusion: In subjects with both neoprene ankle support and elastic bandage reduced ankle pain with more effect of neoprene ankle support. Only the neoprene ankle support had effect on knee JPS.

  10. Theoretical distribution of load in the radius and ulna carpal joint.

    Science.gov (United States)

    Márquez-Florez, Kalenia; Vergara-Amador, Enrique; de Las Casas, Estevam Barbosa; Garzón-Alvarado, Diego A

    2015-05-01

    The purpose of this study is to validate a model for the analysis of the load distribution through the wrist joint, subjected to forces on the axes of the metacarpals from distal to proximal for two different mesh densities. To this end, the Rigid Body Spring Model (RBSM) method was used on a three-dimensional model of the wrist joint, simulating the conditions when making a grip handle. The cartilage and ligaments were simulated as springs acting under compression and tension, respectively, while the bones were considered as rigid bodies. At the proximal end of the ulna the movement was completely restricted, and the radius was allowed to move only in the lateral/medial direction. With these models, we found the load distributions on each carpal articular surface of radius. Additionally, the results show that the percentage of the applied load transmitted through the radius was about 86% for one mesh and 88% for the coarser one; for the ulna it was 21% for one mesh and 18% for the coarser. The obtained results are comparable with previous outcomes reported in prior studies. The latter allows concluding that, in theory, the methodology can be used to describe the changes in load distribution in the wrist. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Identifying interactive effects of task demands in lifting on estimates of in vivo low back joint loads.

    Science.gov (United States)

    Gooyers, Chad E; Beach, Tyson A C; Frost, David M; Howarth, Samuel J; Callaghan, Jack P

    2018-02-01

    This investigation examined interactions between the magnitude of external load, movement speed and (a)symmetry of load placement on estimates of in vivo joint loading in the lumbar spine during simulated occupational lifting. Thirty-two participants with manual materials handling experience were included in the study. Three-dimensional motion data, ground reaction forces, and activation of six bilateral trunk muscle groups were captured while participants performed lifts with two loads at two movement speeds and using two load locations. L4-L5 joint compression and shear force-time histories were estimated using an EMG-assisted musculoskeletal model of the lumbar spine. Results from this investigation provide strong evidence that known mechanical low back injury risk factors should not be viewed in isolation. Rather, injury prevention efforts need to consider the complex interactions that exist between external task demands and their combined influence on internal joint loading. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Observation on Curative Effect on Ankle Joint Sprain by the Way of Massage and Electroacapuncture%推拿和电针治疗踝关节扭伤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘骁蒨; 夏云建

    2014-01-01

    Ankle joint injury is one common disease of surgical soft tissue, this kind of sprain is more general for people engaged in sport activity .8 patients who sprained ankles are cured in the way of clinical physiotherapy by adopting massage and electroacapuncture .The result shows that total effective rate is 87.3%. Clinical curative effect indicates that to use massage and electric needle would have good effect on treating the ankle joint sprain, it also provides a new method and remedy way for recovering in early(short) period after injured in sports(from sport injuries) .%踝关节损伤是一种常见的外科软组织损伤疾病,从事体育运动的人员中踝关节扭伤更为多见。本文对8名踝关节扭伤的患者运用推拿和电针进行临床理疗。结果显示,总有效率87.3%。临床疗效表明推拿和电针治疗踝关节扭伤具有良好效果,为运动损伤后早期康复提供了一种新的方法和治疗途径。

  13. Transfer of lumbosacral load to iliac bones and legs Part 2: Loading of the sacroiliac joints when lifting in a stooped posture

    NARCIS (Netherlands)

    C.J. Snijders (Chris); A. Vleeming (Andry); R. Stoeckart (Rob)

    1993-01-01

    textabstractWe developed a biomechanical model of load transfer by the sacroiliac joints in relation to posture. A description is given of two ways in which the transfer of lumbar load to the pelvis in a stooped posture can take place. One way concerns ligament and muscle forces that act on the

  14. Fluid load support and contact mechanics of hemiarthroplasty in the natural hip joint.

    Science.gov (United States)

    Pawaskar, Sainath Shrikant; Ingham, Eileen; Fisher, John; Jin, Zhongmin

    2011-01-01

    The articular cartilage covering the ends of the bones of diarthrodial synovial joints is thought to have evolved so that the loads are transferred under different and complex conditions, with a very high degree of efficiency and without compromising the structural integrity of the tissue for the life of an individual. These loading conditions stem from different activities such as walking, and standing. The integrity of cartilage may however become compromised due to congenital disease, arthritis or trauma. Hemiarthroplasty is a potentially conservative treatment when only the femoral cartilage is affected as in case of femoral neck fractures. In hemiarthroplasty, a metallic femoral prosthesis is used to articulate against the natural acetabular cartilage. It has also been hypothesized that biphasic lubrication is the predominant mechanism protecting the cartilage through a very high fluid load support which lowers friction. This may be altered due to hemiarthroplasty and have a direct effect on the frictional shear stresses and potentially cartilage degradation and wear. This study modelled nine activities of daily living and investigated the contact mechanics of a hip joint with a hemiarthroplasty, focussing particularly on the role of the fluid phase. It was shown that in most of the activities studied the peak contact stresses and peak fluid pressures were in the superior dome or lateral roof of the acetabulum. Total fluid load support was very high (~90%) in most of the activities which would shield the solid phase from being subjected to very high contact stresses. This was dependent not only on the load magnitude but also the direction and hence on the location of the contact area with respect to the cartilage coverage. Lower fluid load support was found when the contact area was nearer the edges where the fluid drained easily. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  15. Arthrography of the ankle sprains

    International Nuclear Information System (INIS)

    Han, Moon Hee

    1985-01-01

    Ankle arthrography, by direct puncture of joint cavity, is considered to be a simple and accurate diagnostic method for a precise evaluation of ligamentous injury. Forty-seven cases of ankle arthrography were successively performed in the patients of acute ankle sprains. The purpose of this study is to demonstrate how ankle arthrography can delineate the pathologic anatomy in such cases. The results are as follows: 1. Thirty cases among forty seven revealed the findings of ligament tears. 2. For better diagnostic accuracy, the arthrography should be performed within 72 hrs. after injury. 3. The anterior talofibular ligament tears were the most common (twenty-nine cases) of all and seventeen of them revealed tears without association of any other ligament tears. 4. There were ten cases of calcaneofibular ligament tears and nine of them were associated with anterior talofibular ligament tears. 5. Three cases of anterior tibiofibular and one deltoid ligament tears were demonstrated

  16. Experimental study on lateral strength of wall-slab joint subjected to lateral cyclic load

    Science.gov (United States)

    Masrom, Mohd Asha'ari; Mohamad, Mohd Elfie; Hamid, Nor Hayati Abdul; Yusuff, Amer

    2017-10-01

    Tunnel form building has been utilised in building construction since 1960 in Malaysia. This method of construction has been applied extensively in the construction of high rise residential house (multistory building) such as condominium and apartment. Most of the tunnel form buildings have been designed according to British standard (BS) whereby there is no provision for seismic loading. The high-rise tunnel form buildings are vulnerable to seismic loading. The connections between slab and shear walls in the tunnel-form building constitute an essential link in the lateral load resisting mechanism. Malaysia is undergoing a shifting process from BS code to Eurocode (EC) for building construction since the country has realised the safety threats of earthquake. Hence, this study is intended to compare the performance of the interior wall slab joint for a tunnel form structure designed based on Euro and British codes. The experiment included a full scale test of the wall slab joint sub-assemblages under reversible lateral cyclic loading. Two sub-assemblage specimens of the wall slab joint were designed and constructed based on both codes. Each specimen was tested using lateral displacement control (drift control). The specimen designed by using Eurocode was found could survive up to 3.0% drift while BS specimen could last to 1.5% drift. The analysis results indicated that the BS specimen was governed by brittle failure modes with Ductility Class Low (DCL) while the EC specimen behaved in a ductile manner with Ductility Class Medium (DCM). The low ductility recorded in BS specimen was resulted from insufficient reinforcement provided in the BS code specimen. Consequently, the BS specimen could not absorb energy efficiently (low energy dissipation) and further sustain under inelastic deformation.

  17. Finite element analysis of beam-to-column joints in steel frames under cyclic loading

    Directory of Open Access Journals (Sweden)

    Elsayed Mashaly

    2011-03-01

    Full Text Available The aim of this paper is to present a simple and accurate three-dimensional (3D finite element model (FE capable of predicting the actual behavior of beam-to-column joints in steel frames subjected to lateral loads. The software package ANSYS is used to model the joint. The bolted extended-end-plate connection was chosen as an important type of beam–column joints. The extended-end-plate connection is chosen for its complexity in the analysis and behavior due to the number of connection components and their inheritable non-linear behavior. Two experimental tests in the literature were chosen to verify the finite element model. The results of both the experimental and the proposed finite element were compared. One of these tests was monotonically loaded, whereas the second was cyclically loaded. The finite element model is improved to enhance the defects of the finite element model used. These defects are; the long time need for the analysis and the inability of the contact element type to follow the behavior of moment–rotation curve under cyclic loading. As a contact element, the surface-to-surface element is used instead of node-to-node element to enhance the model. The FE results show good correlation with the experimental one. An attempt to improve a new technique for modeling bolts is conducted. The results show that this technique is supposed to avoid the defects above, give much less elements number and less solution time than the other modeling techniques.

  18. Hyaluronan supplementation as a mechanical regulator of cartilage tissue development under joint-kinematic-mimicking loading.

    Science.gov (United States)

    Wu, Yabin; Stoddart, Martin J; Wuertz-Kozak, Karin; Grad, Sibylle; Alini, Mauro; Ferguson, Stephen J

    2017-08-01

    Articular cartilage plays an essential role in joint lubrication and impact absorption. Through this, the mechanical signals are coupled to the tissue's physiological response. Healthy synovial fluid has been shown to reduce and homogenize the shear stress acting on the cartilage surfaces due to its unique shear-thinning viscosity. As cartilage tissues are sensitive to mechanical changes in articulation, it was hypothesized that replacing the traditional culture medium with a healthy non-Newtonian lubricant could enhance tissue development in a cartilage engineering model, where joint-kinematic-mimicking mechanical loading is applied. Different amounts of hyaluronic acid were added to the culture medium to replicate the viscosities of synovial fluid at different health states. Hyaluronic acid supplementation, especially at a physiologically healthy concentration (2.0 mg ml -1 ), promoted a better preservation of chondrocyte phenotype. The ratio of collagen II to collagen I mRNA was 4.5 times that of the control group, implying better tissue development (however, with no significant difference of measured collagen II content), with a good retention of collagen II and proteoglycan in the mechanically active region. Simulating synovial fluid properties by hyaluronic acid supplementation created a favourable mechanical environment for mechanically loaded constructs. These findings may help in understanding the influence of joint articulation on tissue homeostasis, and moreover, improve methods for functional cartilage tissue engineering. © 2017 The Author(s).

  19. Mobile-bearing total ankle arthroplasty : a fundamental assessment of the clinical, radiographic and functional outcomes

    NARCIS (Netherlands)

    Doets, Hendrik Cornelis

    2009-01-01

    Ankle arthritis often leads to significant impairments for the patient. As total ankle arthroplasty (TAA) with use of fixed-bearing (2-component) total ankle prostheses has a high rate of early failures, fusion of the ankle joint is, until today, considered to be the standard surgical treatment for

  20. Stochastic model for joint wave and wind loads on offshore structures

    DEFF Research Database (Denmark)

    Ditlevsen, Ove Dalager

    2002-01-01

    _s,T_z)$ from the North Sea a well fitting joint distribution of $(H_s,T_z)$ is obtained as a so-called Nataf model. Since the wave field is wind driven, there is a correlation between the time averaged wind velocity pressure $Q$ and the characteristic wave height in the stationary situation. Using the Poisson...... process model to concentrate on those load events that are of importance for the evaluation of the safety of the structure, that is, events with $Q$ larger than some threshold $q_0$, available information about the wind velocity pressure distributionin high wind situations can be used to formulate a Nataf...

  1. The role of military footwear and workload on ground reaction forces during a simulated lateral ankle sprain mechanism.

    Science.gov (United States)

    Simpson, Jeffrey D; DeBusk, Hunter; Hill, Christopher; Knight, Adam; Chander, Harish

    2018-03-01

    Ankle sprains are a common orthopedic injury in military populations, which may be attributed to occupational demands and footwear. Minimalist military boots have become popular, but their influence on ground reaction force (GRF) attenuation capabilities during an ankle inversion perturbation are unknown. Therefore, the purpose of this study was to examine potential differences in GRFs during an ankle inversion perturbation in a standard issue (STN) and minimalist military boot (MIN) before and after a simulated military workload. Twenty-one healthy adult males completed an ankle inversion perturbation protocol in each footwear condition before and after an incremental treadmill exercise protocol to volitional exhaustion while wearing a 16kg rucksack. The ankle inversion perturbation protocol consisted of stepping down from a 27cm box onto a force platform with a fulcrum (FUL), which created 25° of inversion upon landing, or flat (FLT) outer sole attached to the plantar aspect of the participants' footwear in random order. Peak vertical, anterior/posterior, and medial/lateral components of the GRF during FUL and FLT conditions were assessed, normalized to multiples of body weight in each footwear. Dependent variables were then analyzed using separate 2 (footwear)×2 (time) repeated measures ANOVA (pfootwear demonstrated significantly greater vertical GRF and significantly less medial GRF during the FUL condition. These results indicate that various mechanical and design characteristics of military footwear may influence GRF attenuation capabilities and ankle joint loading when the foot/ankle complex is forced into inversion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Compression therapy after ankle fracture surgery

    DEFF Research Database (Denmark)

    Winge, R; Bayer, L; Gottlieb, H

    2017-01-01

    PURPOSE: The main purpose of this systematic review was to investigate the effect of compression treatment on the perioperative course of ankle fractures and describe its effect on edema, pain, ankle joint mobility, wound healing complication, length of stay (LOS) and time to surgery (TTS). The aim...... undergoing surgery, testing either intermittent pneumatic compression, compression bandage and/or compression stocking and reporting its effect on edema, pain, ankle joint mobility, wound healing complication, LOS and TTS. To conclude on data a narrative synthesis was performed. RESULTS: The review included...

  3. Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.

    Science.gov (United States)

    Toyota, Yukihiro; Tamura, Maasa; Kirino, Yohei; Sugiyama, Yumiko; Tsuchida, Naomi; Kunishita, Yosuke; Kishimoto, Daiga; Kamiyama, Reikou; Miura, Yasushi; Minegishi, Kaoru; Yoshimi, Ryusuke; Ueda, Atsuhisa; Nakajima, Hideaki

    2017-05-01

    To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA). Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients' visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0-3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable. Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS. US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.

  4. Predicting dynamic knee joint load with clinical measures in people with medial knee osteoarthritis.

    Science.gov (United States)

    Hunt, Michael A; Bennell, Kim L

    2011-08-01

    Knee joint loading, as measured by the knee adduction moment (KAM), has been implicated in the pathogenesis of knee osteoarthritis (OA). Given that the KAM can only currently be accurately measured in the laboratory setting with sophisticated and expensive equipment, its utility in the clinical setting is limited. This study aimed to determine the ability of a combination of four clinical measures to predict KAM values. Three-dimensional motion analysis was used to calculate the peak KAM at a self-selected walking speed in 47 consecutive individuals with medial compartment knee OA and varus malalignment. Clinical predictors included: body mass; tibial angle measured using an inclinometer; walking speed; and visually observed trunk lean toward the affected limb during the stance phase of walking. Multiple linear regression was performed to predict KAM magnitudes using the four clinical measures. A regression model including body mass (41% explained variance), tibial angle (17% explained variance), and walking speed (9% explained variance) explained a total of 67% of variance in the peak KAM. Our study demonstrates that a set of measures easily obtained in the clinical setting (body mass, tibial alignment, and walking speed) can help predict the KAM in people with medial knee OA. Identifying those patients who are more likely to experience high medial knee loads could assist clinicians in deciding whether load-modifying interventions may be appropriate for patients, whilst repeated assessment of joint load could provide a mechanism to monitor disease progression or success of treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

  5. Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction.

    Science.gov (United States)

    Herrington, Lee; Alarifi, Saud; Jones, Richard

    2017-10-01

    Patellofemoral joint pain and degeneration are common in patients who undergo anterior cruciate ligament reconstruction (ACLR). The presence of patellofemoral joint pain significantly affects the patient's ability to continue sport participation and may even affect participation in activities of daily living. The mechanisms behind patellofemoral joint pain and degeneration are unclear, but previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear whether this process occurs after ACLR. To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to the noninjured knee and matched control knees. Controlled laboratory study. Thirty-four elite sports practitioners who had undergone ACLR and 34 age- and sex-matched controls participated in the study. The participants' running gait was assessed via 3D motion capture, and knee loads and forces were calculated by use of inverse dynamics. A significance difference was found in knee extensor moment, knee flexion angles, patellofemoral contact force (about 23% greater), and patellofemoral contact pressure (about 27% greater) between the ACLR and the noninjured limb ( P ≤ .04) and between the ACLR and the control limb ( P ≤ .04); no significant differences were found between the noninjured and control limbs ( P ≥ .44). Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared with the noninjured and control knees. Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.

  6. Conservative treatment of ankle sprain according to a recent literature

    Directory of Open Access Journals (Sweden)

    Urszula Kaźmierczak

    2017-02-01

    Full Text Available Due to complicated structure of ankle, it is exceptionally susceptible to injuries, of which one of the most common is a sprain. The sprain involves soft-tissue injuries that, depending on their level of seriousness, are categorized as first-, second- or third-degree sprains. The main goals of rehabilitation in the acute phase after the injury include reduction of pain, swelling and hematoma, as well as prevention from secondary injuries. During the subacute phase the emphasis should be put on restoring the joint’s function and its range of motion, as well as on gentle loading of the joint. Proprioception training, strength and stretching exercises should also be introduced. The next stage, during which the reconstruction of the damaged tissues takes place, involves the implementation of gradual progressive loading and the variety of earlier introduced procedures. In the final phase of rehabilitation, it is vital to reassure that the patient is able to return to full activity, especially if he or she is an athlete. Therefore, functional testing such as the Dorsiflexion Lunge Test or The Star Excursion Balance Test may be of help. The main predisposing factor for an ankle sprain is a previous injury of the same type. It is due to the fact that such an injury leads to impaired proprioceptive function and impaired postural control. Improper rehabilitation or the lack of thereof may cause the development of chronic ankle instability, which substantially reduces the chances of physical activity and the patient’s quality of life. The implementation of adequate preventive measures based on employing external stabilisers and neuromuscular training appears to be essential. The objective is to regain a good sense of proprioception as well as muscle reaction time within the ankle joint.

  7. Decreased Knee Joint Loading Associated With Early Knee Osteoarthritis After Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Wellsandt, Elizabeth; Gardinier, Emily S; Manal, Kurt; Axe, Michael J; Buchanan, Thomas S; Snyder-Mackler, Lynn

    2016-01-01

    Anterior cruciate ligament (ACL) injury predisposes individuals to early-onset knee joint osteoarthritis (OA). Abnormal joint loading is apparent after ACL injury and reconstruction. The relationship between altered joint biomechanics and the development of knee OA is unknown. Altered knee joint kinetics and medial compartment contact forces initially after injury and reconstruction are associated with radiographic knee OA 5 years after reconstruction. Case-control study; Level of evidence, 3. Individuals with acute, unilateral ACL injury completed gait analysis before (baseline) and after (posttraining) preoperative rehabilitation and at 6 months, 1 year, and 2 years after reconstruction. Surface electromyographic and knee biomechanical data served as inputs to an electromyographically driven musculoskeletal model to estimate knee joint contact forces. Patients completed radiographic testing 5 years after reconstruction. Differences in knee joint kinetics and contact forces were compared between patients with and those without radiographic knee OA. Patients with OA walked with greater frontal plane interlimb differences than those without OA (nonOA) at baseline (peak knee adduction moment difference: 0.00 ± 0.08 N·m/kg·m [nonOA] vs -0.15 ± 0.09 N·m/kg·m [OA], P = .014; peak knee adduction moment impulse difference: -0.001 ± 0.032 N·m·s/kg·m [nonOA] vs -0.048 ± 0.031 N·m·s/kg·m [OA], P = .042). The involved limb knee adduction moment impulse of the group with osteoarthritis was also lower than that of the group without osteoarthritis at baseline (0.087 ± 0.023 N·m·s/kg·m [nonOA] vs 0.049 ± 0.018 N·m·s/kg·m [OA], P = .023). Significant group differences were absent at posttraining but reemerged 6 months after reconstruction (peak knee adduction moment difference: 0.02 ± 0.04 N·m/kg·m [nonOA] vs -0.06 ± 0.11 N·m/kg·m [OA], P = .043). In addition, the OA group walked with lower peak medial compartment contact forces of the involved limb

  8. An accurate fatigue damage model for welded joints subjected to variable amplitude loading

    Science.gov (United States)

    Aeran, A.; Siriwardane, S. C.; Mikkelsen, O.; Langen, I.

    2017-12-01

    Researchers in the past have proposed several fatigue damage models to overcome the shortcomings of the commonly used Miner’s rule. However, requirements of material parameters or S-N curve modifications restricts their practical applications. Also, application of most of these models under variable amplitude loading conditions have not been found. To overcome these restrictions, a new fatigue damage model is proposed in this paper. The proposed model can be applied by practicing engineers using only the S-N curve given in the standard codes of practice. The model is verified with experimentally derived damage evolution curves for C 45 and 16 Mn and gives better agreement compared to previous models. The model predicted fatigue lives are also in better correlation with experimental results compared to previous models as shown in earlier published work by the authors. The proposed model is applied to welded joints subjected to variable amplitude loadings in this paper. The model given around 8% shorter fatigue lives compared to Eurocode given Miner’s rule. This shows the importance of applying accurate fatigue damage models for welded joints.

  9. Linking the mechanics and energetics of hopping with elastic ankle exoskeletons.

    Science.gov (United States)

    Farris, Dominic James; Sawicki, Gregory S

    2012-12-15

    The springlike mechanics of the human leg during bouncing gaits has inspired the design of passive assistive devices that use springs to aid locomotion. The purpose of this study was to test whether a passive spring-loaded ankle exoskeleton could reduce the mechanical and energetic demands of bilateral hopping on the musculoskeletal system. Joint level kinematics and kinetics were collected with electromyographic and metabolic energy consumption data for seven participants hopping at four frequencies (2.2, 2.5, 2.8, and 3.2 Hz). Hopping was performed without an exoskeleton; with an springless exoskeleton; and with a spring-loaded exoskeleton. Spring-loaded ankle exoskeletons reduced plantar flexor muscle activity and the biological contribution to ankle joint moment (15-25%) and average positive power (20-40%). They also facilitated reductions in metabolic power (15-20%) across frequencies from 2.2 to 2.8 Hz compared with hopping with a springless exoskeleton. Reductions in metabolic power compared with hopping with no exoskeleton were restricted to hopping at 2.5 Hz only (12%). These results highlighted the importance of reducing the rate of muscular force production and work to achieve metabolic reductions. They also highlighted the importance of assisting muscles acting at the knee joint. Exoskeleton designs may need to be tuned to optimize exoskeleton mass, spring stiffness, and spring slack length to achieve greater metabolic reductions.

  10. Effect of radial head implant shape on joint contact area and location during static loading.

    Science.gov (United States)

    Shannon, Hannah L; Deluce, Simon R; Lalone, Emily A; Willing, Ryan; King, Graham J W; Johnson, James A

    2015-04-01

    To examine the effect of implant shape on radiocapitellar joint contact area and location in vitro. We used 8 fresh-frozen cadaveric upper extremities. An elbow loading simulator examined joint contact in pronation, neutral rotation, and supination with the elbow at 90° flexion. Muscle tendons were attached to pneumatic actuators to allow for computer-controlled loading to achieve the desired forearm rotation. We performed testing with the native radial head, an axisymmetric implant, a reverse-engineered patient-specific implant, and a population-based quasi-anatomic implant. Implants were inserted using computer navigation. Contact area and location were quantified using a casting technique. We found no significant difference between contact locations for the native radial head and the 3 implants. All of the implants had a contact area lower than the native radial head; however, only the axisymmetric implant was significantly different. There was no significant difference in contact area between implant shapes. The similar contact areas and locations of the 3 implant designs suggest that the shape of the implant may not be important with respect to radiocapitellar joint contact mechanics when placed optimally using computer navigation. Further work is needed to explore the sensitivity of radial head implant malpositioning on articular contact. The lower contact area of the radial head implants relative to the native radial head is similar to previous benchtop studies and is likely the result of the greater stiffness of the implant. Radial head implant shape does not appear to have a pronounced influence on articular contact, and both axisymmetric and anatomic metal designs result in elevated cartilage stress relative to the intact state. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners.

    Science.gov (United States)

    Kuhman, Daniel; Melcher, Daniel; Paquette, Max R

    2016-01-01

    The purpose of this study was to investigate the interaction of foot strike and common speeds on sagittal plane ankle and knee joint kinetics in competitive rear foot strike (RFS) runners when running with a RFS pattern and an imposed forefoot strike (FFS) pattern. Sixteen competitive habitual male RFS runners ran at two different speeds (i.e. 8 and 6 min mile(-1)) using their habitual RFS and an imposed FFS pattern. A repeated measures analysis of variance was used to assess a potential interaction between strike pattern and speed for selected ground reaction force (GRF) variables and, sagittal plane ankle and knee kinematic and kinetic variables. No foot strike and speed interaction was observed for any of the kinetic variables. Habitual RFS yielded a greater loading rate of the vertical GRF, peak ankle dorsiflexor moment, peak knee extensor moment, peak knee eccentric extensor power, peak dorsiflexion and sagittal plane knee range of motion compared to imposed FFS. Imposed FFS yielded greater maximum vertical GRF, peak ankle plantarflexor moment, peak ankle eccentric plantarflexor power and sagittal plane ankle ROM compared to habitual RFS. Consistent with previous literature, imposed FFS in habitual RFS reduces eccentric knee extensor and ankle dorsiflexor involvement but produce greater eccentric ankle plantarflexor action compared to RFS. These acute differences between strike patterns were independent of running speeds equivalent to typical easy and hard training runs in competitive male runners. Current findings along with previous literature suggest differences in lower extremity kinetics between habitual RFS and imposed FFS running are consistent among a variety of runner populations.

  12. Primary ankle arthrodesis for neglected open weber B ankle fracture dislocation.

    LENUS (Irish Health Repository)

    Thomason, Katherine

    2014-07-01

    Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described.

  13. The effect of glenosphere diameter in reverse shoulder arthroplasty on muscle force, joint load, and range of motion.

    Science.gov (United States)

    Langohr, G Daniel G; Giles, Joshua W; Athwal, George S; Johnson, James A

    2015-06-01

    Little is known about the effects of glenosphere diameter on shoulder joint loads. The purpose of this biomechanical study was to investigate the effects of glenosphere diameter on joint load, load angle, and total deltoid force required for active abduction and range of motion in internal/external rotation and abduction. A custom, instrumented reverse shoulder arthroplasty implant system capable of measuring joint load and varying glenosphere diameter (38 and 42 mm) and glenoid offset (neutral and lateral) was implanted in 6 cadaveric shoulders to provide at least 80% power for all variables. A shoulder motion simulator was used to produce active glenohumeral and scapulothoracic motion. All implant configurations were tested with active and passive motion with joint kinematics, loads, and moments recorded. At neutral and lateralized glenosphere positions, increasing diameter significantly increased joint load (+12 ± 21 N and +6 ± 9 N; P  .8). Passive internal rotation was reduced with increased diameter at both neutral and lateralized glenosphere positions (-6° ± 6° and -12° ± 6°; P  .05). At neutral glenosphere position, increasing diameter increased the maximum angles of both adduction (+1° ± 1°; P = .03) and abduction (+8° ± 9°; P < .05). Lateralization also increased abduction range of motion compared with neutral (P < .01). Although increasing glenosphere diameter significantly increased joint load and deltoid force, the clinical impact of these changes is presently unclear. Internal rotation, however, was reduced, which contradicts previous bone modeling studies, which we postulate is due to increased posterior capsular tension as it is forced to wrap around a larger 42 mm implant assembly. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  14. Ankle Sprain Treatment

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Ankle Sprain Treatment Page Content Article Body Acute ankle and ... Pediatrics summarizing the treatment phases of rehabilitation for ankle sprain. Phase Summary Description I Phase I treatment involves ...

  15. Ankle fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this page, please enable JavaScript. An ankle fracture is a break in 1 or more ankle ...

  16. Bonded Joints with “Nano-Stitches”: Effect of Carbon Nanotubes on Load Capacity and Failure Modes

    Directory of Open Access Journals (Sweden)

    Henrique N. P. Oliva

    Full Text Available Abstract Carbon nanotubes were employed as adhesive reinforcement/nano-stitches to aluminum bonded joints. The CNT addition to an epoxy adhesive not only lead to an increase on load capacity but it is also the most probable cause of the mixed failure mode (adhesive/cohesive. The damage evolution was described as the stiffness decrease and the failure mixed modes were related to the load capacity. Although the presence of CNT cluster were observed, in small concentrations (< 1.0 wt. %, these clusters acted as crack stoppers and lead to an increase on lap joint shear strength. The addition of 2.0 wt. % carbon nanotubes lead to an increase on load capacity of approximately 116.2 % when the results were compared against the single lap joints without carbon nanotubes.

  17. A finite element model of the foot and ankle for automotive impact applications.

    Science.gov (United States)

    Shin, Jaeho; Yue, Neng; Untaroiu, Costin D

    2012-12-01

    A finite element (FE) model of the foot and leg was developed to improve understanding of injury mechanisms of the ankle and subtalar joints during vehicle collisions and to aid in the design of injury countermeasures. The FE model was developed based on the reconstructed geometry of a male volunteer close to the anthropometry of a 50th percentile male and a commercial anatomical database. While the forefoot bones were defined as rigid bodies connected by ligament models, the surrounding bones of the ankle and subtalar joints and the leg bones were modeled as deformable structures. The material and structural properties were selected based on a synthesis of current knowledge of the constitutive models for each tissue. The whole foot and leg model was validated in different loading conditions including forefoot impact, axial rotation, dorsiflexion, and combined loadings. Overall results obtained in the model validation indicated improved biofidelity relative to previous FE models. The developed model was used to investigate the injury tolerance of the ankle joint under brake pedal loading for internally and externally rotated feet. Ligament failures were predicted as the main source of injury in this loading condition. A 12% variation of failure moment was observed in the range of axial foot rotations (±15°). The most vulnerable position was the internally rotated (15°) posture among three different foot positions. Furthermore, the present foot and ankle model will be coupled together with other body region FE models into the state-of-art human FE model to be used in the field of automotive safety.

  18. Feedback and Feedforward Control During Walking in Individuals With Chronic Ankle Instability.

    Science.gov (United States)

    Yen, Sheng-Che; Corkery, Marie B; Donohoe, Amy; Grogan, Maddison; Wu, Yi-Ning

    2016-09-01

    Study Design Controlled laboratory study. Background Recurrent ankle sprains associated with chronic ankle instability (CAI) occur not only in challenging sports but also in daily walking. Understanding whether and how CAI alters feedback and feedforward controls during walking may be important for developing interventions for CAI prevention or treatment. Objective To understand whether CAI is associated with changes in feedback and feedforward control when individuals with CAI are subjected to experimental perturbation during walking. Methods Twelve subjects with CAI and 12 control subjects walked on a treadmill while adapting to external loading that generated inversion perturbation at the ankle joint. Ankle kinematics around heel contact during and after the adaptation were compared between the 2 groups. Results Both healthy and CAI groups showed an increase in eversion around heel contact in early adaptation to the external loading. However, the CAI group adapted back toward the baseline, while the healthy controls showed further increase in eversion in late adaptation. When the external loading was removed in the postadaptation period, healthy controls showed an aftereffect consisting of an increase in eversion around heel contact, but the CAI group showed no aftereffect. Conclusion The results provide preliminary evidence that CAI may alter individuals' feedback and feedforward control during walking. J Orthop Sports Phys Ther 2016;46(9):775-783. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6403.

  19. Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial.

    Science.gov (United States)

    Henriksen, M; Hunter, D J; Dam, E B; Messier, S P; Andriacchi, T P; Lohmander, L S; Aaboe, J; Boesen, M; Gudbergsen, H; Bliddal, H; Christensen, R

    2013-12-01

    To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee osteoarthritis (OA). Data from a prospective study of weight loss in obese patients with knee OA (the CARtilage in obese knee OsteoarThritis (CAROT) study) were used to determine changes in knee joint compressive loadings (model estimated) during walking after a successful 16 week weight loss intervention. The participants were divided into 'Unloaders' (participants that reduced joint loads) and 'Loaders' (participants that increased joint loads). The primary symptomatic outcome was changes in knee symptoms, measured with the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, during a subsequent 52 weeks weight maintenance period. The primary structural outcome was changes in tibiofemoral cartilage loss assessed semi-quantitatively (Boston Leeds Knee Osteoarthritis Score (BLOKS) from MRI after the 52 weight maintenance period. 157 participants (82% of the CAROT cohort) with medial and/or lateral knee OA were classified as Unloaders (n = 100) or Loaders (n = 57). The groups showed similar significant changes in symptoms (group difference: -2.4 KOOS points [95% CI -6.8:1.9]) and cartilage loss (group difference: -0.06 BLOKS points [95% CI -0.22:0.11) after 1 year, with no statistically significant differences between Loaders and Unloaders. For obese patients undergoing a significant weight loss, increased knee joint loading for 1 year was not associated with accelerated symptomatic and structural disease progression compared to a similar weight loss group that had reduced ambulatory compressive knee joint loads. NCT00655941. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  20. Vehicle Routing with Three-dimensional Container Loading Constraints—Comparison of Nested and Joint Algorithms

    Science.gov (United States)

    Koloch, Grzegorz; Kaminski, Bogumil

    2010-10-01

    In the paper we examine a modification of the classical Vehicle Routing Problem (VRP) in which shapes of transported cargo are accounted for. This problem, known as a three-dimensional VRP with loading constraints (3D-VRP), is appropriate when transported commodities are not perfectly divisible, but they have fixed and heterogeneous dimensions. In the paper restrictions on allowable cargo positionings are also considered. These restrictions are derived from business practice and they extended the baseline 3D-VRP formulation as considered by Koloch and Kaminski (2010). In particular, we investigate how additional restrictions influence relative performance of two proposed optimization algorithms: the nested and the joint one. Performance of both methods is compared on artificial problems and on a big-scale real life case study.

  1. Fatigue Assessment of High Strength Steel Welded Joints Under Bending Loading

    International Nuclear Information System (INIS)

    Lee, Myeong-Woo; Kim, Yun-Jae; Park, Jun-Hyub

    2014-01-01

    In this study, a fatigue assessment method for vehicle suspension systems having welded geometries was established under a bending loading condition. For the fatigue life estimation of the actual product s welded joints made of different steels, bending fatigue tests were performed on welded specimens with a simplified shape for obtaining the moment-fatigue-life plot. Further, geometry modeling of the simplified welded specimens was conducted. Results of finite element analysis were used to obtain the stress-fatigue-life plot. The analysis results were also used to calculate the stress concentration factors for notch-factor-based fatigue life estimation. The test results were compared with results of the general notch-factor-based fatigue life estimation for improving fatigue assessment. As a result, it was concluded that both the welded fatigue tests and the notch-factor-based fatigue life estimation are necessary for accurate fatigue assessment

  2. Joint loads resulting in ACL rupture: Effects of age, sex, and body mass on injury load and mode of failure in a mouse model.

    Science.gov (United States)

    Blaker, Carina L; Little, Christopher B; Clarke, Elizabeth C

    2017-08-01

    Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterize a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anesthetized C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex, and body mass on ACL injury mechanisms. The ACL injury load (whole joint load required to rupture the ACL) was measured from force-displacement data, and mode of failure was assessed using micro-dissection and histology. ACL injury load was found to increase with body mass and age (p < 0.001) but age was not significant when controlling for mass. Sex had no effect. In contrast, the mode of ACL failure varied with both age and sex groups. Avulsion fractures (complete or mixed with mid-substance tears) were common in all age groups but the proportion of mixed and mid-substance failures increased with age. Females were more likely than males to have a major avulsion relative to a mid-substance tear (p < 0.01). This data compliments studies in human cadaveric knees, and provides a basis for determining the severity of joint injury relative to a major ACL tear in mice, and for selecting joint loading conditions in future experiments using this model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1754-1763, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  3. Joint Optimization of Power Allocation and Load Balancing for Hybrid VLC/RF Networks

    KAUST Repository

    Obeed, Mohanad

    2018-04-18

    In this paper, we propose and study a new joint load balancing (LB) and power allocation (PA) scheme for a hybrid visible light communication (VLC) and radio frequency (RF) system consisting of one RF access point (AP) and multiple VLC APs. An iterative algorithm is proposed to distribute users on APs and distribute the powers of the APs on their users. In the PA subproblem, an optimization problem is formulated to allocate the power of each AP to the connected users for total achievable data rate maximization. In this subproblem, we propose a new efficient algorithm that finds optimal dual variables after formulating them in terms of each other. This new algorithm provides faster convergence and better performance than the traditional subgradient method. In addition, it does not depend on the step size or the initial values of the variables, which we look for, as the subgradient does. Then, we start with the user of the minimum data rate seeking another AP that offers a higher data rate for that user. Users with lower data rates continue reconnecting from one AP to another to balance the load only if this travel increases the summation of the achievable data rates and enhances the system fairness. Two approaches are proposed to have the joint PA and LB performed: a main approach that considers the exact interference information for all users, and a suboptimal approach that aims to decrease the complexity of the first approach by considering only the approximate interference information of users. The numerical results demonstrate that the proposed algorithms improve the system capacity and system fairness with fast convergence.

  4. Joint Optimization of Power Allocation and Load Balancing for Hybrid VLC/RF Networks

    KAUST Repository

    Obeed, Mohanad; Salhab, Anas; Zummo, Salam A.; Alouini, Mohamed-Slim

    2018-01-01

    In this paper, we propose and study a new joint load balancing (LB) and power allocation (PA) scheme for a hybrid visible light communication (VLC) and radio frequency (RF) system consisting of one RF access point (AP) and multiple VLC APs. An iterative algorithm is proposed to distribute users on APs and distribute the powers of the APs on their users. In the PA subproblem, an optimization problem is formulated to allocate the power of each AP to the connected users for total achievable data rate maximization. In this subproblem, we propose a new efficient algorithm that finds optimal dual variables after formulating them in terms of each other. This new algorithm provides faster convergence and better performance than the traditional subgradient method. In addition, it does not depend on the step size or the initial values of the variables, which we look for, as the subgradient does. Then, we start with the user of the minimum data rate seeking another AP that offers a higher data rate for that user. Users with lower data rates continue reconnecting from one AP to another to balance the load only if this travel increases the summation of the achievable data rates and enhances the system fairness. Two approaches are proposed to have the joint PA and LB performed: a main approach that considers the exact interference information for all users, and a suboptimal approach that aims to decrease the complexity of the first approach by considering only the approximate interference information of users. The numerical results demonstrate that the proposed algorithms improve the system capacity and system fairness with fast convergence.

  5. KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

    Science.gov (United States)

    Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

    2014-01-01

    Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

  6. Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat.

    Science.gov (United States)

    Messier, Stephen P; Beavers, Daniel P; Loeser, Richard F; Carr, J Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J; Hunter, David J; Devita, Paul

    2014-09-01

    Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee joint loads in older overweight and obese adults with knee osteoarthritis (OA). Fat depots were quantified using computed tomography, and total lean and fat mass were determined with dual energy x-ray absorptiometry in 176 adults (age, 66.3 yr; body mass index, 33.5 kg·m) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Higher total body mass was significantly associated (P ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (P knee extensor moments (P = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (P = 0.0001), shear (P knee extension moment (P = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (P = 0.002). A regression model that included total thigh and total abdominal fat found that both were significantly associated with knee compressive and shear forces (P ≤ 0.04). Thigh fat was associated with knee abduction (P = 0.03) and knee extension moment (P = 0.02). Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA.

  7. Gender dimorphic ACL strain in response to combined dynamic 3D knee joint loading: implications for ACL injury risk.

    Science.gov (United States)

    Mizuno, Kiyonori; Andrish, Jack T; van den Bogert, Antonie J; McLean, Scott G

    2009-12-01

    While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (approximately 10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gender-specific models were generated and subjected to 6 DOF external load scenarios consistent with both a clinical examination and a dynamic sports maneuver. The ensuing model-based strain predictions were subsequently examined for gender-based discrepancies. Male and female specimen-specific models predicted ACL strain within 0.51%+/-0.10% and 0.52%+/-0.07% of the measured data respectively, and explained more than 75% of the associated variance in each case. Predicted female ACL strains were also significantly larger than respective male values for both simulated 6 DOF load scenarios. Outcomes suggest that the female ACL will rupture in response to comparatively smaller external load applications. Future work must address the underlying anatomical/laxity contributions to knee joint mechanical and resultant ACL loading, ultimately affording prevention strategies that may cater to individual joint vulnerabilities.

  8. Range of Motion of the Ankle According to Pushing Force, Gender and Knee Position.

    Science.gov (United States)

    Cho, Kang Hee; Jeon, Yumi; Lee, Hyunkeun

    2016-04-01

    To investigate the difference of range of motion (ROM) of ankle according to pushing force, gender and knee position. One hundred and twenty-eight healthy adults (55 men, 73 women) between the ages of 20 and 51, were included in the study. One examiner measured the passive range of motion (PROM) of ankle by Dualer IQ Inclinometers and Commander Muscle Testing. ROM of ankle dorsiflexion (DF) and plantarflexion (PF) according to change of pushing force and knee position were measured at prone position. There was significant correlation between ROM and pushing force, the more pushing force leads the more ROM at ankle DF and ankle PF. Knee flexion of 90° position showed low PF angle and high ankle DF angle, as compared to the at neutral position of knee joint. ROM of ankle DF for female was greater than for male, with no significant difference. ROM of ankle PF for female was greater than male regardless of the pushing force. To our knowledge, this is the first study to assess the relationship between pushing force and ROM of ankle joint. There was significant correlation between ROM of ankle and pushing force. ROM of ankle PF for female estimated greater than male regardless of the pushing force and the number of measurement. The ROM of the ankle is measured differently according to the knee joint position. Pushing force, gender and knee joint position are required to be considered when measuring the ROM of ankle joint.

  9. Dynamic ankle control in athletes with ankle instability during sports maneuvers.

    Science.gov (United States)

    Lin, Cheng-Feng; Chen, Chin-Yang; Lin, Chia-Wei

    2011-09-01

    Ankle sprain is a common sports injury. While the effects of static constraints in stabilizing the ankle joint are relatively well understood, those of dynamic constraints are less clear and require further investigation. This study was undertaken to evaluate the dynamic stability of the ankle joint during the landing phase of running and stop-jump maneuvers in athletes with and without chronic ankle instability (CAI). Controlled laboratory study. Fifteen athletes with CAI and 15 age-matched athletes without CAI performed running and stop-jump landing tasks. The dynamic ankle joint stiffness, tibialis anterior (TA)/peroneus longus (PL) and TA/gastrocnemius lateralis (GL) co-contraction indices, ankle joint angle, and root-mean-square (RMS) of the TA, PL, and GL electromyographic signals were measured during each task. During running, the CAI group exhibited a greater ankle inversion angle than the control group in the pre-landing phase (P = .012-.042) and a lower dynamic ankle joint stiffness in the post-landing phase (CAI: 0.109 ± 0.039 N·m/deg; control: 0.150 ± 0.068 N·m/deg; P = .048). In the stop-jump landing task, athletes with CAI had a significantly lower TA/PL co-contraction index during the pre-landing phase (CAI: 49.1 ± 19; control: 64.8 ± 16; P = .009). In addition, the CAI group exhibited a greater ankle inversion (P = .049), a lower peak eversion (P = .04), and a smaller RMS of the PL electromyographic signal in the post-landing phase (CAI: 0.73 ± 0.32; control: 0.51 ± 0.22; P = .04). Athletes with CAI had a relatively inverted ankle, reduced muscle co-contraction, and a lower dynamic stiffness in the ankle joint during the landing phase of sports maneuvers and this may jeopardize the stability of the ankle. Sports training or rehabilitation programs should differentiate between the pre-landing and post-landing phases of sports maneuvers, and should educate athletes to land with an appropriate ankle position and muscle recruitment.

  10. Joint Load Balancing and Power Allocation for Hybrid VLC/RF Networks

    KAUST Repository

    Obeed, Mohanad; Salhab, Anas M.; Zummo, Salam A.; Alouini, Mohamed-Slim

    2018-01-01

    In this paper, we propose and study a new joint load balancing (LB) and power allocation (PA) scheme for a hybrid visible light communication (VLC) and radio frequency (RF) system consisting of one RF\\access point (AP) and multiple VLC\\APs. An iterative algorithm is proposed to distribute the users on the APs and distribute the powers of these APs on their users. In PA subproblem, an optimization problem is formulated to allocate the power of each AP to the connected users for the total achievable data rates maximization. It is proved that the PA optimization problem is concave but not easy to tackle. Therefore, we provide a new algorithm to obtain the optimal dual variables after formulating them in terms of each other. Then, the users that are connected to the overloaded APs and receive less data rates start seeking for other APs that offer higher data rates. Users with lower data rates continue re-connecting from AP to other to balance the load only if this travel increases the summation of the achievable data rates and enhances the system fairness. The numerical results demonstrate that the proposed algorithms improve the system capacity and system fairness with fast convergence.

  11. Joint Load Balancing and Power Allocation for Hybrid VLC/RF Networks

    KAUST Repository

    Obeed, Mohanad

    2018-01-15

    In this paper, we propose and study a new joint load balancing (LB) and power allocation (PA) scheme for a hybrid visible light communication (VLC) and radio frequency (RF) system consisting of one RF\\\\access point (AP) and multiple VLC\\\\APs. An iterative algorithm is proposed to distribute the users on the APs and distribute the powers of these APs on their users. In PA subproblem, an optimization problem is formulated to allocate the power of each AP to the connected users for the total achievable data rates maximization. It is proved that the PA optimization problem is concave but not easy to tackle. Therefore, we provide a new algorithm to obtain the optimal dual variables after formulating them in terms of each other. Then, the users that are connected to the overloaded APs and receive less data rates start seeking for other APs that offer higher data rates. Users with lower data rates continue re-connecting from AP to other to balance the load only if this travel increases the summation of the achievable data rates and enhances the system fairness. The numerical results demonstrate that the proposed algorithms improve the system capacity and system fairness with fast convergence.

  12. Postoperative MR study of the ankle

    International Nuclear Information System (INIS)

    Tosch, U.; Sander, B.; Schubeus, P.; Tepe, H.; Goudarzi, Y.M.

    1991-01-01

    20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress X-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress X-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exsudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR. (orig.) [de

  13. Lumbopelvic muscle activation patterns in three stances under graded loading conditions: Proposing a tensegrity model for load transfer through the sacroiliac joints.

    Science.gov (United States)

    Pardehshenas, Hamed; Maroufi, Nader; Sanjari, Mohammad Ali; Parnianpour, Mohamad; Levin, Stephen M

    2014-10-01

    According to the conventional arch model of the pelvis, stability of the sacroiliac joints may require a predominance of form and force closure mechanisms: the greater the vertical shear force at the sacroiliac joints, the greater the reliance on self-bracing by horizontally or obliquely oriented muscles (such as the internal oblique). But what happens to the arch model when a person stands on one leg? In such cases, the pelvis no longer has imposts, leaving both the arch, and the arch model theory, without support. Do lumbopelvic muscle activation patterns in one-legged stances under load suggest compatibility with a different model? This study compares lumbopelvic muscle activation patterns in two-legged and one-legged stances in response to four levels of graded trunk loading in order to further our understanding the stabilization of the sacroiliac joints. Thirty male subjects experienced four levels of trunk loading (0%, 5%, 10% and 15% of body weight) by holding a bucket at one side, at three conditions: 1) two-legged standing with the bucket in the dominant hand, 2) ipsilateral loading: one-legged standing with the bucket in the dominant hand while using the same-side leg, and 3) contralateral loading: one-legged standing using the same leg used in condition 2, but with the bucket in the non-dominant hand. During these tasks, EMG signals from eight lumbopelvic muscles were collected. ANOVA with repeated design was performed on normalized EMG's to test the main effect of load and condition, and interaction effects of load by condition. Latissimus dorsi and erector spinae muscles showed an antagonistic pattern of activity toward the direction of load which may suggest these muscles as lateral trunk stabilizers. Internal oblique muscles showed a co-activation pattern with increasing task demand, which may function to increase lumbopelvic stability (P sacroiliac joint dysfunctions must be taken into consideration. Our hypothetical model may initiate thinking and

  14. Seasonal Hydrological Loading in Southern Tibet Detected by Joint Analysis of GPS and GRACE.

    Science.gov (United States)

    Zou, Rong; Wang, Qi; Freymueller, Jeffrey T; Poutanen, Markku; Cao, Xuelian; Zhang, Caihong; Yang, Shaomin; He, Ping

    2015-12-04

    In southern Tibet, ongoing vertical and horizontal motions due to the collision between India and Eurasia are monitored by large numbers of global positioning system (GPS) continuous and campaign sites installed in the past decade. Displacements measured by GPS usually include tectonic deformation as well as non-tectonic, time-dependent signals. To estimate the regional long-term tectonic deformation using GPS more precisely, seasonal elastic deformation signals associated with surface loading must be removed from the observations. In this study, we focus on seasonal variation in vertical and horizontal motions of southern Tibet by performing a joint analysis of GRACE (Gravity Recovery and Climate Experiment) and GPS data, not only using continuous sites but also GPS campaign-mode sites. We found that the GPS-observed and GRACE-modeled seasonal oscillations are in good agreements, and a seasonal displacement model demonstrates that the main reason for seasonal variations in southern Tibet is from the summer monsoon and its precipitation. The biggest loading appears from July to August in the summer season. Vertical deformations observed by GPS and modeled by GRACE are two to three times larger than horizontal oscillations, and the north components demonstrate larger amplitudes than the east components. We corrected the GPS position time series using the GRACE-modeled seasonal variations, which gives significant reductions in the misfit and weighted root-mean-squares (WRMS). Misfit (χ2 divided by degree of freedom) reductions for campaign sites range between 20% and 56% for the vertical component, and are much smaller for the horizontal components. Moreover, time series of continuous GPS (cGPS) sites near the 2015 Nepal earthquakes must be corrected using appropriate models of seasonal loading for analyzing postseismic deformation to avoid biasing estimates of the postseismic relaxation.

  15. Are the Kinematics of the Knee Joint Altered during the Loading Response Phase of Gait in Individuals with Concurrent Knee Osteoarthritis and Complaints of Joint Instability? A Dynamic Stereo X-ray Study

    Science.gov (United States)

    Farrokhi, Shawn; Tashman, Scott; Gil, Alexandra B.; Klatt, Brian A.; Fitzgerald, G. Kelley

    2011-01-01

    Background Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional declines in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear. Methods Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait. Findings Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (P knee joint at initial contact was significantly different (P knee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait. Interpretations The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics. PMID:22071429

  16. Are the kinematics of the knee joint altered during the loading response phase of gait in individuals with concurrent knee osteoarthritis and complaints of joint instability? A dynamic stereo X-ray study.

    Science.gov (United States)

    Farrokhi, Shawn; Tashman, Scott; Gil, Alexandra B; Klatt, Brian A; Fitzgerald, G Kelley

    2012-05-01

    Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional decline in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear. Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait. Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (Pknee joint at initial contact was significantly different (Pknee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait. The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. The effect of ankle bracing on knee kinetics and kinematics during volleyball-specific tasks.

    Science.gov (United States)

    West, T; Ng, L; Campbell, A

    2014-12-01

    The purpose of this study was to examine the effects of ankle bracing on knee kinetics and kinematics during volleyball tasks. Fifteen healthy, elite, female volleyball players performed a series of straight-line and lateral volleyball tasks with no brace and when wearing an ankle brace. A 14-camera Vicon motion analysis system and AMTI force plate were used to capture the kinetic and kinematic data. Knee range of motion, peak knee anterior-posterior and medial-lateral shear forces, and peak ground reaction forces that occurred between initial contact with the force plate and toe off were compared using paired sample t-tests between the braced and non-braced conditions (P volleyball tasks. However, ankle bracing was demonstrated to reduce knee lateral shear forces during all of the lateral movement volleyball tasks. Wearing the Active Ankle T2 brace will not impact knee joint range of motion and may in fact reduce shear loading to the knee joint in volleyball players. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial

    DEFF Research Database (Denmark)

    Henriksen, Marius; Hunter, D J; Dam, E B

    2013-01-01

    To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee ost...

  19. Dynamic simulation of knee-joint loading during gait using force-feedback control and surrogate contact modelling.

    Science.gov (United States)

    Walter, Jonathan P; Pandy, Marcus G

    2017-10-01

    The aim of this study was to perform multi-body, muscle-driven, forward-dynamics simulations of human gait using a 6-degree-of-freedom (6-DOF) model of the knee in tandem with a surrogate model of articular contact and force control. A forward-dynamics simulation incorporating position, velocity and contact force-feedback control (FFC) was used to track full-body motion capture data recorded for multiple trials of level walking and stair descent performed by two individuals with instrumented knee implants. Tibiofemoral contact force errors for FFC were compared against those obtained from a standard computed muscle control algorithm (CMC) with a 6-DOF knee contact model (CMC6); CMC with a 1-DOF translating hinge-knee model (CMC1); and static optimization with a 1-DOF translating hinge-knee model (SO). Tibiofemoral joint loads predicted by FFC and CMC6 were comparable for level walking, however FFC produced more accurate results for stair descent. SO yielded reasonable predictions of joint contact loading for level walking but significant differences between model and experiment were observed for stair descent. CMC1 produced the least accurate predictions of tibiofemoral contact loads for both tasks. Our findings suggest that reliable estimates of knee-joint loading may be obtained by incorporating position, velocity and force-feedback control with a multi-DOF model of joint contact in a forward-dynamics simulation of gait. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  20. A Study of the Failure of Joints in Composite Material Fuel Cells Due to Hydraulic Ram Loading

    Science.gov (United States)

    1976-06-01

    H co PSw Z QW <H W CO 33 PS4 o CO O CM \\ Q> 00 vO m CO CM N ra Figure VI.B.l THICKNESS MODEL 55 it acts upon on the membrane, gives the force to be...ability of the joint to carry the loads created by hydraulic ram loading. It would also make the manufacturing procedure easier, less time consuming , and...70 less expensive. Cutting holes and channels in a composite plate not only alters the behavior and load carrying capa- bility of the plate, but it is

  1. Association between increase in vertical ground reaction force loading rate and pain level in women with patellofemoral pain after a patellofemoral joint loading protocol.

    Science.gov (United States)

    Briani, Ronaldo Valdir; Pazzinatto, Marcella Ferraz; Waiteman, Marina Cabral; de Oliveira Silva, Danilo; de Azevedo, Fábio Mícolis

    2018-04-11

    The etiology of patellofemoral pain (PFP) is thought to be the result of increased patellofemoral joint (PFJ) load and aberrant lower extremity mechanics, including altered vertical ground reaction forces (VGRF). However, few studies have investigated the association between an increase in pain and VGRF loading rates in the context of PFP. Thus, this study aimed to investigate the immediate effects of PFJ loading on pain and VGRF loading rate, and to see if there is a link between modification of both pain and VGRF loading rate during stair negotiation. Thirty-four women with PFP underwent VGRF analysis during stair negotiation under two conditions: with (condition 2) and without (condition 1) being previously submitted to a PFJ loading protocol in order to or not to exacerbate their knee pain, respectively. The VGRF loading rates were significantly higher in condition 2 (Mean ± standard deviation (SD)=4.0±0.6N/s) compared to condition 1 (Mean±SD=3.6±0.5N/s) during stair ascent and during stair descent (Mean±SD: condition 1=6.3±1.1N/s; condition 2=7.0±1.4N/s). In addition, VGRF loading rates were higher during stair descent compared to stair ascent in both conditions. There were significant correlations between the increase in pain and VGRF loading rate during both tasks. There seemed to be an important relation between the increase in pain and VGRF loading rates in women with PFP. Based on these findings, interventions aimed at reducing VGRF loading rates are important in the context of PFP. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Surgical procedures in patients with haemophilic arthropathy of the ankle.

    Science.gov (United States)

    Barg, A; Morris, S C; Schneider, S W; Phisitkul, P; Saltzman, C L

    2016-05-01

    In haemophilia, the ankle joint is one of the most common and earliest joints affected by recurrent bleeding, commonly resulting in end-stage ankle osteoarthritis during early adulthood. The surgical treatment of haemophilic ankle arthropathy is challenging. This review aims to highlight the literature addressing clinical outcomes following the most common approaches for different stages of haemophilia-induced ankle osteoarthritis: arthroscopic debridement, joint distraction arthroplasty, supramalleolar osteotomies, total ankle replacement, and ankle arthrodesis. A systematic literature review was performed using established medical literature databases. The following information was retrieved from the literature: patients' demographics, surgical technique, duration of follow-up, clinical outcome including pain relief and complication rate. A total of 42 clinical studies published between 1978 and 2015 were included in the systematic literature review. Eight and 34 studies had prospective and retrospective design, respectively. The most common studies were level IV studies (64.3%). The orthopaedic treatment of patients with haemophilic ankle osteoarthritis is often challenging and requires complete and careful preoperative assessment. In general, both joint-preserving and joint non-preserving procedure types can be performed. All specific relative and absolute contraindications should be considered to achieve appropriate postoperative outcomes. The current literature demonstrated that orthopaedic surgeries, with appropriate indication, in patients with haemophilic ankle arthropathy result in good postoperative results comparable to those observed in non-haemophiliacs. The surgical treatment should be performed in a setting with the ability to have multidisciplinary management, including expertise in haematology. © 2016 John Wiley & Sons Ltd.

  3. Development of a Robotic Assembly for Analyzing the Instantaneous Axis of Rotation of the Foot Ankle Complex

    Directory of Open Access Journals (Sweden)

    Kelly N. Salb

    2016-01-01

    Full Text Available Ankle instantaneous axis of rotation (IAR measurements represent a more complete parameter for characterizing joint motion. However, few studies have implemented this measurement to study normal, injured, or pathological foot ankle biomechanics. A novel testing protocol was developed to simulate aspects of in vivo foot ankle mechanics during mid-stance gait in a human cadaveric specimen. A lower leg was mounted in a robotic testing platform with the tibia upright and foot flat on the baseplate. Axial tibia loads (ATLs were controlled as a function of a vertical ground reaction force (vGRF set at half body weight (356 N and a 50% vGRF (178 N Achilles tendon load. Two specimens were repetitively loaded over 10 degrees of dorsiflexion and 20 degrees of plantar flexion. Platform axes were controlled within 2 microns and 0.008 degrees resulting in ATL measurements within ±2 N of target conditions. Mean ATLs and IAR values were not significantly different between cycles of motion, but IAR values were significantly different between dorsiflexion and plantar flexion. A linear regression analysis showed no significant differences between slopes of plantar flexion paths. The customized robotic platform and advanced testing protocol produced repeatable and accurate measurements of the IAR, useful for assessing foot ankle biomechanics under different loading scenarios and foot conditions.

  4. Pseudoaneurysm of the Anterior Tibial Artery following Ankle Arthroscopy in a Soccer Player

    Directory of Open Access Journals (Sweden)

    Ichiro Tonogai

    2017-01-01

    Full Text Available Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury. Excessive distraction of the ankle puts the neurovascular structures at greater risk for iatrogenic injury of the anterior tibial artery during ankle arthroscopy. Surgeons should look carefully for postoperative ankle swelling and pain after ankle arthroscopy.

  5. Effect of rocker-soled shoes on parameters of knee joint load in knee osteoarthritis.

    Science.gov (United States)

    Madden, Elizabeth G; Kean, Crystal O; Wrigley, Tim V; Bennell, Kim L; Hinman, Rana S

    2015-01-01

    This study evaluated the immediate effects of rocker-soled shoes on parameters of the knee adduction moment (KAM) and pain in individuals with knee osteoarthritis (OA). Three-dimensional gait analysis was performed on 30 individuals (mean (SD): age, 61 (7) yr; 15 (50%) male) with radiographic and symptomatic knee OA under three walking conditions in a randomized order: i) wearing rocker-soled shoes (Skechers Shape-ups), ii) wearing non-rocker-soled shoes (ASICS walking shoes), and iii) barefoot. Peak KAM and KAM angular impulse were measured as primary indicators of knee load distribution. Secondary measures included the knee flexion moment (KFM) and knee pain during walking. Peak KAM was significantly lower when wearing the rocker-soled shoes compared with that when wearing the non-rocker-soled shoes (mean difference (95% confidence interval), -0.27 (-0.42 to -0.12) N·m/BW × Ht%; P < 0.001). Post hoc tests revealed no significant difference in KAM impulse between rocker-soled and non-rocker-soled shoe conditions (P = 0.13). Both peak KAM and KAM impulse were significantly higher during both shoe conditions compared with those during the barefoot condition (P < 0.001). There were no significant differences in KFM (P = 0.36) or knee pain (P = 0.89) between conditions. Rocker-soled shoes significantly reduced peak KAM when compared with non-rocker-soled shoes, without a concomitant change in KFM, and thus may potentially reduce medial knee joint loading. However, KAM parameters in the rocker-soled shoes remained significantly higher than those during barefoot walking. Wearing rocker-soled shoes did not have a significant immediate effect on walking pain. Further research is required to evaluate whether rocker-soled shoes can influence symptoms and progression of knee OA with prolonged wear.

  6. Estudo da confiabilidade da força aplicada durante a mobilização articular ântero-posterior do tornozelo Reliability study on the force applied during anteroposterior mobilization of the ankle joint

    Directory of Open Access Journals (Sweden)

    MA Resende

    2006-01-01

    Full Text Available INTRODUÇÃO: Os fatores que contribuem para a eficiência da manobra de mobilização articular são a intensidade e a reprodutibilidade da força aplicada durante a mobilização, por um ou por diferentes examinadores. OBJETIVO: Avaliar a confiabilidade intra e interexaminador da força de mobilização ântero-posterior da articulação do tornozelo, grau III e IV de Maitland. MÉTODO: Os dois tornozelos de 35 voluntários assintomáticos foram mobilizados por dois examinadores experientes com o procedimento. Uma miniplataforma de força foi posicionada sob a perna do voluntário a fim de captar as forças obtidas durante as manobras de mobilização e seu sinal foi convertido e armazenado em um software DasyLab4.0, o que permitiu o registro dos picos mínimo e máximo das curvas da força aplicada. A análise da confiabilidade foi realizada através do coeficiente de correlação intraclasse (CCI. Para avaliar o erro sistemático das medidas foi utilizado o teste t pareado e o teste t independente, para as condições intra e interexaminadores, respectivamente. O método de Bland e Altman avaliou os limites de concordância das medidas entre os examinadores. RESULTADOS: Os dados demonstraram alta confiabilidade intra-examinador. A confiabilidade inter-examinador foi baixa e moderada para a força máxima e mínima respectivamente, durante a mobilização ântero-posterior da articulação do tornozelo. CONCLUSÃO: Esses dados sugerem que a força aplicada durante a mobilização articular grau III e IV de Maitland no tornozelo, apresenta alta confiabilidade intra-examinador e baixa para interexaminador.BACKGROUND: Factors that contribute towards the efficiency of joint mobilization maneuvers is the intensity and reproducibility of the force applied during mobilization, by one or more examiners. OBJECTIVE: To evaluate the intra and inter-examiner reliability of Maitland grade III and IV anteroposterior mobilization force on the ankle joint

  7. Functional roles of lower-limb joint moments while walking in water.

    Science.gov (United States)

    Miyoshi, Tasuku; Shirota, Takashi; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka; Akai, Masami

    2005-02-01

    To clarify the functional roles of lower-limb joint moments and their contribution to support and propulsion tasks while walking in water compared with that on land. Sixteen healthy, young subjects walked on land and in water at several different speeds with and without additional loads. Walking in water is a major rehabilitation therapy for patients with orthopedic disorders. However, the functional role of lower-limb joint moments while walking in water is still unclear. Kinematics, electromyographic activities in biceps femoris and gluteus maximums, and ground reaction forces were measured under the following conditions: walking on land and in water at a self-determined pace, slow walking on land, and fast walking in water with or without additional loads (8 kg). The hip, knee, and ankle joint moments were calculated by inverse dynamics. The contribution of the walking speed increased the hip extension moment, and the additional weight increased the ankle plantar flexion and knee extension moment. The major functional role was different in each lower-limb joint muscle. That of the muscle group in the ankle is to support the body against gravity, and that of the muscle group involved in hip extension is to contribute to propulsion. In addition, walking in water not only reduced the joint moments but also completely changed the inter-joint coordination. It is of value for clinicians to be aware that the greater the viscosity of water produces a greater load on the hip joint when fast walking in water.

  8. Effects of circumferential ankle pressure on ankle proprioception, stiffness, and postural stability: a preliminary investigation.

    Science.gov (United States)

    You, Sung H; Granata, Kevin P; Bunker, Linda K

    2004-08-01

    Cross-sectional repeated-measures design. Determine the effects of circumferential ankle pressure (CAP) intervention on proprioceptive acuity, ankle stiffness, and postural stability. The application of CAP using braces, taping, and adaptive shoes or military boots is widely used to address chronic ankle instability (CAI). An underlying assumption is that the CAP intervention might improve ankle stability through increased proprioceptive acuity and stiffness in the ankle. METHOD AND MEASURES: A convenience sample of 10 subjects was recruited from the local university community and categorized according to proprioceptive acuity (high, low) and ankle stability (normal, CAI). Proprioceptive acuity was measured when blindfolded subjects were asked to accurately reproduce a self-selected target ankle position before and after the application of CAP. Proprioceptive acuity was determined in 5 different ankle joint position sense tests: neutral, inversion, eversion, plantar flexion, and dorsiflexion. Joint position angles were recorded electromechanically using a potentiometer. Passive ankle stiffness was computed from the ratio of applied static moment versus angular displacement. Active ankle stiffness was determined from biomechanical analyses of ankle motion following a mediolateral perturbation. Postural stability was quantified from the center of pressure displacement in the mediolateral and the anteroposterior directions in unipedal stance. All measurements were recorded with and without CAP applied by a pediatric blood pressure cuff. Data were analyzed using a separate mixed-model analysis of variance (ANOVA) for each dependent variable. Post hoc comparison using Tukey's honestly significant difference (HSD) test was performed if significant interactions were obtained. Significance level was set at P<.05 for all analyses. Significant group (high versus low proprioceptive acuity) x CAP interactions were identified for postural stability. Passive ankle stiffness was

  9. Strain rate dependent orthotropic properties of pristine and impulsively loaded porcine temporomandibular joint disk.

    Science.gov (United States)

    Beatty, M W; Bruno, M J; Iwasaki, L R; Nickel, J C

    2001-10-01

    The purpose of this study was to characterize the tensile stress-strain behavior of the porcine temporomandibular joint (TMJ) disk with respect to collagen orientation and strain rate dependency. The apparent elastic modulus, ultimate tensile strength, and strain at maximum stress were measured at three elongation rates (0.5, 50, and 500 mm/min) for dumbbell-shaped samples oriented along either anteroposterior or mediolateral axes of the disks. In order to study the effects of impact-induced fissuring on the mechanical behavior, the same properties were measured along each orientation at an elongation rate of 500 mm/min for disks subjected to impulsive loads of 0.5 N. s. The results suggested a strongly orthotropic nature to the healthy pristine disk. The values for the apparent modulus and ultimate strength were 10-fold higher along the anteroposterior axis (p disks for either orientation (p > 0.05). The results demonstrated the importance of choosing an orthotropic model for the TMJ disk to conduct finite element modeling, to develop failure criteria, and to construct tissue-engineered replacements. Impact-induced fissuring requires further study to determine if the TMJ disk is orthotropic with respect to fatigue.

  10. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Holsgaard-Larsen, Anders; Creaby, M W

    2016-01-01

    with the contra-lateral leg. METHODS: We estimated indices of knee joint loading (external peak knee adduction moment (KAM), KAM impulse and peak knee flexion moment (KFM)) normalized to body size (i.e., body mass (BM) and height (HT)) using 3D gait analysis in 23 patients (17 men, mean (SD) 46.2 (6.4) years, BMI...... 25.8 (3.4) kg/m(2)) without radiographic knee OA before and 12 months after medial APM. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Peak KAM and KAM impulse increased in the APM leg compared to the contra......-lateral leg from before to 12 months after surgery (change difference: 0.38 Nm/BM*HT% 95% CI 0.01 to 0.76 (P = 0.049) and 0.20 Nm*s/BM*HT% 95% CI 0.10 to 0.30 (P

  11. Clinical evaluation of a new noninvasive ankle arthrometer.

    Science.gov (United States)

    Nauck, Tanja; Lohrer, Heinz; Gollhofer, Albert

    2010-06-01

    A nonradiographic arthrometer was developed to objectively quantify anterior talar drawer instability in stable and unstable ankles. Diagnostic validity of this device was previously demonstrated in a cadaver study. The aim of the present study was to validate the ankle arthrometer in an in vivo setting. Twenty-three subjects participated in the study. An orthopedic surgeon first performed a manual anterior talar drawer test to classify the subjects' ankles as stable or unstable. The subjects were then evaluated using the ankle arthrometer, and filled out a validated self-reported questionnaire (German version of the Foot and Ankle Ability Measure [FAAM-G]). Ankle stiffness was calculated from the low linear region (40-60 N) of the load deformation curves obtained from the ankle arthrometer. Reliability testing of these stiffness values was done based on load deformation curves, with 150 and 200 N maximum anterior drawer loads applied in the ankle arthrometer. Using the manual anterior drawer test, 16 ankles were classified as stable and 7 were classified as unstable. Arthrometer stiffness analysis differentiated stable from unstable ankles (P = 0.00 and P = 0.01, respectively). Test-retest demonstrated an accurate reliability (intraclass correlation coefficient = 0.80). A significant correlation was found between both FAAM-G subscales and the arthrometer stiffness values (r = 0.43 and 0.54; P = 0.04 and 0.01). Discussion Subjects with and without mechanical ankle instability could be differentiated by ankle arthrometer stiffness analysis and the FAAM-G questionnaire results. This nonradiographic device may be relevant for screening athletes at risk for ankle injuries, for clinical follow-up studies, and implementing preventive strategies. Validity and reliability of the new ankle arthrometer is demonstrated in a small cohort in an in vivo setting.

  12. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial

    OpenAIRE

    Fisher Beth E; Kulig Kornelia; Davenport Todd E

    2010-01-01

    Abstract Background Ankle sprains are common within the general population and can result in prolonged disablement. Limited talocrural dorsiflexion range of motion (DF ROM) is a common consequence of ankle sprain. Limited talocrural DF ROM may contribute to persistent symptoms, disability, and an elevated risk for re-injury. As a result, many health care practitioners use hands-on passive procedures with the intention of improving talocrural joint DF ROM in individuals following ankle sprains...

  13. Residual and working stresses in pipe joints in heterogeneous metals, due to common action of welding and service loads

    International Nuclear Information System (INIS)

    Kiselev, S.N.; Voronin, N.N.; Roshchin, V.V.

    1978-01-01

    The stresses in the welded joints of cylindrical shells are studied, which are caused by the total effect of the thermal deformation welding cycles, by the preheats connected with the thermal treatment or operation, and by power loads. Studied were the shell joints made of the steels Kh18N10T and St.3, as well as the joints of three shells made of different metals, St.3+18N1aT steel+copper. The schematic diagram showing the residual stresses set up under effect of different factors are presented. The following has been shown by the study: the preheating of the welded joints of the shells made of diverse metals up to the operational temperatures does not result in obviating the residual stresses. If the welded shells are loaded by the internal pressure up to the stresses of (0.8-O.9) sigmasub(T), in certain cases an essential (up to 60-70%) reduction in the residual welding stresses may be obtained. The effectiveness of a variation in the residual stresses is reduced in the joints that have been thermally treated after welding. The working stresses set up in the welded joints of the shells made of different metals under the operational loading may be essentially reduced through initial preheating with the application of a pressure or without it. The preheating temperature and the pressures applied may be chosen so that to create the residual strains and the stresses of inverse sign as compared with the working stresses

  14. Intrinsic ankle stiffness during standing increases with ankle torque and passive stretch of the Achilles tendon

    Science.gov (United States)

    Gill, Jaspret

    2018-01-01

    Individuals may stand with a range of ankle angles. Furthermore, shoes or floor surfaces may elevate or depress their heels. Here we ask how these situations impact ankle stiffness and balance. We performed two studies (each with 10 participants) in which the triceps surae, Achilles tendon and aponeurosis were stretched either passively, by rotating the support surface, or actively by leaning forward. Participants stood freely on footplates which could rotate around the ankle joint axis. Brief, small stiffness-measuring perturbations (torque or passive stretch. Sway was minimally affected by stretch or lean, suggesting that this did not underlie the alterations in stiffness. In quiet stance, maximum ankle stiffness is limited by the tendon. As tendon strain increases, it becomes stiffer, causing an increase in overall ankle stiffness, which would explain the effects of leaning. However, stiffness also increased considerably with passive stretch, despite a modest torque increase. We discuss possible explanations for this increase. PMID:29558469

  15. Primary ankle arthrodesis for neglected open Weber B ankle fracture dislocation.

    Science.gov (United States)

    Thomason, Katherine; Ramesh, Ashwanth; McGoldrick, Niall; Cove, Richard; Walsh, James C; Stephens, Michael M

    2014-01-01

    Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Comparison of Multisegmental Foot and Ankle Motion Between Total Ankle Replacement and Ankle Arthrodesis in Adults.

    Science.gov (United States)

    Seo, Sang Gyo; Kim, Eo Jin; Lee, Doo Jae; Bae, Kee Jeong; Lee, Kyoung Min; Lee, Dong Yeon

    2017-09-01

    Total ankle replacement (TAR) and ankle arthrodesis (AA) are usually performed for severe ankle arthritis. We compared postoperative foot segmental motion during gait in patients treated with TAR and AA. Gait analysis was performed in 17 and 7 patients undergoing TAR and AA, respectively. Subjects were evaluated using a 3-dimensional multisegmental foot model with 15 markers. Temporal gait parameters were calculated. The maximum and minimum values and the differences in hallux, forefoot, hindfoot, and arch in 3 planes (sagittal, coronal, transverse) were compared between the 2 groups. One hundred healthy adults were evaluated as a control. Gait speed was faster in the TAR ( P = .028). On analysis of foot and ankle segmental motion, the range of hindfoot sagittal motion was significantly greater in the TAR (15.1 vs 10.2 degrees in AA; P = .004). The main component of motion increase was hindfoot dorsiflexion (12.3 and 8.6 degrees). The range of forefoot sagittal motion was greater in the TAR (9.3 vs 5.8 degrees in AA; P = .004). Maximum ankle power in the TAR (1.16) was significantly higher than 0.32 in AA; P = .008). However, the range of hindfoot and forefoot sagittal motion was decreased in both TAR and AA compared with the control group ( P = .000). Although biomechanical results of TAR and AA were not similar to those in the normal controls, joint motions in the TAR more closely matched normal values. Treatment decision making should involve considerations of the effect of surgery on the adjacent joints. Level III, case-control study.

  17. Analysis on Adhesively-Bonded Joints of FRP-steel Composite Bridge under Combined Loading: Arcan Test Study and Numerical Modeling

    Directory of Open Access Journals (Sweden)

    Xu Jiang

    2016-01-01

    Full Text Available The research presented in this paper is an experimental study and numerical analysis on mechanical behavior of the adhesively-bonded joint between FRP sandwich bridge deck and steel girder. Generally, there are three typical stress states in the adhesively-bonded joint: shear stress, tensile stress, and combination of both. To realize these stress states in the adhesively-bonded joint during tests, a specific loading device is developed with the capacity of providing six different loading angles, which are 0°(pure tension, 18°, 36°, 54°, 72° and 90°(pure shear. Failure modes of adhesively-bonded joints are investigated. It indicates that, for the pure shear loading, the failure mode is the cohesive failure (near the interface between the adhesive layer and the steel support in the adhesive layer. For the pure tensile and combined loading conditions, the failure mode is the combination of fiber breaking, FRP delamination and interfacial adhesion failure between the FRP sandwich deck and the adhesive layer. The load-bearing capacities of adhesive joints under combined loading are much lower than those of the pure tensile and pure shear loading conditions. According to the test results of six angle loading conditions, a tensile/shear failure criterion of the adhesively-bonded joint is obtained. By using Finite Element (FE modeling method, linear elastic simulations are performed to characterize the stress distribution throughout the adhesively-bonded joint.

  18. Gait analysis after successful mobile bearing total ankle replacement.

    NARCIS (Netherlands)

    Doets, H.C.; van Middelkoop, M.; Houdijk, J.H.P.; Nelissen, R.G.; Veeger, H.E.J.

    2007-01-01

    Background: The effect of total ankle replacement on gait is not fully known in terms of joint kinematics, ground reaction force, and activity of the muscles of the lower leg. Methods: A comparative gait study was done in 10 patients after uneventful unilateral mobile-bearing total ankle replacement

  19. Design and analysis of push pipe joint under internal pressure and temperature loading

    International Nuclear Information System (INIS)

    Abid, M.; Alam, K.

    2005-01-01

    Pipe joints flanged or welded are commonly used in industry for different applications ranging from sewerage to the high pressure and temperature applications. However, with the rapidly changing technological trends, for optimized space such as for heat exchanger applications, pipe joint design needs special consideration, especially for the internal pipe where no flanged/bolted joint due to space constraint can be used. In addition, where joint opening/closing is the requirement for maintenance or other functional purposes, it becomes inevitable to use some special design. In this paper, a push joint proposed is designed, analyzed, optimized and tested for safe stress and operating conditions. An experimental test rig is designed and tests are performed for internal pressure and temperature separately and joint's behaviour is analyzed in detail for any leaks. FEA results are compared and verified with the mathematical results. Based on the experimental observations, the joint is safe as no leaks are observed. (author)

  20. Numerical Investigation of T-joints with 3D Four Directional Braided Composite Fillers Under Tensile Loading

    Science.gov (United States)

    Li, Xiao-kang; Liu, Zhen-guo; Hu, Long; Wang, Yi-bo; Lei, Bing; Huang, Xiang

    2017-02-01

    Numerical studied on T-joints with three-dimensional four directional (3D4D) braided composite fillers was presented in this article. Compared with conventional unidirectional prepreg fillers, the 3D braided composite fillers have excellent ability to prevent crack from penetrating trigone fillers, which constantly occurred in the conventional fillers. Meanwhile, the 3D braided composite fillers had higher fiber volume fraction and eliminated the fiber folding problem in unidirectional prepreg fillers. The braiding technology and mechanical performance of 3D4D braided fillers were studied. The numerical model of carbon fiber T-joints with 3D4D braided composite fillers was built by finite element analysis software. The damage formation, extension and failing process of T-joints with 3D4D braided fillers under tensile load were investigated. Further investigation was extended to the effect of 3D4D braided fillers with different braiding angles on mechanical behavior of the T-joints. The study results revealed that the filling area was the weakest part of the T-joints where the damage first appeared and the crack then rapidly spread to the glue film around the filling area and the interface between over-laminate and soleplate. The 3D4D braided fillers were undamaged and the braiding angle change induced a little effect on the bearing capacity of T-joints.

  1. Post-Traumatic Osteoarthritis of the Ankle: A Distinct Clinical Entity Requiring New Research Approaches

    Science.gov (United States)

    Delco, Michelle L.; Kennedy, John G.; Bonassar, Lawrence J.; Fortier, Lisa A.

    2017-01-01

    The diagnosis of ankle osteoarthritis (OA) is increasing as a result of advancements in non-invasive imaging modalities such as magnetic resonance imaging, improved arthroscopic surgical technology and heightened awareness among clinicians. Unlike OA of the knee, primary or age-related ankle OA is rare, with the majority of ankle OA classified as post-traumatic (PTOA). Ankle trauma, more specifically ankle sprain, is the single most common athletic injury, and no effective therapies are available to prevent or slow progression of PTOA. Despite the high incidence of ankle trauma and OA, ankle-related OA research is sparse, with the majority of clinical and basic studies pertaining to the knee joint. Fundamental differences exist between joints including their structure and molecular composition, response to trauma, susceptibility to OA, clinical manifestations of disease, and response to treatment. Considerable evidence suggests that research findings from knee should not be extrapolated to the ankle, however few ankle-specific preclinical models of PTOA are currently available. The objective of this article is to review the current state of ankle OA investigation, highlighting important differences between the ankle and knee that may limit the extent to which research findings from knee models are applicable to the ankle joint. Considerations for the development of new ankle-specific, clinically relevant animal models are discussed. PMID:27764893

  2. Experimental behavior of full-scale exterior beam-column space joints retrofitted by ferrocement layers under cyclic loading

    Directory of Open Access Journals (Sweden)

    Ibrahim G. Shaaban

    2018-06-01

    Full Text Available A majority of the traditional reinforced concrete frame buildings, existing across the Middle East, lack adequate confinement in beam-column joints, or in other words, are shear deficient because they were constructed before the introduction of seismic codes for construction. This research studies the experimental behavior of full-scale beam-column space (three-dimensional joints under displacement-controlled cyclic loading. Eleven joint specimens, included a traditionally reinforced one (without adequate shear reinforcement, a reference one with sufficient shear reinforcement according to ACI 318, and nine specimens retrofitted by ferrocement layers, were experimentally tested to evaluate a retrofit technique for strengthening shear deficient beam column joints. The studied variables were the number of layers, orientation angle of expanded wire mesh per layer, and presence of steel angles in the corners of joint specimen prior to wrapping with ferrocement layers. The experimental results showed that proper shear reinforcement for the test joints, according to ACI 318, enhanced the behavior of the specimen over that of the traditionally reinforced specimens without adequate shear reinforcement. The joints retrofitted by ferrocement layers showed higher ultimate capacity, higher ultimate displacement prior to failure (better ductility, and they did not suffer heavily damage as observed for the traditionally reinforced one. Increasing the number of ferrocement layers for retrofitted specimens led to improving performance for such specimens compared to the traditionally reinforced ones in terms of enhancing the ultimate capacity and ultimate displacement. Specimens retrofitted by ferrocement layers reinforced by expanded wire mesh of 60° orientation angle showed slightly better performance than those of 45° orientation angles. Retrofitting using steel angles in addition to ferrocement layers improves the seismic performance of the specimens

  3. Effect of head contact on the rim of the cup on the offset loading and torque in hip joint replacement.

    Science.gov (United States)

    Liu, Feng; Williams, Sophie; Jin, Zhongmin; Fisher, John

    2013-11-01

    Head contact on the rim of the cup causes stress concentration and consequently increased wear. The head contact on the rim of the cup may in addition cause an offset load and torque on the cup. The head-rim contact resulting from microseparation or subluxation has been investigated. An analytical model has been developed to calculate the offset loading and resultant torque on the cup as a function of the translational displacement of the head under simplified loading condition of the hip joint at heel strike during a walking cycle. The magnitude of the torque on the cup was found to increase with the increasing translational displacement, larger diameter heads, eccentric cups, and the coefficient of friction of the contact. The effects of cup inclination, cup rim radius, and cup coverage angle on the magnitude of the torque were found to be relatively small with a maximum variation in the torque magnitude being lower than 20%. This study has shown an increased torque due to the head loading on the rim of the cup, and this may contribute to the incidence of cup loosening. Particularly, metal-on-metal hip joints with larger head diameters may produce the highest offset loading torque.

  4. Measurement of passive ankle stiffness in subjects with chronic hemiparesis using a novel ankle robot

    Science.gov (United States)

    Roy, Anindo; Bever, Christopher T.; Forrester, Larry W.; Macko, Richard F.; Hogan, Neville

    2011-01-01

    Our objective in this study was to assess passive mechanical stiffness in the ankle of chronic hemiparetic stroke survivors and to compare it with those of healthy young and older (age-matched) individuals. Given the importance of the ankle during locomotion, an accurate estimate of passive ankle stiffness would be valuable for locomotor rehabilitation, potentially providing a measure of recovery and a quantitative basis to design treatment protocols. Using a novel ankle robot, we characterized passive ankle stiffness both in sagittal and in frontal planes by applying perturbations to the ankle joint over the entire range of motion with subjects in a relaxed state. We found that passive stiffness of the affected ankle joint was significantly higher in chronic stroke survivors than in healthy adults of a similar cohort, both in the sagittal as well as frontal plane of movement, in three out of four directions tested with indistinguishable stiffness values in plantarflexion direction. Our findings are comparable to the literature, thus indicating its plausibility, and, to our knowledge, report for the first time passive stiffness in the frontal plane for persons with chronic stroke and older healthy adults. PMID:21346215

  5. Load-Displacement Curves of Spot Welded, Bonded, and Weld-Bonded Joints for Dissimilar Materials and Thickness

    Directory of Open Access Journals (Sweden)

    E.A. Al-Bahkali

    2011-12-01

    Full Text Available Three-dimensional finite element models of spot welded, bonded and weld-bonded joints are developed using ABAQUS software. Each model consists of two strips with dissimilar materials and thickness and is subjected to an axial loading. The bonded and weld-bonded joints have specific adhesive thickness. A detailed experimental plan to define many properties and quantities such as, the elastic - plastic properties, modulus of elasticity, fracture limit, and properties of the nugget and heat affected zones are carried out. Experiments include standard testing of the base metal, the adhesive, the nugget and heat affected zone. They also include employing the indentation techniques, and ductile fracture limits criteria, using the special notch tests. Complete load-displacement curves are obtained for all joining models and a comparison is made to determine the best combination.

  6. Ductile fracture mechanism of low-temperature In-48Sn alloy joint under high strain rate loading.

    Science.gov (United States)

    Kim, Jong-Woong; Jung, Seung-Boo

    2012-04-01

    The failure behaviors of In-48Sn solder ball joints under various strain rate loadings were investigated with both experimental and finite element modeling study. The bonding force of In-48Sn solder on an Ni plated Cu pad increased with increasing shear speed, mainly due to the high strain-rate sensitivity of the solder alloy. In contrast to the cases of Sn-based Pb-free solder joints, the transition of the fracture mode from a ductile mode to a brittle mode was not observed in this solder joint system due to the soft nature of the In-48Sn alloy. This result is discussed in terms of the relationship between the strain-rate of the solder alloy, the work-hardening effect and the resulting stress concentration at the interfacial regions.

  7. Chronic Ankle Instability

    Science.gov (United States)

    ... top of the talus is dome-shaped and... Softball Injuries to the Foot and Ankle Your feet ... ankles take a beating when you are playing softball. Softball players should be aware of the following ...

  8. Kinematics of a Novel Ankle Rehabilitation Device with Two Degrees of Freedom

    Directory of Open Access Journals (Sweden)

    Ioan Doroftei

    2015-06-01

    Full Text Available The human ankle joint is the most common injured in sports and daily life in general. Traditionally, ankle injuries are rehabilitated via physiotherapy. However, the experiences suggest that without sufficient rehabilitation many people will have future problems. Furthermore, during a rehabilitation treatment, cooperative and intensive efforts of therapists and patients are required over prolonged sessions. Thus, robotic devices have been developed for human ankle rehabilitation. This paper discusses kinematic aspects of a novel ankle rehabilitation device, which can facilitate the recovery of the ankle joint

  9. Realignment Surgery for Malunited Ankle Fracture.

    Science.gov (United States)

    Guo, Chang-Jun; Li, Xing-Cheng; Hu, Mu; Xu, Yang; Xu, Xiang-Yang

    2017-02-01

    To investigate the characteristics and the results of realignment surgery for the treatment of malunited ankle fracture. Thirty-three patients with malunited fractures of the ankle who underwent reconstructive surgery at our hospital from January 2010 to January 2014 were reviewed. The tibial anterior surface angle (TAS), the tibiotalar tilt angle (TTA), the malleolar angle (MA), and the tibial lateral surface angle (TLS) were measured. Clinical assessment was performed with use of the American Orthopaedic Foot and Ankle Society (AOFAS) scale and visual analogue scale (VAS) scores, and the osteoarthritis stage was determined radiographically with the modified Takakura classification system. The Wilcoxon matched-pairs test was used to analyze the difference between the preoperative and the postoperative data. The mean follow-up was 36 months (range, 20-60 months). The mean age at the time of realignment surgery was 37.1 years (range, 18-62 years). Compared with preoperation, the TAS at the last follow-up showed a significant increase (88.50° ± 4.47° vs. 90.80° ± 3.49°, P = 0.0035); similar results were observed in TTA (1.62° ± 1.66° vs. 0.83° ± 0.90°, P ankle osteoarthritis, and was treated by ankle joint distraction. Realignment surgery for a malunited ankle fracture can reduce pain, improve function, and delay ankle arthrodesis or total ankle replacement. Postoperative large talar tilt and advanced stages of ankle arthritis are the risk factors for the surgery. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  10. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2012-01-01

    Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential...... to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have...

  11. Advancements in ankle arthroscopy

    NARCIS (Netherlands)

    van Dijk, C. Niek; van Bergen, Christiaan J. A.

    2008-01-01

    Important progress has been made during the past 30 years in arthroscopic ankle surgery. Ankle arthroscopy has gradually changed from a diagnostic to a therapeutic tool. Most arthroscopic procedures can be performed by using the anterior working area with the ankle in dorsiflexion or plantar

  12. Complications in ankle arthroscopy

    NARCIS (Netherlands)

    Zengerink, Maartje; van Dijk, C. Niek

    2012-01-01

    To determine the complication rate for ankle arthroscopy. A review of a consecutive series of patients undergoing ankle arthroscopy in our hospital between 1987 and 2006 was undertaken. Anterior ankle arthroscopy was performed by means of a 2-portal dorsiflexion method with intermittent soft tissue

  13. Assessment of Ankle Injuries

    Science.gov (United States)

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  14. Short-term effect of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in patients with rheumatoid arthritis of the ankle and foot joints. A randomized controlled pilot trial.

    Science.gov (United States)

    Wang, Chien-Chih; Lee, Si-Huei; Lin, Hsiao-Yi; Liu, Fu-Wei; Chiou, Hong-Jen; Chan, Rai-Chi; Chou, Chen-Liang

    2017-11-01

    To determine whether hyaluronic acid (HA) injection into rheumatoid arthritis ankles and feet can achieve improvement in foot function and reduce synovial hyper-vascularization. Forty-four patients with RA having unilateral or bilateral painful ankle and foot involvement (N = 75) were studied. All the patients were randomized to receive HA (N = 40) or lidocaine (LI) (N = 35) injection at 2-week intervals; Clinical assessments were performed using a visual analog scale (VAS) and foot function index (FFI total ) including subscales of pain (FFI pain) before injection at baseline, 4 weeks (first evaluation) and 12 weeks (secondary evaluation). Imaging evaluation based on color Doppler ultrasound (CDUS) and synovitis scores was performed simultaneously. HA injection improved the VAS score (p = .009), FFI pain (p = .041), and FFI total (p = .032) considerably more than LI injections did at the first evaluation. The CDUS values at first evaluation (p = .005) and secondary evaluation (p injections reduced the CDUS values of more than half of the joints (54%, p = .042) while the control group exhibited no change (20%, p = .56). However, HA injection did not reduce the CDUS values more than LI injection did. Regarding the evaluation of synovial hypertrophy, no significant difference was observed between or within the groups in the synovitis scores. HA injection improved short-term foot function and pain reduction. HA injection may have a modest effect in reducing synovial hyper-vascularization. Further large-scale study is warranted to confirm this result.

  15. High-resolution morphological and biochemical imaging of articular cartilage of the ankle joint at 3.0 T using a new dedicated phased array coil: in vivo reproducibility study

    International Nuclear Information System (INIS)

    Welsch, Goetz H.; Trattnig, Siegfried; Mamisch, Tallal C.; Weber, Michael; Horger, Wilhelm; Bohndorf, Klaus

    2008-01-01

    The objective of this study was to evaluate the feasibility and reproducibility of high-resolution magnetic resonance imaging (MRI) and quantitative T2 mapping of the talocrural cartilage within a clinically applicable scan time using a new dedicated ankle coil and high-field MRI. Ten healthy volunteers (mean age 32.4 years) underwent MRI of the ankle. As morphological sequences, proton density fat-suppressed turbo spin echo (PD-FS-TSE), as a reference, was compared with 3D true fast imaging with steady-state precession (TrueFISP). Furthermore, biochemical quantitative T2 imaging was prepared using a multi-echo spin-echo T2 approach. Data analysis was performed three times each by three different observers on sagittal slices, planned on the isotropic 3D-TrueFISP; as a morphological parameter, cartilage thickness was assessed and for T2 relaxation times, region-of-interest (ROI) evaluation was done. Reproducibility was determined as a coefficient of variation (CV) for each volunteer; averaged as root mean square (RMSA) given as a percentage; statistical evaluation was done using analysis of variance. Cartilage thickness of the talocrural joint showed significantly higher values for the 3D-TrueFISP (ranging from 1.07 to 1.14 mm) compared with the PD-FS-TSE (ranging from 0.74 to 0.99 mm); however, both morphological sequences showed comparable good results with RMSA of 7.1 to 8.5%. Regarding quantitative T2 mapping, measurements showed T2 relaxation times of about 54 ms with an excellent reproducibility (RMSA) ranging from 3.2 to 4.7%. In our study the assessment of cartilage thickness and T2 relaxation times could be performed with high reproducibility in a clinically realizable scan time, demonstrating new possibilities for further investigations into patient groups. (orig.)

  16. Lateral ankle injury. Literature review and report of two cases.

    Science.gov (United States)

    Pollard, Henry; Sim, Patrick; McHardy, Andrew

    2002-07-01

    Injury to the ankle joint is the most common peripheral joint injury. The sports that most commonly produce high ankle injury rates in their participating athletes include: basketball, netball, and the various codes of football. To provide an up to date understanding of manual therapy relevant to lateral ligament injury of the ankle. A discussion of the types of ligament injury and common complicating factors that present with lateral ankle pain is presented along with a review of relevant anatomy, assessment and treatment. Also included is a discussion of the efficacy of manual therapy in the treatment of ankle sprain. A detailed knowledge of the anatomy of the ankle as well as the early recognition of factors that may delay the rate of healing are important considerations when developing a management plan for inversion sprains of the ankle. This area appears to be under-researched however it was found that movement therapy and its various forms appear to be the most efficient and most effective method of treating uncomplicated ankle injury. Future investigations should involve a study to determine the effect chiropractic treatment (manipulation) may have on the injured ankle.

  17. Validation of Ankle Strength Measurements by Means of a Hand-Held Dynamometer in Adult Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Andrea Ancillao

    2017-01-01

    Full Text Available Uniaxial Hand-Held Dynamometer (HHD is a low-cost device widely adopted in clinical practice to measure muscle force. HHD measurements depend on operator’s ability and joint movements. The aim of the work is to validate the use of a commercial HHD in both dorsiflexion and plantarflexion ankle strength measurements quantifying the effects of HHD misplacements and unwanted foot’s movements on the measurements. We used an optoelectronic system and a multicomponent load cell to quantify the sources of error in the manual assessment of the ankle strength due to both the operator’s ability to hold still the HHD and the transversal components of the exerted force that are usually neglected in clinical routine. Results showed that foot’s movements and angular misplacements of HHD on sagittal and horizontal planes were relevant sources of inaccuracy on the strength assessment. Moreover, ankle dorsiflexion and plantarflexion force measurements presented an inaccuracy less than 2% and higher than 10%, respectively. In conclusion, the manual use of a uniaxial HHD is not recommended for the assessment of ankle plantarflexion strength; on the contrary, it can be allowed asking the operator to pay strong attention to the HHD positioning in ankle dorsiflexion strength measurements.

  18. MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

    Directory of Open Access Journals (Sweden)

    Neelu Prasad

    2016-06-01

    Full Text Available BACKGROUND The ankle joint is one of the most frequently injured joint. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. The talocrural joint is a major weight bearing joint of the body. The weight of the body is transmitted from the tibia and fibula to the talus which distributes the weight anteriorly and posteriorly within the foot. One sixth of the static load of the leg is carried by the fibula at the tibiofibular joint. These require a high degree of stability which is determined by the passive and dynamic factors. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. Conventionally, X-ray techniques have been used to diagnose ligament injuries. Magnetic resonance (MR imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The anatomy of the deltoid ligament

  19. Experimental Study On Lateral Load Capacity of Bamboo RC Beam Column Joints Strengthened By Bamboo Mechanical Anchors

    Directory of Open Access Journals (Sweden)

    Sri Umniati B.

    2017-01-01

    Full Text Available In this paper, the prospective of bamboos which available abundantly especially in Indonesia as rebars and mechanical anchors are studied. And also the endurance of the bamboos mechanical anchors to withstand cyclic loading were observed. Nine classes of bamboos bar were evaluated: consist of 3 different anchors (0, 4 and 8 anchors and 3 different compressive strength (19.19 MPa, 29.61 MPa and 37.96 MPa means 3 × 3 parameters. The results show that the lateral load capacity increased significantly with the present of bamboo anchors specimens: 26.04 % for 4 anchors specimens (C2 and 25 % for the 8 anchors specimens (C3 compared to zero anchor specimens (C1. On the other hand, the compressive strength of concrete have no significant effects to the lateral load capacity. Overall it can be concluded that, bamboo can be used as mechanical anchorage to strengthen beam column joint.

  20. A contact mechanics model for ankle implants with inclusion of surface roughness effects

    Science.gov (United States)

    Hodaei, M.; Farhang, K.; Maani, N.

    2014-02-01

    Total ankle replacement is recognized as one of the best procedures to treat painful arthritic ankles. Even though this method can relieve patients from pain and reproduce the physiological functions of the ankle, an improper design can cause an excessive amount of metal debris due to wear, causing toxicity in implant recipient. This paper develops a contact model to treat the interaction of tibia and talus implants in an ankle joint. The contact model describes the interaction of implant rough surfaces including both elastic and plastic deformations. In the model, the tibia and the talus surfaces are viewed as macroscopically conforming cylinders or conforming multi-cylinders containing micrometre-scale roughness. The derived equations relate contact force on the implant and the minimum mean surface separation of the rough surfaces. The force is expressed as a statistical integral function of asperity heights over the possible region of interaction of the roughness of the tibia and the talus implant surfaces. A closed-form approximate equation relating contact force and minimum separation is used to obtain energy loss per cycle in a load-unload sequence applied to the implant. In this way implant surface statistics are related to energy loss in the implant that is responsible for internal void formation and subsequent wear and its harmful toxicity to the implant recipient.

  1. Arthroscopic ankle arthrodesis with intra-articular distraction.

    Science.gov (United States)

    Kim, Hyong Nyun; Jeon, June Young; Noh, Kyu Cheol; Kim, Hong Kyun; Dong, Quanyu; Park, Yong Wook

    2014-01-01

    Arthroscopic ankle arthrodesis has shown high rates of union comparable to those with open arthrodesis but with substantially less postoperative morbidity, shorter operative times, less blood loss, and shorter hospital stays. To easily perform arthroscopic resection of the articular cartilage, sufficient distraction of the joint is necessary to insert the arthroscope and instruments. However, sometimes, standard noninvasive ankle distraction will not be sufficient in post-traumatic ankle arthritis, with the development of arthrofibrosis and joint contracture after severe ankle trauma. In the present report, we describe a technique to distract the ankle joint by inserting a 4.6-mm stainless steel cannula with a blunt trocar inside the joint. The cannula allowed sufficient intra-articular distraction, and, at the same time, a 4.0-mm arthroscope can be inserted through the cannula to view the joint. Screws can be inserted to fix the joint under fluoroscopic guidance without changing the patient's position or removing the noninvasive distraction device and leg holder, which are often necessary during standard arthroscopic arthrodesis with noninvasive distraction. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Determination of cartilage thickness in the ankle joint. MRT (1,5 T) comparative anatomical study; Bestimmung der Knorpeldicke am oberen Sprunggelenk. Eine MRT(1,5 T)-anatomische Vergleichsstudie

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria); Breitenseher, M.J. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria); Huber, M. [Pathologisch-Bakteriologisches Inst. Baumgartner Hoehe, Wien (Austria); Zettl, R. [Orthopaedisches Krankenhaus Gersthof, Wien (Austria); Rottmann, B. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria); Haller, J. [Hanuschkrankenhaus, Wien (Austria). Radiologische Abt.; Imhof, H. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Klinische Einrichtung Magnet Resonanz und Abt. fuer Osteoradiologie]|[Ludwig Boltzmann Inst. fuer Radiologische Tumordiagnostik, Wien (Austria)

    1997-04-01

    Purpose: The aim of this study was to evaluate the accuracy of MRI in the measurement of cartilage thickness of the ankle joint in comparison to pathologic and histologic specimens. Patients and methods: The ankle joints of four fresh cadaver feet were imaged on a 1.5 T MR-unit in the coronal plane. Standard T{sub 1}-weighted spin echo (SE) and a T{sub 1}-weighted 3D-GE (FLASH-3D) sequence with fat saturation were applied. Following MR imaging, the talus was explanted and cut parallel to the MR images for macroscopic evaluation and histologic specimens were prepared. MRI measurements of the cartilage thickness of the talus were carried out in two ways: Without and with consideration of a transition zone of intermediate signal intensity between hyperintense cartilage and hypointense cortical bone. The data were compared with the anatomic specimens as the gold standard expressing the difference as a percentage value. On histologic specimens thickness of deep calcified cartilage layer was measured. Results: Measurements without the transition zone showed a mean underestimation of talus cartilage thickness of 46.8% (41.3-52.1) for T{sub 1}-SE and 47.5% (43.1-52.1) for fat saturated FLASH-3D images. Considering the transition zone the mean values were 25.0% (23.1-26.2) and 14.1% (6.7-21.5). The histologic specimens showed a three-fold increase of thickness of deep calcified cartilage layer. Conclusions: Measurements of the cartilage layer of the ankle joint on MR images are only accurate if the transition zone (calcified cartilage layer) is considered and the optimal pulse sequence (FLASH-3D-fat-sat) is applied. (orig.) [Deutsch] Ziel: Die Frage, ob die MRT die Dicke des Knorpels exakt bestimmen kann, wird kontrovers diskutiert. Ziel der Studie war die Bestimmung der Knorpeldicke am oberen Sprunggelenk mit der MRT im Vergleich zum anatomischen Praeparat. Material und Methode: Sprunggelenke von 4 Leichen wurden auf einem 1,5 Tesla MR-Geraet mittels T{sub 1}-betonter Spin

  3. Load Dependency of Postural Control--Kinematic and Neuromuscular Changes in Response to over and under Load Conditions.

    Directory of Open Access Journals (Sweden)

    Ramona Ritzmann

    Full Text Available Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL and under loading (UL used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms.Balance performance was recorded under normal loading (NL, 1 g, UL (0.16 g 0.38 g and OL (1.8 g in monopedal stance. Center of pressure (COP displacement and frequency distribution (low 0.15-0.5 Hz (LF, medium 0.5-2 Hz (MF, high 2-6 Hz (HF as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios.Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL.Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of

  4. Load Dependency of Postural Control--Kinematic and Neuromuscular Changes in Response to over and under Load Conditions.

    Science.gov (United States)

    Ritzmann, Ramona; Freyler, Kathrin; Weltin, Elmar; Krause, Anne; Gollhofer, Albert

    2015-01-01

    Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL) and under loading (UL) used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms. Balance performance was recorded under normal loading (NL, 1 g), UL (0.16 g 0.38 g) and OL (1.8 g) in monopedal stance. Center of pressure (COP) displacement and frequency distribution (low 0.15-0.5 Hz (LF), medium 0.5-2 Hz (MF), high 2-6 Hz (HF)) as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios). Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL. Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of

  5. Load Dependency of Postural Control - Kinematic and Neuromuscular Changes in Response to over and under Load Conditions

    Science.gov (United States)

    Ritzmann, Ramona; Freyler, Kathrin; Weltin, Elmar; Krause, Anne; Gollhofer, Albert

    2015-01-01

    Introduction Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL) and under loading (UL) used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms. Methods Balance performance was recorded under normal loading (NL, 1g), UL (0.16g; 0.38g) and OL (1.8g) in monopedal stance. Center of pressure (COP) displacement and frequency distribution (low 0.15-0.5Hz (LF), medium 0.5-2Hz (MF), high 2-6Hz (HF)) as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios). Results Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL. Conclusion Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal

  6. Delayed latency of peroneal reflex to sudden inversion with ankle taping or bracing.

    Science.gov (United States)

    Shima, N; Maeda, A; Hirohashi, K

    2005-01-01

    The purpose of the present study was to examine the effects of ankle taping and bracing based on the peroneal reflex in the hypermobile and normal ankle joints with and without history of ankle injury. Thirty-six ankle joints of 18 collegiate American football athletes with and without previous history of injury were studied. The angle of talar tilt (TT) was measured by stress radiograph for classifying normal (TT5 degrees ) ankles. They were tested with taping, bracing, and without any supports as a control. The latency of peroneus longus muscle was measured by a sudden inversion of 25 degrees using surface EMG signals. The results of the present study show no significant three-way Group (hypermobile or normal ankles) by History (previously injured or uninjured ankles) by Condition (control, taping, or bracing) interaction, while Condition main effect was significant (p0.05). In conclusion, ankle taping and bracing delayed the peroneal reflex latency not only for hypermobile ankles and/or injured ankle joints but also for intact ankle joints.

  7. Three-dimensional dynamic analysis of knee joint during gait in medial knee osteoarthritis using loading axis of knee.

    Science.gov (United States)

    Nishino, Katsutoshi; Omori, Go; Koga, Yoshio; Kobayashi, Koichi; Sakamoto, Makoto; Tanabe, Yuji; Tanaka, Masaei; Arakawa, Masaaki

    2015-07-01

    We recently developed a new method for three-dimensional evaluation of mechanical factors affecting knee joint in order to help identify factors that contribute to the progression of knee osteoarthritis (KOA). This study aimed to verify the clinical validity of our method by evaluating knee joint dynamics during gait. Subjects were 41 individuals (14 normal knees; 8 mild KOAs; 19 severe KOAs). The positions of skin markers attached to the body were captured during gait, and bi-planar X-ray images of the lower extremities were obtained in standing position. The positional relationship between the markers and femorotibial bones was determined from the X-ray images. Combining this relationship with gait capture allowed for the estimation of relative movement between femorotibial bones. We also calculated the point of intersection of loading axis of knee on the tibial proximal surface (LAK point) to analyze knee joint dynamics. Knee flexion range in subjects with severe KOA during gait was significantly smaller than that in those with normal knees (p=0.011), and knee adduction in those with severe KOA was significantly larger than in those with mild KOA (p<0.000). LAK point was locally loaded on the medial compartment of the tibial surface as KOA progressed, with LAK point of subjects with severe KOA rapidly shifting medially during loading response. Local loading and medial shear force were applied to the tibial surface during stance phase as medial KOA progressed. Our findings suggest that our method is useful for the quantitative evaluation of mechanical factors that affect KOA progression. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. 赤凤逢源针刺手法治疗踝关节扭伤的研究%Study on the Chi Feng Feng Yuan manipulation of acupuncture in the treatment of ankle joint sprain

    Institute of Scientific and Technical Information of China (English)

    史莹莺

    2015-01-01

    目的:探讨赤凤逢源针刺手法治疗急性踝关节扭伤的临床疗效。方法:收治急性踝关节扭伤患者132例,按就诊顺序随机分为3组,针刺组44例,采用“赤凤逢源”法针刺治疗;教学组44例,参照《针灸学》治疗踝关节扭伤方法;扶他林组44例,采用扶他林乳剂外擦治疗。观察治疗后患者踝关节疼痛、肿胀及功能改善情况,并对3组患者治疗前、后踝关节症状评分进行比较。结果:3组患者治疗前后症状评分差值比较:①疼痛差值:针刺组2.59(0.92),教学组1.86(0.51),扶他林组1.5(0.876),F=21.669,P=0;肿胀差值:针刺组2.09(0.603),教学组2.09(0.96),扶他林组1.45(0.901),F=8.496,P=0;功能障碍:针刺组:2.14(1.091),教学组2.09(0.96),扶他林组1.77(0.642),F=2.053,P=0.133;总分差值:针刺组6.82(1.632),教学组6.18(1.968),扶他林组4.73(1.37),F=18.021,P=0。止痛效果针刺组疗效优于教学组更优于扶他林组(P1*2=0,P1*3=0,P2*3=0),肿胀疗效针刺组与教学组差不多但都优于扶他林组(P1*2=1.000,P1*3=0.001,P2*3=0.001),关节功能障碍疗效三组差别不大(P=0.133)。从总的疗效来看,针刺组与教学组疗效相近(P1*2=0.180),但均优于扶他林组(P1*2=0.18,P1*3=0.000,P2*3=0.000)。结论:赤凤逢源针刺手法治疗踝关节扭伤,能起到良好的活血止痛效果,值得临床推广应用。%Objective:To investigate the clinical curative effect of Chi Feng Feng Yuan acupuncture in the treatment of acute ankle sprain.Methods:132 patients with acute ankle joint sprain were selected.They were randomly divided into 3 groups according to the order of treatment.44 cases in the acupuncture group were given "Chi Feng Fegn Yuan" acupuncture therapy;the teaching group with 44 cases refered to the methods of "acupuncture" in the treatment of ankle joint sprain;the voltaren group with 44 cases were given votalin

  9. 踝关节扭伤血流动力学静脉曲张疗效研究%Effect of Varicose Vein Treatment on Ankle Joint Sprain Hemodynamic

    Institute of Scientific and Technical Information of China (English)

    丁道旭; 沈艳

    2014-01-01

    Objective:The ankle injury varices and therapeutic effects is researched through theoretical analysis and clinical observation on the effect of strenuous exercise based on dynamic analysis result. Methods:Observing the effects of temper⁃ature and reaction time on the hemodynamic changes, get the results of Q-PCR blood flow showed significant difference ( P<0.05), each group patients have CXCR3 changes with Fe3O4 magnetic particles added and have significant differences, with the effect of variceal suppressed ankle sprain. Results:According to the apparent enzymatic parameters, TH, SB and SBM reaction apparent activation ability is calculated, the results were 43.9, 40.5, 40.8 kJ/Mmol-1. Relationship between catalytic reaction rate and temperature of nitrile hydratase values were shown as((48.01±42.11)ng/mL vs;(136.33± 72.12)ng/ml;(187.98 ± 78.23)ng/mL, P<0.05), and it has varicose veins and blood rheology, resulting in injury edema. Conclusion:According to the analysis of hemodynamics of ankle sprains, positive treatment on hemodynamics of the ankle joint sprain is obtained, and it has good clinical effect.%目的:通过理论分析和临床观察研究基于动力学分析的剧烈运动导致的踝关节损伤的静脉曲张情况和治疗效果。方法:观测温度和反应时间变化对血流动力学的影响,得到血液动力学流的Q-PCR检测结果显示有显著性差异(P<0.05),各组患者的CXCR3随着加入的Fe3O4磁性微粒的变化而产生显著差异,对抑制因踝关节扭伤导致的静脉曲张具有疗效。结果:根据表观酶学参数比较,计算得到TH、SB及SBM的反应表观活化能力,结果分别为43.9、40.5、40.8 kJ·mol-1。腈水合酶的催化反应速率和温度的关系测试值分别为((48.01±42.11)ng/mL vs;(136.33±72.12)ng/ml;(187.98±78.23)ng/mL,P<0.05),通过P-ERK静脉曲张强度通过血流动力学分析得到的踝关节扭伤恢复的磁滞回线,分

  10. Synovial and tenosynovial lipoma arborescens of the ankle in an adult: a case report

    International Nuclear Information System (INIS)

    Babar, S.A.; Mitchell, A.W.; Sandison, A.

    2008-01-01

    Lipoma arborescens is a rare benign fat-containing synovial proliferative lesion that is typically known to affect the knee joint in adults. We present the first case of lipoma arborescens of the ankle joint in an adult patient with involvement of the intra-articluar synovium as well as the synovial sheath of the tendons around the ankle. The MRI features of this lesion in the adult ankle are described. (orig.)

  11. Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton.

    Science.gov (United States)

    Kao, Pei-Chun; Lewis, Cara L; Ferris, Daniel P

    2010-01-19

    To guide development of robotic lower limb exoskeletons, it is necessary to understand how humans adapt to powered assistance. The purposes of this study were to quantify joint moments while healthy subjects adapted to a robotic ankle exoskeleton and to determine if the period of motor adaptation is dependent on the magnitude of robotic assistance. The pneumatically powered ankle exoskeleton provided plantar flexor torque controlled by the wearer's soleus electromyography (EMG). Eleven naïve individuals completed two 30-min sessions walking on a split-belt instrumented treadmill at 1.25m/s while wearing the ankle exoskeleton. After two sessions of practice, subjects reduced their soleus EMG activation by approximately 36% and walked with total ankle moment patterns similar to their unassisted gait (r(2)=0.98+/-0.02, THSD, p>0.05). They had substantially different ankle kinematic patterns compared to their unassisted gait (r(2)=0.79+/-0.12, THSD, probotic ankle exoskeleton (Gordon and Ferris, 2007). Our results strongly suggest that humans aim for similar joint moment patterns when walking with robotic assistance rather than similar kinematic patterns. In addition, greater robotic assistance provided during initial use results in a longer adaptation process than lesser robotic assistance. Copyright 2009 Elsevier Ltd. All rights reserved.

  12. Indications for intra-articular steroid in osteoarthritis of the ankle and ...

    African Journals Online (AJOL)

    The results of treatment with intra-articular steroid in an unselected group of patients with osteo-arthritis of the ankle and metatarsophalangeal joint of the big toe are described. From the results of this trial it is possible to lay down indications for the use of intra-articular steroid in these conditions. In the ankle joint it is ...

  13. The Influence of Mulligan Ankle Taping on Dynamic Balance in the Athletes with and without Chronic Ankle Instability

    Directory of Open Access Journals (Sweden)

    Tahereh Pourkhani

    2014-04-01

    Full Text Available Objective: The ankle joint is the most frequently injured anatomical site in athletes. Ankle instability is responsible for 25% of all time lost from sport. Clinical efficacy of the effect of taping in athletes with chronic ankle instability is unknown. So the purpose of this investigation is the study of the influence of Mulligan ankle taping on dynamic balance in the athletes with and without chronic ankle instability. Materials & Methods: 32 athletes participated in this investigation: 16 subjects with chronic ankle instability, 6 women and 10 men (age 23.5±0.3 years, height 175.4±10.3 cm, weight 73.6±14.5 kg, Foot Ankle Disability Index 74.5±8.62% and Foot Ankle Disability Index Sport 63.5±7.86% and 16 healthy subjects, 6 women and 10 men (age 22.81±7.1 years, height 173.6±12.26 cm, weight 66.4±11.4 kg, Foot Ankle Disability Index and Foot Ankle Disability Index Sport 100%. Dynamic balance was assessed with Star Excursion Balance Test in 3 reaching directions (medial, antero-medial and postero-medial before and after Mulligan ankle taping. Independent and paired t-test were used for statistical analysis. Results: Dynamic balance in healthy group significantly was better than injured group (P&le0.05. Application of taping caused significantly improvement in dynamic balance in both groups (reaching in media, antero-medial and postero-medial directions (P&le0.05 (except reaching in antero-medial direction in healthy group (P>0.05. Conclusion: So it seems that Mulligan ankle taping can improve dynamic balance in the athletes with and without chronic ankle instability.

  14. Recalcitrant Lateral Premalleolar Bursitis of the Ankle Associated with Lateral Ankle Instability

    Directory of Open Access Journals (Sweden)

    Masashi Naito

    2017-01-01

    Full Text Available Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between the bursa and articular cavity of the ankle joint via the sheath of the extensor digitorum longus tendon, which was considered to act as a check valve leading to a large and recalcitrant bursitis. This report provides a novel concept about the etiology of recalcitrant lateral premalleolar bursitis of the ankle.

  15. Evaluation of Water Content in Lumbar Intervertebral Discs and Facet Joints Before and After Physiological Loading Using T2 Mapping MRI.

    Science.gov (United States)

    Yamabe, Daisuke; Murakami, Hideki; Chokan, Kou; Endo, Hirooki; Oikawa, Ryosuke; Sawamura, Shoitsu; Doita, Minoru

    2017-12-15

    T2 mapping was used to quantify the water content of lumbar spine intervertebral discs (IVDs) and facet joints before and after physiological loading. The aim of this study was to clarify the interaction between lumbar spine IVD and facet joints as load-bearing structures by measuring the water content of their matrix after physiological loading using T2 mapping magnetic resonance imaging (MRI). To date, few reports have functionally evaluated lumbar spine IVD and facet joints, and their interaction in vivo. T2 mapping may help detect changes in the water content of IVD and articular cartilage of facet joints before and after physiological loading, thereby enabling the evaluation of changes in interacted water retention between IVD and facet joints. Twenty asymptomatic volunteers (10 female and 10 male volunteers; mean age, 19.3 years; age range, 19-20 years) underwent MRI before and after physiological loading such as lumbar flexion, extension, and rotation. Each IVD from L1/2 to L5/S1 was sliced at center of the disc space, and the T2 value was measured at the nucleus pulposus (NP), anterior annulus fibrosus (AF), posterior AF, and bilateral facet joints. In the NP, T2 values significantly decreased after exercise at every lumbar spinal level. In the anterior AF, there were no significant differences in T2 values at any level. In the posterior AF, T2 values significantly increased only at L4/5. In the bilateral facet joints, T2 values significantly decreased after exercise at every level. There was a significant decrease in the water content of facet joints and the NP at every lumbar spinal level after dynamic loading by physical lumbar exercise. These changes appear to play an important and interactional role in the maintenance of the interstitial matrix in the IVD NP and cartilage in the facet joint. 3.

  16. Female Adults with Patellofemoral Pain Are Characterized by Widespread Hyperalgesia, Which Is Not Affected Immediately by Patellofemoral Joint Loading.

    Science.gov (United States)

    Pazzinatto, Marcella Ferraz; de Oliveira Silva, Danilo; Barton, Christian; Rathleff, Michael Skovdal; Briani, Ronaldo Valdir; de Azevedo, Fábio Mícolis

    2016-10-01

    Compare pressure pain thresholds (PPTs) at the knee and a site remote to the knee in female adults with patellofemoral pain (PFP) to pain-free controls before and after a patellofemoral joint (PFJ) loading protocol designed to aggravate symptoms. Cross-sectional study SETTING: Participants were recruited via advertisements in fitness centers, public places for physical activity and universities. Thirty-eight females with patellofemoral pain, and 33 female pain-free controls. All participant performed a novel PFJ loading protocol involving stair negotiation with an extra load equivalent 35% of body mass. PPTs and current knee pain (measured on a visual analogue scale) was assessed before and after the loading protocol. PPTs were measured at four sites around the knee and one remote site on the upper contralateral limb. Females with PFP demonstrated significantly lower PPTs locally and remote to the knee, both before and after the PFJ loading protocol when compared to control group. Following the loading protocol, PPTs at knee were significantly reduced by 0.54 kgf (95%CI = 0.33; 0.74) for quadriceps tendon, 0.38 kgf (95%CI = 0.14; 0.63) for medial patella, and 0.44 kgf (95%CI = 0.18; 0.69) for lateral patella. No significant change in PPT remote to the knee was observed - 0.10 kgf (95%CI = -0.04; 0.24). Female adults with PFP have local and widespread hyperalgesia compared to pain free controls. A novel loading protocol designed to aggravate symptoms, lowers the PPTs locally at the knee but has no effect on PPT on the upper contralateral limb. This suggests widespread hyperalgesia is not affected by acute symptom aggravation. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Changes in patellofemoral pain resulting from repetitive impact landings are associated with the magnitude and rate of patellofemoral joint loading.

    Science.gov (United States)

    Atkins, Lee T; James, C Roger; Yang, Hyung Suk; Sizer, Phillip S; Brismée, Jean-Michel; Sawyer, Steven F; Powers, Christopher M

    2018-03-01

    Although a relationship between elevated patellofemoral forces and pain has been proposed, it is unknown which joint loading variable (magnitude, rate) is best associated with pain changes. The purpose of this study was to examine associations among patellofemoral joint loading variables and changes in patellofemoral pain across repeated single limb landings. Thirty-one females (age: 23.5(2.8) year; height: 166.8(5.8) cm; mass: 59.6(8.1) kg) with PFP performed 5 landing trials from 0.25 m. The dependent variable was rate of change in pain obtained from self-reported pain scores following each trial. Independent variables included 5-trial averages of peak, time-integral, and average and maximum development rates of the patellofemoral joint reaction force obtained using a previously described model. Pearson correlation coefficients were calculated to evaluate individual associations between rate of change in pain and each independent variable (α = 0.05). Stepwise linear multiple regression (α enter  = 0.05; α exit  = 0.10) was used to identify the best predictor of rate of change in pain. Subjects reported an average increase of 0.38 pain points with each landing trial. Although, rate of change in pain was positively correlated with peak force (r = 0.44, p = 0.01), and average (r = 0.41, p = 0.02) and maximum force development rates (r = 0.39, p = 0.03), only the peak force entered the predictive model explaining 19% of variance in rate of change in pain (r 2  = 0.19, p = 0.01). Peak patellofemoral joint reaction force was the best predictor of the rate of change in pain following repetitive singe limb landings. The current study supports the theory that patellofemoral joint loading contributes to changes in patellofemoral pain. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Loading and fracture response of CFRP-to-steel adhesively bonded joints with thick adherents – Part II: Numerical simulation

    DEFF Research Database (Denmark)

    Anyfantis, Konstantinos; Tsouvalis, Nicholas G.

    2013-01-01

    This work is focused on the numerical simulation of experimentally tested single lap joints, based on cohesive zone modeling techniques. Seven cases have been considered for analysis. The models were built in a 3-dimensional finite element space. The adherents were modeled with continuum elements...... the developed peel, in-plane and out-of-plane shear stresses over the adhesive area. Thus, the global measured response of all cases was justified by examining the stress fields and their variation through the loading history. © 2012 Elsevier Ltd. All rights reserved....

  19. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    International Nuclear Information System (INIS)

    Jordan, L.K. III.; Cooperman, A.E.; Helms, C.A.; Speer, K.P.

    2000-01-01

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  20. Relationship between stress ankle radiographs and injured ligaments on MRI

    International Nuclear Information System (INIS)

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok; Kwon, Soon-Sun

    2013-01-01

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  1. Load carrying capacity of keyed joints reinforced with high strength wire rope loops

    DEFF Research Database (Denmark)

    Jørgensen, Henrik B.; Hoang, Linh Cao

    2015-01-01

    friendly shear connection can be obtained by replacing the U-bars with high strength looped wire ropes. The wire ropes have the advantage of being flexible (they have virtually no bending stiffness) which makes installation of wall elements much easier. The looped wire ropes are usually pre-installed in so......-called wire boxes which are embedded in the precast wall elements. Once the joint is grouted with mortar, the boxes will function as shear keys and the overlapping wire loops will function as transverse reinforcement that replaces the U-bars. This paper presents a rigid-plastic upper bound model to determine...... the shear capacity of wire loop connections. Tests have shown that the shear capacity of such joints – due to the relatively high tensile strength of the wire ropes - is more prone to be governed by fracture of the joint mortar in combination with yielding of the locking bar. To model this type of failure...

  2. Simulations Results of an Ankle Rehabilitation Device

    Directory of Open Access Journals (Sweden)

    Ioan Doroftei

    2015-12-01

    Full Text Available The ankle structure is one of the most important structures of the human body. Due to its important role in human’s activities, this joint is the most injured part of the lower limb. For a complete recovery of the range of motion, recovery exercises are mandatory. The introduction of robotic physical recovery systems represents a modern alternative to traditional recovery. In this paper we present the development of a new ankle rehabilitation device, that aims to fully recover the range of motion required for daily activities.

  3. Hypoalgesic effect of a passive accessory mobilisation technique in patients with lateral ankle pain.

    Science.gov (United States)

    Yeo, Hwee Koon; Wright, Anthony

    2011-08-01

    A randomised, double blind, repeated measures study was conducted to investigate the initial effects of an accessory mobilisation technique applied to the ankle joint in 13 patients with a unilateral sub-acute ankle supination injury. Ankle dorsiflexion range of motion, pressure pain threshold, visual analogue scale rating of pain during functional activity and ankle functional scores were assessed before and after application of treatment, manual contact control and no contact control conditions. There were significant improvements in ankle dorsiflexion range of motion (p = 0.000) and pressure pain threshold (p = 0.000) during the treatment condition. However no significant effects were observed for the other measures. These findings demonstrate that mobilisation of the ankle joint can produce an initial hypoalgesic effect and an improvement in ankle dorsiflexion range of motion. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  4. Finite element modelling of the articular disc behaviour of the temporo-mandibular joint under dynamic loads.

    Science.gov (United States)

    Jaisson, Maxime; Lestriez, Philippe; Taiar, Redha; Debray, Karl

    2011-01-01

    The proposed biodynamic model of the articular disc joint has the ability to affect directly the complete chewing mechanism process and its related muscles defining its kinematics. When subjected to stresses from the mastication muscles, the disc absorbs one part and redistributes the other to become completely distorted. To develop a realistic model of this intricate joint a CT scan and MRI images from a patient were obtained to create sections (layers) and MRI images to create an anatomical joint CAD model, and its corresponding mesh element using a finite element method. The boundary conditions are described by the external forces applied to the joint model through a decomposition of the maximum muscular force developed by the same individual. In this study, the maximum force was operating at frequencies close to the actual chewing frequency measured through a cyclic loading condition. The reaction force at the glenoid fossa was found to be around 1035 N and is directly related to the frequency of indentation. It is also shown that over the years the areas of maximum stresses are located at the lateral portion of the disc and on its posterior rim. These forces can reach 13.2 MPa after a period of 32 seconds (s) at a frequency of 0.5 Hz. An important part of this study is to highlight resilience and the areas where stresses are at their maximum. This study provides a novel approach to improve the understanding of this complex joint, as well as to assess the different pathologies associated with the disc disease that would be difficult to study otherwise.