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Sample records for ankle joint position

  1. Semi-rigid brace and taping decrease variability of the ankle joint position sense

    Directory of Open Access Journals (Sweden)

    Márcia Barbanera

    2014-12-01

    Full Text Available The present study investigated the effect of taping and the semi-rigid ankle brace on ankle joint position sense. Sixteen healthy women (20.8 ± 2.3 years old actively placed the ankle in a target position. The experimental conditions were: 1 wearing no orthosis device, 2 using semi-rigid brace, and 3 wearing ankle taping. Absolute error (AE and variable error (VE were calculated to obtain the joint position sense. We found an interaction effect between condition and target angle at 15o of plantar flexion for the variable VE, which showed smaller errors during the use of taping and semi-rigid brace. In conclusion, the use of ankle joint orthoses, whether taping or semi-rigid brace, decrease the variability of the position sense at 15o of plantar flexion, potentially decreasing ankle sprains occurrence.

  2. Improving human ankle joint position sense using an artificial tongue-placed tactile biofeedback

    CERN Document Server

    Vuillerme, N; Demongeot, J; Payan, Y; Vuillerme, Nicolas; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    Proprioception is comprised of sensory input from several sources including muscle spindles, joint capsule, ligaments and skin. The purpose of the present experiment was to investigate whether the central nervous system was able to integrate an artificial biofeedback delivered through electrotactile stimulation of the tongue to improve proprioceptive acuity at the ankle joint. To address this objective, nine young healthy adults were asked to perform an active ankle-matching task with and without biofeedback. The underlying principle of the biofeedback consisted of supplying subjects with supplementary information about the position of their matching ankle position relative to their reference ankle position through a tongue-placed tactile output device (Tongue Display Unit). Measures of the overall accuracy and the variability of the positioning were determined using the absolute error and the variable error, respectively. Results showed more accurate and more consistent matching performances with than withou...

  3. 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.

  4. 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.

    2009-01-01

    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 participat

  5. Tongue-placed tactile biofeedback suppresses the deleterious effects of muscle fatigue on joint position sense at the ankle

    CERN Document Server

    Vuillerme, Nicolas; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan

    2007-01-01

    Whereas the acuity of the position sense at the ankle can be disturbed by muscle fatigue, it recently also has been shown to be improved, under normal ankle neuromuscular state, through the use of an artificial tongue-placed tactile biofeedback. The underlying principle of this biofeedback consisted of supplying individuals with supplementary information about the position of their matching ankle position relative to their reference ankle position through electrotactile stimulation of the tongue. Within this context, the purpose of the present experiment was to investigate whether this biofeedback could mitigate the deleterious effect of muscle fatigue on joint position sense at the ankle. To address this objective, sixteen young healthy university students were asked to perform an active ankle-matching task in two conditions of No-fatigue and Fatigue of the ankle muscles and two conditions of No-biofeedback and Biofeedback. Measures of the overall accuracy and the variability of the positioning were determin...

  6. Optimizing the use of an artificial tongue-placed tactile biofeedback for improving ankle joint position sense in humans.

    Science.gov (United States)

    Vuillerme, N; Chenu, O; Fleury, A; Demongeot, J; Payan, Y

    2006-01-01

    The performance of an artificial tongue-placed tactile biofeedback device for improving ankle joint position sense was assessed in 12 young healthy adults using an active matching task. The underlying principle of this system consisted of supplying individuals with supplementary information about the position of the matching ankle relative to the reference ankle position through a tongue-placed tactile output device generating electrotactile stimulation on a 36- point (6 x 6) matrix held against the surface of the tongue dorsum. Precisely, (1) no electrodes were activated when both ankles were in a similar angular position within predetermined "angular dead zone" (ADZ); (2) 12 electrodes (2 x 6) of the anterior and posterior zones of the matrix were activated (corresponding to the stimulation of the front and rear portion of the tongue) when the matching ankle was in too plantar and dorsiflexed position relative to the reference ankle, respectively. The effects of two ADZ values of 0.5 degrees and 1.5 degrees were evaluated. Results showed (1) more accurate and more consistent matching performances with than without biofeedback and (2) more accurate and more consistent ankle joint matching performances when using the biofeedback device with the smaller ADZ value. These findings suggest that (1) electrotactile stimulation of the tongue can be used to improve ankle joint proprioception and (2) this improvement can be increased through an appropriate specification of the ADZ parameter provided by the biofeedback system. Further investigations are needed to strengthen the potential clinical value of this device.

  7. Optimizing the Use of an Artificial Tongue-Placed Tactile Biofeedback for Improving Ankle Joint Position Sense in Humans

    CERN Document Server

    Vuillerme, N; Fleury, A; Demongeot, J; Payan, Y; Vuillerme, Nicolas; Chenu, Olivier; Fleury, Anthony; Demongeot, Jacques; Payan, Yohan

    2006-01-01

    The performance of an artificial tongue-placed tactile biofeedback device for improving ankle joint position sense was assessed in 12 young healthy adults using an active matching task. The underlying principle of this system consists of supplying individuals with supplementary information about the position of the matching ankle relative to the reference ankle position through a tongue-placed tactile output device generating electrotactile stimulation on a 36-point (6 X 6) matrix held against the surface of the tongue dorsum. Precisely, (1) no electrodes were activated when both ankles were in a similar angular position within a predetermined "angular dead zone" (ADZ); (2) 12 electrodes (2 X 6) of the anterior and posterior zones of the matrix were activated (corresponding to the stimulation of the front and rear portion of the tongue) when the matching ankle was in a too plantarflexed and dorsiflexed position relative to the reference ankle, respectively. Two ADZ values of 0.5° and 1.5° were...

  8. [Biomechanics of the ankle joint].

    Science.gov (United States)

    Zwipp, H

    1989-03-01

    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  9. Stresses in the ankle joint and total ankle replacement design.

    Science.gov (United States)

    Kakkar, Rahul; Siddique, M S

    2011-06-01

    The ankle is a highly congruent joint with a surface area of 11-13 cm(2). Total ankle replacements have been attempted since the early 1970s and design has continually evolved as the early designs were a failure. This was because the stresses involved and the mutiaxial motion of the ankle has not been understood until recently. It has been shown that the talus slides as well as rolls during the ankle arc of motion from plantarflexion to dorsiflexion. Furthermore, the articular surfaces and the calcaneofibular and tibiocalcaneal ligaments have been shown to form a four bar linkage dictating ankle motion. A new design ankle replacement has been suggested recently which allows multiaxial motion at the ankle while maintaining congruency throughout the arc of motion. The early results of this ankle replacement have been encouraging without any reported failures due to mechanical loosening.

  10. 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.

  11. Hydrocolonotherapy ankle joints after injuries

    OpenAIRE

    Volodymyr Muchin; Oleksandr Zviriaka

    2016-01-01

    Muchin V., Zviriaka O. 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...

  12. FATIGUE DEVICE FOR TESTING ANKLE JOINT ENDOPROSTHESES

    Directory of Open Access Journals (Sweden)

    Cristian TOADER-PASTI

    2012-05-01

    Full Text Available The paper proposes a model of a fatigue device for testing dedicated to ankle prostheses. The concept of the testing device relies on two aspects: almost any type of ankle prosthesis can be tested on it and it has to work on INSTRON axial-torsion testing machine. Starting from these requirements, a 3D functional assembly that reproduces the real movement of the ankle joint during gait cycle has been designed. The device is based on a cam-follower mechanism.

  13. Measurement of tibial nerve excursion during ankle joint dorsiflexion in a weight-bearing position with ultrasound imaging

    Directory of Open Access Journals (Sweden)

    Carroll Matthew

    2012-03-01

    Full Text Available Abstract Background The ability of peripheral nerves to stretch and slide is thought to be of paramount importance to maintain ideal neural function. Excursion in peripheral nerves such as the tibial can be measured by analysis of ultrasound images. The aim of this study was to assess the degree of longitudinal tibial nerve excursion as the ankle moved from plantar flexion to dorsiflexion in a standardised weight-bearing position. The reliability of ultrasound imaging to measure tibial nerve excursion was also quantified. Methods The tibial nerve was imaged over two separate sessions in sixteen asymptomatic participants in a weight-bearing position. Longitudinal nerve excursion was calculated from a three-second video loop captured by ultrasound imaging using frame-by-frame cross-correlation analysis. Intraclass correlation coefficients (ICC with 95% confidence intervals (CI were used to assess the intra-rater reliability. Standard error of the measurement (SEM and smallest real difference (SRD were calculated to assess measurement error. Results Mean nerve excursion was 2.99 mm SEM ± 0.22 mm. The SRD was 0.84 mm for session 1 and 0.66 mm for session 2. Intra-rater reliability was excellent with an ICC = 0.93. Conclusions Assessment of real-time ultrasound images of the tibial nerve via frame-by-frame cross-correlation analysis is a reliable non-invasive technique to assess longitudinal nerve excursion. The relationship between foot posture and nerve excursion can be further investigated.

  14. [Ankle joint arthritis--etiology, diagnosis and treatment].

    Science.gov (United States)

    Uri, Ofir; Haim, Amir

    2008-11-01

    Ankle joint arthritis causes functional limitation and affects the quality of life many patients. It follows traumatic injuries, inflammatory joint arthritis, primary osteoarthritis, hemochromatosis and infections. Understanding the unique anatomy and biomechanics of the ankle is important for diagnosis and treatment of ankle joint pathology. The treatment of ankle joint arthritis has advanced considerably in recent years and it is still a surgical challenge. Total ankle replacement seems to be a promising form of treatment, even though current data does not demonstrate advantages over ankle joint arthrodesis.

  15. 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.

  16. 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.

  17. 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.

  18. 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 < 0.05) between ankle stiffness (5.93 ± 0.75 N x m x deg(-1)) and selected performance variables. Relationships between negative power phase ankle stiffness and horizontal (r = -0.79) and vertical (r = 0.74) centre of mass velocities were opposite in direction to the positive power phase ankle stiffness (horizontal: r = 0.85; vertical: r = -0.54). Thus ankle stiffness may affect the goals of the sprint push-off in different ways, depending on the phase of stance considered.

  19. 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.

  20. [Ankle joint prosthesis for bone defects].

    Science.gov (United States)

    Lampert, C

    2011-11-01

    Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus.

  1. Biomechanics of the ankle joint and clinical outcomes of total ankle replacement.

    Science.gov (United States)

    Michael, Junitha M; Golshani, Ashkahn; Gargac, Shawn; Goswami, Tarun

    2008-10-01

    Until the 1970s ankle arthrodesis was considered to be the "gold-standard" to treat arthritis. But the low fusion rate of ankle arthrodeses along with the inability to achieve normal range of motion led to the growing interest in the development of total ankle replacements. Though the short-term outcomes were good, their long-term outcomes were not as promising. To date, most models do not exactly mimic the anatomical functionality of a natural ankle joint. Therefore, research is being conducted worldwide to either enhance the existing models or develop new models while understanding the intricacies of the joint more precisely. This paper reviews the anatomical and biomechanical aspects of the ankle joint. Also, the evolution and comparison of clinical outcomes of various total ankle replacements are presented.

  2. Effects of ankle joint cooling on peroneal short latency response.

    Science.gov (United States)

    Hopkins, J Ty; Hunter, Iain; McLoda, Todd

    2006-01-01

    While cryotherapy has direct physiological effects on contractile tissues, the extent to which joint cooling affects the neuromuscular system is not well understood. The purpose of the study was to detect changes in ankle dynamic restraint (peroneal short latency response and muscle activity amplitude) during inversion perturbation following ankle joint cryotherapy. A 2x3 factorial design was used to compare reaction time and EMG amplitude data of treatment conditions (cryotherapy and control) across time (pre-treatment, post-treatment, and 30 min post-treatment). Thirteen healthy volunteers (age 23 ± 4 yrs, ht 1.76 ± 0.09 m, mass 78.8 ± 16.6 kg), with no history of lower extremity joint injury participated in this study. Surface EMG was collected from the peroneus longus (PL) of the dominant leg during an ankle inversion perturbation triggered while walking. Subjects walked the length of a 6.1 m runway 30 times. A trap door mechanism, inducing inversion perturbation, was released at heel contact during six randomly selected trials for each leg. Following baseline measurements, a 1.5 L bag of crushed ice was applied to the lateral ankle of subjects in the treatment group with an elastic wrap. A bag similar in weight and consistency was applied to the lateral ankle of subjects in the control group. A repeated measures ANOVA was used to compare treatment conditions across time (p 0.05) for PL reaction time. Average RMS EMG, normalized to an isometric reference position, increased in the cryotherapy group at the 30 min post-treatment interval relative to the control group (p movement is unknown.Short latency response should be measured during functional movement instead of during stance to take into consideration alterations in motor drive.Joint cooling has no effect on peroneal short latency response, and joint cooling may result in increased short term peroneal activation.Joint cooling has no effect on the peroneus longus as a dynamic stabilizer during walking.

  3. Effects of wearing ankle weight on knee joint repositioning sense in the elderly.

    Science.gov (United States)

    Kim, Sooyoung; Jung, Daeun; Han, Jintae; Jung, Jaemin

    2016-09-01

    [Purpose] To investigate the effects of different ankle weights on knee joint repositioning sense in elderly individuals. [Subjects and Methods] Twenty-one subjects were divided for assessment as follows: young (20-30 years, n=10) and elderly (60-70 years, n=11). Knee joint repositioning error was measured by asking the subjects to reposition the target angle of their knee joints while wearing different ankle weights (0%, 0.5%, 1%, and 1.5%) in an open kinetic chain. The Hawk Digital System (60 Hz; Motion Analysis, Santa Rosa, CA, USA) was used to measure knee joint repositioning error. Differences in knee joint repositioning error between the young and elderly groups according to ankle weight load were examined by using two-way mixed repeated-measures analysis of variance. [Results] The knee joint repositioning error was lower with than without ankle weights in both groups. The error value was lowest with the 1.0% weight, though not significantly. Knee joint repositioning error was significantly higher in the elderly under all the ankle weight conditions. [Conclusion] Knee joint repositioning sense can be improved in elderly individuals by wearing proper ankle weights. However, weights that are too heavy might disturb knee joint positioning sense.

  4. Effects of hip and head position on ankle range of motion, ankle passive torque, and passive gastrocnemius tension.

    Science.gov (United States)

    Andrade, R J; Lacourpaille, L; Freitas, S R; McNair, P J; Nordez, A

    2016-01-01

    Ankle joint range of motion (ROM) is notably influenced by the position of the hip joint. However, this result remains unexplained. Thus, the aim of this study was to test if the ankle passive torque and gastrocnemius muscle tension are affected by the hip and the head positions. The torque and the muscle shear elastic modulus (measured by elastography to estimate muscle tension) were collected in nine participants during passive ankle dorsiflexions performed in four conditions (by combining hip flexion at 90 or 150°, and head flexed or neutral). Ankle maximum dorsiflexion angle significantly decreased by flexing the hip from 150 to 90° (P  0.05). Maximal passive torque and shear elastic modulus were higher with the hip flexed at 90° (P  0.05) were found for both torque and shear elastic modulus at a given common ankle angle among conditions. Shifts in maximal ankle angle due to hip angle manipulation are not related neither to changes in passive torque nor tension of the gastrocnemius. Further studies should be addressed to better understand the functional role of peripheral nerves and fasciae in the ankle ROM limits.

  5. The Influence of Exercise on College Students' Ankle Joint Position Sense%跳绳运动对大学生踝关节位置觉的影响

    Institute of Scientific and Technical Information of China (English)

    周勇; 于良; 万建强

    2014-01-01

    选取陕西师范大学24名非体育专业本科生为实验对象,设置实验组和对照组,研究跳绳运动对踝关节位置觉的影响,为在各种体育项目中的踝关节训练以及跳绳运动本身的比赛和训练提供理论依据。方法:将24名同学按照性别与组别均等分为实验组(n=12)和对照组(n=12),实验组跟随陕西师范大学跳绳俱乐部进行为期16周的跳绳训练,对照组在试验期间不参加任何体育俱乐部。结果:女生实验前后左踝可变误差存在显著性差异(P<0.05),其它无显著性差异(P>0.05)。但实验后实验组踝关节位置觉优于对照组,说明跳绳运动对踝关节位置觉的锻炼有一定积极意义。%This article selects 24 non-professional sports of Shaanxi normal university undergraduate students as experimental object, set up the experimental group and control group, and study the influence of the rope skipping motion of ankle joint position sense, training for the ankle in a variety of sports and rope skipping exercise itself provides the theoretical basis of competition and training. Methods:24 students according to gender and equal groups were divided into experimental group(n=12) and control group (n=12), the experimental group with Shaanxi normal university, rope skipping rope skipping training club for 16 weeks, the control group don't participate in any sports clubs during the test. Results:the girl left ankle variable before and after the experiment error exists significant difference (P0.05). But after the experiment ankle position is better than that of control group, experimental group showed the rope skipping movement to ankle joint position sense of exercise has certain positive meaning.

  6. Ankle replacement

    Science.gov (United States)

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... You may not be able to have a total ankle replacement if you have had ankle joint infections in ...

  7. 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.

  8. 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 velocitypower (generation of mechanical energy) was found during MTU shortening. This was also found for the general fascicle velocity pattern in SO. In contrast, substantial differences between ankle 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.

  9. [Revision arthroplasty of the ankle joint].

    Science.gov (United States)

    Hintermann, B; Barg, A; Knupp, M

    2011-11-01

    In the last 20 years total ankle replacement has become a viable alternative to arthrodesis for end-stage osteoarthritis of the ankle. Numerous ankle prosthesis designs have appeared on the market in the past and attracted by the encouraging intermediate results reported in the literature, many surgeons have started to perform this procedure. With increased availability on the market the indications for total ankle replacement have also increased in recent years. In particular, total ankle replacement may now be considered even in younger patients. Therefore, despite progress in total ankle arthroplasty the number of failures may increase. Up to now, arthrodesis was considered to be the gold standard for salvage of failed ankle prostheses. Because of extensive bone loss on the talar side, in most instances tibiocalcaneal fusion is the only reliable solution. An alternative to such extended hindfoot fusions would be revision arthroplasty. To date, however, there are no reported results of revision arthroplasty for salvage of a failed ankle replacement.Based on our experience prosthetic components with a flat undersurface are most likely to be able to find solid support on remaining bone stock. The first 83 cases (79 patients, 46 males, 33 females, average age 58.9 years, range 30.6-80.7 years) with a average follow-up of 5.4 years (range 2-11 years) showed excellent to good results in 69 cases (83%), a satisfactory result in 12 cases (15%) and a fair result in 2 cases (2%) and 47 patients (56%) were pain free. Primary loosening was noted in three cases and of these two cases were successfully revised by another total ankle replacement and in one case with arthrodesis. Another case with hematogenous infection was also revised by arthrodesis. At the last follow-up control two components were considered to be loose and the overall loosening rate was thus 6%.This series has proven that revision arthroplasty can be a promising option for patients with failed total

  10. Supramalleolar osteotomies for degenerative joint disease of the ankle joint: indication, technique and results.

    Science.gov (United States)

    Barg, Alexej; Pagenstert, Geert I; Horisberger, Monika; Paul, Jochen; Gloyer, Marcel; Henninger, Heath B; Valderrabano, Victor

    2013-09-01

    Patients with varus or valgus hindfoot deformities usually present with asymmetric ankle osteoarthritis. In-vitro biomechanical studies have shown that varus or valgus hindfoot deformity may lead to altered load distribution in the tibiotalar joint which may result in medial (varus) or lateral (valgus) tibiotalar joint degeneration in the short or medium term. The treatment of asymmetric ankle osteoarthritis remains challenging, because more than half of the tibiotalar joint surface is usually preserved. Therefore, joint-sacrificing procedures like total ankle replacement or ankle arthrodesis may not be the most appropriate treatment options. The shortand midterm results following realignment surgery, are very promising with substantial pain relief and functional improvement observed post-operatively. In this review article we describe the indications, surgical techniques, and results from of realignment surgery of the ankle joint in the current literature.

  11. The Position Sense and Muscle Force Sense of the Ankle Joint with Functional Instability%功能性不稳踝关节位置觉和肌肉力觉特征

    Institute of Scientific and Technical Information of China (English)

    张秋霞; 张林; 王国祥; 王国栋

    2012-01-01

    Objective To examine the difference in proprioception of the ankle joint with functional instability through analyzing the joint position sense and force sense, in order to provide the basis for the prevention from and treatment on the sprained ankle. Methods Fourteen males subjects with unilateral functional ankle instability (FAD were enrolled in the study, and other 14 healthy matched-paired subjects were served as controls. The target angle of the ankle passively reposition was set at 5° plantar flexion for measuring joint position sense and the target force of the muscle at 25% maximal voluntary isometric contraction for measuring muscle force sense. 2×2 mixed model ANOVA was used to compare the difference in proprioception between two the groups with and without FAI. Results The VEJPS (variable error of joint position sense) and AEJPS (absolute error of joint position sense) of FAI group were not significantly different from those of the control group (P>0.05) .However, there was significant difference in the RVEFS (relative variable error of force sense) and RAEFS (relative absolute error of force sense) between the two groups (P 0.05).. Conclusion The difference between FAI group and the control group was found not in the joint position sense, but in themuscle force sense. The ability of neuromuscular control for the FAI group was impaired. There was only one subject whose proprioception appeared to be normal.%目的:探讨功能性不稳踝关节的位置觉和肌肉力觉特征及其发生机制,为踝关节损伤防治和康复训练提供依据.方法:选取14名有单侧踝关节功能性不稳的受试者为实验组(FAI组),匹配14名无踝关节伤病的受试者作为对照组.测试受试者踝关节跖屈5°的被动定位并被动复位能力作为踝关节位置觉,计算位置觉的可变误差(VEJPS)和绝对误差(AEJPS).测试受试者踝关节跖屈肌群对25%最大等长峰值力矩值的复制能力作为肌肉力觉,计

  12. Position versus force control: using the 2-DOF robotic ankle trainer to assess ankle's motor control.

    Science.gov (United States)

    Farjadian, Amir B; Nabian, Mohsen; Hartman, Amber; Corsino, Johnathan; Mavroidis, Constantinos; Holden, Maureen K

    2014-01-01

    An estimated of 2,000,000 acute ankle sprains occur annually in the United States. Furthermore, ankle disabilities are caused by neurological impairments such as traumatic brain injury, cerebral palsy and stroke. The virtually interfaced robotic ankle and balance trainer (vi-RABT) was introduced as a cost-effective platform-based rehabilitation robot to improve overall ankle/balance strength, mobility and control. The system is equipped with 2 degrees of freedom (2-DOF) controlled actuation along with complete means of angle and torque measurement mechanisms. Vi-RABT was used to assess ankle strength, flexibility and motor control in healthy human subjects, while playing interactive virtual reality games on the screen. The results suggest that in the task with 2-DOF, subjects have better control over ankle's position vs. force.

  13. Differences between measured and resultant joint moments during isometric contractions at the ankle joint.

    Science.gov (United States)

    Arampatzis, Adamantios; Morey-Klapsing, Gaspar; Karamanidis, Kiros; DeMonte, Gianpiero; Stafilidis, Savvas; Brüggemann, Gert-Peter

    2005-04-01

    The purpose of this study was to examine two hypotheses: (a) during voluntary and electrically induced isometric contractions the moments measured at the dynamometer are different from the resultant moments in the same plane around the ankle joint and (b) at a given resultant moment during electrically induced isometric contractions the ankle angle while loading is different from the ankle angle while unloading. Twenty-seven long distance runners participated in the study. All subjects performed isometric maximal voluntary contractions (MVC) and contractions induced by electrostimulation at four different ankle-knee angle combinations on a Biodex-dynamometer. The kinematics of the leg were recorded using the vicon 624 system with eight cameras operating at 120 Hz. The main findings were: (a) the resultant moment at the ankle joint and the moment measured by the Biodex-dynamometer during isometric contractions are different, (b) during a plantar flexion effort the ankle angle changes significantly, whereas the knee angle shows only small and in most cases not significant changes, and (c) at identical resultant ankle joint moments the ankle angles are different between the loading and the unloading phases. The observed differences may lead to erroneous conclusions concerning the following: (a) diagnostic of muscle architecture, (b) estimation of the moment-ankle angle relationship and (c) estimation of the strain and hysteresis of tendons and aponeuroses.

  14. Individuals with multiple sclerosis redistribute positive mechanical work from the ankle to the hip during walking.

    Science.gov (United States)

    Davies, Brenda L; Hoffman, Rashelle M; Kurz, Max J

    2016-09-01

    Individuals with multiple sclerosis (MS) typically walk slower, have reduced cadences and shorter step lengths. While these spatiotemporal gait alterations have been thought to be due to decreased power generation at the ankle, the distribution of mechanical work across the ankle, knee and hip joints during walking is not well understood. By quantifying the mechanical work at each joint, the compensatory mechanisms utilized by individuals with MS to maintain gait speed may be better understood. Fifteen subjects with MS (EDSS: 4.4±1.0) and fifteen healthy age-matched control subjects completed a three-dimensional gait analysis. The net mechanical work at the ankle, knee and hip joints was quantified for the stance phase of gait. Our results found that the less impaired leg of the subjects with MS generated a similar amount of mechanical work as the control group; however, the ankle joint produced less positive mechanical work, and the hip joint generated more positive mechanical work. Additionally, the less impaired leg of the subjects with MS and the leg of the control group generated more positive work than the more impaired leg of the subjects with MS. These outcomes suggest that individuals with MS may adopt a hip compensatory strategy with their less impaired leg during gait due to the limited amount of mechanical work generated at the ankle.

  15. Three-dimensional computer graphics-based ankle morphometry with computerized tomography for total ankle replacement design and positioning.

    Science.gov (United States)

    Kuo, Chien-Chung; Lu, Hsuan-Lun; Leardini, Alberto; Lu, Tung-Wu; Kuo, Mei-Ying; Hsu, Horng-Chaung

    2014-05-01

    Morphometry of the bones of the ankle joint is important for the design of joint replacements and their surgical implantations. However, very little three-dimensional (3D) data are available and not a single study has addressed the Chinese population. Fifty-eight fresh frozen Chinese cadaveric ankle specimens, 26 females, and 32 males, were CT-scanned in the neutral position and their 3D computer graphics-based models were reconstructed. The 3D morphology of the distal tibia/fibula segment and the full talus was analyzed by measuring 31 parameters, defining the relevant dimensions, areas, and volumes from the models. The measurements were compared statistically between sexes and with previously reported data from Caucasian subjects. The results showed that, within a general similarity of ankle morphology between the current Chinese and previous Caucasian subjects groups, there were significant differences in 9 out of the 31 parameters analyzed. From a quantitative comparison with available prostheses designed for the Caucasian population, few of these designs have both tibial and talar components suitable in dimension for the Chinese population. The current data will be helpful for the sizing, design, and surgical positioning of ankle replacements and for surgical instruments, especially for the Chinese population.

  16. Time-varying identification of ankle dynamic joint stiffness during movement with constant muscle activation.

    Science.gov (United States)

    Guarin, Diego L; Kearney, Robert E

    2015-01-01

    Dynamic joint stiffness defines the torque generated at the joint in response to position perturbations. Dynamic stiffness is modulated by the angular position and the muscle activation level, making it difficult to estimate during large movements and/or time-varying muscle contractions. This paper presents a new methodology for estimating dynamic joint stiffness during movement and muscle activation. For this, we formulate a novel, nonlinear, dynamic joint stiffness model and present a new algorithm to estimate its parameters. The algorithm assumes that the variability in the model parameters is a function of the mean joint position. Using this methodology we estimated the dynamic joint stiffness at the ankle throughout ramp and hold displacements during a constant muscle contraction. The estimated model accurately predicted the intrinsic and reflex torques produced at the ankle as a response to small position perturbations during large displacement with muscle activation. Preliminary results show that during muscle contraction, ankle intrinsic stiffness estimated during movement is significantly lower than that estimated during quasi-stationary experiments.

  17. Ankle and hip postural strategies defined by joint torques

    Science.gov (United States)

    Runge, C. F.; Shupert, C. L.; Horak, F. B.; Zajac, F. E.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    Previous studies have identified two discrete strategies for the control of posture in the sagittal plane based on EMG activations, body kinematics, and ground reaction forces. The ankle strategy was characterized by body sway resembling a single-segment-inverted pendulum and was elicited on flat support surfaces. In contrast, the hip strategy was characterized by body sway resembling a double-segment inverted pendulum divided at the hip and was elicited on short or compliant support surfaces. However, biomechanical optimization models have suggested that hip strategy should be observed in response to fast translations on a flat surface also, provided the feet are constrained to remain in contact with the floor and the knee is constrained to remain straight. The purpose of this study was to examine the experimental evidence for hip strategy in postural responses to backward translations of a flat support surface and to determine whether analyses of joint torques would provide evidence for two separate postural strategies. Normal subjects standing on a flat support surface were translated backward with a range of velocities from fast (55 cm/s) to slow (5 cm/s). EMG activations and joint kinematics showed pattern changes consistent with previous experimental descriptions of mixed hip and ankle strategy with increasing platform velocity. Joint torque analyses revealed the addition of a hip flexor torque to the ankle plantarflexor torque during fast translations. This finding indicates the addition of hip strategy to ankle strategy to produce a continuum of postural responses. Hip torque without accompanying ankle torque (pure hip strategy) was not observed. Although postural control strategies have previously been defined by how the body moves, we conclude that joint torques, which indicate how body movements are produced, are useful in defining postural control strategies. These results also illustrate how the biomechanics of the body can transform discrete control

  18. Measurement device for ankle joint kinematic and dynamic characterisation.

    Science.gov (United States)

    Giacomozzi, C; Cesinaro, S; Basile, F; De Angelis, G; Giansanti, D; Maccioni, G; Masci, E; Panella, A; Paolizzi, M; Torre, M; Valentini, P; Macellari, V

    2003-07-01

    The paper describes a measurement device for obtaining the kinematic characterisation and isometric loading of ankle joints under different working conditions. Non-invasive, in vivo experiments can be conducted with this experimental apparatus, the potential of which could be usefully exploited in basic biomedical research, prosthesis design, clinical applications, sports medicine and rehabilitation. The device determines the 3D movement of the foot with respect to the shank and evaluates the torques and moments around the three articular axes in relation to any desired angular position of the ankle complex. When integrated with superficial electromyographic techniques and electrical stimulation, it allows the assessment of the functionality of the lower leg in both mechanical and myo-electrical terms. The paper reports the main mechanical and electronic features of the device (high linearity; maximum moment ranges +/- 300 Nm for flexion-extension, +/- 35 Nm for both pronation-supination and internal-external rotation; angular ranges: +/- 100 degrees of dorsi-plantar flexion, +/- 50 degrees of internal-external rotation and prono-supination; linear ranges: +/- 25 mm along each axis). Results from a healthy volunteer, under voluntary or stimulated conditions, helped in testing its operatability, reliability, robustness, repeatability and effectiveness. Preliminary simplified protocols have been also applied to 20 healthy volunteers, and the main results were 80.8 +/- 11.9 degrees of internalexternal rotation, 46.2 +/- 9.1 degrees of prono-supination and 74.6 +/- 13.1 degrees of flexion-extension. Torques and moments were normalised with respect to a body mass index of 30. The maximum plantar flexion moment (57.5 + 21.3 Nm) was measured with the foot at 150 of dorsal flexion; the maximum dorsal flexion moment (50.2 + 20.3 Nm) was measured with the foot at 150 of plantar flexion.

  19. [Arthrodesis versus total joint replacement of the ankle].

    Science.gov (United States)

    Mittlmeier, T

    2013-06-01

    In general, for the treatment of end-stage osteoarthritis of the ankle joint arthrodesis is considered to be the gold standard based on its versatility and eligibility for numerous indications. Nowadays, total ankle arthroplasty represents a viable alternative to ankle arthrodesis taking into account distinct premises as both procedures provide a calculable reduction of the preoperative pain level and a comparable functional gain. Furthermore, current 10-year-survival rates of total ankle replacement are reported to range between 76 % and 89 %. Revision rates of up to 10 % for both techniques have been reported with manifest differences within the respective spectrum of complications. Due to the fact that more than two thirds of patients suffer from post-traumatic osteoarthritis with a relatively low average of age concomitant malalignment, soft tissue damage or instability may frequently occur. A restoration of anatomic axes and an adequate centering of the talus under the tibia appear to be crucial for the outcome as well as an adequate soft tissue balancing, in particular in total ankle replacement. Thus, the selection of the correct indication and the right choice of treatment on the basis of complete preoperative diagnostics considering necessary additive surgical measures are of paramount importance for the final outcome.

  20. Joint stiffness of the ankle and the knee in running.

    Science.gov (United States)

    Günther, Michael; Blickhan, Reinhard

    2002-11-01

    The spring-mass model is a valid fundament to understand global dynamics of fast legged locomotion under gravity. The underlying concept of elasticity, implying leg stiffness as a crucial parameter, is also found on lower motor control levels, i.e. in muscle-reflex and muscle-tendon systems. Therefore, it seems reasonable that global leg stiffness emerges from local elasticity established by appropriate joint torques. A recently published model of an elastically operating, segmented leg predicts that proper adjustment of joint elasticities to the leg geometry and initial conditions of ground contact provides internal leg stability. Another recent study suggests that in turn the leg segmentation and the initial conditions may be a consequence of metabolic and bone stress constraints. In this study, the theoretical predictions were verified experimentally with respect to initial conditions and elastic joint characteristics in human running. Kinematics and kinetics were measured and the joint torques were estimated by inverse dynamics. Stiffnesses and elastic nonlinearities describing the resulting joint characteristics were extracted from parameter fits. Our results clearly support the theoretical predictions: the knee joint is always stiffer and more extended than the ankle joint. Moreover, the knee torque characteristic on the average shows the higher nonlinearity. According to literature, the leg geometry is a consequence of metabolic and material stress limitations. Adapted to this given geometry, the initial joint angle conditions in fast locomotion are a compromise between metabolic and control effort minimisation. Based on this adaptation, an appropriate joint stiffness ratio between ankle and knee passively safeguards the internal leg stability. The identified joint nonlinearities contribute to the linearisation of the leg spring.

  1. Knee and ankle joint torque-angle relationships of multi-joint leg extension.

    Science.gov (United States)

    Hahn, Daniel; Olvermann, Matthias; Richtberg, Jan; Seiberl, Wolfgang; Schwirtz, Ansgar

    2011-07-28

    The force-length-relation (F-l-r) is an important property of skeletal muscle to characterise its function, whereas for in vivo human muscles, torque-angle relationships (T-a-r) represent the maximum muscular capacity as a function of joint angle. However, since in vivo force/torque-length data is only available for rotational single-joint movements the purpose of the present study was to identify torque-angle-relationships for multi-joint leg extension. Therefore, inverse dynamics served for calculation of ankle and knee joint torques of 18 male subjects when performing maximum voluntary isometric contractions in a seated leg press. Measurements in increments of 10° knee angle from 30° to 100° knee flexion resulted in eight discrete angle configurations of hip, knee and ankle joints. For the knee joint we found an ascending-descending T-a-r with a maximum torque of 289.5° ± 43.3 Nm, which closely matches literature data from rotational knee extension. In comparison to literature we observed a shift of optimum knee angle towards knee extension. In contrast, the T-a-r of the ankle joint vastly differed from relationships obtained for isolated plantar flexion. For the ankle T-a-r derived from multi-joint leg extension subjects operated over different sections of the force-length curve, but the ankle T-a-r derived from isolated joint efforts was over the ascending limb for all subjects. Moreover, mean maximum torque of 234.7 ± 56.6 Nm exceeded maximal strength of isolated plantar flexion (185.7 ± 27.8 Nm). From these findings we conclude that muscle function between isolated and more physiological multi-joint tasks differs. This should be considered for ergonomic and sports optimisation as well as for modelling and simulation of human movement.

  2. 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.

  3. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3100 Section 888.3100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/composite semi-constrained cemented prosthesis is a device intended to be implanted to replace...

  4. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3110 Section 888.3110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... 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...

  5. 21 CFR 888.3120 - Ankle joint metal/polymer non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3120 Section 888.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... metal/polymer non-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace an ankle joint. The...

  6. 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.

  7. Finite element stress analysis of some ankle joint prostheses.

    Science.gov (United States)

    Falsig, J; Hvid, I; Jensen, N C

    1986-05-01

    A three-dimensional finite element stress analysis was employed to calculate stresses in a distal tibia modelled with three simple total ankle joint replacement tibial components. The bone was modelled as a composite structure consisting of cortical and trabecular bone in which the trabecular bone was either homogeneous with a constant modulus of elasticity or heterogenous with experimentally determined heterogeneity. The results were sensitive to variations in trabecular bone material property distributions, with lower stresses being calculated in the heterogeneous model. An anterolateral application of load, which proved the least favourable, was used in comparing the prosthetic variants. Normal and shear stresses at the trabecular bone-cement interface and supporting trabecular bone were slightly reduced by addition of metal backing to the polyethylene articular surface, and a further reduction to very low values was obtained by addition of a long intramedullary peg bypassing stresses to the cortical bone.

  8. 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.

  9. 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

  10. The effect of talo-crural joint manipulation on range of motion at the ankle joint in subjects with a history of ankle injury.

    Science.gov (United States)

    Andersen, Skye; Fryer, Gary A; McLaughlin, Patrick

    2003-07-01

    Introduction: There is little research available on the effects of peripheral joint manipulation. Only a few studies have examined the effect of manipulation on ankle range of motion, with conflicting results. This study aimed to determine whether a single high-velocity, low-amplitude (HVLA) thrust manipulation to the talo-crural joint altered ankle range of motion in subjects with a history of lateral ligament sprain.Methods: Male and female volunteers (N=52) with a history of lateral ligament sprain were randomly assigned into either an experimental group (n=26) or a control group (n=26). Those in the experimental group received a single HVLA thrust to the talo-crural joint, whilst those in the control group received no treatment intervention. Pre-test and post-test measurements of passive dorsiflexion range of motion were taken.Results: No significant changes in dorsiflexion range of motion were detected between manipulated ankles and those of control subjects using dependent and independent t-tests. Ankles that cavitated displayed a greater mean DFR and large effect size (d=0.8) compared to those that did not gap and cavitate, but analysis with ANOVA revealed these differences to be not significant.Conclusion: HVLA manipulation of the ankle did not increase dorsiflexion range of motion in subjects with a history of lateral ligament sprain.

  11. Mechanics of the ankle and subtalar joints revealed through a 3D quasi-static stress MRI technique.

    Science.gov (United States)

    Siegler, S; Udupa, J K; Ringleb, S I; Imhauser, C W; Hirsch, B E; Odhner, D; Saha, P K; Okereke, E; Roach, N

    2005-03-01

    A technique to study the three-dimensional (3D) mechanical characteristics of the ankle and of the subtalar joints in vivo and in vitro is described. The technique uses an MR scanner compatible 3D positioning and loading linkage to load the hindfoot with precise loads while the foot is being scanned. 3D image processing algorithms are used to derive from the acquired MR images bone morphology, hindfoot architecture, and joint kinematics. The technique was employed to study these properties both in vitro and in vivo. The ankle and subtler joint motion and the changes in architecture produced in response to an inversion load and an anterior drawer load were evaluated. The technique was shown to provide reliable measures of bone morphology. The left-to-right variations in bone morphology were less than 5%. The left-to-right variations in unloaded hindfoot architecture parameters were less than 10%, and these properties were only slightly affected by inversion and anterior drawer loads. Inversion and anterior drawer loads produced motion both at the ankle and at the subtalar joint. In addition, high degree of coupling, primarily of internal rotation with inversion, was observed both at the ankle and at the subtalar joint. The in vitro motion produced in response to inversion and anterior drawer load was greater than the in vivo motion. Finally, external motion, measured directly across the ankle complex, produced in response to load was much greater than the bone movements measured through the 3D stress MRI technique indicating the significant effect of soft tissue and skin interference.

  12. Design and simulation of a cable-pulley-based transmission for artificial ankle joints

    Science.gov (United States)

    Liu, Huaxin; Ceccarelli, Marco; Huang, Qiang

    2016-06-01

    In this paper, a mechanical transmission based on cable pulley is proposed for human-like actuation in the artificial ankle joints of human-scale. The anatomy articular characteristics of the human ankle is discussed for proper biomimetic inspiration in designing an accurate, efficient, and robust motion control of artificial ankle joint devices. The design procedure is presented through the inclusion of conceptual considerations and design details for an interactive solution of the transmission system. A mechanical design is elaborated for the ankle joint angular with pitch motion. A multi-body dynamic simulation model is elaborated accordingly and evaluated numerically in the ADAMS environment. Results of the numerical simulations are discussed to evaluate the dynamic performance of the proposed design solution and to investigate the feasibility of the proposed design in future applications for humanoid robots.

  13. The effect of strapping on the motor performance of the ankle and wrist joints.

    Science.gov (United States)

    Kauranen, K; Siira, P; Vanharanta, H

    1997-08-01

    The purpose of this study was to examine the effect of strapping on different components of motor performance of wrist and ankle joints. The subjects were 14 healthy volunteers (12 females, two males), aged 21-33 years, with no known previous injuries of the ankle and wrist joints. The measurements were made with the HPM/BEP system and Isokinetic Lido Active Multi-joint system. First, the subjects performed the test without strapping and then, on the following day, with strapped right wrist and ankle joints. The strapping of the wrist increased the simple reaction time by 9%, choice reaction time by 9% and decreased the wrist tapping speed by 21%. Wrist strength decreased in flexion (180 degrees/s) by 14% and ulnar deviation (180 degrees/s) by 8%. The strapping of the ankle increased the simple reaction time by 12%, choice reaction time by 9% and decreased foot tapping speed by 14%. Ankle strength in plantar flexion decreased in 60 degrees/s by 22% and 180 degrees/s by 14% and in inversion in 60 degrees/s by 28% and 180 degrees/s by 15%. These results suggest the strapping of ankle and wrist joints reduces motor performance in the above-mentioned directions as measured by the following parameters: simple reaction time, choice reaction time, tapping speed, and muscle strength.

  14. EFFICACY OF WEIGHT BEARING DISTAL TIBIOFIBULAR JOINT MOBILIZATION WITH MOVEMENT (MWM IN IMPROVING PAIN, DORSIFLEXION RANGE AND FUNCTION IN PATIENTS WITH POSTACUTE LATERAL ANKLE SPRAIN

    Directory of Open Access Journals (Sweden)

    Kumari Nisha

    2014-06-01

    Full Text Available Background: Various treatments in physiotherapy are available for ankle sprain with no consensus like taping, bracing, splinting, cryotherapy, electrotherapy modality like ultrasound, laser therapy, interferential therapy and HVGS, joint mobilization. Mulligan’s mobilizations-with movement (MWM have been proposed as novel manual therapy technique to improve joint ROM by combining physiological and accessory joint movements. He developed a suite of treatment techniques on the basis of his theory of positional faults and altered joint kinematics following injuries affecting spinal and peripheral joints. Objective: To find out the efficacy of distal tibiofibular joint MWM in conjunction with conventional treatment over conventional treatment alone for improving pain , dorsiflexion range and lower extremity function in patients with post acute lateral ankle sprain. Subject and methods: 30 lateral ankle sprain subjects were randomized into 2 groups:- Group 1(n=15 were received distal tibiofibular joint MWM along with conventional treatment and Group 2 (n=15 subjects were received conventional treatment only. Treatment consist of 3 sessions spread over 1 week, each session 48 hours apart and data is recorded at beginning and end of treatment regimen. Results: Independent t-test showed statistical significant improvement in only weight bearing lunge measure for dorsiflexion (p=0.008 in group 1 over group 2 and paired t-test was used for within group analysis which showed significant improvement in both the groups in all the outcome variables (p=0.000 Discussion and conclusion: Both the groups demonstrated significant improvement in pain, range and lower extremity function in lateral ankle sprain and distal tibiofibular joint mobilization with movement in conjunction with conventional treatment will be significantly more effective than conventional treatment alone in improving weight bearing ankle dorsiflexion range (Weight bearing lunge measure in

  15. 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.

  16. Triceps surae muscle-tendon unit length changes as a function of ankle joint angles and contraction levels: the effect of foot arch deformation.

    Science.gov (United States)

    Iwanuma, Soichiro; Akagi, Ryota; Hashizume, Satoru; Kanehisa, Hiroaki; Yanai, Toshimasa; Kawakami, Yasuo

    2011-09-23

    The purpose of this study was to clarify how foot deformation affects the relationship between triceps surae muscle-tendon unit (MTU) length and ankle joint angle. For six women and six men a series of sagittal magnetic resonance (MR) images of the right foot were taken, and changes in MTU length (the displacement of the calcaneal tuberosity), foot arch angle, and ankle joint angle were measured. In the passive session, each subject's ankle joint was secured at 10° dorsiflexed position, neutral position (NP), and 10° and 20° plantar flexed positions while MR images were acquired. In the active session, each subject was requested to perform submaximal isometric plantar flexions (30%, 60%, and 80% of voluntary maximum) at NP. The changes in MTU length in each trial were estimated by two different formulae reported previously. The changes of the measured MTU length as a function of ankle joint angles observed in all trials of the active session were significantly (ptriceps surae MTU length-ankle joint angle relationship during plantar flexion.

  17. Supramalleolar osteotomy for realignment of the ankle joint.

    Science.gov (United States)

    Siddiqui, Noman A; Herzenberg, John E; Lamm, Bradley M

    2012-10-01

    Ankle replacement systems have not been as reliable as hip replacements in providing long-term relief of pain, increased motion, and return to full activity. Supramalleolar Osteotomy is an extraarticular procedure that realigns the mechanical axis, thereby restoring ankle function. The literature discussing knee arthritis has shown that realignment osteotomies of the tibia improve function and prolong total knee replacement surgery. The success of the procedure is predicated on understanding the patient's clinical and radiographic presentation and proper preoperative assessment and planning.

  18. Compensatory strategies during walking in response to excessive muscle co-contraction at the ankle joint.

    Science.gov (United States)

    Wang, Ruoli; Gutierrez-Farewik, Elena M

    2014-03-01

    Excessive co-contraction causes inefficient or abnormal movement in several neuromuscular pathologies. How synergistic muscles spanning the ankle, knee and hip adapt to co-contraction of ankle muscles is not well understood. This study aimed to identify the compensation strategies required to retain normal walking with excessive antagonistic ankle muscle co-contraction. Muscle-actuated simulations of normal walking were performed to quantify compensatory mechanisms of ankle and knee muscles during stance in the presence of normal, medium and high levels of co-contraction of antagonistic pairs gastrocnemius+tibialis anterior and soleus+tibialis anterior. The study showed that if co-contraction increases, the synergistic ankle muscles can compensate; with gastrocmemius+tibialis anterior co-contraction, the soleus will increase its contribution to ankle plantarflexion acceleration. At the knee, however, almost all muscles spanning the knee and hip are involved in compensation. We also found that ankle and knee muscles alone can provide sufficient compensation at the ankle joint, but hip muscles must be involved to generate sufficient knee moment. Our findings imply that subjects with a rather high level of dorsiflexor+plantarflexor co-contraction can still perform normal walking. This also suggests that capacity of other lower limb muscles to compensate is important to retain normal walking in co-contracted persons. The compensatory mechanisms can be useful in clinical interpretation of motion analyses, when secondary muscle co-contraction or other deficits may present simultaneously in subjects with motion disorders.

  19. Ankle Joint Angle and Lower Leg Musculotendinous Unit Responses to Cryotherapy.

    Science.gov (United States)

    Akehi, Kazuma; Long, Blaine C; Warren, Aric J; Goad, Carla L

    2016-09-01

    Akehi, K, Long, BC, Warren, AJ, and Goad, CL. Ankle joint angle and lower leg musculotendinous unit responses to cryotherapy. J Strength Cond Res 30(9): 2482-2492, 2016-The use of cold application has been debated for its influence on joint range of motion (ROM) and stiffness. The purpose of this study was to determine whether a 30-minute ice bag application to the plantarflexor muscles or ankle influences passive ankle dorsiflexion ROM and lower leg musculotendinous stiffness (MTS). Thirty-five recreationally active college-aged individuals with no history of lower leg injury 6 months before data collection volunteered. On each testing day, we measured maximum passive ankle dorsiflexion ROM (°) and plantarflexor torque (N·m) on an isokinetic dynamometer to calculate the passive plantarflexor MTS (N·m per degree) at 4 joint angles before, during, and after a treatment. Surface electromyography amplitudes (μV), and skin surface and ambient air temperature (°C) were also measured. Subjects received an ice bag to the posterior lower leg, ankle joint, or nothing for 30 minutes in different days. Ice bag application to the lower leg and ankle did not influence passive ROM (F(12,396) = 0.67, p = 0.78). Passive torque increased after ice bag application to the lower leg (F(12,396) = 2.21, p = 0.011). Passive MTS at the initial joint angle increased after ice bag application to the lower leg (F(12,396) = 2.14, p = 0.014) but not at the other joint angles (p > 0.05). Surface electromyography amplitudes for gastrocnemius and soleus muscles increased after ice application to the lower leg (F(2,66) = 5.61, p = 0.006; F(12,396) = 3.60, p < 0.001). Ice bag application to the lower leg and ankle joint does not alter passive dorsiflexion ROM but increases passive ankle plantarflexor torque in addition to passive ankle plantarflexor MTS at the initial joint angle.

  20. Reliability of metatarsophalangeal and ankle joint torque measurements by an innovative device.

    Science.gov (United States)

    Man, Hok-Sum; Leung, Aaron Kam-Lun; Cheung, Jason Tak-Man; Sterzing, Thorsten

    2016-07-01

    The toe flexor muscles maintain body balance during standing and provide push-off force during walking, running, and jumping. Additionally, they are important contributing structures to maintain normal foot function. Thus, weakness of these muscles may cause poor balance, inefficient locomotion and foot deformities. The quantification of metatarsophalangeal joint (MPJ) stiffness is valuable as it is considered as a confounding factor in toe flexor muscles function. MPJ and ankle joint stiffness measurement is still largely depended on manual skills as current devices do not have good control on alignment, angular joint speed and displacement during measurement. Therefore, this study introduces an innovative dynamometer and protocol procedures for MPJ and ankle Joint torque measurement with precise and reliable foot alignment, angular joint speed and displacement control. Within-day and between-day test-retest experiments on MPJ and ankle joint torque measurement were conducted on ten and nine healthy male subjects respectively. The mean peak torques of MPJ and ankle joint of between-day and within-day measurement were 1.50±0.38Nm/deg and 1.19±0.34Nm/deg. The corresponding torques of the ankle joint were 8.24±2.20Nm/deg and 7.90±3.18Nm/deg respectively. Intraclass-correlation coefficients (ICC) of averaged peak torque of both joints of between-day and within-day test-retest experiments were ranging from 0.91 to 0.96, indicating the innovative device is systematic and reliable for the measurements and can be used for multiple scientific and clinical purposes.

  1. Mobility of the ankle joint: recording of rotatory movements in the talocrural joint in vitro with and without the lateral collateral ligaments of the ankle.

    Science.gov (United States)

    Rasmussen, O; Tovborg-Jensen, I

    1982-02-01

    A method for graphic recording of rotatory movements in osteoligamentous ankle preparations is described. By this method it is possible to record characteristic mobility patterns in two planes at the same time. The ankle is affected by a known torque, so that the individual mobility patterns are reproducible with unchanged condition of the ligaments. Six amputated legs were investigated in the sagittal and horizontal planes and another six in the sagittal and frontal planes. Mobility patterns were recorded with intact ligaments and after successive cutting of the lateral collateral ligaments of the ankle in the anteroposterior direction. In the sagittal plane increased dorsiflexion was observed after total cutting of the lateral ligaments, while plantar flexion remained unchanged. In the horizontal plane the internal rotation of the talus increased in step with increasing injury to the ligament, particularly when the ankle was plantar flexed. When all collateral ligaments had been cut, an increase in external rotation occurred, especially in dorsiflexion. In the frontal plane the talar tilt increased gradually with increasing injury to the ligaments. Talar tilt was at a maximum in the neutral position of the ankle or in plantar flexion. After total severing of the collateral ligaments, however, talar tilt was most marked in dorsiflexion of the ankle.

  2. Muscle, reflex and central components in the control of the ankle joint in healthy and spastic man.

    Science.gov (United States)

    Sinkjaer, T

    1997-01-01

    In understanding the control of the ankle joint during different motor tasks, we have to investigate at least three components, namely the influence of i) the passive and intrinsic properties of the intact and active muscle system around the joint (termed the non-reflex component), ii) the mechanical importance of the stretch reflex in the stretched and unloaded muscles, and iii) the supraspinal control of the stretch reflex. This thesis is dealing with the importance of the three components in healthy and spastic persons during sitting, standing, and walking. The results are based on stretch reflex and H-reflex measurements from the ankle extensor muscles. During stretch reflex experiments the foot was mounted to a platform (portable during walking) from which the ankle joint torque and the position were measured. To elicit a stretch reflex, the ankle joint was rotated by a strong motor connected to the platform. The mechanical importance of the stretch reflex was investigated by measuring the changes in joint torque. Electrically, the stretch reflex was recorded as the compound muscle action potential through bipolar surface EMG electrodes placed over the soleus muscle. During H-reflex experiments, the tibial nerve was stimulated at the popliteal fossa and the H-reflex recorded over the soleus muscle as during stretch reflex experiments. To investigate how the contractile properties of a muscle in humans depend on the history of activation, we investigated the intrinsic stiffness of the ankle extensors in healthy subjects. At matched background contraction in sitting subjects, a prolonged contraction increased the intrinsic muscle stiffness by 49%. Muscle yielding has been considered especially important for understanding the reflex compensation. We found a general lack of muscle yield and a mechanically important non-reflex stiffness of the ankle extensors showing that non-reflex stiffness is a prominent factor in normal movements of the ankle joint. In both

  3. Proprioceptive impairments associated with knee osteoarthritis are not generalized to the ankle and elbow joints.

    Science.gov (United States)

    Shanahan, Camille J; Wrigley, Tim V; Farrell, Michael J; Bennell, Kim L; Hodges, Paul W

    2015-06-01

    The mechanisms for proprioceptive changes associated with knee osteoarthritis (OA) remain elusive. Observations of proprioceptive changes in both affected knees and other joints imply more generalized mechanisms for proprioceptive impairment. However, evidence for a generalized effect remains controversial. This study examined whether joint repositioning proprioceptive deficits are localized to the diseased joint (knee) or generalized across other joints (elbow and ankle) in people with knee OA. Thirty individuals with right knee OA (17 female, 66±7 [mean±SD] years) of moderate/severe radiographic disease severity and 30 healthy asymptomatic controls of comparable age (17 female, 65±8years) performed active joint repositioning tests of the knee, ankle and elbow in randomised order in supine. Participants with knee OA had a larger relative error for joint repositioning of the knee than the controls (OA: 2.7±2.1°, control: 1.6±1.7°, p=.03). Relative error did not differ between groups for the ankle (OA: 2.2±2.5°, control: 1.9±1.3°, p=.50) or elbow (OA: 2.5±3.3°, control: 2.9±2.8°, p=.58). These results are consistent with a mechanism for proprioceptive change that is localized to the knee joint. This could be mediated by problems with mechanoreceptors, processing/relay of somatosensory input to higher centers, or joint-specific interference with cognitive processes by pain.

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

    Directory of Open Access Journals (Sweden)

    R.I. Kunz

    2014-10-01

    Full Text Available 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.

  5. Bone shape difference between control and osteochondral defect groups of the ankle joint

    NARCIS (Netherlands)

    Tümer, N; Blankevoort, L; van de Giessen, M; Terra, M P; de Jong, P.A.; Weinans, H; Tuijthof, G J M; Zadpoor, A A

    2016-01-01

    OBJECTIVE: The etiology of osteochondral defects (OCDs), for which the ankle (talocrural) joint is one of the common sites, is not yet fully understood. In this study, we hypothesized that bone shape plays a role in development of OCDs. Therefore, we quantitatively compared the morphology of the tal

  6. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  7. 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.

  8. Primary meningococcal septic arthritis of the ankle joint: a case report.

    Science.gov (United States)

    Gee, Christopher; Tandon, Tarang; Avasthi, Adish; Jerwood, Susie; Rao, Biyyam M; Cavanagh, Simon

    2014-01-01

    We present the case of a healthy 18-year-old female who presented with history of an acute onset, painful, swollen right ankle joint. Microbiologic samples from the ankle aspirate grew Neisseria meningitidis. She had had no previous contact with a patient with meningitis nor any existing or preceding clinical symptoms of meningitis. She was treated with surgical drainage with mini-open arthrotomy and a repeat washout at 48 hours. The identification of the organism was expedited using the Analytical Profiling Index (bioMérieux UK, Basingstoke, UK). Our patient was treated with 2 weeks of third-generation cephalosporin antibiotics. At the final follow-up visit, the inflammatory markers had returned to normal, with a normal ankle joint and no evidence of long-term sequelae of septic arthritis. Primary septic arthritis with N. meningitidis is exceptionally rare in the adult population and has been most often reported in the knee. To the best of our knowledge, this is the first reported case of primary septic arthritis of the native adult ankle joint in a healthy individual due to N. meningitides that was diagnosed and treated appropriately with no residual sequelae of the disease.

  9. Factors affecting the range of motion of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis who walk daily.

    Science.gov (United States)

    Matsui, Nobumasa; Shoji, Morio; Kitagawa, Takashi; Terada, Shigeru

    2016-05-01

    [Purpose] Increased plantar pressure during walking is a risk factor for foot ulcers because of reduced range of motion at the ankle and first metatarsophalangeal joints. However, the range of motion in patients undergoing hemodialysis has not yet been determined. A cross-sectional study was performed to investigate the factors affecting the range of motion of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis who walk daily. [Subjects and Methods] Seventy feet of 35 patients receiving hemodialysis therapy were examined. Measurements included the passive range of motion of plantar flexion and dorsiflexion of the ankle joint, and flexion and extension of the first metatarsophalangeal joint. [Results] Hemodialysis duration was not associated with ankle and first metatarsophalangeal joint range of motion in patients undergoing hemodialysis. Diabetes duration was significantly associated with limited ankle joint mobility. Finally, blood hemoglobin levels, body mass index, and age were associated with first metatarsophalangeal joint range of motion. [Conclusion] The present study identified age, diabetes, and decreased physical activity, but not hemodialysis duration, to be risk factors for limited joint mobility of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis.

  10. Foot and ankle joint kinematics in rheumatoid arthritis cannot only be explained by alteration in walking speed

    NARCIS (Netherlands)

    Dubbeldam, R.; Nene, A.V.; Buurke, J.H.; Groothuis-Oudshoorn, C.G.M.; Baan, H.; Drossaers-Bakker, K.W.; Laar, van de M.A.F.J.; Hermens, H.

    2011-01-01

    Rheumatoid arthritis (RA) manifests itself in the foot and ankle of RA patients. The foot and ankle joint kinematics of these patients differ from that of healthy subjects. However, the factors that lead to these differences are not yet fully understood. The aim of this study was to analyse the effe

  11. Combined pre-injection wrist and ankle MRI protocol and steroid joint injections in juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Graham, T.B. [Monroe Carell Jr. Children' s Hospital at Vanderbilt, Department of Pediatric Rheumatology, Nashville, TN (United States)

    2011-10-15

    Precise localization of affected compartments of the wrist and ankle in children with an established diagnosis of juvenile idiopathic arthritis (JIA) is clinically challenging. The purpose of this paper is to describe our experience utilizing a pre-injection MRI protocol of the wrist and ankle for localizing disease activity followed by fluoroscopically guided joint injections in children with JIA. (orig.)

  12. Three-dimensional morphological characteristics measurement of ankle joint based on computed tomography image post-processing

    Institute of Scientific and Technical Information of China (English)

    CHEN Yan-xi; LU Xiao-ling; BI Gang; YU Xiao; HAO Yi-li; ZHANG Kun; ZOU Li-ling; MEI Jiong; YU Guang-rong

    2011-01-01

    Background As precise positioning of ankle radiography is not possible,quantitative measurement of all syndesmotic parameters on repeated ankle X-ray films may be of little value.The purpose of this study was to provide a set of scientific and objective evaluation criteria for assessing the quality of ankle fracture reduction accurately and reliably by an intelligent combining three-dimensional (3-D) computed tomography (CT) measurement model.Methods From June 2008 to March 2011,all the thin-slice CT images of 100 cases (50 males and 50 females) with normal ankle joint scanned by 16-slice spiral CT were collected.Two-dimensional (2-D) and 3-D images of ankle joints were generated by using multiple planar reconstruction (MPR) and surface shaded display (SSD) respectively.The relevant parameters about bone structures and their relationship were measured and analyzed based on 3-D topological narrow division technique and 3-D measurement techniques combining essential elements of point,line and surface.Results In this study,the mean distance from lateral malleolus tip to talocrural articular surface,the tip of medial malleolus anterior colliculus to talocrural articular surface and lateral malleolus tip to the tip of medial malleolus anterior colliculus were (22.83±1.12) mm,(12.84±1.09) mm,and (61.18±9.03) mm respectively in male group,and (20.16±1.00)mm,(10.30±1.05) mm and (53.00±1.40) mm respectively in female group.The above three parameters were correlated with gender,height and weight (P <0.05).However,the mean perpendicular distance from lateral malleolus tip to the plane through the tip of medial malleolus anterior colliculus,the talocrural angle,later clear space,medial clear space,and the superior clear space were (9.93±0.29) mm,(10.01±0.38)°,(1.94±0.16) mm,(2.78±0.19) mm,and (3.14±0.15)mm respectively in 100 cases,were not significance correlated with gender,height and weight (P >0.05).Conclusions This study could provide a certain amount of

  13. 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.

  14. Joint appointments in practice positions.

    Science.gov (United States)

    Hutelmyer, C M; Donnelly, G F

    1996-01-01

    Faculty practice has been a value in both nursing education and nursing service. Recent changes in education provide the opportunity for practice to be rewarded in the university setting. Changes in health care delivery demand expert practitioners and leadership in advanced practice nursing. The history of education-practice integration is reviewed. A new role of the practitioner educator (reverse joint appointee) is presented. Benefits of the position to both education and practice are discussed.

  15. 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...... immobilization. Importantly, Hcond revealed significant facilitation of conditioned reflexes, but only for longer conditioning intervals, suggesting that immobilization increased excitability only of slower, indirect corticospinal pathways. No changes were observed in the control group. Immobilization had...... no significant effects on spinal reflex measures. CONCLUSIONS: 8weeks of ankle joint immobilization was accompanied by pathway-specific modulation of corticospinal transmission. SIGNIFICANCE: It is particularly interesting that fast corticospinal projections were unaffected as these are involved in controlling...

  16. Joint loads in marsupial ankles reflect habitual bipedalism versus quadrupedalism.

    Directory of Open Access Journals (Sweden)

    Kristian J Carlson

    Full Text Available Joint surfaces of limb bones are loaded in compression by reaction forces generated from body weight and musculotendon complexes bridging them. In general, joints of eutherian mammals have regions of high radiodensity subchondral bone that are better at resisting compressive forces than low radiodensity subchondral bone. Identifying similar form-function relationships between subchondral radiodensity distribution and joint load distribution within the marsupial postcranium, in addition to providing a richer understanding of marsupial functional morphology, can serve as a phylogenetic control in evaluating analogous relationships within eutherian mammals. Where commonalities are established across phylogenetic borders, unifying principles in mammalian physiology, morphology, and behavior can be identified. Here, we assess subchondral radiodensity patterns in distal tibiae of several marsupial taxa characterized by different habitual activities (e.g., locomotion. Computed tomography scanning, maximum intensity projection maps, and pixel counting were used to quantify radiodensity in 41 distal tibiae of bipedal (5 species, arboreal quadrupedal (4 species, and terrestrial quadrupedal (5 species marsupials. Bipeds (Macropus and Wallabia exhibit more expansive areas of high radiodensity in the distal tibia than arboreal (Dendrolagus, Phascolarctos, and Trichosurus or terrestrial quadrupeds (Sarcophilus, Thylacinus, Lasiorhinus, and Vombatus, which may reflect the former carrying body weight only through the hind limbs. Arboreal quadrupeds exhibit smallest areas of high radiodensity, though they differ non-significantly from terrestrial quadrupeds. This could indicate slightly more compliant gaits by arboreal quadrupeds compared to terrestrial quadrupeds. The observed radiodensity patterns in marsupial tibiae, though their statistical differences disappear when controlling for phylogeny, corroborate previously documented patterns in primates and

  17. ACUTE EFFECTS OF TWO MASSAGE TECHNIQUES ON ANKLE JOINT FLEXIBILITY AND POWER OF THE PLANTAR FLEXORS

    Directory of Open Access Journals (Sweden)

    Grant J.B. McKechnie

    2007-12-01

    Full Text Available The purpose of this study was to determine if three minutes of petrissage and tapotement forms of massage would influence plantar flexors' flexibility, and muscle power. Nineteen participants were randomly subjected to three conditions (control and two massages before performing two power tests. Prior to the intervention, subjects completed ankle joint flexibility assessments. The conditions were; (1 control, where subjects lay prone and had a therapist's hands resting, (2 vigorous petrissage, and (3 tapotement applied at a rate of 4Hz; all on the triceps surae. Following completion of the intervention, subjects immediately completed a post- ankle joint flexibility test, followed by a drop-jump and concentric calf raise. The power measures were; concentric peak force, rate of force development, and drop-jump height / contact time. The data showed a significant increase (p < 0.05 in ankle joint angle on the right leg and a corresponding tendency on the left. No significant change was seen with the power measures. Results suggest that massage can increase plantar flexors' flexibility without a change in power and thus may be an alternative to static stretching during an athletic warm-up

  18. Effects of plyometric training on passive stiffness of gastrocnemii and the musculo-articular complex of the ankle joint.

    Science.gov (United States)

    Fouré, A; Nordez, A; Guette, M; Cornu, C

    2009-12-01

    This study aimed to determine simultaneously the effects of plyometric training on the passive stiffness of the ankle joint musculo-articular complex, the gastrocnemii muscle-tendon complex (MTC) and the Achilles tendon in order to assess possible local adaptations of elastic properties. Seventeen subjects were divided into a trained (TG) group and a control (CG) group. They were tested before and after 8 weeks of a plyometric training period. The ankle joint range of motion (RoM), the global musculo-articular passive stiffness of the ankle joint, the maximal passive stiffness of gastrocnemii and the stiffness of the Achilles tendon during isometric plantar flexion were determined. A significant increase in the jump performances of TG relative to CG was found (squat jumps: +17.6%, P=0.008; reactive jumps: +19.8%, P=0.001). No significant effect of plyometric training was observed in the ankle joint RoM, musculo-articular passive stiffness of the ankle joint or Achilles tendon stiffness (P>0.05). In contrast, the maximal passive stiffness of gastrocnemii of TG increased after plyometric training relative to CG (+33.3%, P=0.001). Thus, a specific adaptation of the gastrocnemii MTC occurred after plyometric training, without affecting the global passive musculo-articular stiffness of the ankle joint.

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

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    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.

  20. Ankle pain

    Science.gov (United States)

    ... which cushions joints) Infection in the ankle joint Osteoarthritis , gout , rheumatoid arthritis , Reiter syndrome , and other types ... Ma, MD, assistant professor, chief, sports medicine and shoulder service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  1. Comparative study on isokinetic capacity of knee and ankle joints by functional injury.

    Science.gov (United States)

    Jeon, Kyoungkyu; Seo, Byoung-Do; Lee, Sang-Ho

    2016-01-01

    [Purpose] To collect basic data for exercise programs designed to enhance functional knee and ankle joint stability based on isokinetic measurement and muscle strength evaluations in normal and impaired functional states. [Subjects and Methods] Twenty-four subjects were randomly assigned to the athlete group and the control group (n = 12 each). Data were collected of isokinetic knee extensor and flexor strength at 60°/sec, 180°/sec, and 240°/sec and ankle plantar and dorsiflexor strength at 30°/sec and 120°/sec. [Results] Significant intergroup differences were observed in peak torque of the right extensors at 60°/sec, 180°/sec, and 240°/sec and the right flexors at 240°/sec. Significant differences were observed in peak torque/body weight in the right extensors at 60°/sec, 180°/sec, and 240°/sec and in the right flexors at 180°/sec and 240°/sec. Significant peak torque differences were noted in the left ankle joint dorsiflexor at 30°/sec and 120°/sec, right plantar flexor at 120°/sec, left plantar flexor at 30°/sec, left dorsiflexor at 30°/sec and 120°/sec, and right dorsiflexor at 120°/sec. [Conclusion] Isokinetic evaluation stimulates muscle contraction at motion-dependent speeds and may contribute to the development of intervention programs to improve knee and ankle joint function and correct lower-extremity instability.

  2. Assessment of subtalar joint neutral position:a cadaveric study

    Institute of Scientific and Technical Information of China (English)

    CHEN Yan-xi; YU Guang-rong; MEI Jiong; ZHOU Jia-qian; WANG Wen

    2008-01-01

    Background Subtalar joint(STJ)neutral position is the position typically used by clinicians to obtain a cast representation of a patient's foot before fabrication of biomechanical functional orthosis. But no method for measuring STJ neutral position has been proven accurate and reproducible by different testers. This study was conducted to investigate the STJ neutral position in normal feet in cadavers. Methods Twelve fresh-frozen specimens of amputated lower legs were used. Pressure-sensitive films were inserted into the anterior and posterior articulation of STJ. The contact areas for various foot positions and under axial loads of 600 N were determined based on the gray level of the digitized film. The STJ neutral positions were determined as the ankle-foot position where the maxlmum contact area was achieved, because the neutral position of a joint was defined as the position where the concave and convex surfaces were completely congruous. Results In ankle-foot neutral position, the contact area of STJ was(2.79±0.24)cm2. In the range of motion of adduction-abduction (ADD-ABD), the maximum contact area was(3.00±0.26)cm2 when the foot was positioned 10°of ABD (F=221.361, P<0.05). In the range of motion of dorsiflexion-plantarflexion (DF-PF), the maximum contact area was (3. 61±0. 25)cm2 when the foot was positioned 20°of DF(F=121.067, P<0.05). In the range of motion of inversion-eversion (INV-EV), the maximum contact area was(3. 14+0.26)cm2 when the foot was positioned 10°of EV(F=256. 252, P<0.05). Conclusions Joints, such as STJ, therefore, are not necessarily in neutral position when the ankle. foot is placed in the traditional concept of neutral position. The results demonstrate that the most approximate STJ neutral position was in the foot position of 10°of abduction, 20°of dorsiflexion and 10°of eversion.

  3. Total ankle replacement - surgical treatment and rehabilitation.

    Science.gov (United States)

    Prusinowska, Agnieszka; Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting.

  4. Adaptations to long-term strength training of ankle joint muscles in old age.

    Science.gov (United States)

    Simoneau, Emilie; Martin, Alain; Van Hoecke, Jacques

    2007-07-01

    The aim of this study was to enquire whether older adults, who continue plantar-flexion (PF) strength training for an additional 6-month period, would achieve further improvements in neuromuscular performance, in the ankle PFs, and in the antagonist dorsi-flexors (DFs). Twenty-three healthy older volunteers (mean age 77.4 +/- 3.7 years) took part in this investigation and 12 of them followed a 1-year strength-training program. Both neural and muscular factors were examined during isometric maximal voluntary contraction (MVC) torques in ankle PF and DF pre-training, post 6 and post 12 months. The main finding was that 6 months of additional strength training of the PFs, beyond 6 months, allowed further improvements in neuromuscular performance at the ankle joint in older adults. Indeed, during the first 6 months of progressive resistance training, there was an increase in the PF MVC torque of 11.1 +/- 19.9 N m, and then of 11.1 +/- 17.9 N m in the last 6-month period. However, it was only after 1 year that there was an improvement in the evoked contraction at rest in PF (+ 8%). The strength training of the agonist PF muscles appeared to have an impact on the maximal resultant torque in DF. However, it appeared that this gain was first due to modifications occurring in the trained PFs muscles, then, it seemed that the motor drive of the DFs per se was altered. In conclusion, long-term strength training of the PFs resulted in continued improvements in neuromuscular performance at the ankle joint in older adults, beyond the initial 6 months.

  5. A novel ultrasound technique for detection of osteochondral defects in the ankle joint: a parametric and feasibility study.

    Science.gov (United States)

    Sarkalkan, Nazli; Loeve, Arjo J; van Dongen, Koen W A; Tuijthof, Gabrielle J M; Zadpoor, Amir A

    2015-01-01

    (Osteo)chondral defects (OCDs) in the ankle are currently diagnosed with modalities that are not convenient to use in long-term follow-ups. Ultrasound (US) imaging, which is a cost-effective and non-invasive alternative, has limited ability to discriminate OCDs. We aim to develop a new diagnostic technique based on US wave propagation through the ankle joint. The presence of OCDs is identified when a US signal deviates from a reference signal associated with the healthy joint. The feasibility of the proposed technique is studied using experimentally-validated 2D finite-difference time-domain models of the ankle joint. The normalized maximum cross correlation of experiments and simulation was 0.97. Effects of variables relevant to the ankle joint, US transducers and OCDs were evaluated. Variations in joint space width and transducer orientation made noticeable alterations to the reference signal: normalized root mean square error ranged from 6.29% to 65.25% and from 19.59% to 8064.2%, respectively. The results suggest that the new technique could be used for detection of OCDs, if the effects of other parameters (i.e., parameters related to the ankle joint and US transducers) can be reduced.

  6. MR imaging of inflammatory joint diseases of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Weishaupt, D.; Schweitzer, M.E.; Alam, F.; Karasick, D. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology; Wapner, K. [Dept. of Orthopedic Surgery, Hahneman Medical College, Philadelphia, PA (United States)

    1999-12-01

    Pain affecting the foot and ankle is a common complaint frequently attributable to inflammatory joint diseases. Although conventional radiography is regarded as the initial step in the diagnostic investigation, MR imaging may contribute to further evaluation of these patients due to the direct visualization of the inflammatory soft tissue formed in the disease and its effects on bone, cartilage and para-articular structures. The high spatial resolution of MR imaging combined with tissue characterization often allows initial detection of inflammatory joint abnormalities at a stage that precedes radiographic evaluation. The typical MR appearance of certain inflammatory joint disorders may be helpful in narrowing the wide differential diagnosis. Furthermore, MR imaging can be used for an exact assessment of the extent of the disorder as well as its complications. Accurate diagnostic information can guide the clinician in further diagnostic tests and implementation of proper therapeutic treatment. (orig.)

  7. MR arthrography of the ankle joint; MR-Arthrographie des Sprunggelenkes

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S.; Rand, T.; Breitenseher, M.; Ba-Ssalamah, A.; Schick, S.; Imhof, H. [Universitaetsklinik fuer Radiodiagnostik, AKH-Wien (Austria)

    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.) [Deutsch] Aufgrund des ausgezeichneten Weichteilkontrastes ist die konventionelle MRT die bildgebende Methode der Wahl in der Beurteilung von Sprunggelenkserkrankungen. Die konventionelle MRT kann zuverlaessig normale und akut verletzte Ligamente darstellen. Im subakuten und chronischen Stadium der Verletzung fehlt jedoch oft die Gelenksfluessigkeit die fuer eine exakte Abgrenzung der verletzten Ligamente notwendig ist. Die MR-Arthrographie sollte in diesen Faellen durchgefuehrt werden, da die intraartikulaere KM-Applikation den Gelenksraum distendiert mit verbesserter Unterscheidbarkeit intraartikulaerer Strukturen. Diese Gelenksdistension mit der MR-Arthrographie ist auch in der Stadiumbeurteilung der Osteochondritis dissecans hilfreich, da in Faellen von instabilen Laesionen eine KM-Umspuelung des Dissekats leichter dargestellt werden kann. Schliesslich verbessert die MR-Arthrographie aufgrund des hohen Kontrastes und der Gelenksdistension auch den Nachweis von

  8. Methodical features of physical rehabilitation of sportsmen with intra articulate injuries of ankle joint at the out-patient stage

    Directory of Open Access Journals (Sweden)

    Youssef Charbel

    2016-12-01

    Full Text Available Purpose: the analysis of modern approaches to application of means and forms of physical rehabilitation of sportsmen with intra articulate injuries of ankle joint at the out-patient stage. Material & Methods: the analysis of urgent special references on the problem of treatment and rehabilitation at intra articulate injuries of ankle joint. Results: it is defined that together with the broad application of traditional complex techniques of medical physical culture, classical massage and physical therapy, the percent of use of nonconventional methods of non-drug therapy grows objectively and significantly in the last decade in physical rehabilitation. Conclusions: the connected application of east bath and special techniques of east massage for rehabilitation of sportsmen with intra articulate injuries of ankle joint at the out-patient stage in special literature is described not enough that in turn demands the additional practical researches among methods of non-drug therapy.

  9. Classification of fractures in the area of the ankle joint for practical surgical concerns

    Energy Technology Data Exchange (ETDEWEB)

    Gay, B.

    1983-09-01

    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.

  10. Influence of the helical and six available Cardan sequences on 3D ankle joint kinematic parameters.

    Science.gov (United States)

    Sinclair, J; Taylor, P J; Edmundson, C J; Brooks, D; Hobbs, S J

    2012-09-01

    Cardan/Euler and helical angles are the popular methods of quantifying angular kinematics. Cardan angles are sequence dependent and crosstalk can influence the kinematic calculations. The International Society of Biomechanics (ISB) recommends a sagittal, coronal, and then transverse (XYZ) sequence of rotations, although it has been proposed that when calculating rotations outside of the sagittal plane, this may not be the most appropriate method. This study investigated the influence of the helical and six available Cardan sequences on three-dimensional (3D) ankle joint kinematics. Kinematic data were obtained using an eight-camera motion analysis system as participants ran at 4.0 m/s +/- 5%. Repeated measures ANOVAs were used to compare kinematic parameters, and intraclass correlations were employed to identify evidence of crosstalk across planes. The results indicate that in the transverse and coronal planes, peak angle and range of motion values using the YXZ and ZXY sequences were significantly greater than the other sequences. Furthermore, utilization of YXZ and ZXY sequences was associated with the strongest correlations from the sagittal plane, and the XYZ sequence was found to be associated with the lowest correlations. It appears that for the representation of 3D ankle joint kinematics, the XYZ sequence is associated with minimal planar crosstalk and as such its use is encouraged.

  11. Ultrasound and magnetic resonance imaging of healthy paediatric ankles and knees: a baseline for comparison with haemophilic joints.

    Science.gov (United States)

    Keshava, S N; Gibikote, S V; Mohanta, A; Poonnoose, P; Rayner, T; Hilliard, P; Lakshmi, K M; Moineddin, R; Ignas, D; Srivastava, A; Blanchette, V; Doria, A S

    2015-05-01

    The study was undertaken to document cartilage and soft tissue changes/findings in ankles and knees of normal children of different age groups to be used for comparison in the assessment of children with haemophilia. Cartilage thickness and soft tissue changes were recorded at predetermined sites of ankles/knees on both US and MRI in healthy boys in three age groups: 7-9; 10-14; and 15-18 years. To assess the validity of the ultrasound and MRI measurements, an ex vivo study was done using agar phantoms with techniques and scanners similar to those applied in vivo. Twenty (48%) knees and 22 (52%) ankles of 42 boys, were evaluated. There was a reduction in the thickness of joint cartilage with age. A difference in cartilage measurements was noted in most sites between the age groups on both US and MRI (P ankles or knees (P = 0.20, P = 0.68 or P = 0.75, P = 0.63 for US, MRI, respectively). Although cartilage measurements were smaller on US than on MRI for both ankles and knees (P US measurements were smaller than corresponding phantom's measurements, P = 0.02. Age-related measurements were noted for cartilage thickness on US and MRI in ankles and knees. US measurements were smaller than corresponding MRI measurements at most joint sites, which were supported by results on small-diameter phantoms.

  12. Ilizarov External Fixator Versus Retrograde Intramedullary Nailing for Ankle Joint Arthrodesis in Diabetic Charcot Neuroarthropathy.

    Science.gov (United States)

    ElAlfy, Barakat; Ali, Ayman M; Fawzy, Sallam I

    Charcot neuroarthropathy of the ankle joint is a destructive process that leads to instability and significant morbidity that can end with amputation. Surgical arthrodesis in Charcot neuroarthropathy has a high failure rate. The aim of the present prospective study was to compare the outcomes of an Ilizarov external fixator and retrograde intramedullary nailing (IMN) for tibiotalar arthrodesis in Charcot neuroarthropathy. From February 2010 to October 2013, 27 patients (16 males and 11 females) with Charcot neuropathy of the ankle joint were treated in our department. Their ages ranged from 32 to 75 (average 54) years. Of the 27 patients, 14 received an Ilizarov external fixator and 13 underwent IMN. A preoperative clinical and radiologic assessment of all patients was performed. The outcomes were measured for bone union, development of complications, and clinical follow-up. The mean score of modified American Orthopaedic Foot and Ankle Society ankle hindfoot scale was 80 ± 2.7 points in the Ilizarov group and 75 ± 1.9 points in the IMN group. In the Ilizarov group, 12 of 14 patients achieved union, and in the IMN group, 10 of 13 patients achieved union. The complication rate was significantly greater in the external fixator group than in the IMN group. The complications in the Ilizarov group included nonunion in 2 patients (14%), pin tract infection in 8 (57%), pin tract loosening in 3 (21%), surgical wound infection in 3 (21%), and wound breakdown in 1 patient (7%). In the IMN group, nonunion occurred in 3 patients (23.1%), back-out of a distal locking bolt in 2 (15.4 %), and a superficial wound infection that resolved with antibiotics in 1 patient (7.7%). In conclusion, retrograde IMN and the Ilizarov external fixator both yielded better union for tibiotalar arthrodesis in Charcot neuroarthropathy. The Ilizarov external fixator resulted in a greater union rate than IMN but the complications with external fixation were significantly greater than those

  13. Control of torque direction by spinal pathways at the cat ankle joint.

    Science.gov (United States)

    Nichols, T R; Lawrence, J H; Bonasera, S J

    1993-01-01

    To study the biomechanics of the calcaneal tendon's complex insertion onto the calcaneus, we measured torque-time trajectories exerted by the triceps surae and tibialis anterior muscles in eight unanesthetized decerebrate cats using a multi-axis force-moment sensor placed at the ankle joint. The ankle was constrained to an angle of 110 degrees plantarflexion. Muscles were activated using crossed-extension (XER), flexion (FWR), and caudal cutaneous sural nerve (SNR) reflexes. Torque contributions of other muscles activated by these reflexes were eliminated by denervation or tenotomy. In two animals, miniature pressure transducers were implanted among tendon fibers from the lateral gastrocnemius (LG) muscle that insert straight into the calcaneus or among tendon fibers from the medial gastrocnemius (MG) that cross over and insert on the lateral aspect of calcaneus. Reflexively evoked torques had the following directions: FWR, dorsiflexion and adduction; SNR, plantarflexion and abduction; and XER, plantarflexion and modest abduction or adduction. The proportion of abduction torque to plantarflexion torque was always greater for SNR than XER; this difference was about 50% of the magnitude of abduction torque generated by tetanic stimulation of the peronei. During SNR, pressures were higher in regions of the calcaneal tendon originating from MG than regions originating from LG. Similarly, pressures within the MG portion of the calcaneal tendon were higher during SNR than during XER, although these two reflexes produced matched ankle plantarflexion forces. Selective tenotomies and electromyographic recordings further demonstrated that MG generated most of the torque in response to SNR, while soleus, LG, and MG all generated torques in response to XER.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Discussion on clinical efficacy and discussion of prone position after ankle lateral,posterolateral approach combined with medial joint approach for the treatment of trimalleolar fracture%探讨内踝、外踝与后踝俯卧位联合入路治疗三踝骨折的临床研究

    Institute of Scientific and Technical Information of China (English)

    周瑜斌

    2016-01-01

    Objective To investigate the clinical efficacy of prone position after ankle lateral,posterolateral approach combined with medial joint approach for the treatment of trimalleolar fracture.Methods 52 cases of patients who were treated for trimalleolar fracture in hour hospital from June 2013 to June 2014 in our hospital were selected as the research object,.They were randomly divided into observation group and the control group.The observation group was used the prone position after ankle lateral,posterolateral approach combined with medial joint approach for treatment, the control group was used conventional fracture for treatment.The clinical curative effect was observed.Results For the obervation group,the mean operative time was (93.5±4.6) minutes,the average amount of bleeding was (85.5±10.3) ml, the average hospitalization time of postoperative was (11.2±1.1) days,the average healing time was (5.2±0.5) months.As for the control group,the average operation time was (103.5±8.7) minutes,the average amount of bleeding was (105.5 ± 8.6) ml,the averaged postoperative hospitalization time was (13.4 ±1.5) days,the average healing time was (5.9 ±0.8) months.In the observation group,the average operation time,average bleeding volume,postoperative hospitalization time, the average healing time were significantly lower than those in the control group,and there were significant differences (P﹤0.05).There were no fracture displacement,no implant loosening,no wound infection;while the patients of the control group patients were stage Ⅰ healing,2 cases of fracture displacement,2 cases in the locker,3 cases of wound infection and bone.According to Baird Jackson scoring system was used to evaluate the effect,the result showed that, observation group was excellent in 10 cases,good in 10 cases,6 cases,the excellent and good rate was 76.9%;the control group were excellent in 4 cases,good in 5 cases,17 cases,the overall excellent and good rate was 34.6%,the excellent

  15. Kinesio-Taping Application and Corticospinal Excitability at the Ankle Joint

    Science.gov (United States)

    Tremblay, Francois; Karam, Siobhan

    2015-01-01

    Context Physiotherapists and athletic trainers often use Kinesio Taping (KT) to prevent and treat musculoskeletal injuries in athletes, yet evidence about its effects on neuromuscular performance is conflicting. Objective To investigate the influence of a KT application directed at the ankle joint on measures of corticospinal excitability with transcranial magnetic stimulation. Design Controlled laboratory study. Setting Research laboratory. Patients or Other Participants Twelve healthy young women (age = 23.1 ± 1.9 years; range, 19–26 years). Intervention(s) Participants were tested under no-tape and KT conditions according to a random sequence order. The KT was applied to the skin overlying the dorsiflexor and plantar-flexor muscles of the ankle. Main Outcome Measure(s) We assessed changes in the amplitude of motor-evoked potentials elicited at rest and during movement and changes in the silent period and background muscle activity during movement. Results Taping conditions had no effect on motor-evoked potential amplitude at rest or during movement or on the silent-period duration and background muscle activity. Conclusions Our results concur with other recent reports, showing KT applications have little influence at the neuromuscular level. Alterations in sensory feedback ascribed to elastic taping are likely insufficient to modulate corticospinal excitability in a functionally meaningful manner. PMID:26090708

  16. Finite Element Analysis Of Large Deformation Of Articular Cartilage In Upper Ankle Joint Of Occupant In Military Vehicles During Explosion

    Directory of Open Access Journals (Sweden)

    Klekiel T.

    2015-09-01

    Full Text Available The paper presents the analysis of the load of lower limbs of occupants in the armoured military vehicle, which has been destroyed by detonation of the Improvised Explosive Device (IED charge under the vehicle. A simplified model of the human lower limb focused on upper ankle joint was developed in order to determine the reaction forces in joints and load in particular segments during the blast load. The model of upper ankle joint, include a tibia and an ankle bone with corresponding articular cartilage, has been developed. An analysis of the stress distribution under the influence of forces applied at different angles to the biomechanical axis of a limb has been performed. We analyzed the case of the lower limb of a sitting man leaning his feet on the floor. It has been shown that during a foot pronation induced by a knee outward deviation, the axial load on the foot causes significantly greater tension in the tibia. At the same time it has been shown that within the medial malleolus, tensile stresses occur on the surface of the bone which may lead to fracture of the medial malleolus. It is a common case of injuries caused by loads on foot of passengers in armored vehicles during a mine or IED load under the vehicle. It was shown that the outward deviation of the knee increases the risk of the foot injury within the ankle joint.

  17. Long-term follow-up of mobile-bearing total ankle replacement in patients with inflammatory joint disease.

    Science.gov (United States)

    Kraal, T; van der Heide, H J L; van Poppel, B J; Fiocco, M; Nelissen, R G H H; Doets, H C

    2013-12-01

    Little is known about the long-term outcome of mobile-bearing total ankle replacement (TAR) in the treatment of end-stage arthritis of the ankle, and in particular for patients with inflammatory joint disease. The aim of this study was to assess the minimum ten-year outcome of TAR in this group of patients. We prospectively followed 76 patients (93 TARs) who underwent surgery between 1988 and 1999. No patients were lost to follow-up. At latest follow-up at a mean of 14.8 years (10.7 to 22.8), 30 patients (39 TARs) had died and the original TAR remained in situ in 28 patients (31 TARs). The cumulative incidence of failure at 15 years was 20% (95% confidence interval (CI) 11 to 28). The mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of the surviving patients at latest follow-up was 80.4 (95% CI 72 to 88). In total, 21 patients (23 TARs) underwent subsequent surgery: three implant exchanges, three bearing exchanges and 17 arthrodeses. Neither design of TAR described in this study, the LCS and the Buechel-Pappas, remains currently available. However, based both on this study and on other reports, we believe that TAR using current mobile-bearing designs for patients with end-stage arthritis of the ankle due to inflammatory joint disease remains justified.

  18. Contractile and elastic ankle joint muscular properties in young and older adults.

    Directory of Open Access Journals (Sweden)

    Christopher J Hasson

    Full Text Available The purpose of this study was to investigate age-related differences in contractile and elastic properties of both dorsi- (DF and plantarflexor (PF muscles controlling the ankle joint in young and older adults. Experimental data were collected while twelve young and twelve older male and female participants performed maximal effort isometric and isovelocity contractions on a dynamometer. Equations were fit to the data to give torque-angle (Tθ and torque-angular velocity (Tω relations. Muscle series-elasticity was measured during ramped dynamometer contractions using ultrasonography to measure aponeurosis extension as a function of torque; second order polynomials were used to characterize the torque-extension (TΔL relation. The results showed no age differences in DF maximal torque and none for female PF; however, older males had smaller maximal PF torques compared to young males. In both muscle groups and genders, older adults had decreased concentric force capabilities. Both DF and PF TΔL relations were more nonlinear in the older adults. Older PF, but not DF muscles, were stiffer compared to young. A simple antagonism model suggested age-related differences in Tθ and Tω relations would be magnified if antagonistic torque contributions were included. This assessment of static, dynamic, and elastic joint properties affords a comprehensive view of age-related modifications in muscle function. Although many clinical studies use maximal isometric strength as a marker of functional ability, the results demonstrate that there are also significant age-related modifications in ankle muscle dynamic and elastic properties.

  19. The management of Charcot joint disease affecting the ankle and foot by arthrodesis controlled by an Ilizarov frame: early results.

    Science.gov (United States)

    El-Gafary, K A M; Mostafa, K M; Al-Adly, W Y

    2009-10-01

    Charcot osteoarthropathy of the foot is a chronic and progressive disease of bone and joint associated with a risk of amputation. The main problems encountered in this process are osteopenia, fragmentation of the bones of the foot and ankle, joint subluxation or even dislocation, ulceration of the skin and the development of deep sepsis. We report our experience of a series of 20 patients with Charcot osteoarthropathy of the foot and ankle treated with an Ilizarov external fixator. The mean age of the group was 30 years (21 to 50). Diabetes mellitus was the underlying cause in 18 patients. Five had chronic ulcers involving the foot and ankle. Each patient had an open lengthening of the tendo Achillis with excision of all necrotic and loose bone from the ankle, subtalar and midtarsal joints when needed. The resulting defect was packed with corticocancellous bone graft harvested from the iliac crest and an Ilizarov external fixator was applied. Arthrodesis was achieved after a mean of 18 weeks (15 to 20), with healing of the skin ulcers. Pin track infection was not uncommon, but no frame had to be removed before the arthrodesis was sound. Every patient was able to resume wearing regular shoes after a mean of 26.5 weeks (20 to 45).

  20. The effects of ankle joint muscle strengthening and proprioceptive exercise programs accompanied by functional electrical stimulation on stroke patients' balance.

    Science.gov (United States)

    Kim, Kyunghoon; Lee, Sukmin; Kim, Donghoon; Kim, Kyou Sik

    2015-09-01

    [Purpose] The purpose of the present study was to examine the effects of ankle joint muscle strengthening and proprioceptive exercises accompanied by functional electrical stimulation on stroke patients' balance ability. [Methods] For six weeks beginning in April 2015, 22 stroke patients receiving physical therapy at K Hospital located in Gyeonggi-do were divided into a functional electrical stimulation (FES), ankle proprioceptive exercise and ankle joint muscle strengthening exercise group (FPS group) of 11 patients and an FES and stretching exercise group (FS group) of 11 patients. The stimulation and exercises were conducted for 30 min per day, five days per week for six weeks. Balance ability was measured using a BioRescue and the Berg balance scale, functional reach test, and the timed up-and-go test were also used as clinical evaluation indices. Repeated measures ANOVA was conducted to examine differences between before the exercises and at three and six weeks after beginning the exercises within each group, and the amounts of change between the two groups were compared. [Results] In the comparison within each group, both groups showed significant differences between before and after the experiment in all the tests and comparison between the groups showed that greater improvement was seen in all values in the FPS group. [Conclusion] In the present study, implementing FES and stretching exercises plus ankle joint muscle strengthening and proprioceptive exercises was more effective at improving stroke patients balance ability than implementing only FES and stretching exercises.

  1. 非骨水泥型踝关节置换术治疗踝关节骨性关节炎%Non-cement total ankle replacement for osteoarthritis of ankle joint

    Institute of Scientific and Technical Information of China (English)

    李志锐; 董纪元

    2012-01-01

    Objective To study the surgical procedure and therapeutic effect of non-cement total ankle replacement for osteoarthritis of ankle joint. Methods Eighteen patients(19 ankle-joints) with osteoarthritis of ankle joint underwent non-cement total ankle replacement and were followed up for 18.5 months(range 8-45 months). Pain, motion and function of ankle joints were compared before and after operation. The function of ankle-joint was assessed with the Kofoed scoring system. Results The symptoms, signs and function of ankle-joint were improved in all patients after operation, with the extension, flexion and score of ankle-joint increased to 18.6°, 28.3°, and 80.7 after operation from 8.8°, 12.5°, and 42.2 before operation. No looseness and infection were found on X-ray film. Conclusion Non-cement total ankle replacement is an effective procedure for osteoarthritis of ankle joint.%目的 探讨非骨水泥型踝关节置换术治疗踝关节骨性关节炎的手术策略和临床疗效.方法 对18例(19踝)踝关节骨性关节炎患者行非骨水泥型踝关节置换术,平均随访时间为18.5(8-45)个月.对手术前后关节疼痛、活动度、关节功能改善进行对比研究,术后关节功能根据Kofoed评分进行评价.结果 所有患者术后临床症状及踝关节功能都有不同程度的改善.背伸活动度由术前平均8.8°,改善为术后平均18.6°;跖屈活动度由术前平均12.5°,改善为术后平均28.3°; Kofoed评分由术前平均42.2分,改善为术后平均80.7分.X线片分析未见假体松动及感染表现.结论 非骨水泥型踝关节置换术是治疗踝关节骨性关节炎的有效方法.

  2. Total ankle replacement – surgical treatment and rehabilitation

    Science.gov (United States)

    Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting. PMID:27407223

  3. [Arthrodesis and endoprostheses of the ankle joint: indications, techniques and pitfalls].

    Science.gov (United States)

    Wirth, S H; Klammer, G; Espinosa, N

    2013-09-01

    If adequate conservative measures for the treatment of end-stage ankle osteoarthritis have failed, surgery may be taken into consideration. After exorbitant failure rates in the beginning of total ankle replacement, nowadays this kind of treatment has regained lot of interest and has become a viable alternative to ankle fusion. The correct indication and a precise explanation of the surgical procedure, outcomes and potential complications provide a solid base for future success.Currently, there is no doubt that total ankle replacement has become an important player in the treatment of symptomatic and debilitating end-stage ankle arthritis. With increasing number of patients who undergo total ankle replacement the experience with this kind of procedure increases too. As a consequence several surgeons have started to stretch indications favoring total ankle replacement. However, it must be mentioned here, despite progress in terms of improved anatomical and biomechanical understanding of the hindfoot and improved surgical techniques and instruments, total ankle replacement and ankle fusion remain challenging and difficult procedures. We provide a review article including an overview of the relevant techniques. This article should serve as rough guide for surgeons and help in decision-making regarding total ankle replacement and ankle fusion.

  4. Comparison of ankle and subtalar joint complex range of motion during barefoot walking and walking in Masai Barefoot Technology sandals

    Directory of Open Access Journals (Sweden)

    Birch Ivan

    2011-01-01

    Full Text Available Abstract Background Masai Barefoot Technology (MBT, Switzerland produce footwear which they claim simulate walking barefoot on soft undulating ground. This paper reports an investigation into the effect of MBT sandals on the motion of the ankle and subtalar joint complex during walking. Methods Range of motion data was collected in the sagittal, frontal and transverse plane from the ankle and subtalar joint complex from 32 asymptomatic subjects using the CODA MPX30 motion analysis system during both barefoot walking and walking in the MBT sandal. Shod and un-shod data were compared using the Wilcoxon signed ranks test. Results A significantly greater range of motion in the frontal and sagittal planes was recorded when walking in the MBT sandal (p = 0.031, and p = 0.015 respectively. In the transverse plane, no significant difference was found (p = 0.470. Conclusions MBT sandals increase the range of motion of the ankle and subtalar joint complex in the frontal and sagittal planes. MBT footwear could therefore have a role to play in the management of musculoskeletal disorders where an increase in frontal and sagittal plane range of motion is desirable.

  5. Combined Effects of Stretching and Resistance Training on Ankle Joint Flexibility

    Directory of Open Access Journals (Sweden)

    E. Kato

    2013-01-01

    Full Text Available The purpose of the present study was to clarify the combined effects of stretching and resistance training on the active and passive dorsiflexion range of motion of ankle joint. Sixteen young adult men were randomly assigned to a training (n=8 or a control (n=8 group. The training group trained one leg for the combined program of static calf stretching and dorsiflexors resistance training program (STR+TR and the other leg for static stretching program only (STR. The training group executed stretching of both legs every day and resistance training every other day for six weeks. After the training program, in STR+TR side, both active and passive dorsiflexion range of motions significantly (P<0.05 increased and also isometric maximal voluntary dorsiflexion torque increased, while in STR side, only passive dorsiflexion range of motion increased. In passive dorsiflexion range of motion, increased dorsiflexion ROM was accompanied by increased tendon elongation not muscle elongation. In conclusion, the combined program of stretching for calf muscles and resistance training for dorsiflexors increases active as well as passive dorsiflexion range of motion, while static calf stretching program is effective only for the increase in passive dorsiflexion range of motion.

  6. 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.

  7. 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

  8. Total Ankle Replacement Survival Rates Based on Kaplan-Meier Survival Analysis of National Joint Registry Data.

    Science.gov (United States)

    Bartel, Annette F P; Roukis, Thomas S

    2015-10-01

    National joint registry data provides unique information about primary total ankle replacement (TAR) survival. We sought to recreate survival curves among published national joint registry data sets using the Kaplan-Meier estimator. Overall, 5152 primary and 591 TAR revisions were included over a 2- to 13-year period with prosthesis survival for all national joint registries of 0.94 at 2-years, 0.87 at 5-years and 0.81 at 10-years. National joint registry datasets should strive for completion of data presentation including revision definitions, modes and time of failure, and patients lost to follow-up or death for complete accuracy of the Kaplan-Meier estimator.

  9. Effects of ankle joint mobilization with movement and weight-bearing exercise on knee strength, ankle range of motion, and gait velocity in patients with stroke: a pilot study.

    Science.gov (United States)

    An, Chang-Man; Won, Jong-Im

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of ankle joint mobilization with movement on knee strength, ankle range of motion, and gait velocity, compared with weight-bearing exercise in stroke patients. [Subjects and Methods] Thirty subjects with chronic stroke were divided into three groups: MWM (n = 12), WBE (n = 8), and control (n = 10). All groups attended physical therapy sessions 3 times a week for 5 weeks. Subjects in the MWM group performed mobilization with movement exercises, whilst participants in the WBE group performed weight-bearing exercises. Knee peak torque, ankle range of motion, and spatiotemporal gait parameters were evaluated before and after the interventions. [Results] Knee extensor peak torque increased significantly in both MWM and WBE groups. However, only the MWM group showed significant improvement in passive and active ankle range of motion and gait velocity, among the three groups. [Conclusion] Ankle joint mobilization with movement intervention is more effective than simple weight-bearing intervention in improving gait speed in stroke patients with limited ankle motion.

  10. Therapeutic effect of total ankle replacement for osteoarthritis of ankle joint%人工全踝关节置换术治疗踝关节骨关节炎的疗效分析

    Institute of Scientific and Technical Information of China (English)

    李为; 李颖; 周一新; 蒋毅; 及松洁; 李金龙; 邵宏翊

    2011-01-01

    Objective To observe the efficacy of total ankle replacement in treatment of osteoarthritis of ankle joint.Methods Between October 1999 and October 2006,42 patients with ankle osteoarthritis were admitted in Beijing Jishuitan Hospital.All the patients met surgical indications and were performed total ankle replacement with S.T.A.R.system ( Scandinavian Total Ankle Replacement) (Waldemar Link,Hamburg,Germany).The pain in patients,motion and function of joint were evaluated pre- and post-operatively according to Kofoed scoring system,and the efficacy was evaluated with the Mayo'evaluation criteria of total ankle replacement.Results According to Kofoed scoring system,the postoperative situation was obviously superior to the preoperative in pain,motion and function of joint(P < 0.05 ),and the excellent and good rate was 90.32%.While,the excellent and good rate was 87.5%with the Mayo' evaluation criteria of total ankle replacement.Conclusion Total ankle replacement,which can relieve pain,restore ankle function and improve ankle activity,provides another effective method for the patients who need ankle arthrodesis.%目的 观察人工全踝关节置换术治疗踝关节骨关节炎的疗效.方法 对1999年10月- 2006年10月所收治的42例患有严重踝关节骨关节炎并符合手术适应证的患者进行人工全踝关节置换术.并按照Kofoed评分标准,对患者的疼痛程度、踝关节功能、踝关节活动度进行评分;同时根据Mayo踝关节置换的评价标准对患者进行疗效评价.结果 根据Kofoed评分标准,术后患者在疼痛、功能和活动度方面都明显优于术前(P<0.05),优良率为90% (28/31);而根据Mayo踝关节置换的评价标准,优良率为87% (27/31).结论 人工全踝置换术能有效缓解踝关节疼痛,改善踝关节活动度及功能,为需行踝关节融合术患者提供一种有效的方法.

  11. Ankle ligament injuries

    Directory of Open Access Journals (Sweden)

    Per A.F.H. Renström

    1998-06-01

    Full Text Available Acute ankle ligament sprains are common injuries. The majority of these occur during athletic participation in the 15 to 35 year age range. Despite the frequency of the injury, diagnostic and treatment protocols have varied greatly. Lateral ligament complex injuries are by far the most common of the ankle sprains. Lateral ligament injuries typically occur during plantar flexion and inversion, which is the position of maximum stress on the anterotalofibular liagment (ATFL. For this reason, the ATFL is the most commonly torn ligament during an inversion injury. In more severe inversion injuries the calcaneofibular (CFL, posterotalofibular (PTFL and subtalar ligament can also be injured. Most acute lateral ankle ligament injuries recover quickly with nonoperative management. The treatment program, called "functional treatment," includes application of the RICE principle (rest, ice, compression, and elevation immediately after the injury, a short period of immobilization and protection with an elastic or inelastic tape or bandage, and early motion exercises followed by early weight bearing and neuromuscular ankle training. Proprioceptive training with a tilt board is commenced as soon as possible, usually after 3 to 4 weeks. The purpose is to improve the balance and neuromuscular control of the ankle. Sequelae after ankle ligament injuries are very common. As much as 10% to 30% of patients with a lateral ligament injury may have chronic symptoms. Symptoms usually include persistent synovitis or tendinitis, ankle stiffness, swelling, and pain, muscle weakness, and frequent giving-way. A well designed physical therapy program with peroneal strengthening and proprioceptive training, along with bracing and/or taping can alleviate instability problems in most patients. For cases of chronic instability that are refractory to bracing and external support, surgical treatment can be explored. If the chronic instability is associated with subtalar instability

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

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    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.

  13. Ageing effects on knee and ankle joint angles at key events and phases of the gait cycle.

    Science.gov (United States)

    Begg, R K; Sparrow, W A

    2006-01-01

    The objective of this research was to determine whether joint angles at critical gait events and during major energy generation/absorption phases of the gait cycle would reliably discriminate age-related degeneration during unobstructed walking. The gaits of 24 healthy adults (12 young and 12 elderly) were analysed using the PEAK Motus motion analysis system. The elderly participants showed significantly greater single (60.3% versus 62.3%, p phase. The plantarflexing ankle joint motion during the stance to swing phase transition (A2) for the young group (31.3 degrees ) was about twice ( p gait to assist in weight acceptance. Reduced dorsiflexion by the elderly in the swing phase implies greater risk of toe contact with obstacles. Overall, the results suggest that joint angle measures at critical events/phases in the gait cycle provide a useful indication of age-related degeneration in the control of lower limb trajectories during unobstructed walking.

  14. Combined total ankle replacement and modified bridle tendon transfer for end-stage ankle joint arthrosis with paralytic dropfoot: report of an unusual case.

    Science.gov (United States)

    Bibbo, Christopher; Baronofsky, Hyim J; Jaffe, Leland

    2011-01-01

    In recent years, total ankle replacement has become a reasonable option for many patients with end-stage ankle arthrosis. In order to be successful, total ankle replacement requires a relatively balanced alignment of the foot in relation to the leg. Such alignment is traditionally achieved surgically by means of stabilization of the hindfoot in conjunction with relocation osteotomy of the calcaneus and/or tibia. In this report, we describe the unconventional combination of total ankle replacement in an adult patient with concomitant paralysis that was addressed by means of tendon transfer.

  15. 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.

  16. Analysis of Ankle Joint by Three-Dimensional Finite Element——Biomechanical Character of the Soccer Ankle%距踝关节的三维有限元分析——足球踝发生的生物力学特点

    Institute of Scientific and Technical Information of China (English)

    刘露梅; 廖铦; 陈建明; 张建新; 周毅强

    2013-01-01

    目的:应用三维有限元的计算分析方法,研究踝关节在不同体位、不同载荷的条件下,距踝关节软骨表面的应力变量,揭示足球踝发生的生物力学规律.方法:将正常男性足踝部的CT扫描数据,导入三维建模软件建立几何模型后,进行有限元网格划分.分析踝关节在跖屈45°、35°体位下,远距离和近距离踢球时,距骨表面的应力分布数据.结果:①成功创立踝关节跖屈45°、35°两组三维有限元模型.前者:220876个节点,1280039个单元,后者:178163个节点,1036740个单元.②经计算得到踝关节4种工况的yon-mises应力云图.结论:①胫距和距腓关节面,是足球踝软骨损伤与炎症的好发部位.②如运动员以踝关节跖屈45°位姿势踢球,可减少足球踝的发生率.%Objective:To study the variables of stress on cartilage surface of ankle joint under different posture and load conditions, and to analyze the biomechanical characteristics of the soccer ankle by three-dimensional finite element model (3-D FEM) method. Methods: A 3-D FEM of normal adult ankle was established through spiral CT images and meshed. The stress distribution on the surface of talus when kicked football from close and distant site under position of ankle joint in plantar flexion 45°and 35° were analyzed. Results: ①We established two groups of 3-D FEM with plantar flexion 45°and 35°, the former: 220876 nodal points, 1280039 elements, the other: 178163 nodal points, 1036740 elements. ②We got the von-mises stress of ankle joint under 4 different conditions via calculating the data. Conclusion: ①The tibiotalar and talofib-ular articular surface are predilection sites of cartilage damage and inflammation of football ankle. ②Playing football at 45° plantar flexion can protect football players from soccer ankle.

  17. Do we need hip-ankle radiographs to assess the coronal alignment and implant position after total knee replacement?

    Science.gov (United States)

    Dargel, Jens; Oppermann, Johannes; Eysel, Peer; Penning, Lenhard

    2016-01-01

    Aims and Objectives: Restoration of the coronal alignment of the knee is known to be one of the major criteria of a successful total knee arthroplasty (TKA). It therefore appears to be mandatory to routinely assess the postoperative limb alignment using hip-ankle radiographs and to identify implants that may be at risk of premature failure. However, there is no clear consensus whether weight-bearing hip-ankle radiographs or rather standardized a-p knee-radiographs should be used to assess implant position and coronal alignment after TKA. It is the aim of the present study to investigate if implant position and the mechanical alignment after TKA can reproducibly be assessed using standardized a-p knee-radiographs or rather if weight-bearing hip-ankle radiographs are needed. Materials and Methods: This study was performed on 100 postoperative weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position (MPTA, LDFA) was assessed using the MediCAD software, which served as a control. The hip-ankle radiographs were then digitally cropped to 80%, 60% and 40% of the leg-length. In each cropped radiograph, tibial coronal implant position was assessed by referencing against the visible mid-shaft, whereas femoral implant position was referenced against the visible mid-shaft (anatomical axis) or against a surrogate mechanical axis, which was drawn perpendicular to the distal tangent of the femoral component. Each measurement was performed by three independent observers. The difference between the alignment parameters in the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated for each parameter. Results: The ICC for inter-observer agreement of measurement of the mechanical femorotibial angle was significantly higher in hip-ankle radiographs (.95) when compared with a radiograph cropped

  18. 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)

    2016-01-01

    Introduction 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. Methods 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. Results 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%. Conclusions 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

  19. 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.

  20. 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.

  1. Closed medial total subtalar joint dislocation without ankle fracture: a case report

    Science.gov (United States)

    2014-01-01

    Introduction Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. Case presentation We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Conclusions Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain. PMID:25240955

  2. Method for lower extremity exoskeleton's ankle joint trajectory to track human's in swing phase%在摆动相中用于下肢外骨骼跟踪人体踝关节轨迹的方法

    Institute of Scientific and Technical Information of China (English)

    贾山; 路新亮; 韩亚丽; 王兴松

    2014-01-01

    为实现外骨骼摆动腿踝关节对人体踝关节运动轨迹的跟踪,建立了外骨骼摆动腿逆运动学模型与卡尔曼滤波预测模型,并在外骨骼摆动腿踝关节处设置人机位姿误差传感器,同时进行了人体步态实验。仿真中以实验测取的人体踝关节相对于其髋关节的运动轨迹作为外骨骼踝关节的跟踪对象,并依此计算外骨骼踝关节处人机位姿误差。采用卡尔曼滤波器对外骨骼摆动腿的髋、膝关节位置进行预测,再利用外骨骼逆运动学模型对预测结果进行校正。结果表明:该方法能良好地实现外骨骼摆动腿踝关节对人体踝关节的运动轨迹跟踪,并且卡尔曼滤波预测能明显改善跟踪的滞后性,同时仅需检测外骨骼踝关节处的人机位姿误差也有助于简化人机之间的传感器布置。%To achieve the tracking of the exoskeleton's ankle joint motion trajectory to the human's in the swing phase of a gait,an inverse kinematics model of the exoskeleton's swing leg and a Kal-man filtering prediction model are established.Human-machine posture error sensors are set on the exoskeleton's ankle joints.Meanwhile,human gait experiments are carried out.In the simulation, the trajectory data of the human's ankle joint relative to the hip joint obtained in the experiments are taken as the reference trajectory of the exoskeleton's ankle joint and the calculation basis of the hu-man-machine posture error at the exoskeleton's ankle joint.The Kalman filter is employed to predict the angular positions of the exoskeleton's hip and knee joints.Then,the results of inverse kinematics of the exoskeleton are utilized to correct the prediction.The simulation results indicate that this meth-od can well achieve the tracking of the exoskeleton's ankle joint motion trajectory to the human's in the swing phase of a gait.The Kalman filtering prediction model can significantly decrease the track-ing lag.And the demand

  3. Understanding the effect of touchdown distance and ankle joint kinematics on sprint acceleration performance through computer simulation.

    Science.gov (United States)

    Bezodis, Neil Edward; Trewartha, Grant; Salo, Aki Ilkka Tapio

    2015-06-01

    This study determined the effects of simulated technique manipulations on early acceleration performance. A planar seven-segment angle-driven model was developed and quantitatively evaluated based on the agreement of its output to empirical data from an international-level male sprinter (100 m personal best = 10.28 s). The model was then applied to independently assess the effects of manipulating touchdown distance (horizontal distance between the foot and centre of mass) and range of ankle joint dorsiflexion during early stance on horizontal external power production during stance. The model matched the empirical data with a mean difference of 5.2%. When the foot was placed progressively further forward at touchdown, horizontal power production continually reduced. When the foot was placed further back, power production initially increased (a peak increase of 0.7% occurred at 0.02 m further back) but decreased as the foot continued to touchdown further back. When the range of dorsiflexion during early stance was reduced, exponential increases in performance were observed. Increasing negative touchdown distance directs the ground reaction force more horizontally; however, a limit to the associated performance benefit exists. Reducing dorsiflexion, which required achievable increases in the peak ankle plantar flexor moment, appears potentially beneficial for improving early acceleration performance.

  4. 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…

  5. Movement behavior of high-heeled walking: how does the nervous system control the ankle joint during an unstable walking condition?

    Directory of Open Access Journals (Sweden)

    Tine Alkjær

    Full Text Available The human locomotor system is flexible and enables humans to move without falling even under less than optimal conditions. Walking with high-heeled shoes constitutes an unstable condition and here we ask how the nervous system controls the ankle joint in this situation? We investigated the movement behavior of high-heeled and barefooted walking in eleven female subjects. The movement variability was quantified by calculation of approximate entropy (ApEn in the ankle joint angle and the standard deviation (SD of the stride time intervals. Electromyography (EMG of the soleus (SO and tibialis anterior (TA muscles and the soleus Hoffmann (H- reflex were measured at 4.0 km/h on a motor driven treadmill to reveal the underlying motor strategies in each walking condition. The ApEn of the ankle joint angle was significantly higher (p<0.01 during high-heeled (0.38±0.08 than during barefooted walking (0.28±0.07. During high-heeled walking, coactivation between the SO and TA muscles increased towards heel strike and the H-reflex was significantly increased in terminal swing by 40% (p<0.01. These observations show that high-heeled walking is characterized by a more complex and less predictable pattern than barefooted walking. Increased coactivation about the ankle joint together with increased excitability of the SO H-reflex in terminal swing phase indicates that the motor strategy was changed during high-heeled walking. Although, the participants were young, healthy and accustomed to high-heeled walking the results demonstrate that that walking on high-heels needs to be controlled differently from barefooted walking. We suggest that the higher variability reflects an adjusted neural strategy of the nervous system to control the ankle joint during high-heeled walking.

  6. Treatment of total dislocations of the ankle joint%踝关节完全脱位的治疗

    Institute of Scientific and Technical Information of China (English)

    洪建军; 余可和; 赖红燕; 周一飞; 余洋; 左海强

    2010-01-01

    Objective To explore mechanism and treatment of total dislocations of the ankle joint.Methods Thirty-nine patients with total dislocations of the ankle joint were treated in our department from January 2003 to December 2008. There were 25 males and 14 females. Their ages ranged from 14 to 69 years old, averaging 31.6 years old. There were 10 cases of closed injury and 29 open injury; 23 cases of fracture-dislocation and 16 dislocation. According to the direction of talus dislocation, there were 15 cases of medial dislocation, 10 posterior dislocation, 10 lateral dislocation and 4 upward dislocation. Seven cases received conservative treatment and 32 surgery. Seven cases underwent flap transfer at the second stage and 2 amputation of the total ankle joint. Results Thirty-five patients were followed up for 1 to 4 years (average, 26 months). According to the AOFAS functional evaluation system, their pain score averaged 40,their functional score 50, and their objective sign score 10. The mean postoperative score was 86. 5(ranging from 48 to 96). Conclusions To prevent instability and traumatic arthritis of the ankle joint, it is essential to secure fine reduction and fixation of the fracture-dislocations, as well as repair of the ligaments of the ankle joint at an early stage. As skin necrosis often occurs in open dislocations, it is also important to prevent infection of the ankle joint by early flap transfer.%目的 探讨踝关节完全脱位的损伤机制与疗效.方法 2003年1月至2008年12月共收治39例踝关节完全脱位患者,男25例,女14例;年龄14~69岁,平均31.6岁.闭合性脱位10例,开放性脱位29例;伴踝关节骨折23例.按距骨移位方向分类:内侧脱位15例,外侧脱位10例,踝关节后脱位10例,旋转分离向上脱位4例.保守治疗7例,闭合复位短腿石膏固定6周;手术治疗32例,包括骨折脱位复位内固定22例,其中行外侧副韧带修复6例,三角韧带修复3例;单纯行三角韧带修复2

  7. 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.

  8. Total ankle replacement. Design evolution and results.

    Science.gov (United States)

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  9. Summary of Human Ankle Mechanical Impedance During Walking

    Science.gov (United States)

    Rouse, Elliott J.; Krebs, Hermano Igo

    2016-01-01

    The human ankle joint plays a critical role during walking and understanding the biomechanical factors that govern ankle behavior and provides fundamental insight into normal and pathologically altered gait. Previous researchers have comprehensively studied ankle joint kinetics and kinematics during many biomechanical tasks, including locomotion; however, only recently have researchers been able to quantify how the mechanical impedance of the ankle varies during walking. The mechanical impedance describes the dynamic relationship between the joint position and the joint torque during perturbation, and is often represented in terms of stiffness, damping, and inertia. The purpose of this short communication is to unify the results of the first two studies measuring ankle mechanical impedance in the sagittal plane during walking, where each study investigated differing regions of the gait cycle. Rouse et al. measured ankle impedance from late loading response to terminal stance, where Lee et al. quantified ankle impedance from pre-swing to early loading response. While stiffness component of impedance increases significantly as the stance phase of walking progressed, the change in damping during the gait cycle is much less than the changes observed in stiffness. In addition, both stiffness and damping remained low during the swing phase of walking. Future work will focus on quantifying impedance during the “push off” region of stance phase, as well as measurement of these properties in the coronal plane. PMID:27766187

  10. Joint positioning sense, perceived force level and two-point discrimination tests of young and active elderly adults

    Directory of Open Access Journals (Sweden)

    Priscila G. Franco

    2015-08-01

    Full Text Available Background: Changes in the proprioceptive system are associated with aging. Proprioception is important to maintaining and/or recovering balance and to reducing the risk of falls.Objective:To compare the performance of young and active elderly adults in three proprioceptive tests.Method:Twenty-one active elderly participants (66.9±5.5 years and 21 healthy young participants (24.6±3.9 years were evaluated in the following tests: perception of position of the ankle and hip joints, perceived force level of the ankle joint, and two-point discrimination of the sole of the foot.Results:No differences (p>0.05 were found between groups for the joint position and perceived force level. On the other hand, the elderly participants showed lower sensitivity in the two-point discrimination (higher threshold when compared to the young participants (p < 0.01.Conclusion:Except for the cutaneous plantar sensitivity, the active elderly participants had maintained proprioception. Their physical activity status may explain similarities between groups for the joint position sense and perceived force level, however it may not be sufficient to prevent sensory degeneration with aging.

  11. Modified Blair ankle fusion for ankle arthritis

    Institute of Scientific and Technical Information of China (English)

    Wang Shuangli; Huang Zhang; Xiong Gaoxin; Chen Guang; Yin Zhongxiang; Jiang Hua

    2014-01-01

    Objective:To investigate the clinical outcome of modified Blair ankle fusion for ankle arthritis.Methods:Between November 2009 and June 2012,28 patients with ankle arthritis were treated,among whom 11 had obvious foot varus deformity,and 17 were almost normal in appearance.There were 13 males and 15 females with an average age of 49.4 years (range,23-67 years).The main symptoms included swelling,pain,and a limited range of motion of the ankles.The ankle joints functions were assessed by American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scale (VAS) preoperatively and at 1 year follow-up.Results:Twenty-eight patients were followed up for 19.8 months on average (range,1-2 years).Superficial wound infection occurred in 3 cases,and was cured after debridement; the other incisions healed by first intention without complications.All ankles were fused at 1 year follow-up after operation.The symptom was relieved completely in all patients at last follow-up without complication of implant failure,or nonunion.The postoperative AOFAS ankle and hindfoot score was 83.13±3.76,showing significant difference when compared with the preoperative score (45.38±3.21,P<0.01).VAS was significantly decreased from 8.01±0.63 to 2.31±1.05 at 1 year follow-up (P<0.05).Conclusion:Modified Blair ankle fusion has the advantages of high feasiblity,less cost and rigid fixation.It shows high reliability in pain relief and may obtain a good clinical effectiveness.

  12. 矩形弹性髓内钉治疗胫腓骨骨折配合术后康复锻炼对膝踝关节功能恢复的影响%The effect of rectangular elastic intramedullary nail treatment plus postsurgery rehabilitation exercises on the function restoration of knee and ankle joint in fracture of tibia and fibula

    Institute of Scientific and Technical Information of China (English)

    牛子全

    2001-01-01

    @@ Background: The bony union phase is long in the fracture of tibia and fibula. The fixation will have an effect on the function of knee joint and ankle joint inevitably after a long duration. Using rectangular elastic intramedullary nail plus proper rehabilitation exercises after surgery achieved rather satisfying effect on the functional restoration of knee joint and ankle joint.

  13. 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

    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......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...

  14. 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”). D

  15. The effects of balance training and ankle training on the gait of elderly people who have fallen.

    Science.gov (United States)

    Choi, Jung-Hyun; Kim, Nyeon-Jun

    2015-01-01

    [Purpose] The aim of this study was to examine the effects of balance training and muscle training around the ankle joints on the gait of elderly people who have experienced a fall. [Subjects] Twenty-six elderly people with a risk of falling and a Berg Balance Scale score of 37 to 50 points who had experienced a fall in the last year were randomly and equally assigned to either a balance training group or an ankle training group. The balance training group received training on a hard floor, training while maintaining balance on a cushion ball in a standing position, and training while maintaining balance on an unstable platform in a standing position; the ankle training group received training to strengthen the muscles around the ankle joints and conducted stretch exercise for the muscles around the ankle joints. [Results] There were significant changes in gait velocity, step length, and stride length in the balance training group after the intervention; there were significant changes in gait velocity, cadence, step time, cycle time, step length, and stride length in the ankle training group after the intervention. In a between-group comparison, the gait velocity of the balance training group showed a significant improvement compared with the ankle training group. [Conclusion] Both balance training and ankle joint training are effective in enhancing the gait ability of elderly people with a risk of falling; in particular, balance training is effective in improving the gait velocity of elderly people who have experienced a fall compared with ankle joint training.

  16. 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

  17. 智能牵伸及其在踝部痉挛和挛缩中的应用%Intelligent Stretching and Its Application in Spasticity and Contracture of Ankle Joint (review)

    Institute of Scientific and Technical Information of China (English)

    邱纪方; 赵秋华; 钱志勇; 祁欣; 卢金; 宋建飞; 徐聪琴; 邵梦鸣; 王潇珺; 徐蔚; 赖珊珊; 周容之; 周访华; 潘华舫

    2015-01-01

    Contracture and spasticity of ankle joints were major sources of disability in neurological impairment including stroke and cerebral palsy, etc. The manual stretching used in physical therapy might be laborious and time-consuming to the therapists and the outcome was dependent on the experience and the subjective"end feeling"of the therapists. A device was developed that could safely stretch the an-kle joint to its extreme positions with quantitative control of the resistance torque and stretching velocity. Furthermore, it could satisfy a strong need for quantitative and objective measures of the impairment and rehabilitation outcome. This was just the meaning intelligent stretching referred to. This article described the origin of the concept of intelligent stretching and its definition, operational principle, and su-periority and weakness, as well as its application in ankle joint spasticity and contracture in patients with stroke and cerebral palsy.%神经功能受损,如脑卒中、脑瘫等可以引起踝部痉挛/挛缩。治疗师的牵拉费力、费时,且依赖其主观“终末感觉”。智能牵伸可以安全牵伸踝关节至极限位置,并能定量控制阻力矩和拉伸速度。此外,它能够满足定量和客观测量功能损害和康复效果的需要。本文介绍了智能牵伸的由来和定义,原理与优缺点以及它在脑瘫和脑卒中患者踝部痉挛/挛缩中的应用。

  18. Failure to restore sagittal tibiotalar alignment in total ankle arthroplasty: Its relationship to the axis of the tibia and the positioning of the talar component.

    Science.gov (United States)

    Cho, J; Yi, Y; Ahn, T K; Choi, H J; Park, C H; Chun, D I; Lee, J S; Lee, W C

    2015-11-01

    The purpose of this study was to evaluate the change in sagittal tibiotalar alignment after total ankle arthroplasty (TAA) for osteoarthritis and to investigate factors affecting the restoration of alignment. This retrospective study included 119 patients (120 ankles) who underwent three component TAA using the Hintegra prosthesis. A total of 63 ankles had anterior displacement of the talus before surgery (group A), 49 had alignment in the normal range (group B), and eight had posterior displacement of the talus (group C). Ankles in group A were further sub-divided into those in whom normal alignment was restored following TAA (41 ankles) and those with persistent displacement (22 ankles). Radiographic and clinical results were assessed. Pre-operatively, the alignment in group A was significantly more varus than that in group B, and the posterior slope of the tibial plafond was greater (p < 0.01 in both cases). The posterior slope of the tibial component was strongly associated with restoration of alignment: ankles in which the alignment was restored had significantly less posterior slope (p < 0.001). An anteriorly translated talus was restored to a normal position after TAA in most patients. We suggest that surgeons performing TAA using the Hintegra prosthesis should aim to insert the tibial component at close to 90° relative to the axis of the tibia, hence reducing posterior soft-tissue tension and allowing restoration of normal tibiotalar alignment following surgery.

  19. The effect of varying the plantarflexion resistance of an ankle-foot orthosis on knee joint kinematics in patients with stroke.

    Science.gov (United States)

    Kobayashi, Toshiki; Leung, Aaron K L; Akazawa, Yasushi; Hutchins, Stephen W

    2013-03-01

    Ankle-foot orthoses (AFOs) can improve gait in patients with hemiplegia. However, it is anecdotally known that excessive plantarflexion resistance of an AFO could induce undesired knee flexion at early stance. The aim of this study was to systematically investigate the effect of varying the degrees of plantarflexion resistance of an AFO on knee flexion angles at early stance in five subjects with chronic stroke who demonstrated two clear knee flexion peaks at early stance and swing. Each subject wore an experimental AFO constructed with an oil-damper type ankle joint and was instructed to walk at their self-selected walking speed under five plantarflexion resistance conditions. The sagittal plane ankle and knee joint kinematics and gait speed were analyzed using a 3-D Motion Analysis System. A number of significant differences (Pknee flexion angles at early stance amongst different plantarflexion resistance conditions were revealed. The knee flexion angle was 23.80 (3.25) degrees under the free hinge joint condition (condition 1), while that was 26.09 (3.79) degrees under the largest resistance condition (condition 5). It was therefore demonstrated that increasing the plantarflexion resistance of an AFO would induce more knee flexion at early stance phase in patients with stroke.

  20. 论普通高校排球项目踝关节力量训练的重要性%On the Importance of Ankle Joint Strength Training in General Colleges and Universities' Volleyball Courses

    Institute of Scientific and Technical Information of China (English)

    杨枝创

    2012-01-01

    This paper illustrates the importance of strength training in ankle joints by analyzing the technical characteristics of volleyball with the help of analyzing the physiological structure and the motion features of ankle joint, and the reason for ankle jonits athletic injury.%分析了排球运动的技术特征,借助踝关节生理结构、运动特征及踝关节运动损伤的机制及原因分析,论述踝关节力量训练的重要性。

  1. 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

  2. Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill.

    Science.gov (United States)

    Jensen, Bente R; Hovgaard-Hansen, Line; Cappelen, Katrine L

    2016-08-01

    Running on a lower-body positive-pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100%, 80%, 60%, 40%, and 20% body weight (BW). Surface electromyography, ground reaction force, and running characteristics were measured. Relative knee and ankle joint forces were estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and antigravity forces. At 20% BW, knee extensor EMGpeak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100% BW values. Plantar flexors decreased to 52% and 58% at 20% BW, while activity of biceps femoris muscle remained unchanged. Unweighting with LBPP reduced estimated joint force significantly although less than proportional to the degree of weight support (ankle). It was concluded that leg muscle activation adapted to the new biomechanical environment, and the effect of unweighting on estimated knee force was more pronounced than on ankle force.

  3. Joint positioning sense, perceived force level and two-point discrimination tests of young and active elderly adults

    OpenAIRE

    Franco,Priscila G.; Santos, Karini B.; André L. F. Rodacki

    2015-01-01

    Background: Changes in the proprioceptive system are associated with aging. Proprioception is important to maintaining and/or recovering balance and to reducing the risk of falls. Objective: To compare the performance of young and active elderly adults in three proprioceptive tests. Method: Twenty-one active elderly participants (66.9±5.5 years) and 21 healthy young participants (24.6±3.9 years) were evaluated in the following tests: perception of position of the ankle and hip joints, perceiv...

  4. 踝关节骨关节炎治疗方法的临床回顾%Clinical review of treatment of ankle joint osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    王玉光; 陆芸

    2016-01-01

    Ankle osteoarthritis is a common disease of which the incidence was lower than hip or knee osteoarthritis;however , the patients are progressively increasing .Treatments traditionally consist of the measures relieving pain such as analgesia , physiotherapy , and injections .Operative fusion of the ankle is required for the mid and late phases of the ankle osteoarthritis .Rerecently, interest has increased in ankle arthroscopy and new arthroplasty designs .This is a review of the treatment methods and research progress of ankle joint osteoarthritis .%踝关节骨关节炎在临床中是很常见的慢性退行性疾病,其发病率要低于膝关节骨关节炎与髋关节骨关节炎,然而,在临床中发现患者数在逐年增多。许多传统的治疗方法仅仅能够缓解其引起的疼痛等临床症状,例如,热敷理疗、药物关节内注射等等。虽然踝关节融合术是治疗中晚期踝关节骨关节炎的首选手术方式,但近年来,关节镜技术以及踝关节置换术的日渐成熟也给踝关节骨关节炎带来了新的思路。本文对有关踝关节骨关节炎的治疗进展进行综述。

  5. THE EFFECTS OF KINESIO TAPING ON PROPRIOCEPTION AT THE ANKLE

    Directory of Open Access Journals (Sweden)

    Mark DeBeliso

    2004-03-01

    Full Text Available An experiment was designed to determine if KinesioTM taping the anterior and lateral portion of the ankle would enhance ankle proprioception compared to the untaped ankle. 30 subjects, 15 men, 15 women, ages 18-30 participated in this study. Exclusion criteria: Ankle injury < 6 months prior to testing, significant ligament laxity as determined through clinical evaluation by an ATC, or any severe foot abnormality. Experiment utilized a single group, pretest and posttest. Plantar flexion and inversion with 20° of plantar flexion reproduction of joint position sense (RJPS was determined using an ankle RJPS apparatus. Subjects were barefooted, blindfolded, and equipped with headphones playing white noise to eliminate auditory cues. Subjects had five trials in both plantar flexion and inversion with 20° plantar flexion before and after application of the KinesioTM tape to the anterior/lateral portion of the ankle. Constant error and absolute error were determined from the difference between the target angle and the trial angle produced by the subject. The treatment group (KinesioTM taped subjects showed no change in constant and absolute error for ankle RJPS in plantar flexion and 20º of plantar flexion with inversion when compared to the untaped results using the same motions. The application of KinesioTM tape does not appear to enhance proprioception (in terms of RJPS in healthy individuals as determined by our measures of RJPS at the ankle in the motions of plantar flexion and 20º of plantar flexion with inversion.

  6. Effects of needle knife release with multidirectional contracture of orthotics for ankle joint contractures after stroke%针刀配合矫正器治疗卒中后踝关节挛缩疗效观察

    Institute of Scientific and Technical Information of China (English)

    吕召霞; 贾荣娟; 苑克进; 吴喜娟; 于志红

    2015-01-01

    Objective To observe the clinical efficacy of needle knife release with multidirectional ankle brace on ankle joint contracture in patients with cerebral apoplexy. Methods Choose from February 2010 to November 2011, Shandong Province, Weihai Wendeng Central Hospital inpatient treatment of 98 patients with ankle joint contracture after stroke were randomly divided into observation group and control group, 49 patients for each group. Patients in control group were given routine rehabilitation therapy including normal limb position put, antagonist muscle strength training, slow and passively stretching of muscle cramps and acupuncture treatment. Patients in observation group were given needle knife relieve and wear ankle brace treatment on the basis of routine rehabilitation. Values of ankle motion and the modified Ashworth scale (MAS) of ankle joint were evaluated 1 month after treatment in two groups of patients. SPSS statistical software package was used for data analysis. Values of MAS in lower limb ankle were tested with χ 2. The range of ankle motion was detected by t-test. A P-value < 0.05 was considered to be statistically significant. Results Ankle range of motion was significantly better in observation group (19.8±3.7)°than that of control group [(10.3±2.3)°, t' = 15.36, P< 0.05]. Modified Ashworth lower limb spasticity efficiency rating of 85.7% was significantly better than the control group 67.3%, the difference was statistically significant ( χ 2= 4.60,P<0.05). Conclusion Needle knife relieve postoperative plus wear ankle garment orthotics for treatment of ankle joint contracture after stroke shows good clinical result, alleviates suffering, and which is worthy promoting.%目的:观察针刀松解配合多向踝关节矫正器治疗脑卒中患者踝关节挛缩的临床疗效。方法选择2010年2月至2011年11月山东省威海市文登中心医院住院治疗的98例脑卒中踝关节挛缩患者,随机分为观察组与对照组各49例

  7. Marked loss of sympathetic nerve fibers in chronic Charcot foot of diabetic origin compared to ankle joint osteoarthritis.

    Science.gov (United States)

    Koeck, Franz-Xaver; Bobrik, Verena; Fassold, Alexander; Grifka, Joachim; Kessler, Sigurd; Straub, Rainer H

    2009-06-01

    The pathogenesis of Charcot foot is based on three disputed factors: (1) loss of neurotrophic influence, (2) microtraumatic lesions, and (3) neurovascular disturbances. These etiological causes were uncovered by clinicophysiological tests. However, no results of quantitative nerve density studies of sympathetic and sensory substance P-positive (SP+) nerve fibers are available. We studied the density of sympathetic and SP+ nerve fibers in three distinct areas of the tarsus. Fifteen patients with ankle osteoarthritis (OA) and 15 patients with diabetic Charcot foot were included. Patients with OA did not differ from those with Charcot foot in SP+ sensory nerve fiber density. However, at all three areas, the density of sympathetic nerve fibers was significantly lower in patients with Charcot foot compared to OA (p = 0.006). In addition, we found that the sympathetic nerve repellent factor semaphorin 3C was highly expressed in inflamed tissue in Charcot patients. In Charcot foot of diabetic origin a severe loss of sympathetic nerve fibers was observed. These findings in chronically inflamed Charcot foot lend support to the neurovascular theory in the late chronic phase, which probably depends on the inflammatory upregulation of nerve repellent factors.

  8. Noninvasive ankle distraction: relationship between force, magnitude of distraction, and nerve conduction abnormalities.

    Science.gov (United States)

    Dowdy, P A; Watson, B V; Amendola, A; Brown, J D

    1996-02-01

    Seven healthy volunteers (14 ankles; four males, 3 females) with no history of ankle or foot pathology were placed in a modified beach chair position on an operating table for ankle distraction using a noninvasive ankle distractor. In-line traction of 0 to 225 N (50 lb) in 22.5-N (5-lb) increments was applied to the ankle. A direct lateral radiograph was obtained at each distraction force. The joint space was measured on the lateral radiographs using electronic microcalipers. Surface recordings of the superficial peroneal, deep peroneal dorsal digital cutaneous, and sural nerves were obtained. The ankle joint space increased progressively from an average 3.1 mm with no force applied to an average 4.2 mm with 225 N (50 lb) distraction force applied. The maximum joint distraction averaged 1.3 mm (range, 0.35 to 2.35 mm). The sensory amplitudes were diminished or absent with increasing time and force of distraction. The decreased amplitudes were most marked after 1 hour of distraction with 135 N (30 lb) or greater distraction force. This correlated with symptoms of paresthesias. The superficial and deep peroneal cutaneous nerves were affected to a much greater extent than the sural nerve. The amplitudes quickly returned to normal values with the weight being released from the ankle. The noninvasive ankle distractor safely increased ankle joint space by more than 1 mm. Distraction with 135 N (30 lb) or more for 1 hour is associated with reversible nerve conduction changes. Based on these findings, we recommend using the noninvasive ankle distraction apparatus for ankle arthroscopy, with up to 135 N (30 lb) of traction applied to the foot for up to 1 hour. Greater force, applied for longer periods, is associated with increasing nerve conduction abnormalities.

  9. MR findings associated with positive distraction of the hip joint achieved by axial traction

    Energy Technology Data Exchange (ETDEWEB)

    Suter, Aline; Dietrich, Tobias J.; Maier, Matthias; Pfirrmann, Christian W.A. [Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Dora, Claudio [Orthopedic University Hospital Balgrist, Orthopedic Surgery, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2015-06-01

    To determine which MR-arthrography findings are associated with positive hip joint distraction. One hundred patients with MR arthrography of the hip using axial traction were included. Traction was applied during the MR examination with an 8 kg (females) or 10 kg (males) water bag, attached to the ankle over a deflection pulley. Fifty patients showing joint space distraction were compared to an age- and gender-matched control group of 50 patients that did not show a joint distraction under axial traction. Two radiologists assessed the neck-shaft angle, lateral and anterior center-edge (CE) angles, CE angles in the transverse plane, extrusion index of the femoral head, acetabular depth, alpha angle, acetabular version, ligamentum teres, joint capsule and ligaments, iliopsoas tendon and the labrum. Mean joint space distraction in the study group was 0.9 ± 0.6 mm. Patients with positive joint space distraction had significantly higher neck-shaft angles (control group 131.6 ± 5.4 /study group 134.1 ± 6.1 , p < 0.05), smaller lateral CE angles (38.1 ± 5.9 /34.6 ± 7.2 , p < 0.05), smaller overall transverse CE angles (161.4 ± 9.9 /153.6 ± 9.6 , p < 0.001), smaller acetabular depth (4.1 ± 2.4 mm/5.8 ± 2.5 mm, p < 0.01), higher alpha angles (53.5 ± 7.8 /59.2 ± 10.1 , p < 0.01) and a thicker ligamentum teres (4.7 ± 1.4 mm/5.4 ± 1.8 mm, p < 0.05). The other parameters revealed no significant differences. ICC values for interobserver agreement were 0.71-0.95 and kappa values 0.43-0.92. Increased neck-shaft angles, small CE angles, small acetabular depth, higher alpha angles and a thick ligamentum teres are associated with positive joint distraction. (orig.)

  10. 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;

    2016-01-01

    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 ... with contractures. 6 weeks of daily uphill gait training improves functional gait parameters such as gait speed and dorsal flexion during gait in adults with cerebral palsy....

  11. Comparative analysis of the ankle joints in juvenile male soccer players with imaging%少儿男性足球运动员踝关节影像学分析

    Institute of Scientific and Technical Information of China (English)

    黄耀彬; 赵银霞; 肖继杰; 李勉文; 张锐; 李绍林

    2016-01-01

    Objective To investigate the characteristics of children male soccer players' ankle imaging features.Methods From October 2015 to February 2016,a total of 32 male children players of two soccer clubs in Guangzhou were enrolled in this study.The ages of all cases were from 10 to 14 years,average age was (11.3 ± 0.9) years.A total of 15 male children in region ordinary primary and secondary school students were set as control group,ages were from 10 to 14 years,average age was (12.1 ± 1.2) years.All objects' ankle were examined by X-ray for positive and lateral positions;routine CT scanning and then on the workstation restructuring for axial,coronal and sagittal slices;and examined by MR.MR scan was with special surface coil for ankle joint for horizontal axis T2WI;coronal T1WI;coronary proton density weighted imaging (PWI);sagittal T2 WI with fat suppression;sagittal PWI with isotropic and fat suppression sequence of fast field echo.The ankle bone morphological structures were observed on X-ray;the ankle bone mineral density,cortical bone thickness and sesamoid bone quantity was being observed and measured on CT;and the tenosynovitis,Achilles tendinitis,synovitis,and cancellous bone edema signal were observed on MR.Results For study group,a total of 32 cases and 64 ankles joints were completed by X-ray,CT and MR examination.A total of 15 cases and 30 ankles joints were completed by X-ray in control group,26 ankle joints were completed by CT scan and 22 ankle joints were completed by MR examination.X-ray examination showed there was no statistically significant difference between the two groups in ankle bone structure.CT showed that navicular bone CT value was (296 ±82) HU in research group and navicular bone CT value was (266 ± 107) HU in control group,the difference was statistically significant (P =0.03).MR showed the incidence of diseases in research group that the tendon sheath peripheral inflammation was 92.2% (59/64),Achilles tendon lesions was 18.8

  12. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements.

    Science.gov (United States)

    Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban

    2016-03-01

    The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met.

  13. Finite element mechanical analysis of ankle joint inversion%踝关节内翻的有限元力学分析

    Institute of Scientific and Technical Information of China (English)

    郭国新; 赵长义; 曹雷; 任国山

    2012-01-01

    BACKGROUND: In recent years, with the wide application of finite element analysis in the field of biomechanics, studies on the ankle joint from domestic and abroad scholars have been increased. However, the study is mainly on static states, searching the literature of the past few years, reports about ankle injury in non-mid-stance have seldom been found.OBJECTIVE: To make finite element biomechanical analysis of the ankle three-dimensional digital model; to observe the changes of displacement distribution, shear stress and stress of every part of the ankle joint from different perspective; and to discuss the ankle injury mechanism under the condition of inversion.METHODS: The three-dimensional digital model of ankle that processed in Mimics and Geomagic surfale was imported into Ansys, and then made a finite element analysis of the obtained model at different inversion angles after constraining conditions, loading pressure and solving.RESULTS AND CONCLUSION: In this article ,10 different inversion angles of the ankle joint model were simulated successfully, that were 10°, 15°, 20°, 25°, 30°, 45°, 60°, 70°, 80° and 85°. At each inversion angle, we made finite element mechanical analysis, and obtained the distribution of displacement, shear stress, and stress of every part of the ankle joint from different spatial dimensional. After studying the datum, we draw a conclusion that the x (y, z)-displacement, xy (yz, xz)-shear stress, x (y, z)-stress were increased gradually with the increasing of the inversion angle, the maximum stress located on the lateral malleolus and the lateral part of trochlea tali, where was the most fragile part of the ankle joint to be broken. In addition, the x-displacement of talus was increased with the increasing of inversion angle, which influenced the distribution of stress on the whole ankle joint model.%背景:近年来,骨科生物力学领域的研究不断成熟和发展,研究方法多采用有限元分析软件.作者

  14. Ankle fusion using a 2-incision, 3-screw technique

    NARCIS (Netherlands)

    R.P.M. Hendrickx; G.M.M.J. Kerkhoffs; S.A.S. Stufkens; C.N. van Dijk; R.K. Marti

    2011-01-01

    Reliable fusion and optimal correction of the alignment of the ankle joint using a 2-incision, 3-screw technique. Symptomatic osteoarthritis of the ankle joint after insufficient other treatment, severe deformity of the osteoarthritic ankle joint, or salvation procedure after failed arthroplasty. Ac

  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

    (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...

  16. A novel ultrasound technique for detection of osteochondral defects in the ankle joint: A parametric and feasibility study

    NARCIS (Netherlands)

    Sarkalkan, N.; Loeve, A.J.; Van Dongen, K.W.A.; Tuijthof, G.J.M.; Zadpoor, A.A.

    2015-01-01

    (Osteo)chondral defects (OCDs) in the ankle are currently diagnosed with modalities that are not convenient to use in long-term follow-ups. Ultrasound (US) imaging, which is a cost-effective and non-invasive alternative, has limited ability to discriminate OCDs. We aim to develop a new diagnostic te

  17. Forces predicted at the ankle during running.

    Science.gov (United States)

    Burdett, R G

    1982-01-01

    A biomechanical model of the ankle joint was developed and was used to predict the forces at the ankle during the stance phase of running. Measurements from five cadavers were averaged to obtain insertion points and directions of pull of equivalent tendons with respect to the assumed center of the ankle joint. A minimum joint force solution was obtained by assuming that only two equivalent muscle groups could exert force at one time. Three subjects ran at 4.47 m/s across a force platform that recorded the external forces and moments acting on the foot. Cinematography was used to measure the foot and leg positions during stance. Peak resultant joint forces ranging from 9.0 to 13.3 times body weight and peak Achilles tendon forces ranging from 5.3 to 10.0 times body weight were predicted. Small variations in some cases resulted in large differences in predicted forces. The highest tendon forces predicted exceeded those reported to cause damage to cadaver tendons in other studies.

  18. Muscle activation and estimated relative joint force during running with weight support on a lower-body positive pressure treadmill

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Hovgaard-Hansen, Line; Cappelen, Katrine Louise

    2016-01-01

    Running on a lower-body positive pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg...... muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100, 80, 60, 40 and 20% body-weight (BW). Surface EMG, ground reaction force and running characteristics were measured. Relative knee and ankle joint forces were...... estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and anti-gravity forces. At 20%BW, knee extensor EMGpeak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100%BW values. Plantar flexors decreased to 52% and 58% at 20%BW...

  19. Magnetic resonance imaging of the ankle in female ballet dancers en pointe

    Energy Technology Data Exchange (ETDEWEB)

    Russell, Jeffrey A. (Dept. of Dance, Univ. of California-Irvine, Irvine, CA (United States)), e-mail: jeff.russell@uci.edu; Shave, Ruth M. (Dept. of Radiology, Russells Hall Hospital, Dudley (United Kingdom)); Yoshioka, Hiroshi (Dept. of Radiological Sciences, Univ. of California-Irvine, Irvine, CA (United States)); Kruse, David W. (Dept. of Orthopaedic Surgery and Family Medicine, Univ. of California-Irvine, Irvine, CA (United States)); Koutedakis, Yiannis; Wyon, Matthew A. (School of Sport, Performing Arts and Leisure, Univ. of Wolverhampton, Walsall (United Kingdom))

    2010-07-15

    Background: Ballet dancers require extreme range of motion of the ankle, especially weight-bearing maximum plantar flexion (en pointe). In spite of a high prevalence of foot and ankle injuries in ballet dancers, the anatomy and pathoanatomy of this position have not been sufficiently studied in weight-bearing. Magnetic resonance imaging (MRI) is a beneficial method for such study. Purpose: To develop an MRI method of evaluating the ankles of female ballet dancers standing en pointe and to assess whether pathological findings from the MR images were associated with ankle pain reported by the subjects. Material and Methods: Nine female ballet dancers (age, 21+-2.9 years; dance experience, 16+-4.1 years; en pointe dance experience, 7+-4.9 years) completed an ankle pain visual analog scale questionnaire and underwent T1- and T2-weighted scans using a 0.25 T open MRI device. The ankle was scanned in three positions: supine with full plantar flexion, standing with the ankle in anatomical position, and standing en pointe. Results: Obtaining MR images of the ballet dancers en pointe was successful in spite of limitations imposed by the difficulty of remaining motionless in the en pointe position during scanning. MRI signs of ankle pathology and anatomical variants were observed. Convergence of the posterior edge of the tibial plafond, posterior talus, and superior calcaneus was noted in 100% of cases. Widened anterior joint congruity and synovitis/joint effusion were present in 71% and 67%, respectively. Anterior tibial and/or talar spurs and Stieda's process were each seen in 44%. However, clinical signs did not always correlate with pain reported by the subjects. Conclusion: This study successfully established an ankle imaging technique for ballet dancers en pointe that can be used in the future to assess the relationship between en pointe positioning and ankle pathoanatomy in ballet dancers

  20. The impact of the initial stance position on lower limb joint kinetics in the taekwondo roundhouse kick

    Directory of Open Access Journals (Sweden)

    Daniel Jandačka

    2013-06-01

    Full Text Available BACKGROUND: To achieve good performance, taekwondo athletes should optimize the stance position of the foot on the ground. OBJECTIVE: The aim of this study is to compare generated net joint power (hip, knee and ankle during stance phase, magnitude of peak foot velocity of the attacking lower extremity and execution stance time produced from three stance positions (forward "0°", diagonal "45°", orthogonal "90°" in the taekwondo roundhouse kick. METHODS: Ten taekwondo athletes participated in the study; their experience of practicing taekwondo ranged between 13.8 ± 5.8 years. The kinetics and kinematics of the athletes’ movement during the roundhouse kick were recorded. The execution stance time and the magnitude of peak foot velocity were determined. The net joint power of the kicking lower extremity during the stance phase was calculated using the inverse dynamics method. Then the peak net joint power was determined. RESULTS: The analysis of variance for repeated measures showed that there is a significant main effect of the stance position on the peak net hip joint power in the three planes. In addition, the stance position does not affect the magnitude of the peak foot velocity of the kicking lower extremity and execution stance time. CONCLUSIONS: The necessity to produce a higher net hip joint power in the stance phase of the roundhouse kick from the position when the feet are placed orthogonal to the target of the kick, compared with the execution of the kick from the forward or diagonal position, must be taken into account for purposes of rationalizing strength training of taekwondo athletes or for selecting the technique of the roundhouse kick.

  1. 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

    . METHOD: Two experienced examiners mobilized both ankles of thirty-five healthy subjects. A force platform was positioned under the calves of these subjects to detect the forces applied during the maneuvers. The signals were converted and recorded using the DasyLab 4.0 software. The maximum and minimum peak forces from the curves obtained were then analyzed. The intraclass correlation coefficient (ICC was used to assess the intra and inter-examiner reliability. To evaluate any systematic error in the measurements, the paired t-test was utilized on the intra-examiner data and the t-test for independent samples for the inter-examiner data. The Bland & Altman method was used to assess the concordance limits for the measurements from the two examiners. RESULTS: The data showed high intra-examiner reliability. The inter-examiner reliability was low and moderate for the maximum and minimum forces respectively, during anteroposterior mobilization of the ankle joint. CONCLUSIONS: These data suggest that the force applied during Maitland grade III and IV mobilization of the ankle joint presents high intra-examiner reliability and low inter-examiner reliability.

  2. Cutaneous mechanisms of isometric ankle force control.

    Science.gov (United States)

    Choi, Julia T; Lundbye-Jensen, Jesper; Leukel, Christian; Nielsen, Jens Bo

    2013-07-01

    The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force output. We used repetitive electrical stimulation of the superficial peroneal (foot dorsum) and medial plantar nerves (foot sole) to disrupt cutaneous afferent input in 8 healthy subjects. We measured the effects of repetitive nerve stimulation on (1) tactile thresholds, (2) performance in an ankle force-matching and (3) an ankle position-matching task. Additional force-matching experiments were done to compare the effects of transient versus continuous stimulation in 6 subjects and to determine the effects of foot anesthesia using lidocaine in another 6 subjects. The results showed that stimulation decreased cutaneous sensory function as evidenced by increased touch threshold. Absolute dorsiflexion force error increased without visual feedback during peroneal nerve stimulation. This was not a general effect of stimulation because force error did not increase during plantar nerve stimulation. The effects of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases.

  3. 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.

  4. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2016-01-01

    Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions) and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed.

  5. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis.

    Directory of Open Access Journals (Sweden)

    Kimberly A Ingraham

    Full Text Available Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed.

  6. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis

    Science.gov (United States)

    Simon, Ann M.; Hargrove, Levi J.

    2016-01-01

    Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions) and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed. PMID:26807889

  7. Kinesio Tape and Shoulder-Joint Position Sense

    Science.gov (United States)

    Aarseth, Lindsay M.; Suprak, David N.; Chalmers, Gordon R.; Lyon, Lonnie; Dahlquist, Dylan T.

    2015-01-01

    Context Joint position sense (JPS) is a key neuromuscular factor for developing and maintaining control of muscles around a joint. It is important when performing specialized tasks, especially at the shoulder. No researchers have studied how Kinesio Tape (KT) application affects JPS. Objective To investigate the effects of KT application and no tape on shoulder JPS at increasing shoulder elevations in athletes. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants A total of 27 healthy athletes who did not participate in overhead sports (age = 20.44 ± 1.05 years, height = 175.02 ± 11.67 cm, mass = 70.74 ± 9.65 kg) with no previous pathologic shoulder conditions volunteered for the study. All participants were from 1 university. Intervention(s) Shoulder JPS was assessed at increasing elevations with and without KT application. Participants attempted to actively replicate 3 target positions with and without the KT and without visual guidance. Main Outcome Measure(s) We examined absolute and variable repositioning errors at increasing shoulder-elevation levels with and without KT application. Results Data revealed an interaction between tape and position for absolute error (F2,52 = 4.07, P = .02); simple effects revealed an increase in error, with KT demonstrating a 2.65° increase in error at 90° of elevation compared with no tape (t26 = 2.65, P = .01). The effect size was medium (ω2 = .135). Variable error showed no interaction of tape and position (F2,52 = .709, P = .50). Further analysis of simple effects was not needed. However, we still calculated the effect size and observed small effect sizes for tape (ω2 = .002), position (ω2 = .072), and tape by position (ω2 = .027). Conclusions At 90° of elevation, shoulder JPS was impaired by the application of KT. PMID:26090707

  8. Revision of the aseptic and septic total ankle replacement.

    Science.gov (United States)

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  9. 磁共振三维脂肪抑制T2加权快速回波序列在评估健康受试者踝关节韧带解剖结构的应用研究%Application of MR 3D FSE CUBE sequence in evaluation of anatomy of ligament ankle joint of healthy volunteers

    Institute of Scientific and Technical Information of China (English)

    刘磊

    2014-01-01

    目的:分析3.0 T磁共振三维脂肪抑制T2加权快速回波(3D FSE CUBE)序列与常规检查技术2D FSE序列对健康受试者踝关节韧带解剖细节显示的价值。方法选取36名健康受试者踝关节进行磁共振成像(MRI),使用GE HDXT 3.0 T磁共振扫描仪及高分辨率膝关节专用线圈。本研究所使用的MRI序列为二维脂肪抑制T2加权(2D-FSE-T2WI)和3D FSE CUBE。扫描范围包括踝关节的冠状位、矢状位和轴位。分别计算上述2个序列对于踝关节联合韧带、外侧副韧带、三角韧带的显示率。从而评价上述2个序列对于踝关节韧带的显示能力。结果3D FSE CUBE序列对于踝关节韧带的显示优于常规2D序列,二者之间的差异具有统计学意义(P<0.05)。3D FSE CUBE序列对于踝关节各韧带的显示能力要明显高于普通FSE序列。结论3D FSE CUBE是一种新的磁共振序列,可以进行不同的加权图像扫描,对于踝关节韧带正常解剖结构的显示清晰,可以满足临床诊断的需要。%Objective To analyse the value of MR 3D FSE CUBE sequence and conventional 2D FSE T 2WI sequence in evaluation of anatomy of ligament ankle joint of healthy volunteers at 3T MR scanner. Methods The ankles in 36 cases were examined with MR imaging spin echo-T2 weighted imaging (2D T2WI FSE) and 3D FSE CUBE. Sweep range ankle coronal and sagittal and axial position. The above two sequences were calculated respectively for the ankle joint ligament, the detection rate of the lateral collateral ligament, deltoid ligament, to evaluate these two sequences for the ankle ligaments show ability. Results 3D FSE CUBE sequence provided a significantly higher rate for all ligament ankle joint compared with conventional 2D sequence , there was significant difference between them (P<0.05). Conclusion 3D FSE CUBE is a new technique for examination of ankle joint, which can be different weighted image scanning.It can clearly show the

  10. 健美操训练对女大学生踝关节力觉影响的实验研究%Research on the Force Sense of the Ankle Joint on Female Aerobics Training

    Institute of Scientific and Technical Information of China (English)

    陈瑞琴; 林辉; 张秋霞

    2014-01-01

    Gymnastics is in the accompaniment of music, to exercise as the basic method, based on aerobic exercise, to promote health, sport and entertainment purposes shape. Aerobics is the most important technology of bounding techniques, is mainly caused by the ankle, knee, hip flexion and extension buffer, reduce the impact motion of the joint, thereby reducing the human body caused by injury. Increase the ankle proprioception, can improve the ability of the ankle joint control of peripheral nerve muscle, make the ankle joint to maintain coordination and stable body in move, jump landing, control the whole body posture, achieve beautification action, improve the ability of the movement technical level. In this study, the experimental study of Aerobics on female college students' Ankle haptic effects of training as the research object, aims to explore the aerobics every index of ankle joint force, which provides a theoretical basis for the ankle joint sports injury and aerobics teaching and training, competition.%健美操是在音乐的伴奏下,以身体练习为基本手段、以有氧运动为基础,达到增进健康、塑造形体和娱乐目的的一项体育运动。健美操最重要的技术是弹动技术,主要是依靠踝、膝、髋关节的屈伸缓冲而产生,减少运动对关节的冲力,从而减少对人体造成的损伤。踝关节本体感觉能力的增加,可提高踝关节周围神经肌肉控制能力,使踝关节在弹动、跳跃落地时保持身体的协调稳定,控制整个身体姿态,达到美化动作,提高运动技术水平的能力。本研究以健美操训练对女大学生踝关节力觉影响的实验研究为研究对象,旨在探讨健美操运动对踝关节的力觉各指标的影响,为减少踝关节运动损伤的发生和健美操的教学训练、比赛提供一定的理论依据。

  11. Changes in head and neck position affect elbow joint position sense.

    Science.gov (United States)

    Knox, Joanna J; Hodges, Paul W

    2005-08-01

    Changes in the position of the head and neck have been shown to introduce a systematic deviation in the end-point error of an upper limb pointing task. Although previous authors have attributed this to alteration of perceived target location, no studies have explored the effect of changes in head and neck position on the perception of limb position. This study investigated whether changes in head and neck position affect a specific component of movement performance, that is, the accuracy of joint position sense (JPS) at the elbow. Elbow JPS was tested with the neck in four positions: neutral, flexion, rotation and combined flexion/rotation. A target angle was presented passively with the neck in neutral, after a rest period; this angle was reproduced actively with the head and neck in one of the test positions. The potential effects of distraction from head movement were controlled for by performing a movement control in which the head and neck were in neutral for the presentation and reproduction of the target angle, but moved into flexion during the rest period. The absolute and variable joint position errors (JPE) were greater when the target angle was reproduced with the neck in the flexion, rotation, and combined flexion/rotation than when the head and neck were in neutral. This study suggests that the reduced accuracy previously seen in pointing tasks with changes in head position may be partly because of errors in the interpretation of arm position.

  12. Chinese Massage Therapy for Ankle Injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Ming-xia; LI Nian-qun; HUANG Guo-qi

    2003-01-01

    Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises. Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%. Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint.

  13. 骨外固定支架技术在踝关节融合与矫形中的应用%Application of external fixation in ankle joint arthrodesis

    Institute of Scientific and Technical Information of China (English)

    谢鸣; 黄若昆; 方真华; 赵晶晶; 李静; 肖凯; 勘武生

    2011-01-01

    目的 探讨骨外固定支架技术在踝关节融合与矫形中的疗效.方法 2001年1月至2009年6月采用外固定支架技术治疗27例踝关节创伤性患者,男18例,女9例;年龄32~68岁,平均41岁.其中创伤性关节炎13例,地方性大骨节病3例,骨关节炎5例,结核性踝关节炎2例,踝关节置换术后失败3例,骨髓炎1例.为保证骨对骨加压接触行外固定支架固定.结果 所有患者术后获6~38个月(平均10个月)随访.随访发现关节无肿胀和疼痛,行走步态和功能明显改善,X线片示关节均获骨性融合.结论 外固定支架技术用于踝关节融合率高,对踝关节感染及复合足踝关节畸形有一定优势性.%Objective To study the curative effect of external fixation in ankle joint arthrodesis.Methods From January 2001 to June 2009, we used external fixation in arthrodesis for 27 cases of traumatic ankle joint They were 18 males and 9 females, with an average age of 41 years (range, 32 to 68 years) . There were 13 cases of traumatic osteoarthritis of the ankle joint, 3 cases of local kaschin beck disease, 5 cases of ankle osteoarthritis, 2 cases of tuberculous ankle arthritis, 3 cases of ankle replacement failure, one case of osteomyelitis. Fibular flap grafts were used in 8 cases, bone autografts in 11 cases, bone allografts in 2 cases,and combined bone grafts in 11 cases. External fixation was applied for all cases to ensure compressive contact between bone ends. Results The patients were followed up for 6 to 38 months (average, 10 months). No pain or swelling was found at the ankle joint. Significant improvements were made in walking gait and function of the ankle. X-ray films verified bony fusion in all cases. Conclusion External fixation can lead to a high rate of bony fusion of the ankle joint, and is advantageous for treatment of ankle infection and combined deformity of the ankle and foot.

  14. JOINT POSITION SENSE IN TURKISH PROFESSIONAL BALLET DANCERS

    Directory of Open Access Journals (Sweden)

    S. Rana VAROL

    2013-04-01

    Full Text Available Purpose. The aim of this study was to compare the joint position sense (JPS between professional ballet dancers and non-dancers controls.Methods. The study group consisted of thirty six professional ballet dancers and gender-matched controls. Measurements were performed on each group after filling out a questionnaire about their dance and injury backgrounds. Left and right arm flexion 50º and abduction 50º and left and right leg flexion 55º and abduction 70º were selected as measurement movements from dancers’ routine practice. Subjects repeated each movement six times with five-second intervals. Acumar Digital Inclinometer was used for JPS measurements and Gollehon Extendable Goniometer was used for validating the accuracy of measurements. The outcome measurement was an error score calculated as the mean absolute deviation (MAD between the target and replicated angle.Results. JPS was significantly better in the dancer group compared to the control group. JPS did not show a significant difference between males and females. It was found no correlation between dance year and MAD values, except for the left hip abduction MAD levels (p≤0.05. No significant difference was found between the right and left extremities. In comparing the upper and lower extremities, there was no significant difference except for the comparison of right shoulder and right hip flexion. Conclusion. Professional ballet dancers demonstrated greater accuracy in joint position. “Continued and repeated practice” may improve proprioceptive responses of dancers.

  15. Cutaneous mechanisms of isometric ankle force control

    DEFF Research Database (Denmark)

    Choi, Julia T; Jensen, Jesper Lundbye; Leukel, Christian

    2013-01-01

    The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force...... of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle...... joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases....

  16. Effects of different surgical mananement of the three-column injury of ankle on the peak contact pressure in the tibiotalar joint%不同手术方式治疗踝关节韧带复合体损伤的生物力学评价

    Institute of Scientific and Technical Information of China (English)

    董伟强; 余斌; 白波

    2015-01-01

    Objective To study the effects of different surgical procedures of clinical treatment of the three-column injury of ankle on the peak contact pressure in the tibiotalarjoint. Methods Six fresh cadaveric adult ankles were used for creation of 3 models of different surgical proceduresof treatment for the three-column injury of ankle. In model A, the medial and lateral ligaments of ankle joint were intact(repaired), the broken inferior tibiofibular ligament were not fixed. In model B, the medial and lateral ligaments of ankle joint were intact(repaired),the broken inferior tibiofibular ligament was fixed by a screw. In model C, lateral ligaments of ankle joint were intact(repaired), the broken inferior tibiofibular ligament was fixed by a screw, but the broken medial ligaments were not repaired. The three groups were tested in order A、B、C. The 3 models were tested with an electronic pressure sensor in a BOSE material testing machine, respectively, in 5 positions. The peak values of the compressive stresses of the 3 models in 5 positions were recorded. All data were collected and analyzed using SPSS22.0. Results Model B exhibited the smallest average stress in all 5 positions, followed by model C and model A, with significant differences between B and A groups (P<0.05).There were significant differences between B and C groups (P<0.05)at 10° dorsal extension and 10° valgus position. Conclusion The surgical management of the three-column injury of ankle where the medial and lateral ligaments are intact or repaired, and the tibiofibular syndesmosisis effectively fixed can reduce the peak contact pressure in the tibiotalar joint.%目的:研究不同手术方式治疗踝关节3个韧带复合体同时损伤的生物力学特征。方法选用6例成年新鲜正常踝关节,建立3组模型:A组:模拟内、外侧韧带损伤后予以形态和张力完全修复,下胫腓联合不固定。B组:模拟内、外侧韧带损伤后予以形态和张力完全修

  17. Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series.

    Science.gov (United States)

    Barg, A; Elsner, A; Hefti, D; Hintermann, B

    2010-07-01

    The standard treatment for end-stage osteoarthritis of the ankle joint in haemophilic patients has been fusion of the ankle joint. Total ankle replacement is still controversial as a treatment option. The objective of this prospective study was to evaluate the mid-term outcome in patients treated with total ankle replacement using an unconstrained three-component ankle implant. Ten haemophilic ankles in eight patients (mean age: 43.2 years, range 26.7-57.5) treated with total ankle replacement were followed up for a minimum of 2.7 years (mean: 5.6, range 2.7-7.6). The outcome was measured with clinical and radiological evaluations. There were no intra- or peri-operative complications. The AOFAS-hindfoot-score increased from 38 (range 8-57) preoperatively to 81 (range 69-95) postoperatively. All patients were satisfied with the results. Four patients became pain free; in the whole patient cohort pain level decreased from 7.1 (range 4-9) preoperatively to 0.8 (range 0-3) postoperatively. All categories of SF-36 score showed significant improvements in quality of life. In one patient, open ankle arthrolysis was performed because of painful arthrofibrosis. For patients with haemophilic osteoarthritis of the ankle joint, total ankle replacement is a valuable alternative treatment to ankle fusion.

  18. Arthroscopy-Assisted Closed Reduction and Percutaneous Nail Fixation of Unstable Ankle Fractures: Description of a Minimally Invasive Procedure

    OpenAIRE

    Kong, Christopher; Kolla, Lee; Wing, Kevin; Younger, Alastair S.E.

    2014-01-01

    When one is surgically managing an unstable ankle fracture, anatomic reduction of the syndesmosis is typically accomplished using an open surgical approach. We propose an arthroscopically assisted technique that restores normal anatomy while using a percutaneously placed intramedullary nail to fix the fibula. The patient is positioned supine, and the ankle is placed under traction by use of a tensor bandage. Standard anteromedial and anterolateral arthroscopy portals are used. The joint is ex...

  19. Research on Ankle-joint Injury of Basketball Fans in Baoji University of Arts and Sciences%宝鸡文理学院篮球运动爱好者踝关节损伤的浅析

    Institute of Scientific and Technical Information of China (English)

    魏俊民

    2011-01-01

    本文通过问卷调查的方式,对宝鸡文理学院91名学生篮球爱好者在篮球运动中踝关节损伤的原因及性质进行调查分析,提出合理的预防措施,以便减少篮球爱好者在篮球运动中踝关节的损伤的概率.%Through the questionnaire survey, the paper investigates and analyzes ankle-joint injury reason and nature to 91 fans of Baoji University of Arts and Sciences in basketball, advances reasonablely preventive measures, to ruduce ankle-joint injury probability in basketball.

  20. Surface electromyography studies in standing position confirm that ankle strategy remains disturbed even following successful treatment of patients with a history of sciatica

    Science.gov (United States)

    Huber, Juliusz; Lisiński, Przemysław; Ciesielska, Jagoda; Kulczyk, Aleksandra; Lipiec, Joanna; Bandosz, Agata

    2016-01-01

    [Purpose] It is hypothesized that ankle strategy can be changed in patients with a history of sciatica. The aim of this study was to detect residual disturbances following successful treatment. [Subjects and Methods] In patients with a history of sciatica (N=11) and pseudo-sciatica (N=9), differences in muscle activity were recorded with bilateral surface polyelectromyography and stability measurements (center of foot pressure sway and center of spectrum) in normal standing and tandem positions. Results were compared with recordings in healthy people (N=9) to identify abnormalities in electromyographic and postural studies. [Results] Increased amplitude of electromyographic recordings from the gastrocnemius and extensor digiti muscles on the affected side was detected more in patients with a history of sciatica than pseudo-sciatica syndromes in tandem position. Fewer amplitude fluctuations were observed in both positions preferably in patients following sciatica. Changes in center of foot pressure sway and center of spectrum during balance platform studies were detected in normal standing position in this group of patients. No similar abnormalities in electromyographic and postural studies were detected in healthy people. [Conclusion] Sciatica and pseudo-sciatica evoke persistent disturbances in activity of muscles responsible for ankle strategy. Electromyography differentiates the two groups of patients better than postural studies. PMID:27065544

  1. 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.

  2. PA positioning significantly reduces testicular dose during sacroiliac joint radiography

    Energy Technology Data Exchange (ETDEWEB)

    Mekis, Nejc [Faculty of Health Sciences, University of Ljubljana (Slovenia); Mc Entee, Mark F., E-mail: mark.mcentee@ucd.i [School of Medicine and Medical Science, University College Dublin 4 (Ireland); Stegnar, Peter [Jozef Stefan International Postgraduate School, Ljubljana (Slovenia)

    2010-11-15

    Radiation dose to the testes in the antero-posterior (AP) and postero-anterior (PA) projection of the sacroiliac joint (SIJ) was measured with and without a scrotal shield. Entrance surface dose, the dose received by the testicles and the dose area product (DAP) was used. DAP measurements revealed the dose received by the phantom in the PA position is 12.6% lower than the AP (p {<=} 0.009) with no statistically significant reduction in image quality (p {<=} 0.483). The dose received by the testes in the PA projection in SIJ imaging is 93.1% lower than the AP projection when not using protection (p {<=} 0.020) and 94.9% lower with protection (p {<=} 0.019). The dose received by the testicles was not changed by the use of a scrotal shield in the AP position (p {<=} 0.559); but was lowered by its use in the PA (p {<=} 0.058). Use of the PA projection in SIJ imaging significantly lowers, the dose received by the testes compared to the AP projection without significant loss of image quality.

  3. Individual-specific muscle maximum force estimation using ultrasound for ankle joint torque prediction using an EMG-driven Hill-type model.

    Science.gov (United States)

    de Oliveira, Liliam Fernandes; Menegaldo, Luciano Luporini

    2010-10-19

    EMG-driven models can be used to estimate muscle force in biomechanical systems. Collected and processed EMG readings are used as the input of a dynamic system, which is integrated numerically. This approach requires the definition of a reasonably large set of parameters. Some of these vary widely among subjects, and slight inaccuracies in such parameters can lead to large model output errors. One of these parameters is the maximum voluntary contraction force (F(om)). This paper proposes an approach to find F(om) by estimating muscle physiological cross-sectional area (PCSA) using ultrasound (US), which is multiplied by a realistic value of maximum muscle specific tension. Ultrasound is used to measure muscle thickness, which allows for the determination of muscle volume through regression equations. Soleus, gastrocnemius medialis and gastrocnemius lateralis PCSAs are estimated using published volume proportions among leg muscles, which also requires measurements of muscle fiber length and pennation angle by US. F(om) obtained by this approach and from data widely cited in the literature was used to comparatively test a Hill-type EMG-driven model of the ankle joint. The model uses 3 EMGs (Soleus, gastrocnemius medialis and gastrocnemius lateralis) as inputs with joint torque as the output. The EMG signals were obtained in a series of experiments carried out with 8 adult male subjects, who performed an isometric contraction protocol consisting of 10s step contractions at 20% and 60% of the maximum voluntary contraction level. Isometric torque was simultaneously collected using a dynamometer. A statistically significant reduction in the root mean square error was observed when US-obtained F(om) was used, as compared to F(om) from the literature.

  4. The Independent and Joint Association of Blood Pressure, Serum Total Homocysteine, and Fasting Serum Glucose Levels With Brachial-Ankle Pulse Wave Velocity in Chinese Hypertensive Adults.

    Science.gov (United States)

    Liu, Xiaoyun; Sun, Ningling; Yu, Tao; Fan, Fangfang; Zheng, Meili; Qian, Geng; Wang, Binyan; Wang, Yu; Tang, Genfu; Li, Jianping; Qin, Xianhui; Hou, Fanfan; Xu, Xiping; Yang, Xinchun; Chen, Yundai; Wang, Xiaobin; Huo, Yong

    2016-09-28

    This study aimed to investigate the independent and joint association of blood pressure (BP), homocysteine (Hcy), and fasting blood glucose (FBG) levels with brachial-ankle pulse wave velocity (baPWV, a measure of arterial stiffness) in Chinese hypertensive adults.The analyses included 3967 participants whose BP, Hcy, FBG, and baPWV were measured along with other covariates. Systolic BP (SBP) was analyzed as 3 categories (SBP < 160 mmHg; 160 to 179 mmHg; ≥ 180 mmHg); Hcy as 3 categories (< 10 μmol/L; 10 to 14.9 μmol/L; ≥ 15.0 μmol/L) and FBG: normal (FBG < 5.6 mmol/L), impaired (5.6 mmol/L ≤ FBG < 7.0 mmol/L), and diabetes mellitus (FBG ≥ 7.0 mmol/L). We performed linear regression analyses to evaluate their associations with baPWV with adjustment for covariables.When analyzed individually, BP, Hcy, and FBG were each associated with baPWV. When BP and FBG were analyzed jointly, the highest baPWV value (mean ± SD: 2227 ± 466 cm/s) was observed in participants with FBG ≥ 7.0 mmol/L and SBP ≥ 180 mmHg (β = 432.5, P < 0.001), and the lowest baPWV value (mean ± SD: 1692 ± 289 cm/s) was seen in participants with NFG and SBP < 160 mmHg. When Hcy and FBG were analyzed jointly, the highest baPWV value (2072 ± 480 cm/s) was observed in participants with FBG ≥ 7.0 mmol/L and Hcy ≥ 15.0 μmol/L (β = 167.6, P < 0.001), while the lowest baPWV value (mean ± SD: 1773 ± 334 cm/s) was observed in participants with NFG and Hcy < 10 μmol/L.In Chinese hypertensive adults, SBP, Hcy, and FBG are individually and jointly associated with baPWV.Our findings underscore the importance of identifying individuals with multiple risk factors of baPWV including high SBP, FBG, and Hcy.

  5. Experimental Robot Position Sensor Fault Tolerance Using Accelerometers and Joint Torque Sensors

    Science.gov (United States)

    Aldridge, Hal A.; Juang, Jer-Nan

    1997-01-01

    Robot systems in critical applications, such as those in space and nuclear environments, must be able to operate during component failure to complete important tasks. One failure mode that has received little attention is the failure of joint position sensors. Current fault tolerant designs require the addition of directly redundant position sensors which can affect joint design. The proposed method uses joint torque sensors found in most existing advanced robot designs along with easily locatable, lightweight accelerometers to provide a joint position sensor fault recovery mode. This mode uses the torque sensors along with a virtual passive control law for stability and accelerometers for joint position information. Two methods for conversion from Cartesian acceleration to joint position based on robot kinematics, not integration, are presented. The fault tolerant control method was tested on several joints of a laboratory robot. The controllers performed well with noisy, biased data and a model with uncertain parameters.

  6. Arthroscopic Management of Complications Following Total Ankle Replacement.

    Science.gov (United States)

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  7. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    Science.gov (United States)

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients.

  8. 下胫腓联合螺钉位置对踝关节活动度影响的有限元研究%Effects of two different positions of tibiofibular syndesmosis screws on the ankle motion: a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    刘清华; 余斌; 张堃; 李忠; 庄岩; 姚建锋; 马建兵

    2014-01-01

    Objective To analyze the effects of 2 different screw positions on the ankle motion by means of three-dimensional finite element models of inferior tibiofibular syndesmosis injury fixated by screws.Methods Helical CT scan images of right foot from a 30 year-old male volunteer were obtained.Using Mimics 10.01 and SolidWorks 2009,three-dimensional structures of the foot bones were reconstructed,ligamentous connection was simulated and contact pair between each joint was generated.Next,3 three-dimensional finite element models were established of normal ankle,tibiofibular syndesmosis injury fixated with screws placed 2.5 cm and 5.0 cm above the tibiotalar joint respectively.Neutral position with single foot standing,internal rotation and external rotation of the ankle were simulated for solution.Results Movements of the distal tibia and fibula decreased significantly in the anterior/posterior and medial/lateral directions after screw fixation at both positions,but the absolute displacements were both less than 0.3 mm between the distal tibia and fibula.After screw fixation at both positions,the relative rotation angles of the tibiotalar joint were 1.75° and 1.65° respectively at internal rotation of the ankle,and 0.60° and 0.54° respectively at external rotation of the ankle.Conclusions Screw fixation of the tibiofibular syndesmosis at the 2 positions is reliable but decrease the displacement of each bone and rotational motion range of the ankle.There is no significant difference between the 2 screw positions regarding the effects on the ankle motion.%目的 利用有限元法分析下胫腓联合损伤两种位置螺钉固定对踝关节活动度的影响.方法 获取1名30岁男性志愿者的右足螺旋CT扫描图像,利用Mimics 10.01、SolidWorks 2009等软件进行骨骼的三维重建、模拟韧带连接和生成关节接触等,分别建立包含正常踝关节、下胫腓联合损伤踝上2.5 cm、5.0 cm螺钉固定的三维有限元模型.在模型中

  9. Impact of ruptured tibiofibular syndesmosis on biomechanics of the ankle joint%下胫腓联合断裂对踝关节生物力学影响的研究

    Institute of Scientific and Technical Information of China (English)

    董伟强; 余斌; 白波

    2015-01-01

    目的 探究踝关节下胫腓联合前韧带断裂和全部断裂对踝关节生物力学的影响. 方法 选用6具成年健康新鲜踝关节,建立3组模型:A组:踝关节内、外侧韧带及下胫腓联合完好作为正常组;B组:把A组下胫腓联合前韧带切断,作为下胫腓联合部分损伤组;C组:把B组标本下胫腓联合完全切断;作为下胫腓联合完全断裂组;把6具踝关节按A→C顺序分别入组并置入电子压力传感器,置于生物力学机上分别在背伸10°、内翻20°、外翻20°、跖屈20°、中立位5种状态下加载,记录和比较各组标本踝关节的峰值压力,以及峰值压力主要部位. 结果 在各种状态下应力A组<B组<C组,三组间两两比较差异均有统计学意义(P<0.05).B、C组在中立位、背伸10°位、跖屈20°位主要受力位置较A组有向外增大趋势,C组较B组更为明显. 结论 下胫腓联合前韧带断裂和下胫腓联合完全韧带断裂会增加踝关节应力,后者增加更为明显;而且两种情况下受力主要位置有向外增大趋势,后者增大更明显.%Objective To explore the impact of partial or complete rupture of the tibiofibular syndesmosis on the biomechanical properties of the ankle joint.Methods Six fresh cadaveric specimens of adult ankle were used for creation of 3 models of tibiofibular syndesmosis.In model A,the medial and lateral ligaments of the ankle joint and the tibiofihular syndesmosis were intact.In model B,only the anterior lower tibiofibular ligament was broken.In model C,all inferior tibiofibular ligaments were broken.The 3 models were tested with an electronic pressure sensor in a BOSE material testing machine respectively at 5 positions:10° dorsal extension,20° inversion,20° eversion,20° plantar flexion,and neutral position.The peak values and locations of the compressive stresses of the 3 models at 5 positions were recorded.All the data were collected and analyzed using IBM SPSS 22.0 statistical

  10. Powered ankle-foot prosthesis for the improvement of amputee ambulation.

    Science.gov (United States)

    Au, Samuel K; Herr, Hugh; Weber, Jeff; Martinez-Villalpando, Ernesto C

    2007-01-01

    This paper presents the mechanical design, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can provide active mechanical power during the stance period of walking. The basic architecture of the prosthesis is a unidirectional spring, configured in parallel with a force-controllable actuator with series elasticity. With this architecture, the anklefoot prosthesis matches the size and weight of the human ankle, and is also capable of delivering high mechanical power and torque observed in normal human walking. We also propose a biomimetic control scheme that allows the prosthesis to mimic the normal human ankle behavior during walking. To evaluate the performance of the prosthesis, we measured the rate of oxygen consumption of three unilateral transtibial amputees walking at self-selected speeds to estimate the metabolic walking economy. We find that the powered prosthesis improves amputee metabolic economy from 7% to 20% compared to the conventional passive-elastic prostheses (Flex-Foot Ceterus and Freedom Innovations Sierra), even though the powered system is twofold heavier than the conventional devices. This result highlights the benefit of performing net positive work at the ankle joint to amputee ambulation and also suggests a new direction for further advancement of an ankle-foot prosthesis.

  11. Osteoarthritis of the Foot and Ankle

    Science.gov (United States)

    ... that creates an increased risk of arthritis. Symptoms People with osteoarthritis in the foot or ankle experience, in varying degrees, one or more of the following: Pain and stiffness in the joint Swelling in or near the joint Difficulty walking or bending the joint Some patients with osteoarthritis ...

  12. 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

  13. Clinical transformation of ankle joint biomechanics analyzed by three-dimensional finite element%踝关节三维有限元生物力学研究的临床转化

    Institute of Scientific and Technical Information of China (English)

    郭鹏超; 王成伟

    2014-01-01

      结果与结论:踝关节生物力学机制复杂,各种损伤后都可能打破其周围结构的力学平衡而导致不稳定,诱发创伤性关节炎。踝关节三维有限元模型可准确反映解剖学结构特点、虚拟仿真可以再现手术方式及过程逼真的模拟,模拟压缩、拉伸、弯曲、扭转、抗疲劳等力学实验,并从静态的生物力学转向动态的方向研究,为分析临床疾病进而找到更合适的诊治方案。%BACKGROUND:Ankle joint is a center of body weight, foot pressure buffering and human contact with the ground and easily gets injury. The study of orthopedic biomechanics continues to mature and develop. Models were established with three-dimensional finite element software to analyze ankle biomechanics and to study clinical diseases, which gradual y become a hot research topic. OBJECTIVE:To investigate the current status of three-dimensional finite element analysis of biomechanics in the ankle and to review the clinical research progress. METHODS:China National Knowledge Infrastructure and PubMed (from January 1986 to March 2014) were used to search the related finite element articles about ankle. The retrieval words included ankle, finite element, biomechanics and mechanics research. After excluding objective-independent papers or repeated articles, 47 papers were included for further analysis. RESULTS AND CONCLUSION:Ankle joint complex biomechanics mechanism and variety of injury could break mechanics balance of its surrounding structure and lead to instability and traumatic arthritis. Ankle’s three-dimensional finite element model can accurately reflect anatomical structure and virtual simulation can reappear the operation method in the simulation biomechanics experiment, such as compression, tension, bending, torsion and anti-fatigue mechanics. It makes the direction of the research from biomechanics of static to dynamic, which finds a more suitable solution to diagnose and treat

  14. The effect of dynamic ankle-foot orthosis on ankle joints of children with cerebral palsy%动踝矫形鞋对脑瘫儿童踝关节的影响

    Institute of Scientific and Technical Information of China (English)

    杜文静; 李慧慧; 谈恩民; 王磊

    2015-01-01

    Aim:To analyze the effects of ankle foot orthosis on angle of ankle plantar flexion and dorsiflexion,and the walking cycle of lower limbs of children with cerebral palsy.Methods:25 subjects with cerebral palsy came to the physical therapy rehabilitation center volunteered to participate in the ex-periment in Shenzhen Disabled Rehabilitation Center,Guangdong,China in 2014 -06 /2014 -07,who were abnormal during walking.The child's parents or guardian informed consent.According to the chron-ological age,subjects were divided into four groups,5 of 2 ~4 years old group (2y ≤ age 0.05),and there was no significant difference between left and right side (P >0.05 ),the variance was equal.Between each age group,the parameters had no significant difference (P >0.05)expect for the cycle time between no wearing ankle-foot orthopedic and wearing ankle -foot orthopedic (P =0.02 <0.05).The cycle of time of left/right was 0.989 ±0.071 during no wearing ankle-foot orthopedic,and the coefficient of variation was 7.18% in all the samples.The cycle of time of left/right was 1.003 ±0.045 during wearing ankle-foot orthopedic,and the coefficient of variation was 4.49% in all the samples.It indicated that the gait of left and right was symmetry.Conclusion:The datas of 25 subjects were different between no wearing ankle-foot orthopedic and wearing ankle-foot ortho-pedic.① The more age were older,the smaller the angles of ankle plantar flexion were during no wearing ankle-foot orthopedic in all groups except 2 ~4 years old group.② The angle of ankle plantar flexion of children with wearing ankle-foot orthopedic were bigger than that of children without wearing ankle-foot orthopedic in different groups except the right side of 2 ~4 years old group and left side of 8 ~10 years old group,and the angle of ankle dorsiflexion of children with wearing ankle-foot orthopedic were bigger than that of children without wearing ankle-foot orthopedic in different groups.③ The more age were ol

  15. Modeling of Human Joint Structures.

    Science.gov (United States)

    1982-09-01

    Radial Lateral " epicondyle Olecranon Radius Ulna Figure 3. Lateral aspect of the right elbow joint. -17- Annular Ligament This strong band encircles... elbow joint, knee joint, human joints, shoulder joint, ankle joint, joint models, hip joint, ligaments. 20. ABSTRACT (Continue on reverse side If...ligaments. -A rather extended discussion of the articulations and anatomical descriptions of the elbow , shoulder, hip, knee and ankle joints are

  16. Comparison of total ankle replacement and ankle arthrodesis in patients with haemophilia using gait analysis: two case reports

    OpenAIRE

    Dauty, Marc; Gross, Raphael; Leboeuf, Fabien; Trossaert, Marc

    2015-01-01

    Background Severe hemophilia is an inherited, lifelong bleeding disorder characterized by spontaneous bleeding, which results in painful joint deformities. Currently two surgical treatments are available to treat haemophilia-related ankle joint destruction: ankle arthrodesis and total ankle replacement. The aim of the present study was to compare these two surgical procedures in haemophiliac subjects. Case presentation Kinematic and dynamic parameters were quantified using a three-dimensional...

  17. Medium- to long-term outcome of ankle arthrodesis

    NARCIS (Netherlands)

    R.P.M. Hendrickx; S.A.S. Stufkens; E.E. de Bruijn; I.N. Sierevelt; C.N. van Dijk; G.M.M.J. Kerkhoffs

    2011-01-01

    Despite improvement in outcome after ankle arthroplasty, fusion of the ankle joint is still considered the gold standard. A matter of concern is deterioration of clinical outcome as a result of loss of motion and advancing degeneration of adjacent joints. We performed a long-term study to address th

  18. 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.

  19. The feasibility of total ankle prosthesis for severe arthropathy in haemophilia and prothrombin deficiency.

    NARCIS (Netherlands)

    Heide, H.J. van der; Nováková, I.R.O.; Waal Malefijt, M.C. de

    2006-01-01

    The standard treatment for end-stage arthropathy of the ankle joint in haemophilia has been fusion of the ankle joint. Total ankle replacement is used in osteoarthritis and especially in rheumatoid arthritis with good medium-term results. In this case series three patients are being described, in wh

  20. Conversion of ankle autofusion to total ankle replacement using the Salto XT revision prosthesis.

    Science.gov (United States)

    Williamson, Emilie R C; Demetracopoulos, Constantine A; Ellis, Scott J

    2016-09-01

    Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered. We describe the clinical and radiographic outcomes achieved in this case. At 12 months post-operatively the patient reported significant reduction of pain, increased FAOS scores and had increased ankle range of motion.

  1. Effects of Tai Chi versus Proprioception Exercise Program on Neuromuscular Function of the Ankle in Elderly People: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Jing Liu

    2012-01-01

    Full Text Available Background. Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people. Methods. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures included joint position sense and muscle strength of ankle. Subjects completed a satisfaction questionnaire upon study completion in Tai Chi and proprioception groups. Results. (1 Both Tai Chi group and proprioception exercise group were significantly better than control group in joint position sense of ankle, and there were no significant differences in joint position sense of ankle between TC group and PE group. (2 There were no significant differences in muscle strength of ankle among groups. (3 Subjects expressed more satisfaction with Tai Chi than with proprioception exercise program. Conclusions. None of the outcome measures on neuromuscular function at the ankle showed significant change posttraining in the two structured exercise groups. However, the subjects expressed more interest in and satisfaction with Tai Chi than proprioception exercise.

  2. Research regarding wires elastic deformations influence on joints positioning of a wire-driven robotic arm

    Science.gov (United States)

    Ciofu, C.; Stan, G.

    2016-08-01

    In this paper, we present the influence of driving wires deformation on positioning precision of joints from an elephant's trunk robotic arm. Robotic arms driven by wires have the joint accuracy largely depending on wires rigidity. The joint moment of resistance causes elastic deformation of wires and it is determined by: manipulated object load, weight loads previous to the analyzed joint and inherent resistance moment of joint. Static load analysis emphasizes the particular wires elastic deformation of each driven joint from an elephant's trunk robotic arm with five degrees of freedom. We consider the case of a constant manipulated load. Errors from each driving system of joints are not part of the closed loop system. Thus, precision positioning depends on wires elastic deformation which is about microns and causes angle deviation of joints about tens of minutes of sexagesimal degrees. The closer the joints to base arm the smaller positioning precision of joint. The obtained results are necessary for further compensation made by electronic corrections in the programming algorithm of the elephant's trunk robotic arm to improve accuracy.

  3. The reliability of knee joint position testing using electrogoniometry

    Directory of Open Access Journals (Sweden)

    Winter Adele

    2008-01-01

    Full Text Available Abstract Background The current investigation examined the inter- and intra-tester reliability of knee joint angle measurements using a flexible Penny and Giles Biometric® electrogoniometer. The clinical utility of electrogoniometry was also addressed. Methods The first study examined the inter- and intra-tester reliability of measurements of knee joint angles in supine, sitting and standing in 35 healthy adults. The second study evaluated inter-tester and intra-tester reliability of knee joint angle measurements in standing and after walking 10 metres in 20 healthy adults, using an enhanced measurement protocol with a more detailed electrogoniometer attachment procedure. Both inter-tester reliability studies involved two testers. Results In the first study, inter-tester reliability (ICC[2,10] ranged from 0.58–0.71 in supine, 0.68–0.79 in sitting and 0.57–0.80 in standing. The standard error of measurement between testers was less than 3.55° and the limits of agreement ranged from -12.51° to 12.21°. Reliability coefficients for intra-tester reliability (ICC[3,10] ranged from 0.75–0.76 in supine, 0.86–0.87 in sitting and 0.87–0.88 in standing. The standard error of measurement for repeated measures by the same tester was less than 1.7° and the limits of agreement ranged from -8.13° to 7.90°. The second study showed that using a more detailed electrogoniometer attachment protocol reduced the error of measurement between testers to 0.5°. Conclusion Using a standardised protocol, reliable measures of knee joint angles can be gained in standing, supine and sitting by using a flexible goniometer.

  4. Gait training facilitates central drive to ankle dorsiflexors in children with cerebral palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Petersen, Tue Hvass; Farmer, Simon Francis;

    2015-01-01

    facilitate corticospinal transmission and improve the control of the ankle joint in children with cerebral palsy. Sixteen children with cerebral palsy (Gross Motor Classification System I:6, II:6, III:4) aged 5-14 years old, were recruited for the study. Evaluation of gait ability and intramuscular coherence...... in the strength of coherence in the beta and gamma band were positively correlated with improvements in the subjects' ability to lift the toes in the swing phase. These data show that daily intensive gait training increases beta and gamma oscillatory drive to ankle dorsiflexor motor neurons and that it improves...

  5. Distributed Multiagent for NAO Robot Joint Position Control Based on Echo State Network

    Directory of Open Access Journals (Sweden)

    Ling Qin

    2015-01-01

    Full Text Available Based on echo state networks, the joints position control of NAO robot is studied in this paper. The process to control the robot position can be divided into two phases. The senor parameters are released during the first phase. Depending on the dynamic coupling effect between the angle acceleration of passive joint and the torque of active joint, passive joint can be controlled indirectly to the desired position along the desired trajectory. The ESN control rules during the first phase are described and ESN controller is designed to control the motion of passive joint. The brake is locked during the second phase; then active joint is controlled to the desired position. The experimental control system based on PMAC controller is designed and developed. Finally, the joint position control of the NAO robot is achieved successfully by experiments. Echo state networks utilized incremental updates driven by new sensor readings and massive short memory with history inputs; thus varying communication rates can help imitate human upper limb motion based on wearable sensors to obtain human joint angles.

  6. 人工全踝关节置换治疗踝关节骨病早中期效果观察%Intermediate and short-term clinical observation after treatment for bone diseases of ankle joint with Scandinavian total ankle replacement

    Institute of Scientific and Technical Information of China (English)

    刘先哲; 陈朦村; 杨述华; 许伟华; 冯勇

    2015-01-01

    Objective To evaluate results and demonstrate problems of Scandinavian total ankle replacement (STAR) in patients with ankle arthritis and clarify its role as a growing alternatives to ankle fusion.Methods Retrospectively analyzed 43 patients who had total ankle replacement from May 1999 to January 2013.All cases were evaluated with interview focusing on pain,daily activities and clinical and radiologic examinations.The average age of patients was 46 (range,35 to 56) years old.Among these cases,9 patients suffered from posttraumatic arthritis,25 osteoarthritis,5 rheumatoid arthritis and 4 avascular necrosis of the talar body.All patients complained about ankle joint pain and swelling as well as limited ROM of joint.Results Mean follow-up was 6.7 (1.5 to 12 years) years.37 cases had complete follow-up.The average preoperative ankle score was 27.0± 10.5,pain degree score was 16.5± 12.8,joint function score was 10.6±7.4,ROM score was 8.2±5.2.The average preoperative ankle score was 86.5±13.2,pain degree score was 49.5±4.5,joint function score was 19.7±9.5,ROM score was 19.2±3.2.The indicatiors compared with preoperative,postoperative differences have statistical significance.The score of postoperative Kofoed were divided into excellent 35 cases,good 1 case and poor 1 case,excellent and good rate was 97.3%.The American orthopaedic foot and ankle society (AOFAS) scoring system was improved from 40.5 preoperatively to 80.6 postoperatively.No postoperative loosening or migrating of the prosthesis was noted.Conclusion It was demonstrated that the standardized and normalized operative techniques as well as operative tools closely matched to the prosthesis could achieve favorable outcomes according to the clinical and radiographic outcomes and overall acceptable cornplication rates in the present study.STAR was a choice for the patients with advanced osteoarthritis,posttraumatic arthritis,rheumatic arthritis and avascular necrosis of the talar body.%目的 探讨

  7. Advanced age and the mechanics of uphill walking: a joint-level, inverse dynamic analysis.

    Science.gov (United States)

    Franz, Jason R; Kram, Rodger

    2014-01-01

    We sought to gain insight into age-related muscular limitations that may restrict the uphill walking ability of old adults. We hypothesized that: (1) old adults would exhibit smaller peak ankle joint kinetics and larger peak hip joint kinetics than young adults during both level and uphill walking and (2) these age-related differences in ankle and hip joint kinetics would be greatest during uphill vs. level walking. We quantified the sagittal plane ankle, knee, and hip joint kinetics of 10 old adults (mean ± SD, age: 72 ± 5 yrs) and 8 young adults (age: 27 ± 5 yrs) walking at 1.25 m/s on a dual-belt, force-measuring treadmill at four grades (0°, +3°, +6°, +9°). As hypothesized, old adults walked with smaller peak ankle joint kinetics (e.g., power generation: -18% at +9°) and larger peak hip joint kinetics (e.g., power generation: +119% at +9°) than young adults, most evident during the late stance phase of both level and uphill conditions. Old adults performed two to three times more single support positive work than young adults via muscles crossing the knee. In partial support of our second hypothesis, the age-related reduction in peak ankle joint moments was greater during uphill (-0.41 Nm/kg) vs. level (-0.30 Nm/kg) walking. However, old adults that exhibited reduced propulsive ankle function during level walking could perform 44% more trailing leg positive ankle joint work to walk uphill. Our findings indicate that maintaining ankle power generation and trailing leg propulsive function should be the primary focus of "prehabilitation" strategies for old adults to preserve their uphill walking ability.

  8. System Wide Joint Position Sensor Fault Tolerance in Robot Systems Using Cartesian Accelerometers

    Science.gov (United States)

    Aldridge, Hal A.; Juang, Jer-Nan

    1997-01-01

    Joint position sensors are necessary for most robot control systems. A single position sensor failure in a normal robot system can greatly degrade performance. This paper presents a method to obtain position information from Cartesian accelerometers without integration. Depending on the number and location of the accelerometers. the proposed system can tolerate the loss of multiple position sensors. A solution technique suitable for real-time implementation is presented. Simulations were conducted using 5 triaxial accelerometers to recover from the loss of up to 4 joint position sensors on a 7 degree of freedom robot moving in general three dimensional space. The simulations show good estimation performance using non-ideal accelerometer measurements.

  9. Coordinated joint motion control system with position error correction

    Energy Technology Data Exchange (ETDEWEB)

    Danko, George (Reno, NV)

    2011-11-22

    Disclosed are an articulated hydraulic machine supporting, control system and control method for same. The articulated hydraulic machine has an end effector for performing useful work. The control system is capable of controlling the end effector for automated movement along a preselected trajectory. The control system has a position error correction system to correct discrepancies between an actual end effector trajectory and a desired end effector trajectory. The correction system can employ one or more absolute position signals provided by one or more acceleration sensors supported by one or more movable machine elements. Good trajectory positioning and repeatability can be obtained. A two-joystick controller system is enabled, which can in some cases facilitate the operator's task and enhance their work quality and productivity.

  10. Coordinated joint motion control system with position error correction

    Energy Technology Data Exchange (ETDEWEB)

    Danko, George L.

    2016-04-05

    Disclosed are an articulated hydraulic machine supporting, control system and control method for same. The articulated hydraulic machine has an end effector for performing useful work. The control system is capable of controlling the end effector for automated movement along a preselected trajectory. The control system has a position error correction system to correct discrepancies between an actual end effector trajectory and a desired end effector trajectory. The correction system can employ one or more absolute position signals provided by one or more acceleration sensors supported by one or more movable machine elements. Good trajectory positioning and repeatability can be obtained. A two joystick controller system is enabled, which can in some cases facilitate the operator's task and enhance their work quality and productivity.

  11. Radiographic Evaluation of the Ankle Mortise

    Directory of Open Access Journals (Sweden)

    Hamid Mirbagheri

    2010-05-01

    Full Text Available The ankle joint is the most frequently injured joint in adults. Decisions on management are usually based on clinical examination and interpretation of the x-rays. Stability of the ankle mortise relies on the configuration of the osseous structures and the ligaments. A basic radiographic examination consists of a mortise-view and a lateral view. Some add the AP-view. The Mortise view is an AP-view with 15-25 degrees endorotation of the foot. "nThe view clearly demonstrates both lateral and medial joint spaces. On a true AP-view the talus overlaps a portion of the lateral malleolus obscuring the lateral aspect of the ankle joint. However, the AP-view will give you an extra view on both malleoli from a different angle. The lateral radiograph of the ankle should include the base of the fifth metatarsal because of the frequency of fractures at this side that clinically mimic a fracture of the ankle.

  12. Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography

    Directory of Open Access Journals (Sweden)

    Zahra Dalili

    2012-01-01

    Conclusion: The assessment of joint spaces in right and left sides should be done independently. Overall, the measured joint spaces except Sjs are not different in two sexes. The data from this study could be a useful and comparable reference for the clinical assessment of condylar position in patients with normal functional joints.

  13. Early intra-articular complement activation in ankle fractures

    DEFF Research Database (Denmark)

    Schmal, Hagen; Salzmann, Gian M; Niemeyer, Philipp;

    2014-01-01

    osteochondritis dissecans (OCD) of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1 β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture...... and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures....

  14. Automatic control of positioning along the joint during EBW in conditions of action of magnetic fields

    Science.gov (United States)

    Druzhinina, A. A.; Laptenok, V. D.; Murygin, A. V.; Laptenok, P. V.

    2016-11-01

    Positioning along the joint during the electron beam welding is a difficult scientific and technical problem to achieve the high quality of welds. The final solution of this problem is not found. This is caused by weak interference protection of sensors of the joint position directly in the welding process. Frequently during the electron beam welding magnetic fields deflect the electron beam from the optical axis of the electron beam gun. The collimated X-ray sensor is used to monitor the beam deflection caused by the action of magnetic fields. Signal of X-ray sensor is processed by the method of synchronous detection. Analysis of spectral characteristics of the X-ray sensor showed that the displacement of the joint from the optical axis of the gun affects on the output signal of sensor. The authors propose dual-circuit system for automatic positioning of the electron beam on the joint during the electron beam welding in conditions of action of magnetic interference. This system includes a contour of joint tracking and contour of compensation of magnetic fields. The proposed system is stable. Calculation of dynamic error of system showed that error of positioning does not exceed permissible deviation of the electron beam from the joint plane.

  15. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management.

  16. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update.

    Science.gov (United States)

    2015-10-01

    The following statement was prepared by the Special Committee to Revise the Joint American Association of Endodontists/American Academy of Oral and Maxillofacial Radiology Position on Cone Beam Computed Tomography, and approved by the AAE Board of Directors and AAOMR Executive Council in May 2015. AAE members may reprint this position statement for distribution to patients or referring dentists.

  17. Ankle Sprain Treatment

    Science.gov (United States)

    ... Emergencies > Sports Injuries > Ankle Sprain Treatment Health Issues Listen Español Text Size Email Print Share Ankle Sprain Treatment Page Content Article Body Acute ankle and foot injuries are common in athletes and other active young people. Sprains account for the greatest number ...

  18. Management of Osseous and Soft-Tissue Ankle Equinus During Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Simonson, Devin C

    2015-10-01

    Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These techniques include anterior tibiotalar joint cheilectomy, posterior superficial muscle compartment lengthening, posterior ankle capsule release, and release of the posterior portions of the medial and lateral collateral ligament complexes. The rationale for these procedures and the operative sequence of events for these procedures are presented.

  19. Salvage arthrodesis for failed total ankle arthroplasty

    Science.gov (United States)

    Zürcher, Arthur W

    2010-01-01

    Background and purpose Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease. Patients and methods Between 1994 and 2005, salvage arthrodesis was performed on 18 ankles (18 patients). Diagnosis was inflammatory joint disease (IJD) in 15 cases and osteoarthritis (OA) in 3. Tibio-talar fusion was performed in 7 ankles, and tibio-talocalcaneal fusion in 11. Serial radiographs were studied for time to union. Clinical outcome at latest follow-up was measured by the AOFAS score, the foot function index (FFI) and by VAS scores for pain, function, and satisfaction. Results Blade plates were used in 7 ankles (4 IJD, 3 OA); all united. Nonunion developed in 7 of the 11 rheumatic ankles stabilized by other methods. 11 patients (8 fused ankles, 3 nonunions) were available for clinical evaluation. Their mean AOFAS score was 62 and mean overall FFI was 70. VAS score for pain was 20, for function 64, and for satisfaction 74. The scores were similar in united and non-united ankles. Interpretation Blade plate fixation is successful in salvage arthrodesis for failed TAA. A high nonunion rate was found after salvage ankle arthrodesis in IJD with other methods of fixation. Clinical results were fair to good. PMID:20175648

  20. Age-related changes in the joint position sense of the human hand

    Directory of Open Access Journals (Sweden)

    Kalisch T

    2012-11-01

    Full Text Available Tobias Kalisch,1,2,* Jan-Christoph Kattenstroth,2,* Rebecca Kowalewski,2 Martin Tegenthoff,1 Hubert R Dinse21Department of Neurology, BG-Kliniken Bergmannsheil, Ruhr-University Bochum, Bochum, Germany; 2Neural Plasticity Lab, Institute for Neuroinformatics, Ruhr-University Bochum, Bochum, Germany*These authors contributed equally to this workAbstract: Age-related changes in lower limb joint position sense and their contributions to postural stability are well documented. In contrast, only a few studies have investigated the effect of age on proprioceptive hand function. Here, we introduce a novel test for measuring joint position sense in the fingers of the human hand. In a concurrent matching task, subjects had to detect volume differences between polystyrene balls grasped with their dominant (seven test stimuli: 126–505 cm3 and their nondominant hand (three reference stimuli: 210, 294, and 505 cm3. A total of 21 comparisons were performed to assess the number of errors, the weight of errors (ie, the volume difference between test and reference stimuli, and the direction of errors (ie, over- or underestimation of test stimulus. The test was applied to 45 healthy subjects aged 21 to 79 years. Our results revealed that all variables changed significantly with age, with the number of errors showing the strongest increase. We also assessed tactile acuity (two-point discrimination thresholds and sensorimotor performance (pegboard performance in a subset of subjects, but these scores did not correlate with joint position sense performance, indicating that the test reveals specific information about joint position sense that is not captured with pure sensory or motor tests. The average test–retest reliability assessed on 3 consecutive days was 0.8 (Cronbach's alpha. Our results demonstrate that this novel test reveals age-related decline in joint position sense acuity that is independent from sensorimotor performance.Keywords: aging, hand

  1. Is ankle involvement underestimated in rheumatoid arthritis? Results of a multicenter ultrasound study.

    Science.gov (United States)

    Gutierrez, Marwin; Pineda, Carlos; Salaffi, Fausto; Raffeiner, Bernd; Cazenave, Tomas; Martinez-Nava, Gabriela A; Bertolazzi, Chiara; Vreju, Florentin; Inanc, Nevsun; Villaman, Eduardo; Delle Sedie, Andrea; Dal Pra, Fernando; Rosemffet, Marcos

    2016-11-01

    The aim of this study is to investigate the prevalence of subclinical ankle involvement by ultrasound in patients with rheumatoid arthritis (RA). The study was conducted on 216 patients with RA and 200 healthy sex- and age-matched controls. Patients with no history or clinical evidence of ankle involvement underwent US examination. For each ankle, tibio-talar (TT) joint, tibialis anterior (TA) tendon, extensor halux (EH) and extensor common (EC) tendons, tibialis posterior (TP) tendon, flexor common (FC) tendon and flexor hallux (FH) tendon, peroneous brevis (PB) and longus (PL) tendons, Achilles tendon (AT) and plantar fascia (PF) were assessed. The following abnormalities were recorded: synovitis, tenosynovitis, bursitis, enthesopathy and rupture. BMI, DAS28, RF ESR and CRP were also obtained. A total of 432 ankles of patients with RA and 400 ankles of healthy controls were assessed. In 188 (87%) patients with RA, US showed ankle abnormalities whereas, in control group, US found abnormalities in 57 (28.5 %) subjects (p = 0.01). The most frequent US abnormality in RA patients was TP tenosynovits (69/216) (31.9 %), followed by PL tenosynovitis (58/216) (26.9 %), TT synovitis (54/216) (25 %), PB tenosynovitis (51/216) (23.6 %), AT enthesopathy (41/216) (19 %) and AT bursitis (22/216) (10.2 %). In 118 RA patients out of 216 (54.6%), a positive PD was found. No statistically significant correlation was found between the US findings and age, disease duration, BMI, DAS28, RF, ESR and CRP. The present study provides evidence of the higher prevalence of subclinical ankle involvement in RA patients than in age- and gender-matched healthy controls identified by US.

  2. Joint Coordination and Muscle Activities of Ballet Dancers During Tiptoe Standing.

    Science.gov (United States)

    Tanabe, Hiroko; Fujii, Keisuke; Kouzaki, Motoki

    2017-01-01

    We aimed to investigate joint coordination of lower limbs in dancers during tiptoe standing and the relationship between joint coordination and muscle coactivation. Seven female ballet dancers performed tiptoe standing with six leg positions (fi e classical dance positions and one modern dance position) for 10 s. The kinematic data of the metatarsophalangeal (MP), ankle, knee, and hip joints was collected, and surface electromyography (EMG) of over 13 lower limb muscles was conducted. Principal component analysis was performed to determine joint coordination. MP-ankle and ankle-knee had in-phase coordination, whereas knee-hip showed anti-phase coordination in the sagittal plane. In addition, most EMG-EMG coherence around the MP and ankle joints was significant up to 50 Hz when these two joints swayed with in-phase. This suggests that different joint coordination patterns are associated with neural processing related to different muscle coactivation patterns. In conclusion, ballet dancers showed in-phase coordination from the MP to knee joints, which was associated with muscle coactivation to a higher frequency domain (up to 50 Hz) in comparison with anti-phase coordination.

  3. Staged bilateral ankle arthroplasty for the treatment of patient with severe defect of the talus (case report

    Directory of Open Access Journals (Sweden)

    K. S. Mikhaylov

    2013-01-01

    Full Text Available Ankle arthroplasty is known to become more successful procedure versus ankle fusion in patients with ankle osteoarthritis. This article represents a clinical case of performing three-staged bilateral ankle arthroplasty by means of HINTEGRA and Mobility implants in a patient with severe defect of the talus. The patient was followed up for 2 years for right ankle and 4 years - for left ankle. The correct treatment strategy gave the patient a new lease of life. He resumed sports activities, being pain-free in both the ankle joints.

  4. Control method for exoskeleton ankle with surface electromyography signals

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen; WANG Zhen; JIANG Jia-xin; QIAN Jin-wu

    2009-01-01

    This paper is concerned with a control method for an exoskeleton ankle with clectromyography (EMG) signals.The EMG signals of human ankle and the exoskeleton ankle are introduced.Then a control method is proposed to control the exoskeleton ankle using the EMG signals.The feed-forward neural network model applied here is composed of four layers and uses the back-propagation training algorithm.The output signals from neural network are processed by the wavelet transform.Finally the control orders generated from the output signals are passed to the motor controller and drive the exoskeleton to move.Through experiments,the equality of neural network prediction of ankle movement is evaluated by giving the correlation coefficient.It is shown from the experimental results that the proposed method can accurately control the movement of ankle joint.

  5. Total ankle replacement. Early experiences with STAR prosthesis.

    Science.gov (United States)

    Murnaghan, J. M.; Warnock, D. S.; Henderson, S. A.

    2005-01-01

    Early designs of Total Ankle Replacement (TAR) had a high failure rate. More recent experience with the 3-piece, meniscal bearing, total ankle replacement has been more promising. We report a review of the early results of our first 22 prostheses in 20 patients undergoing Scandinavian Total Ankle Replacement (STAR) in Northern Ireland. There was a mean follow-up time of 26 months. Seventeen patients are pain-free at the ankle joint during normal daily activities. Two of the early cases have required revision surgery due to technical errors. Other complications have included malleolar fractures, poor wound healing and postoperative stiffness. These early results show high levels of patient satisfaction, and we are encouraged to continue with total ankle arthroplasty. There is a steep initial learning curve and use of TAR should be restricted to foot and ankle surgeons. Images Fig 1 Figs 2a and b Figs 2 c and d PMID:16022128

  6. Intra-articular Pressure Based Stress Analysis of the Distal Tibia Following Insertion of a Total Ankle Replacement

    OpenAIRE

    Soodmand, Ehsan; Natsakis, Tassos; Jonkers, Ilse; Vander Sloten, Jos

    2015-01-01

    The ankle joint plays an important role in transferring the human body weight to the ground. Given the associated loading, Osteoarthritis (OA) is one of the most common disorders in the ankle joint. The most common treatment of ankle OA is total ankle arthroplasty (TAA). However it is not known whether TAA influences the stress levels of the bone structures and specially the distal tibia. Clinical studies previously related the occurrence of tibia cysts to focal stress concentrations. In this...

  7. Quantitative Effects on Proximal Joints of Botulinum Toxin Treatment for Gastrocnemius Spasticity: A 4-Year-Old Case Study

    Directory of Open Access Journals (Sweden)

    Veronica Cimolin

    2009-01-01

    Full Text Available Botulinum toxin A (BTA is a recognized treatment for the early management of spasticity in children with Cerebral Palsy. This study quantified with Gait Analysis (GA the gait pattern of a 4-year-old diplegic child with calf contracture before, 5 days, and 3 months after BTA injections into gastrocnemius. Kinematic and kinetic data of main lower limb joints were investigated. After only 5 days, ankle dorsi-plantarflexion and knee flex-extension improved, but hip joint worsened, increasing its excessive flexion, to compensate the improvement in knee position of the treated limb and to obtain better stability. A worsening of hip power happened. After 3 months, all joints generally improved their position during gait cycle. Hip and knee joints increased their range of movement and improvements occurred at ankle kinematics and kinetisc, too; a better ankle position and an increase of its capacity of propulsion during terminal stance were evident.

  8. 踝关节本体感觉的测量方法研究与应用%Development and application of measurement methods for ankle proprioception

    Institute of Scientific and Technical Information of China (English)

    张秋霞; 花秀琴; 施永健

    2011-01-01

    BACKGROUND: The loss of the ankle proprioception is an important reason for ankle sprain. But there is no standard in themeasurement methods of the ankle proprioception.OBJECTIVE: To review the measurement methods of the ankle proprioception.METHODS: This study was retrived by the author with the key words of “joint position sense, muscle force sense; balancecapacity; proprioception; ankle joint” in English and “proprioception; balance capacity; ankle joint” in Chinese from PubMeddatabaseand VIP database. Articles related with the measurement methods of ankl e proprioception were included. The duplicatedarticles were excluded. A total of 53 articles, 2 in Chinese and 51 in English, were included in the final analysis.RESULTS AND CONCLUSION: There are such measurement methods of proprioception, as joint position sense, muscle forcesense, threshold to detect passive motion, joint movement sense, balance measurement. The selection of measurement methodsof the ankle proprioception should be based on actual needs.%背景:踝关节本体感觉能力的降低可能是踝关节容易反复损伤的一个重要原因,而对于踝关节本体感觉的定量评定方法一直没有一个标准化的测试方法.目的:通过查阅大量资料并进行分析总结,对踝关节本体感觉的测量方法的研究现状进行综述.方法:由作者检索PubMed数据库及维普数据库的相关文章.英文检索词为"joint position sense,muscle force sense;balance capacity;proprioception;ankle joint";中文检索词为"本体感觉,平衡能力,踝关节".共入选53篇文献进行归纳总结.结果与结论:踝关节本体感觉的测量方法包括关节位置觉、肌肉力觉、侦测被动运动变化阈值、关节运动觉、平衡能力等,在实际应用中应根据实际情况需要来确定选用哪种方法作为踝关节本体感觉的测量方法.

  9. SPARKy-Spring Ankle with Regenerative Kinematics

    Science.gov (United States)

    2011-09-01

    89-93215-02-1 98560/10/$15 ©ICROS 142 1 BIONIC RUNNING FOR UNILATERAL TRANSTIBIAL MILITARY AMPUTEES Joseph Hitt, James Merlo, and Jonathan...ankle joint, and n optical switch embedded at the heel provides the necessary ensor feedback. Advantech’s 650MHZ PC-104 with 512MB on oard memory is

  10. Leaders' management of creative ideas: The joint impact of achievement goals and position power

    NARCIS (Netherlands)

    Sijbom, R.B.L.; Janssen, O.; van Yperen, N.W.

    2013-01-01

    In the present research, we examined the joint impact of leaders’ achievement goals and position power on their integrative management of creative ideas delivered either by a subordinate or a superior. In a field study (N = 149), we found that leaders’ mastery goals, but not their performance goals,

  11. Leaders' management of creative ideas : The joint impact of achievement goals and position power

    NARCIS (Netherlands)

    Sijbom, R.B.L.; Janssen, O.; van Yperen, N.W.

    2013-01-01

    In the present research, we examined the joint impact of leaders’ achievement goals and position power on their integrative management of creative ideas delivered either by a subordinate or a superior. In a field study (N = 149), we found that leaders’ mastery goals, but not their performance goals,

  12. Test-retest reliability of joint position and kinesthetic sense in the elbow of healthy subjects

    DEFF Research Database (Denmark)

    Juul-Kristensen, B.; Lund, Hans Aage; Hansen, K.;

    2008-01-01

    Proprioception is an important effect measure in neuromuscular function training in physiotherapy. Reliability studies of methods for measuring proprioception are few on joint position sense (JPS) and threshold to detection of a passive movement (TDPM) on the elbow. The aim was to study test...

  13. Total ankle replacement--evolution of the technology and future applications.

    Science.gov (United States)

    Yu, John J; Sheskier, Steven

    2014-01-01

    Total ankle arthroplasty was developed to reduce pain and retain motion of the ankle joint in patients with osteoarthritis much like its total hip and knee counterparts. Orthopaedic surgeons are well equipped to evaluate and treat patients with end-stage hip or knee arthritis; however, the management of patients with ankle arthritis represents a challenge to both general orthopaedic surgeons and to the foot and ankle surgeons to whom these patients are often referred. Although techniques for both hip and knee arthroplasty have evolved to provide long-term pain relief and functional improvement, neither ankle arthrodesis nor arthroplasty has demonstrated comparably favorable outcomes in long-term follow-up studies. Early ankle arthroplasty designs with highly constrained cemented components were abandoned due to unacceptably high failure rates and complications. While arthrodesis is still considered the "gold standard" for treatment of end-stage ankle arthritis, progression of adjacent joint arthrosis and diminished gait efficiency has led to a resurgence of interest in ankle arthroplasty. Long-term outcome studies for total ankle replacement found excellent or good results in 82% of patients who received a newer generation ankle device compared with 72% if undergoing ankle fusion. Continued long-term follow-up studies are necessary, but total ankle arthroplasty has become a viable option for surgical treatment of ankle arthritis.

  14. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents

    OpenAIRE

    Cho, Bong-Hae; Jung, Yun-Hoa

    2012-01-01

    Purpose To investigate the prevalence of osteoarthritic changes and condylar positioning of the temporomandibular joint (TMJ) in Korean children and adolescents with or without temporomandibular disorders (TMDs). Materials and Methods A total of 101 asymptomatic and 181 symptomatic children and adolescents aged 10 to 18 years old were included in the study. Osteoarthritic changes such as flattening, sclerosis, osteophytes, or erosion, and the parasagittal positioning of the condyle were asses...

  15. 下胫腓联合螺钉位置对踝关节应力分布影响的有限元分析%Effects of the screw positions at the tibiofibular syndesmosis on the stress distribution at the ankle: a finite element analysis

    Institute of Scientific and Technical Information of China (English)

    刘清华; 余斌; 李忠; 庄岩; 张堃

    2013-01-01

    Objective To analyze the effects of 2 different screw positions on the stress distribution at the ankle in three-dimensional finite element models of screw fixation of the inferior tibiofibular syndesmosis.Methods Helical CT scan images of the right foot of a 30 year-old male volunteer were obtained.Software (Mimics,SolidWorks and Simulation) was used to reconstruct three-dimensional bone structures,to simulate ligamentous connections and to generate articular contacts in 3 finite element models of normal ankle,screw fixation for tibiofibular syndesmosis injury with screw placement at 2.5 cm and 5.0 cm above the tibiotalar joint respectively.Loads were applied in simulations of the ankle at the neutral position with single-foot standing,internal rotation and external rotation for calculation of the stress distributions at the ankle.Results Screw fixation with 2 different placement positions decreased the stresses on the periarticular ligaments of the ankle but increased the stresses on the crural interosseous membrane.The stresses on the fibular attachment point of the proximal crural interosseous membrane increased to 28.91MPa and 27.76MPa respectively in the load simulation under internal rotation of the ankle.The contact forces at the major articulations were reduced.The contact forces in the load simulation under internal rotation of the ankle decreased to 136.55N and 120.14N between the tibia and talus,and 42.68N and 39.33N between the fibula and talus; the contact forces in the load simulation under external rotation of the ankle decreased to 167.93 N and 158.17 N between the tibia and talus,and 39.47N and 40.21N between the fibula and talus,respectively.Conclusion The three-dimensional finite element models of screw fixation of the inferior tibiofibular syndesmosis show that 2different screw placement positions will lead to changes in the stress distribution at the ankle but the differences are not significant between the 2 positions.%目的 利用有限元

  16. Condylar position on the lateral individualized corrected tomography in internal derangement of temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keun Min; Hwang, Eui Hwan; Lee, Sang Rae [College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2002-06-15

    To examine the possible relationship between condylar position and disk displacement in the temporomandibular joint. 79 temporomandibular joints in 40 patients having temporomandibular disorders were classified into three categories: no disk displacement (NDD), disk displacement with reduction (DDWR), and disk displacement without reduction (DDWOR). Disk positions were assessed from clinical and MRI findings. The relationship between the three categories and condylar positions was evaluated using lateral individualized corrected tomography. Clinical findings regarding the relationship between condyle and disk positions having anterior, centric, and posterior positions were 27%, 27%, and 46%, respectively, in NDD, 43%, 17%, and 40%, respectively, in DDWR, and 44%, 22%, and 34%, respectively, in DDWOR. There were no significant differences in condylar positions between each of the groups (P>0.05). In the relationship between condyle and disk positions with MRI findings, anterior, centric, and posterior positions were 38%, 38%, and 24%, respectively, in NDD, 29%, 21%, and 50%, respectively, in DDWR, and 44%, 9%, and 47% respectively, in DDWOR. There were significant differences in the condylar positions when MRI was utilized (P<0.05). There was a significant correlation between the condyle and disk positions with MRI findings on lateral individualized corrected tomography.

  17. Knee joint strength ratios and effects of hip position in rugby players.

    Science.gov (United States)

    Deighan, Martine A; Serpell, Benjamin G; Bitcon, Mark J; De Ste Croix, Mark

    2012-07-01

    Measures of knee joint function, although useful in predicting injury, can be misleading because hip position in traditional seated isokinetic tests is dissimilar to when injuries occur. This study aimed to determine the differences between seated and supine peak torques and strength ratios and examine the interaction of position with joint velocity. This was a cross-sectional, repeated measures study. Isokinetic knee extensor and flexor concentric and eccentric peak torque was measured seated and supine (10° hip flexion) at 1.04 and 3.14 rad·s(-1) in 11 Rugby players. Repeated measures analysis of variance and paired t-tests were used to analyze peak torques and strength ratios. Bonferroni post hoc, limits of agreement, and Pearson's correlation were applied. Seated peak torque was typically greater than that for supine for muscle actions and velocities. The values ranged from 109 ± 18 N·m (mean ± σ) for supine hamstring concentric peak torque at 1.04 rad·s(-1) to 330 ± 71 for seated quadriceps eccentric peak torque at 1.04 rad·s(-1). There was a significant position × muscle action interaction; eccentric peak torque was reduced more than concentric in the supine position. Knee joint strength ratios ranged from 0.47 ± 0.06 to 0.86 ± 0.23, with a significant difference in means between supine and seated positions for functional ratio at 3.14 rad·s(-1) observed; for seated it was 0.86 ± 0.23; and for supine, it was 0.68 ± 0.15 (p torques and knee joint strength ratios. Therefore, the hip angle should be nearer 10° when measuring knee joint function because this is more ecologically valid. Using similar protocols, sports practitioners can screen for injury and affect training to minimize injury.

  18. Total ankle arthroplasty in end-stage ankle arthritis

    OpenAIRE

    Demetracopoulos, Constantine A.; Halloran, James P.; Maloof, Paul; Samuel B Adams; Parekh, Selene G.

    2013-01-01

    Recent advancements in ankle prosthesis design, combined with improved surgical techniques for correction of coronal plane deformity and ligamentous balancing, have led to a resurgence of interest in total ankle arthroplasty for the treatment of end-stage ankle arthritis. Although ankle arthrodesis has long been considered the gold standard treatment for ankle arthritis, recent studies have shown that patients who undergo total ankle replacement have equivalent pain relief and improved functi...

  19. Proprioceptive acuity assessment via joint position matching: from basic science to general practice.

    Science.gov (United States)

    Goble, Daniel J

    2010-08-01

    Over the past several decades, studies of use-dependent plasticity have demonstrated a critical role for proprioceptive feedback in the reorganization, and subsequent recovery, of neuromotor systems. As such, an increasing emphasis has been placed on tests of proprioceptive acuity in both the clinic and the laboratory. One test that has garnered particular interest is joint position matching, whereby individuals must replicate a reference joint angle in the absence of vision (ie, using proprioceptive information). On the surface, this test might seem straightforward in nature. However, the present perspective article informs therapists and researchers alike of multiple insights gained from a recent series of position matching studies by the author and colleagues. In particular, 5 factors are outlined that can assist clinicians in developing well-informed opinions regarding the outcomes of tests of position matching abilities. This information should allow for enhanced diagnosis of proprioceptive deficits within clinical settings in the future.

  20. Surface electromyography studies in standing position confirm that ankle strategy remains disturbed even following successful treatment of patients with a history of sciatica

    OpenAIRE

    Huber, Juliusz; Lisiński, Przemysław; Ciesielska, Jagoda; Kulczyk, Aleksandra; Lipiec, Joanna; Bandosz, Agata

    2016-01-01

    [Purpose] It is hypothesized that ankle strategy can be changed in patients with a history of sciatica. The aim of this study was to detect residual disturbances following successful treatment. [Subjects and Methods] In patients with a history of sciatica (N=11) and pseudo-sciatica (N=9), differences in muscle activity were recorded with bilateral surface polyelectromyography and stability measurements (center of foot pressure sway and center of spectrum) in normal standing and tandem positio...

  1. Characterization of ankle function during stair ambulation

    OpenAIRE

    Gates, Deanna H.; Lelas, Jennifer L.; Della Croce, Ugo; Herr, Hugh; Bonato, Paolo

    2004-01-01

    The aim of this study was to examine the ankle joint during level walking, stair ascent, and stair descent to determine models for use in the design of prosthetic and orthotic systems. Ten healthy subjects were asked to walk (1) across a level walkway, (2) up, and (3) down an instrumented stairway. Sagittal plane kinematic and kinetic data were analyzed to obtain ankle biomechanics during the stance phase of each task. Each stance phase was broken down into sub-phases based on the power traje...

  2. An examination of ankle, knee, and hip torque production in individuals with chronic ankle instability.

    Science.gov (United States)

    Gribble, Phillip A; Robinson, Richard H

    2009-03-01

    There is some debate in the literature as to whether strength deficits exist at the ankle in individuals with chronic ankle instability (CAI). Additionally, there is evidence to suggest that knee and hip performance is altered in those with CAI. Therefore, the purpose of this study was to determine whether CAI is associated with deficits in ankle, knee, and hip torque. Fifteen subjects with unilateral CAI and fifteen subjects with healthy ankles participated. Subjects reported to the laboratory for one session during which the torque production of ankle plantar flexion/dorsiflexion, knee flexion/extension, and hip flexion/extension were measured with an isokinetic device. Subjects performed 5 maximum-effort repetitions of a concentric/concentric protocol at 60 degrees .s for both extremities. Average peak torque (APT) values were calculated. The subjects with CAI demonstrated significantly less APT production for knee flexion (F1,28 = 5.40; p = 0.03) and extension (F1,28 = 5.34; p = 0.03). Subjects with CAI exhibited significantly less APT for ankle plantar flexion in the injured limb compared with their noninjured limb (F1,28 = 6.51; p = 0.02). No significant difference in ankle dorsiflexion or hip flexion/extension APT production existed between the 2 groups. Individuals with CAI, in addition to deficits in ankle plantar flexion torque, had deficits in knee flexor and extensor torque, suggesting that distal joint instability may lead to knee joint neuromuscular adaptations. There were no similar deficits at the hip. Future research should determine what implications this has for prevention and rehabilitation of lower-extremity injury. Clinicians may need to consider including rehabilitation efforts to address these deficits when rehabilitating patients with CAI.

  3. Effect of continuous passive motion on the prevention of ankle joint dysfunction and osteoporosis of patients with paraplegia%持续被动运动在改善截瘫患者踝关节屈伸功能和减轻骨质疏松的效果观察

    Institute of Scientific and Technical Information of China (English)

    黄苑芬; 韩颖; 张志娟; 赖文娟; 曾秋华

    2011-01-01

    Objective To investigate the effect of continuoua passive motion (CPM) on ankle joint dysfunction and osteoporosis of patients with paraplegia.Methods 60 patienls with paraplegia were divided randomjy into CPM group(n = 32) and control group(n = 28).The CPM group received therapy of continuous passive motion, and the control group only underwent therapy of routine rehabilitation.Their ankle joint pasaive ranges of motion (PROM) and bone mineral density (BMD) before and after rehabilitation were assessed and compared.Results After staying in bed for some time, both CPM group and control group developed ankle joint motion limitation and osteoporosis to a certain degree(P < 0.05).But the dysfunction of snkle joint motion range and reduction of BMD in CPM group was greatly smaller than that in the control group(P < 0.05).Conclusion CPM can significandy improve ankle joint dysfunction and osteoporosis of patients with paraplegia.%目的 观察持续被动运动(continuous passive motion,CPM)在改善截瘫患者踝关节屈伸功能和减轻骨质疏松的效果.方法 将60例截瘫患者随机分为CPM组32例和对照组28例,CPM组应用CPM,对照组应用人工手法被动运动.比较治疗前后两组患者躁关节被动屈伸活动范围和骨密度的差异.结果 治疗后CPM组患者踝关节活动度和骨密度优于对照组(均P<0.01).结论 CPM可改善截瘫患者踝关节屈伸功能,减轻骨质疏松的发生.

  4. A 200-m All-out Front-crawl Swim Modifies Competitive Swimmers' Shoulder Joint Position Sense

    NARCIS (Netherlands)

    Uematsu, A.; Kurita, Y.; Inoue, K.; Okuno, K.; Hortobagyi, T.; Suzuki, S.

    2015-01-01

    We tested the hypothesis that an all-out-effort 200-m front-crawl swim trial affects competitive swimmers' shoulder joint position sense. On Day 1, we measured shoulder joint position sense before and after the swim trial, and on Day 2 before and after 2 min of seated rest. On both days, shoulder jo

  5. Ankle morphology amplifies calcaneus movement relative to triceps surae muscle shortening.

    Science.gov (United States)

    Csapo, R; Hodgson, J; Kinugasa, R; Edgerton, V R; Sinha, S

    2013-08-15

    The present study investigated the mechanical role of the dorsoventral curvature of the Achilles tendon in the conversion of the shortening of the plantarflexor muscles into ankle joint rotation. Dynamic, sagittal-plane magnetic resonance spin-tagged images of the ankle joint were acquired in six healthy subjects during both passive and active plantarflexion movements driven by a magnetic resonance compatible servomotor-controlled foot-pedal device. Several points on these images were tracked to determine the 1) path and deformation of the Achilles tendon, 2) ankle's center of rotation, and 3) tendon moment arms. The degree of mechanical amplification of joint movement was calculated as the ratio of the displacements of the calcaneus and myotendinous junction. In plantarflexion, significant deflection of the Achilles tendon was evident in both the passive (165.7 ± 7.4°; 180° representing a straight tendon) and active trials (166.9 ± 8.8°). This bend in the dorsoventral direction acts to move the Achilles tendon closer to the ankle's center of rotation, resulting in an ∼5% reduction of moment arm length. Over the entire range of movement, the overall displacement of the calcaneus exceeded the displacement of the myotendinous junction by ∼37%, with the mechanical gains being smaller in dorsi- and larger in plantarflexed joint positions. This is the first study to assess noninvasively and in vivo using MRI the curvature of the Achilles tendon during both passive and active plantarflexion movements. The dorsoventral tendon curvature amplifies the shortening of the plantarflexor muscles, resulting in a greater displacement of the tendon's insertion into the calcaneus compared with its origin.

  6. Registry data trends of total ankle replacement use.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2013-01-01

    Joint arthroplasty registry data are meaningful when evaluating the outcomes of total joint replacement, because they provide unbiased objective information regarding survivorship and incidence of use. Critical evaluation of the registry data information will benefit the surgeon, patient, and industry. However, the implementation and acceptance of registry data for total ankle replacement has lagged behind that of hip and knee implant arthroplasty. Currently, several countries have national joint arthroplasty registries, with only some procuring information for total ankle replacement. We performed an electronic search to identify publications and worldwide registry databanks with pertinent information specific to total ankle replacement to determine the type of prostheses used and usage trends over time. We identified worldwide registry data from 33 countries, with details pertinent to total ankle replacement identified in only 6 countries. The obtained information was arbitrarily stratified into 3 distinct periods: 2000 to 2006, 2007 to 2010, and 2011. Within these study periods, the data from 13 total ankle replacement systems involving 3,980 ankles were identified. The vast majority (97%) of the reported ankle replacements were 3-component, mobile-bearing, uncemented prostheses. Three usage trends were identified: initial robust embracement followed by abrupt disuse, minimal use, and initial embracement followed by sustained growth in implantation. Before the widespread acceptance of new total ankle replacements, the United States should scrutinize and learn from the international registry data and develop its own national joint registry that would include total ankle replacement. Caution against the adoption of newly released prostheses, especially those without readily available revision components, is recommended.

  7. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms.

    Science.gov (United States)

    Barrera-Mora, José Ma; Espinar Escalona, Eduardo; Abalos Labruzzi, Camilo; Llamas Carrera, José Ma; Ballesteros, Emilio Jiménez-Castellanos; Solano Reina, Enrique; Rocabado, Mariano

    2012-04-01

    The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.

  8. Clinical advances and improvements of ankle joint prostheses(Ⅰ)%人工踝关节假体改进与临床进展(一)

    Institute of Scientific and Technical Information of China (English)

    毛宾尧

    2007-01-01

    随着人工踝关节运动载荷概念的援用、踝关节生物力学和运动学的深人研究,促进了人工踝关节的设计,促进临床疗效迅速提高。其疗效从第1代的3年生存率17%~32%、第2代的24%~44%提高至第3代的78%~96%。以STAR(Scadinavian total ankle replacement)假体为代表的第3代、3件套、双关节和半限制型的临床疗效在世界各国的大宗报告8~14年优良率为64%~91%,生存率为79.7%~100%,获得各国医生的广泛认可。

  9. Conversion of failed ankle arthroplasty to an arthrodesis. Technique using an arthrodesis nail and a cage filled with morsellized bone graft.

    NARCIS (Netherlands)

    Bullens, P.H.J.; Waal Malefijt, M.C. de; Louwerens, J.W.

    2010-01-01

    Arthrodesis of the ankle joint after a failed ankle prosthesis is most often demanding because of bone loss. The bone loss is also responsible for limb length discrepancy. Intramedullary nail fixation has been described to be successful for arthrodesis of the arthritic ankle joint. We report the use

  10. Effect of anterior translation of the talus on outcomes of three-component total ankle arthroplasty

    Science.gov (United States)

    2013-01-01

    Background Ankle osteoarthritis commonly involves sagittal malalignment with anterior translation of the talus relative to the tibia. Total ankle arthroplasty has become an increasingly popular treatment for patients with symptomatic ankle osteoarthritis. However, no comprehensive study has been conducted on the outcomes of total ankle arthroplasty for osteoarthritis with preoperative sagittal malalignment. The purpose of this study was to evaluate the effect of anterior translation of the talus on outcomes of three-component total ankle arthroplasty. Methods One hundred and four osteoarthritic ankles in 104 patients who underwent three-component total ankle arthroplasty were included in this study. The 104 ankles were divided into 2 groups: ankles with anteriorly translated talus (50 ankles), and ankles with non-translated talus (54 ankles). Clinical and radiographic outcomes were assessed in both groups. The mean follow-up duration was 42.8 ± 17.9 months (range, 24 to 95 months). Results Forty-six (92%) of 50 ankles with anterior translation of the talus showed relocation of the talus within the mortise at 6 months, and 48 (96%) ankles were relocated at 12 months after total ankle arthroplasty. But, 2 (4%) ankles were not relocated until the final follow-up. The AOFAS scores, ankle range of motion, and radiographic outcomes showed no significant difference between the two groups at the final follow-up (p > 0.05 for each). Conclusions In majority of cases, the anteriorly translated talus in osteoarthritic ankles was restored to an anatomical position within 6 months after successful three-component total ankle arthroplasty. The clinical and radiographic outcomes in the osteoarthritic ankles with anteriorly translated talus group were comparable with those in non-translated talus group. PMID:24007555

  11. ASSESSMENT AND COMPARISION OF CERVICAL JOINT POSITION SENSE IN SUBJECTS WITH CHRONIC NECK PAIN vs NORMALS

    Directory of Open Access Journals (Sweden)

    Oberoi Mugdha

    2015-06-01

    Full Text Available Background: The abundance of mechanoreceptors in the cervical spine and their central and reflex afferent connections to the vestibular, visual and postural control system suggests that the cervical proprioceptive information provides important somatosensory information influencing postural stability, head orientation and eye movement control. Disturbances to the afferent input from the cervical region is thought to underlie symptoms of dizziness, unsteadiness, visual disturbances and signs of altered postural stability, cervical proprioception and head and eye movement control in people with chronic neck pain. This study aimed to assess and compare cervical joint position sense in subjects with chronic neck pain vs normals. Methods: Total 60 subjects, divided into two groups chronic neck pain group (n=30 (12 males and 18 females with mean age of 40.7 years and control group (n=30 with age and gender matched normal individuals were assessed for baseline data and demographic variables. Head repositioning accuracy test was used to assess cervical joint position sense in degrees. Results: The difference in the head repositioning error values were found to be extremely significant (p<0.0001 for all the neck movements for subjects with chronic neck pain as compared to normals. Conclusion: Cervical joint position sense in subjects with chronic neck pain is found to be altered as compared to age and gender matched normals.

  12. Can ankle imbalance be a risk factor for tensor fascia lata muscle weakness?

    Science.gov (United States)

    Zampagni, Maria L; Corazza, I; Molgora, A Paladini; Marcacci, M

    2009-08-01

    Risk factors that can determine knee and ankle injuries have been investigated and causes are probably multifactorial. A possible explanation could be related by the temporary inhibition of muscular control following an alteration of proprioceptive regulation due to the ankle imbalance pathology. The purpose of our study was to validate a new experimental set up to quantify two kinesiologic procedures (Shock Absorber Test (SAT) and Kendall and Kendall's Procedure (KKP)) to verify if a subtalus stimulus in an ankle with imbalance can induce a non-appropriate response of controlateral tensor fascia lata muscle (TFL). Fifteen male soccer players with ankle imbalance (AIG) and 14 healthy (CG) were tested after (TEST) before (NO-TEST) a manual percussion in subtalus joint (SAT). A new tailor-made device equipped with a load cell was used to quantify TFL's strength activation in standardized positions. Two trials for each subject were performed, separated by at least one 4-min resting interval. In NO-TEST conditions both AIG and CG showed a progressive adaptation of the subject to the force imposed by operator. No reduction in mean force, mean peak force, and muscle force duration (p>0.5). AIG presented significant differences (mean difference 0.92+/-0.46 s; p=0.000) in muscle force duration in TEST conditions. Our results indicated that "wrong" proprioceptive stimuli coming from the subtalus joint in AIG might induce inhibition in terms of duration of TFL muscle altering the knee stability. This kinesiological evaluation might be useful to prevent ankle and knee injuries.

  13. Clinical measures of hip and foot-ankle mechanics as predictors of rearfoot motion and posture.

    Science.gov (United States)

    Souza, Thales R; Mancini, Marisa C; Araújo, Vanessa L; Carvalhais, Viviane O C; Ocarino, Juliana M; Silva, Paula L; Fonseca, Sérgio T

    2014-10-01

    Health professionals are frequently interested in predicting rearfoot pronation during weight-bearing activities. Previous inconsistent results regarding the ability of clinical measures to predict rearfoot kinematics may have been influenced by the neglect of possible combined effects of alignment and mobility at the foot-ankle complex and by the disregard of possible influences of hip mobility on foot kinematics. The present study tested whether using a measure that combines frontal-plane bone alignment and mobility at the foot-ankle complex and a measure of hip internal rotation mobility predicts rearfoot kinematics, in walking and upright stance. Twenty-three healthy subjects underwent assessment of forefoot-shank angle (which combines varus bone alignments at the foot-ankle complex with inversion mobility at the midfoot joints), with a goniometer, and hip internal rotation mobility, with an inclinometer. Frontal-plane kinematics of the rearfoot was assessed with a three-dimensional system, during treadmill walking and upright stance. Multivariate linear regressions tested the predictive strength of these measures to inform about rearfoot kinematics. The measures significantly predicted (p ≤ 0.041) mean eversion-inversion position, during walking (r(2) = 0.40) and standing (r(2) = 0.31), and eversion peak in walking (r(2) = 0.27). Greater values of varus alignment at the foot-ankle complex combined with inversion mobility at the midfoot joints and greater hip internal rotation mobility are related to greater weight-bearing rearfoot eversion. Each measure (forefoot-shank angle and hip internal rotation mobility) alone and their combination partially predicted rearfoot kinematics. These measures may help detecting foot-ankle and hip mechanical variables possibly involved in an observed rearfoot motion or posture.

  14. European nursing organizations stand up for family presence during cardiopulmonary resuscitation: a joint position statement.

    Science.gov (United States)

    Moons, Philip; Norekvål, Tone M

    2008-01-01

    Empirical evidence suggests that family presence during cardiopulmonary resuscitation (CPR) has beneficial effects. Although many American professional organizations have endorsed the idea of family presence, there is less formal support in Europe. In addition, the attitude of nurses from Anglo-Saxon countries, such as United Kingdom and Ireland, is more positive toward family presence than the attitude of nurses of mainland Europe. In order to support existing guidelines and to stimulate health care organizations to develop a formal policy with respect to family witnessed CPR, 3 important European nursing organizations have recently developed a joint position statement.

  15. Flap surgery in treatment of patients with pathology of ankle

    Directory of Open Access Journals (Sweden)

    D. I. Kutyanov

    2013-01-01

    Full Text Available Objective: to determine the capabilities and perspectives of flap surgery in treatment of patients with traumas and diseases of ankle joint region. Material and methods. The results of surgical treatment of 88 such patients. All the patients were treated in the Vreden Russian Research Institute of Traumatology and Orthopedics within the period from 2000 to 2011. All the patients had pedicled flap transfer (46 cases or free tissue transfer (45 cases. 11 patients had additional need in other open orthopedic operations of ankle joint. Besides this, scientific works dealing with the studied problem have been analyzed. Results and conclusions. It has been stated that flap surgery is predominantly used as the only and exhaustive method of treatment of such patients (87,5%. In these situations pedicled flap transfer and free tissue transfer tend to be used in comparatively equal quantities. Flap surgery is now seldom used as a component of complex surgical treatment. It is used only in some cases of bone reconstruction of distal tibia by Ilizarov bone transport, in some cases of tumors of ankle joint as well as in some cases of local infectious complications after internal fixation and total ankle arthroplasty. Patients with the pathology of this kind have a high need in free tissue transfer (from 66,7% to 83,3%. Progressing technology of total ankle arthroplasty will contribute to the frequency of use of flap surgery for patients with pathology of ankle joint.

  16. Finite element analysis of a composite artificial ankle

    Science.gov (United States)

    Perkins, Leigh Ann; Johnston, Lawrence; Denniston, Charles; Czekalski, Blaise E.

    1993-01-01

    Ultra-light carbon fiber composite materials are being utilized in artificial limbs with increasing frequency in recent years. Dr. Arthur Copes, an orthotist from Baton Rouge, Louisiana, has developed a graphite expoxy composite material artificial ankle (Copes/Bionic Ankle) that is intended to be used by amputees who require the most advanced above-and-below-the-knee prosthetic devices. The Copes/Bionic Ankle is designed to reproduce the function of the natural ankle joint by allowing the composite material to act as a spring mechanism without the use of metal mechanical parts. NASA Marshall Space Flight Center has agreed to participate in the design effort by providing the structural analysis of the artificial ankle design.

  17. Position sense at the human elbow joint measured by arm matching or pointing.

    Science.gov (United States)

    Tsay, Anthony; Allen, Trevor J; Proske, Uwe

    2016-10-01

    Position sense at the human elbow joint has traditionally been measured in blindfolded subjects using a forearm matching task. Here we compare position errors in a matching task with errors generated when the subject uses a pointer to indicate the position of a hidden arm. Evidence from muscle vibration during forearm matching supports a role for muscle spindles in position sense. We have recently shown using vibration, as well as muscle conditioning, which takes advantage of muscle's thixotropic property, that position errors generated in a forearm pointing task were not consistent with a role by muscle spindles. In the present study we have used a form of muscle conditioning, where elbow muscles are co-contracted at the test angle, to further explore differences in position sense measured by matching and pointing. For fourteen subjects, in a matching task where the reference arm had elbow flexor and extensor muscles contracted at the test angle and the indicator arm had its flexors conditioned at 90°, matching errors lay in the direction of flexion by 6.2°. After the same conditioning of the reference arm and extension conditioning of the indicator at 0°, matching errors lay in the direction of extension (5.7°). These errors were consistent with predictions based on a role by muscle spindles in determining forearm matching outcomes. In the pointing task subjects moved a pointer to align it with the perceived position of the hidden arm. After conditioning of the reference arm as before, pointing errors all lay in a more extended direction than the actual position of the arm by 2.9°-7.3°, a distribution not consistent with a role by muscle spindles. We propose that in pointing muscle spindles do not play the major role in signalling limb position that they do in matching, but that other sources of sensory input should be given consideration, including afferents from skin and joint.

  18. Elbow joint variability for different hand positions of the round off in gymnastics.

    Science.gov (United States)

    Farana, Roman; Irwin, Gareth; Jandacka, Daniel; Uchytil, Jaroslav; Mullineaux, David R

    2015-02-01

    The aim of the present study was to conduct within-gymnast analyses of biological movement variability in impact forces, elbow joint kinematics and kinetics of expert gymnasts in the execution of the round-off with different hand positions. Six international level female gymnasts performed 10 trials of the round-off from a hurdle step to a back-handspring using two hand potions: parallel and T-shape. Two force plates were used to determine ground reaction forces. Eight infrared cameras were employed to collect the kinematic data automatically. Within gymnast variability was calculated using biological coefficient of variation (BCV) discretely for ground reaction force, kinematic and kinetic measures. Variability of the continuous data was quantified using coefficient of multiple correlations (CMC). Group BCV and CMC were calculated and T-test with effect size statistics determined differences between the variability of the two techniques examined in this study. The major observation was a higher level of biological variability in the elbow joint abduction angle and adduction moment of force in the T-shaped hand position. This finding may lead to a reduced repetitive abduction stress and thus protect the elbow joint from overload. Knowledge of the differences in biological variability can inform clinicians and practitioners with effective skill selection.

  19. THE EFFECT OF CONSERVATIVELY TREATED ACL INJURY ON KNEE JOINT POSITION Sense

    Science.gov (United States)

    Herrington, Lee

    2016-01-01

    ABSTRACT Background Proprioception is critical for effective movement patterns. However, methods of proprioceptive measurement in previous research have been inconsistent and lacking in reliability statistics making it applications to clinical practice difficult. Researchers have suggested that damage to the anterior cruciate ligament (ACL) can alter proprioceptive ability due to a loss of functioning mechanoreceptors. The majority of patients opt for reconstructive surgery following this injury. However, some patients chose conservative rehabilitation options rather than surgical intervention. Purpose The purpose of this study was to determine the effect of ACL deficiency on knee joint position sense following conservative, non-operative treatment and return to physical activity. A secondary purpose was to report the reliability and measurement error of the technique used to measure joint position sense, (JPS) and comment on the clinical utility of this measurement. Study Design Observational study design using a cross-section of ACL deficient patients and matched uninjured controls. Methods Twenty active conservatively treated ACL deficient patients who had returned to physical activity and twenty active matched controls were included in the study. Knee joint position sense was measured using a seated passive-active reproductive angle technique. The average absolute angle of error score, between 10 °-30 ° of knee flexion was determined. This error score was derived from the difference between the target and repositioning angle. Results The ACL deficient patients had a greater error score (7.9 °±3.6) and hence poorer static proprioception ability that both the contra-lateral leg (2.0 °±1.6; p = 0.0001) and the control group (2.6 °±0.9; p = 0.0001). The standard error of the mean (SEM) of this JPS technique was 0.5 ° and 0.2 ° and the minimum detectable change (MDC) was 1.3 ° and 0.4 ° on asymptomatic and symptomatic subjects

  20. The effects of ankle Kinesio taping on ankle stiffness and dynamic balance.

    Science.gov (United States)

    Fayson, Shirleeah D; Needle, Alan R; Kaminski, Thomas W

    2013-01-01

    The purpose of this study was to determine the effects of Kinesio® taping on static restraint and dynamic postural control of the ankle joint. Thirty female subjects with no history of ankle injury participated in this study. Subjects were tested for passive ankle laxity and stiffness, and time to stabilization following forward, backward, medial, and lateral hops. Subjects were tested prior to tape application, immediately following application, and following 24 hours of use. Differences between taping conditions were investigated using analyses of variance and pairwise comparisons. Stiffness increased following initial application and 24 hours of Kinesio® tape use (F = 6.99, p = .003), despite no observed changes in ankle laxity (F = 0.77, p = .49); however, no changes were observed in time-to-stabilization (F = 0.03, p = .97). Our results suggest that Kinesio® tape may improve static restraint in the ankle joint without altering peak motion or dynamic postural control. A future investigation into Kinesio® tape efficacy in injury prevention or rehabilitation is warranted.

  1. A 200-m All-out Front-crawl Swim Modifies Competitive Swimmers' Shoulder Joint Position Sense.

    Science.gov (United States)

    Uematsu, A; Kurita, Y; Inoue, K; Okuno, K; Hortobágyi, T; Suzuki, S

    2015-11-01

    We tested the hypothesis that an all-out-effort 200-m front-crawl swim trial affects competitive swimmers' shoulder joint position sense. On Day 1, we measured shoulder joint position sense before and after the swim trial, and on Day 2 before and after 2 min of seated rest. On both days, shoulder joint position sense was measured in the seated position using electromagnetic movement sensors in a position-matching paradigm. An investigator abducted participants' left (reference) shoulder joint in the frontal plane to test angles of 90°, 135°, and 180°. Participants then actively abducted the right (indicator) shoulder joint to match the position of the left, reference arm. After the 200-m all-out front-crawl swim trial, the indicator relative to the reference angle differed by 4.4° toward adduction at the 180° (vertical) testing position (Pswim compared with the no-swim control trial. An all-out 200-m front-crawl swim trial can selectively increase competitive swimmers' shoulder joint position sense error and increase variation in matching error in horizontal arm position.

  2. Ultrasound-guided interventions of the foot and ankle.

    Science.gov (United States)

    Yablon, Corrie M

    2013-02-01

    Ultrasound (US) provides excellent delineation of tendons and ligaments in the foot and ankle and provides real-time visualization of a needle during interventions, yielding greater accuracy and efficacy than the traditional blind approach using anatomical landmarks. For this reason, US is rapidly gaining acceptance as the preferred modality for guiding interventions in the foot and ankle where the anatomy is complex, neurovascular structures should be identified, and precise technique is demanded. In the foot and ankle, US is especially useful to guide tendon sheath, bursal, and Achilles paratenon injections, Morton neuroma injections, plantar fascial injections, and joint aspirations and injections.

  3. Modified Evans peroneus brevis lateral ankle stabilization for balancing varus ankle contracture during total ankle replacement.

    Science.gov (United States)

    Roukis, Thomas S

    2013-01-01

    Lateral ankle instability is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, I have described a modification of the Evans peroneus brevis tendon lateral ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis is then transferred either to the anterior distal tibia concomitantly with total ankle replacement or through the tibia when performed after total ankle replacement and secured with plate and screw fixation. This modified Evans peroneus brevis tendon is useful in providing lateral ankle stability during or after primary and revision total ankle replacement.

  4. Robust Tracking Control of Robot Manipulators Using Only Joint Position Measurements

    Directory of Open Access Journals (Sweden)

    Ancai Zhang

    2013-01-01

    Full Text Available This paper concerns the tracking control of a robot manipulator with unknown uncertainties and disturbances. It presents a new control method that uses only joint position measurements to design a tracking controller. The controller has two parts. One is based on a feedback linearization technique; it makes the nominal model of a manipulator asymptotically track a desired trajectory. The other is based on the idea of equivalent input disturbance (EID; it compensates for uncertainties and disturbances. Together they enable a robot manipulator to precisely track the desired trajectory. The new control algorithm is applied to a two-link robot manipulator, and simulation results demonstrate the validity of this method.

  5. Lower limb joint kinetics during the first stance phase in athletics sprinting: three elite athlete case studies.

    Science.gov (United States)

    Bezodis, Neil Edward; Salo, Aki Ilkka Tapio; Trewartha, Grant

    2014-01-01

    This study analysed the first stance phase joint kinetics of three elite sprinters to improve the understanding of technique and investigate how individual differences in technique could influence the resulting levels of performance. Force (1000 Hz) and video (200 Hz) data were collected and resultant moments, power and work at the stance leg metatarsal-phalangeal (MTP), ankle, knee and hip joints were calculated. The MTP and ankle joints both exhibited resultant plantarflexor moments throughout stance. Whilst the ankle joint generated up to four times more energy than it absorbed, the MTP joint was primarily an energy absorber. Knee extensor resultant moments and power were produced throughout the majority of stance, and the best-performing sprinter generated double and four times the amount of knee joint energy compared to the other two sprinters. The hip joint extended throughout stance. Positive hip extensor energy was generated during early stance before energy was absorbed at the hip as the resultant moment became flexor-dominant towards toe-off. The generation of energy at the ankle appears to be of greater importance than in later phases of a sprint, whilst knee joint energy generation may be vital for early acceleration and is potentially facilitated by favourable kinematics at touchdown.

  6. Ankle Brachial Index

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H. (Dept. of Radiology and Dept. of Medical Sciences, Uppsala Univ. Hospital, Uppsala (SE))

    2008-03-15

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one >=50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a >= 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population

  7. Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography

    OpenAIRE

    Zahra Dalili; Nasim Khaki; Seyed Javad Kia; Fatemeh Salamat

    2012-01-01

    Background: The optimal position of the condyle in glenoid fossa is a fundamental question in dentistry. There is no quantitative standard for the optimal position of mandibular condyle in the glenoid fossa in our population. The purpose of this study is to assess the position of the condyle by cone beam computed tomography (CBCT) images in patient with normal function of temporomandibular joint (TMJ). Materials and Methods: In this cross-sectional study, CBCT images of 40 class I skeleta...

  8. Biomechanical characteristics of distal tibial articular surface defect of the ankle joint:three-dimensional finite element analysis%踝关节胫骨远端关节面缺损生物力学特征的三维有限元分析

    Institute of Scientific and Technical Information of China (English)

    宋作成; 闫小龙

    2016-01-01

    BACKGROUND:Studies found that three-dimensional finite element analysis can be used in the study of ankle biomechanics, but research on distal tibial articular surface defect was few. OBJECTIVE:To analyze the biomechanics of distal tibial articular surface defect with three-dimensional finite element, and provide the basis for mechanism of ankle injury related diseases. METHODS:We established ankle three-dimensional finite element model, and set different diameters of distal tibial articular surface defect, observed the peak stress of distal tibial articular surface at load of 1 400 N and the flexor of 14°, at load of 700 N and neutral position, at load 2 100 N and dorsiflexion of 10°, and contact area of tibial astragaloid joint surface at different postures and different defect diameters. RESULTS AND CONCLUSION:(1) At load of 1 400 N and plantar flexion of 14°, the distal tibial articular surface front quadrant stress peak was smal est when the distal tibial articular surface defect diameter was 8 mm, and was maximum when defect diameter was 16 mm;the distal tibial articular surface front inner quadrant stress peak was smal est when the distal tibial articular surface defect diameter was 12 mm, and maximum when defect diameter was 16 mm;the distal tibial articular surface posterior quadrant stress peak was smal est when defect diameter was 12 mm, distal tibial articular surface posterior inner quadrant stress peak was smal est when defect diameter was 0 mm;the distal tibial exterior stress peak was maximum when defect diameter was 16 mm. (2) At load of 700 N and neutral position, exterior front quadrant, front inner quadrant, posterior quadrant and posterior inner quadrant stress peaks increased with the distal tibial articular surface defect increases;the distal tibial articular surface defect stress peak was maximum when defect diameter was 16 mm. (3) At load of 2 100 N and dorsiflexion of 10°, the distal tibial articular surface stress peak was maximum

  9. Note: Position/torque control of antagonistic robot joint with high-compliant twisted string actuators (TSAs).

    Science.gov (United States)

    Park, Jihyuk; Kim, Ji-Chul; Kim, Kyung-Soo; Kim, Soohyun

    2016-12-01

    A tendon-driven robot joint that has a low inertia compared with a conventional drive system is proposed. The robot joint displaces the drive system toward the robot base, and it is driven by twisted string actuators (TSAs), which are a substitute for the conventional heavy drive system. The design of the proposed robot joint is based on an antagonistic scheme that is actuated by two motors. The torques from the motors are transmitted to the robot joint through the TSAs. Based on the geometric analysis of TSAs, strategies for position and torque control are proposed for an antagonistic robot joint driven by TSAs. To verify the proposed control strategies, several control experiments are conducted using a developed prototype of a robot joint.

  10. RELIABILITY AND ACCURACY OF JOINT POSITION SENSE MEASUREMENT IN THE LABORATORY AND CLINIC; UTILISING A NEW SYSTEM

    OpenAIRE

    N. Nasseri; M.R. Hadian; H. Bagheri; S. Talebian G. Olyaei

    2007-01-01

    Measurement of the joint angles is used to assess the joint position sense (JPS). The aim of this study was to introduce a simple, fast, less expensive and objective method of measurement for JPS. In the current research, the accuracy and reliability of a system, consist of digital photography, nonreflective markers and manual analysis were evaluated. For this purpose, digital photos were taken from 72 angles of the knee positions of twenty four healthy subjects. The angles were measured by u...

  11. Short-term effects of kinesio tape on joint position sense, isokinetic measurements, and clinical parameters in patellofemoral pain syndrome

    OpenAIRE

    Kurt, Emine Eda; Büyükturan, Öznur; Erdem, Hatice Rana; Tuncay, Figen; Sezgin, Hicabi

    2016-01-01

    [Purpose] To evaluate the short-term effects of kinesio tape on joint position sense, isokinetic measurements, kinesiophobia, symptoms, and functional limitations in patients with patellofemoral pain syndrome. [Subjects and Methods] A total of 90 patients (112 knees) with patellofemoral pain syndrome were randomized into a kinesio tape group (n=45) or placebo kinesio tape group (n=45). Baseline isokinetic quadriceps muscle tests and measurements of joint position sense were performed in both ...

  12. Use of an acrylic mold for mortise view improvement in ankle fractures: a feasibility study

    NARCIS (Netherlands)

    Donken, C.C.; Verhofstad, M.H.J.; Edwards, M.J.R.; Schoemaker, M.C.; Laarhoven, C.J.H.M. van

    2011-01-01

    We investigated an acrylic mold for use in obtaining ankle radiographs in 31 consecutive patients with ankle fracture. The radiologic examination consisted of routine lateral and mortise views, with the same views procured with the use of the acrylic mold to position the ankle. Radiographic evidence

  13. Evaluation of flexibility of the ankle in elementary students with mental retardation

    Directory of Open Access Journals (Sweden)

    Stavrou V.

    2011-01-01

    Full Text Available Aim: This study aims to measure and evaluate the flexibility of the legs, namely the ankle by measuring the maximum values in flexion and extension of both legs. Method: The study included twelve students with mental retardation. Measured and recorded values of ankle-bending extent of both legs and assign the average of each test. Calculated and measurement the temperature of space and time. The measurement flexion and extension of the ankle was a plastic protractor. Results: The flexion presents decrease at the right ankle relationship with the left ankle by 1.86. The extension presents decrease at the left ankle relationship with the right ankle by 11.43. Conclusions: The results found that the normal range of motion of joints has a significant role in improving efficiency and thus on quality of life of persons with mental retardation. The flexibility is a determinant of performance and therefore should be evaluated at regular intervals.

  14. Time-of-arrival distributions from position-momentum and energy-time joint measurements

    CERN Document Server

    Baute, A D; Muga, J G; Sala-Mayato, R

    2000-01-01

    The position-momentum quasi-distribution obtained from an Arthurs and Kelly joint measurement model is used to obtain indirectly an ``operational'' time-of-arrival (TOA) distribution following a quantization procedure proposed by Kocha\\'nski and Wódkiewicz [Phys. Rev. A 60, 2689 (1999)]. This TOA distribution is not time covariant. The procedure is generalized by using other phase-space quasi-distributions, and sufficient conditions are provided for time covariance that limit the possible phase-space quasi-distributions essentially to the Wigner function, which, however, provides a non-positive TOA quasi-distribution. These problems are remedied with a different quantization procedure which, on the other hand, does not guarantee normalization. Finally an Arthurs and Kelly measurement model for TOA and energy (valid also for arbitrary conjugate variables when one of the variables is bounded from below) is worked out. The marginal TOA distribution so obtained, a distorted version of Kijowski's distribution, is...

  15. Influence of a Full Body Compression Suit on Trunk Positioning and Knee Joint Mechanics During Lateral Movements.

    Science.gov (United States)

    Mornieux, Guillaume; Weltin, Elmar; Pauls, Monika; Rott, Franz; Gollhofer, Albert

    2017-02-09

    Trunk positioning has been shown to be associated with knee joint loading during athletic tasks, especially changes of direction. The purpose of the present study was to test whether a full body compression suit (FBCS) would improve trunk positioning and knee joint control during lateral movements. Twelve female athletes performed lateral reactive jumps (LRJ) and unanticipated cuttings with and without the customized FBCS, while 3D kinematics and kinetics were measured. FBCS did not influence trunk positioning during LRJ and led to increased trunk lateral lean during cuttings (P knee joint abduction and internal rotation angles were reduced during LRJ (P knee joint moments were comparable during cuttings. FBCS cannot support the trunk segment during unanticipated dynamic movements. But increased trunk lateral lean during cutting maneuvers was not high enough to elicit increased knee joint moments. On the contrary, knee joint abduction and internal rotation were reduced during LRJ, speaking for a better knee joint alignment with FBCS. Athletes seeking to improve trunk positioning may not benefit from a full body compression suit.

  16. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  17. Early Intra-Articular Complement Activation in Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Hagen Schmal

    2014-01-01

    Full Text Available Cytokine regulation possibly influences long term outcome following ankle fractures, but little is known about synovial fracture biochemistry. Eight patients with an ankle dislocation fracture were included in a prospective case series and matched with patients suffering from grade 2 osteochondritis dissecans (OCD of the ankle. All fractures needed external fixation during which joint effusions were collected. Fluid analysis was done by ELISA measuring aggrecan, bFGF, IL-1β, IGF-1, and the complement components C3a, C5a, and C5b-9. The time periods between occurrence of fracture and collection of effusion were only significantly associated with synovial aggrecan and C5b-9 levels (P<0.001. Furthermore, synovial expressions of both proteins correlated with each other (P<0.001. Although IL-1β expression was relatively low, intra-articular levels correlated with C5a (P<0.01 and serological C-reactive protein concentrations 2 days after surgery (P<0.05. Joint effusions were initially dominated by neutrophils, but the portion of monocytes constantly increased reaching 50% at day 6 after fracture (P<0.02. Whereas aggrecan and IL-1β concentrations were not different in fracture and OCD patients, bFGF, IGF-1, and all complement components were significantly higher concentrated in ankle joints with fractures (P<0.01. Complement activation and inflammatory cell infiltration characterize the joint biology following acute ankle fractures.

  18. Influences of size and position of defects on the fatigue life of electron beam welded-aluminum alloy joints

    Institute of Scientific and Technical Information of China (English)

    LU Li; ZHAO Haiyan; CAI Zhipeng; CUI Xiaofang

    2007-01-01

    Defects such as pores influence the fatigue life of electron beam-welded aluminum alloy joints. In this paper,the influences of pore size and position on the fatigue life of aluminum overlap joint are studied. A finite element model (FEM), combined with experimental data, is established to evaluate the fatigue life of overlap joints. By employing this FE model, the effects of pore size and position on fatigue lives of overlap joints are investigated and discussed. From the present study, when pore position is closer to the weld bead tip or the faying surface, the fatigue life decreases. Also, there is a critical size for the pore; when the pore size is larger than the critical value, the fatigue strength decreases sharply.

  19. 单侧功能性踝关节不稳者的单足静态平衡能力%The single foot static balancing ability of people suffering from single side functional ankle joint instability

    Institute of Scientific and Technical Information of China (English)

    张阳; 张秋霞; 金超

    2014-01-01

    In order to probe into the characteristics of the single foot static balancing ability of people suffering from single side functional ankle joint instability, the authors used a WIN-POD balancing instrument to test the static balancing ability of 15 people suffering from single side functional ankle joint instability and 15 normal people in eyes opened and shut single foot standing conditions for 10, and revealed the following findings: 1) in an eyes opened left foot standing condition, the differences in envelop area and axisY shaking amplitude between the people in the experiment group and the people in the control group were statistically significant (P<0.05); in an eyes shut standing condition, except axesX andY shaking speeds, the differences in other indexes between the people in the experiment group and people in the control group were statistically significant (P<0.05); 2) in an eyes shut right foot standing condition, the differences in envelop area and axisY shaking amplitude between the people in the experi-ment group and the people in the control group were statistically significant (P<0.05); 3) for the people in the ex-periment group, in an eyes opened standing condition, the difference in envelop area between the ill foot and the healthy one was statistically significant (P<0.05), in an eyes shut standing condition, the differences in envelop area and average axisY shaking amplitude between the ill foot and the healthy one were statistically significant (P<0.05); 4) for the people in the control group, in an eyes shut standing condition, except axesX andY shaking speeds, the differences in other indexes between the left foot and the right one were all statistically significant (P<0.05). The said findings indicate the followings: for people suffering from single side functional ankle joint instability, the bal-ancing ability of the ill foot is slightly weaker than that of the corresponding foot of normal people, and also weaker than that of the

  20. Bottom-up estimation of joint moments during manual lifting using orientation sensors instead of position sensors.

    Science.gov (United States)

    Faber, Gert S; Kingma, Idsart; van Dieën, Jaap H

    2010-05-01

    L5/S1, hip and knee moments during manual lifting tasks are, in a laboratory environment, frequently established by bottom-up inverse dynamics, using force plates to measure ground reaction forces (GRFs) and an optoelectronic system to measure segment positions and orientations. For field measurements, alternative measurement systems are being developed. One alternative is the use of small body-mounted inertial/magnetic sensors (IMSs) and instrumented force shoes to measure segment orientation and GRFs, respectively. However, because IMSs measure segment orientations only, the positions of segments relative to each other and relative to the GRFs have to be determined by linking them, assuming fixed segment lengths and zero joint translation. This will affect the estimated joint positions and joint moments. This study investigated the effect of using segment orientations only (orientation-based method) instead of using orientations and positions (reference method) on three-dimensional joint moments. To compare analysis methods (and not measurement methods), GRFs were measured with a force plate and segment positions and/or orientations were measured using optoelectronic marker clusters for both analysis methods. Eleven male subjects lifted a box from floor level using three lifting techniques: a stoop, a semi-squat and a squat technique. The difference between the two analysis methods remained small for the knee moments: knee joint and with reasonable accuracy at the hip and L5/S1 joints using segment orientation and GRF data only.

  1. Shoulder muscle function depends on elbow joint position: an illustration of dynamic coupling in the upper limb.

    Science.gov (United States)

    Yu, Jay; Ackland, David C; Pandy, Marcus G

    2011-07-07

    Shoulder muscle function has been documented based on muscle moment arms, lines of action and muscle contributions to contact force at the glenohumeral joint. At present, however, the contributions of individual muscles to shoulder joint motion have not been investigated, and the effects of shoulder and elbow joint position on shoulder muscle function are not well understood. The aims of this study were to compute the contributions of individual muscles to motion of the glenohumeral joint during abduction, and to examine the effect of elbow flexion on shoulder muscle function. A three-dimensional musculoskeletal model of the upper limb was used to determine the contributions of 18 major muscles and muscle sub-regions of the shoulder to glenohumeral joint motion during abduction. Muscle function was found to depend strongly on both shoulder and elbow joint positions. When the elbow was extended, the middle and anterior deltoid and supraspinatus were the greatest contributors to angular acceleration of the shoulder in abduction. In contrast, when the elbow was flexed at 90°, the anterior deltoid and subscapularis were the greatest contributors to joint angular acceleration in abduction. This dependence of shoulder muscle function on elbow joint position is explained by the existence of dynamic coupling in multi-joint musculoskeletal systems. The extent to which dynamic coupling affects shoulder muscle function, and therefore movement control, is determined by the structure of the inverse mass matrix, which depends on the configuration of the joints. The data provided may assist in the diagnosis of abnormal shoulder function, for example, due to muscle paralysis or in the case of full-thickness rotator cuff tears.

  2. Motion Simulation of a New Ankle Rehabilitation Device

    Directory of Open Access Journals (Sweden)

    Cristina Racu (Cazacu

    2016-06-01

    Full Text Available The ankle structure holds one of the most important role in the human biomechanics. Due to complexity of everyday activities this joint is the most prone to be injured part of the lower limb. For a complete recovery of the locomotion function, recovery exercises are mandatory. The introduction of robotic physical recovery systems represents a modern alternative to traditional recovery. Based on the 3D virtual model and a previous dimensional synthesis of a new ankle rehabilitation device, its motion simulation is presented in this paper, to prove that it may fully recover the range of motion required for this joint.

  3. Rehabilitation trainging of ankle fractures after open reduction%踝部骨折切开复位术后康复训练

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Background:Ankle joint is a weight carrying one,which treatment focuses on anatomical reduction of articular surface.The ultimate aim is completely recovery of joint function.It is much benefit for open reduction with rational rehabilitation training of post operation to function recovery of ankle joint.

  4. X-Ray Exam: Ankle

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Ankle KidsHealth > For Parents > X-Ray Exam: Ankle A A A What's in ... español Radiografía: tobillo What It Is An ankle X-ray is a safe and painless test that ...

  5. Ultrasound of ankle and foot: overuse and sports injuries.

    Science.gov (United States)

    Khoury, Viviane; Guillin, Raphaël; Dhanju, Jag; Cardinal, Etienne

    2007-06-01

    Sports and overuse injuries of the ankle and foot are commonly encountered in clinical practice. Ultrasound (US) has been established as an excellent diagnostic modality for foot and ankle injuries, providing a rapid noninvasive, economical, and readily available tool that is well tolerated by the patient with acute or chronic pain. The opportunity for dynamic examination is another advantage of US in evaluating ankle and foot pathology, where maneuvers such as muscle contraction and stressing of the joint may be particularly helpful. In many cases, US can be used as a first-line and only imaging modality for diagnosis. This article focuses on ankle disorders related to sports or overuse that affect tendons, including tendinosis, tenosynovitis, paratendinitis, rupture, dislocation, and ligaments that are commonly torn. The sonographic features of certain common foot disorders related to physical activity and overuse are also discussed, including plantar fasciitis, Morton's neuroma, stress fractures, and plantar plate injury.

  6. Reconstruction of hip, knee, and ankle bony fused in non-functional position of ankylosing spondylitis patients%晚期强直性脊柱炎髋、膝、踝关节非功能位骨性强直的功能重建

    Institute of Scientific and Technical Information of China (English)

    吕厚山; 袁燕林; 寇伯龙; 周殿阁; 关振鹏

    2000-01-01

    目的探讨晚期强直性脊柱炎髋、膝、踝关节均在非功能位骨性强直患者的关节功能重建。方法 1996年1月~1997年5月采用一次麻醉下同侧髋、膝、踝关节同时置换术,对2例晚期强直性脊柱炎3侧髋、膝、踝关节骨性融合在非功能位的患者进行关节功能重建;分别随访22个月和36个月,观察关节活动度恢复情况,进行关节功能评分。结果 2例患者膝关节术后平均活动度为76.7。,HSS评分平均提高45分;髋关节术后平均总活动度为145.7°,Harris评分提高37.7分。随访期间患者髋、膝、踝关节活动度基本正常,生活自理。结论对于晚期强直性脊柱炎下肢多关节骨性强直在非功能位的患者,同侧下肢髋、膝、踝三关节同时置换是一种有效的关节功能重建方法。%Objective To evaluate the reconstruction of hip, knee and ankle joints with bony fusion at non-functional positions for patients with severe late-stage ankylosing spondylitis (AS). Methods From January 1996 to May 1997,simultaneous ipsilateral total hip,knee and ankle replacement was performed under single anesthesia on 2 patients (3 sides) with multiple joint deformity including bony fusion at non-functional positions. They were followed for 29 months on average. Results Satisfactory range of motion and function were observed. HSS knee score on average was improved by 45 points and Harris hip score by 37.7 points. There were no wound healing problems or late infection. No aseptic loosening was found. Conclusions Simultaneous ipsilateral total hip,knee and ankle replacement not only reduced cost for hospitalization, but also facilitated early rehabilitation. To our knowledge, this is the first report on this type of surgery, named ipsilateral tri-arthroplasty.

  7. Muscle and reflex changes with varying joint angle in hemiparetic stroke

    Directory of Open Access Journals (Sweden)

    Alibiglou Laila

    2008-02-01

    Full Text Available Abstract Background Despite intensive investigation, the origins of the neuromuscular abnormalities associated with spasticity are not well understood. In particular, the mechanical properties induced by stretch reflex activity have been especially difficult to study because of a lack of accurate tools separating reflex torque from torque generated by musculo-tendinous structures. The present study addresses this deficit by characterizing the contribution of neural and muscular components to the abnormally high stiffness of the spastic joint. Methods Using system identification techniques, we characterized the neuromuscular abnormalities associated with spasticity of ankle muscles in chronic hemiparetic stroke survivors. In particular, we systematically tracked changes in muscle mechanical properties and in stretch reflex activity during changes in ankle joint angle. Modulation of mechanical properties was assessed by applying perturbations at different initial angles, over the entire range of motion (ROM. Experiments were performed on both paretic and non-paretic sides of stroke survivors, and in healthy controls. Results Both reflex and intrinsic muscle stiffnesses were significantly greater in the spastic/paretic ankle than on the non-paretic side, and these changes were strongly position dependent. The major reflex contributions were observed over the central portion of the angular range, while the intrinsic contributions were most pronounced with the ankle in the dorsiflexed position. Conclusion In spastic ankle muscles, the abnormalities in intrinsic and reflex components of joint torque varied systematically with changing position over the full angular range of motion, indicating that clinical perceptions of increased tone may have quite different origins depending upon the angle where the tests are initiated. Furthermore, reflex stiffness was considerably larger in the non-paretic limb of stroke patients than in healthy control subjects

  8. Multivariable dynamic ankle mechanical impedance with relaxed muscles.

    Science.gov (United States)

    Lee, Hyunglae; Krebs, Hermano Igo; Hogan, Neville

    2014-11-01

    Neurological or biomechanical disorders may distort ankle mechanical impedance and thereby impair locomotor function. This paper presents a quantitative characterization of multivariable ankle mechanical impedance of young healthy subjects when their muscles were relaxed, to serve as a baseline to compare with pathophysiological ankle properties of biomechanically and/or neurologically impaired patients. Measurements using a highly backdrivable wearable ankle robot combined with multi-input multi-output stochastic system identification methods enabled reliable characterization of ankle mechanical impedance in two degrees-of-freedom (DOFs) simultaneously, the sagittal and frontal planes. The characterization included important ankle properties unavailable from single DOF studies: coupling between DOFs and anisotropy as a function of frequency. Ankle impedance in joint coordinates showed responses largely consistent with a second-order system consisting of inertia, viscosity, and stiffness in both seated (knee flexed) and standing (knee straightened) postures. Stiffness in the sagittal plane was greater than in the frontal plane and furthermore, was greater when standing than when seated, most likely due to the stretch of bi-articular muscles (medial and lateral gastrocnemius). Very low off-diagonal partial coherences implied negligible coupling between dorsiflexion-plantarflexion and inversion-eversion. The directions of principal axes were tilted slightly counterclockwise from the original joint coordinates. The directional variation (anisotropy) of ankle impedance in the 2-D space formed by rotations in the sagittal and frontal planes exhibited a characteristic "peanut" shape, weak in inversion-eversion over a wide range of frequencies from the stiffness dominated region up to the inertia dominated region. Implications for the assessment of neurological and biomechanical impairments are discussed.

  9. Recycling energy to restore impaired ankle function during human walking.

    Directory of Open Access Journals (Sweden)

    Steven H Collins

    Full Text Available BACKGROUND: Humans normally dissipate significant energy during walking, largely at the transitions between steps. The ankle then acts to restore energy during push-off, which may be the reason that ankle impairment nearly always leads to poorer walking economy. The replacement of lost energy is necessary for steady gait, in which mechanical energy is constant on average, external dissipation is negligible, and no net work is performed over a stride. However, dissipation and replacement by muscles might not be necessary if energy were instead captured and reused by an assistive device. METHODOLOGY/PRINCIPAL FINDINGS: We developed a microprocessor-controlled artificial foot that captures some of the energy that is normally dissipated by the leg and "recycles" it as positive ankle work. In tests on subjects walking with an artificially-impaired ankle, a conventional prosthesis reduced ankle push-off work and increased net metabolic energy expenditure by 23% compared to normal walking. Energy recycling restored ankle push-off to normal and reduced the net metabolic energy penalty to 14%. CONCLUSIONS/SIGNIFICANCE: These results suggest that reduced ankle push-off contributes to the increased metabolic energy expenditure accompanying ankle impairments, and demonstrate that energy recycling can be used to reduce such cost.

  10. Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2012-06-01

    Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

  11. Preoperative gait characterization of patients with ankle arthrosis.

    Science.gov (United States)

    Khazzam, Michael; Long, Jason T; Marks, Richard M; Harris, Gerald F

    2006-08-01

    The purpose of this study was to evaluate the kinematic changes that occur about the foot and ankle during gait in patients with degenerative joint disease (DJD). By comparing a normal adult population with what was found in the DJD population we determined how the motion of theses groups differed, thereby characterizing how this pathology affects foot and ankle motion. A 15-camera Vicon Motion Analysis System was used in conjunction with weight bearing radiographs to obtain three-dimensional motion of the foot and ankle during ambulation. The study was comprised of 34 patients and 35 ankles diagnosed with DJD (19 men and 15 women) of the ankle and 25 patients with normal ankles (13 men and 12 women). Dynamic foot and ankle motion was analyzed using the four-segment Milwaukee Foot Model (MFM). The data from this model resulted in three-dimensional (3D) kinematic parameters in the sagittal, coronal, and transverse planes as well as spatial-temporal parameters. Patient health status was evaluated using the SF-36 Health Survey and American Orthopaedics Foot and Ankle Society (AOFAS) hindfoot scores. The DJD group showed significant differences (pgait. This decreased range of motion may be related to several factors including bony deformity, muscle weakness, and attempts to decrease the pain associated with weight bearing. To date there has not been a study which describes the effect of this disease process on motion of the foot and ankle. These findings may prove to be useful in the pre-operative assessment of these patients.

  12. Footballer's ankle: a case report

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Footballer' s ankle is anterior bony spur or anterior impingement symptom of the ankle with anterior ankle pain, limited and painful dorsiflexion. The cause is commonly seen in athletes and dancers, and is probably due to repetitive minor trauma. The condition was firstly described by Morris;1 McMurray2 reported good results from excision of the spurs, naming it footballer's ankle. Opening resection of osteophytes of the anterior tibial and superior talar is an effective treatment for anterior impingement of the ankle.

  13. 军事跳伞着陆踝关节损伤危险因素及生物力学研究进展%Risk factors of causing military parachutist' s ankle joints injury during landing and biomechanical research progress

    Institute of Scientific and Technical Information of China (English)

    崔松超; 伍骥; 郑超; 黄蓉蓉; 文偃伍

    2012-01-01

    Objective To comprehensively analyze risk factors of causing parachutist's ankle joints injury during landing and review the progress on the biomechanical research.Literature resource and selection Original research papers and reviews in fields of aviation medicine and medical information.Literature quotation Twenty-eight research articles and reviews published at home and abroad were cited.Literature synthesis With the development of biomechanics,many researchers have emerged into the mechanism of parachutist' s ankle joints injury and risk factors during parachute landing all over the world,and the protection measures have gradually progressed.Conclusion There are many factors affecting the biomechanical characteristics of ankle joints in parachutist's landing.Although traditional biomechanical research method can reflect the basic strain condition of ankle joint bone and anadesma,but internal stress transfer mechanism of ankle joint bone and soft tissue can't be discovered under the circumstance of different strain afforded in military parachutist's landing.Therefore,it is significant to apply digital technology and finite element analysis on the biomechanical research of ankle and foot in the future.%目的 通过文献综合分析军事跳伞踝关节着陆损伤的危险因素及相关生物力学的研究进展. 资料来源与选择 国内外该领域的相关文献. 资料引用 引用国内外公开发表的文献28篇. 资料综合 随着生物力学技术的发展,国内外对军事跳伞踝关节着陆损伤的机制和相关的危险因素也有了更好的理解,相应的损伤防护措施也不断进步. 结论 影响军事跳伞中踝关节生物力学特性的因素很多,传统的生物力学研究方法虽然可以反映踝关节骨与韧带的基本受力情况,但是无法发现军事跳伞中不同受力情况下的踝关节骨骼、软组织等内部的应力传递机制,借助数字化技术及运用有限元法模拟足踝部生物力学

  14. A radiographic study on the condylar position in temporomandibular joint dysfunction patients

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Seo Howan; Kim, Jae Duck [Dept. of Oral Radiology, Division of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1987-11-15

    The author obtained the transcranial-oblique lateral radiograms from 78 patients (26 male, 52 female) with temporom andibular dysfunction problem. And then, the author analyzed the dimensional changes of the TMJ space on centric occlusion, horizontal condylar movement and antero-posterior positional relationship of condyle to the articular eminence on 2.54 cm mouth opening with clicking, TMJ pain and mouth opening limitation respectively, which were the symptoms of the temporomandibular joint pain dysfunction problem, and compared these data with control group. The results were as follow: 1. In centric occlusion, anterior and posterior TMJ space of experimental group was slightly lesser than those of the control group, also superior TMJ space of experimental group was significantly lesser than that of the control group. (p<0.01) br> 2. In 2.54 cm mouth opening, the condylar horizontal movement and the antero-posterior positional relationship to the articular eminence were significantly lesser than those of the control group. (p<0.01) br> 3. Examined experimental group, the degree of condylar horizontal movement of affected side was lesser than that of the normal side in 2.54 cm mouth opening.

  15. 三维各向同性磁共振成像分析踝关节解剖结构%Three-dimensional isotropic magnetic resonance imaging of the ankle joint

    Institute of Scientific and Technical Information of China (English)

    赵文吉; 张鑫涛; 吴著; 赵银霞; 胡绍勇; 李绍林

    2015-01-01

    目的:对比各向同性三维快速自旋回波(3 dimensional fast spin echo,3D-FSE)和三维快速场回波(3 dimensional fast field echo,3D-FFE)及二维快速自旋回波(2 dimensional fast spin echo,2D-FSE)对踝关节解剖结构显示的特点。方法随机选10名志愿者进行各向同性3D-FSE、3D-FFE及2D-FSE序列磁共振扫描以及三维重建,并测量各组织的信噪比(signal-to-noise ratio, SNR)、对比信噪比(contrast-to-noise ratio, CNR),用5分利克特表(5-point Likert scale)评估各序列各组织的成像质量。结果在各组织中的3D-FSE序列SNR最高,在软骨、肌肉、肌腱中其次为3D-FFE序列;软骨-骨髓、肌肉-肌腱、关节液-肌腱中的3D-FSE的CNR最高,其次为3D-FFE,各序列间具有统计学差异(P<0.05)。主观评估三种序列踝关节软骨的成像质量,各序列间有统计学差异(P<0.05),3D-FFE成像质量最好,其次为3D-FSE。主观评估韧带中3D-FSE、2D-FSE序列均优于3D-FFE序列(P<0.05);主观评估肌腱中,除腓短肌腱外,其余肌腱都有统计学差异(P<0.05),且都是3D-FSE成像质量最好,其次为2D-FSE序列。结论各向同性3D-FSE序列具有最高的SNR、CNR,能任意平面重建,扫描时间短,可全面评估复杂关节的解剖结构,广泛应用临床。%Objective To compare the image quality of isotropic 3-dimensional fast spin echo (3D-FSE), 3D fast field echo (3D-FFE), and 2D fast spin echo (2D-FSE) sequences in magnetic resonance imaging (MRI) of the anatomical structure of the ankle joint. Methods The ankle joints of 10 healthy volunteers were examined with isotropic 3D-FSE, 3D-FFE and 2D-FSE sequences using a 1.5T MR scanner and 3D reconstruction. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the tissues were measured. Two radiologists evaluated the image quality of the 3 sequences using a 5-point Likert scale in a double-blinded manner

  16. Explosive resistance training increases rate of force development in ankle dorsiflexors and gait function in adults with cerebral palsy

    DEFF Research Database (Denmark)

    Kirk, Henrik; Geertsen, Svend Sparre; Lorentzen, Jakob

    2016-01-01

    development of ankle dorsiflexors (RFDdf), improves gait function and affects passive ankle joint stiffness in adults with CP.Thirty-five adults (age 36.5; range: 18-59 years) with CP were non-randomly assigned to a PRT or non-training control (CON) group in this explorative trial. The PRT group trained ankle...... dorsiflexion, plantarflexion, leg press, hamstring curls, abdominal curls and back extension 3 days/week for 12 weeks, with 3 sets per exercise and progressing during the training period from 12-6 RM. RFDdf, 3-D gait analysis, functional performance and ankle joint passive- and reflex-mediated muscle stiffness...

  17. Three-dimensional Motion Analysis of the Ankle during Backward Walking.

    Science.gov (United States)

    Soda, Naoki; Ueki, Tsutomu; Aoki, Takaaki

    2013-06-01

    [Purpose] The purpose of this study was to perform kinematic and kinetic analyses of the ankle during both forward and backward walking using three-dimensional motion analysis. [Subjects] The subjects were 11 healthy adults. [Methods] Measurements of forward and backward walking motions were taken using a three-dimensional motion analysis device and 3 ground reaction force plates. The analysis segment was the standing phase and the items analyzed were walking time, maximum dorsal flexion of the ankle, maximum angle of plantar flexion, peak ankle power in the sagittal plane, workload of the ankle, and work rate. Statistical analysis consisted of comparisons using the t-test for each of the items measured during both forward and backward walking. [Results] The backward walking group had significantly lower ankle power, workload, and work rate. [Conclusion] The propulsive force in backward walking must come from some factor other than the ankle. The analysis of joint power is an important index for understanding the motion.

  18. The proportion of distal fibula Salter-Harris type I epiphyseal fracture in the paediatric population with acute ankle injury: a prospective MRI study.

    Science.gov (United States)

    Hofsli, Mikael; Torfing, Trine; Al-Aubaidi, Zaid

    2016-03-01

    Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter-Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All paediatric patients with ankle injury, seen at the emergency room from September 2012 to May 2013 at a single institution, underwent a standardized clinical examination, and their radiographs were obtained if found necessary. All images and data were recorded prospectively and patients suspected of having SH1FDF were referred for MRI of the ankle joint. Out of 391 paediatric patients seen at the emergency room with ankle injury, 38 patients had a clinical suspicion of SH1FDF. A total of 31 patients, 18 male and 13 female, with a mean age of 10 ± 2.86 years, were included in the study. Only seven patients were excluded from the study. MRI was obtained on an average of 6.9 ± 2.87 days. None of the included patients had evidence of SH1FDF on MRI. Our study and review of the literature verifies the high false-positive rate of clinically suspected SH1FDF. Most children had ligamentous lesions, bone contusion or joint effusion, rather than SH1FDF.

  19. Multicenter follow-up study of ankle fracture surgery

    Institute of Scientific and Technical Information of China (English)

    XU Hai-lin; WANG Gang; WANG Guang-lin; WU Xin-bao; LIU Li-min; LI Xuan; ZHANG Dian-ying; FU Zhong-guo; WANG Tian-bing; ZHANG Pei-xun; JIANG Bao-guo; SHEN Hui-liang

    2012-01-01

    Background Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available.The aim of this research was to evaluate the epidemiological features and surgical outcomes of ankle fractures by reviewing 235 patients who underwent ankle fracture surgery at five hospitals in China.Methods This study included patients who underwent ankle fracture surgery at five Chinese hospitals from January 2000 to July 2009.Age,gender,mechanism of injury,Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture type,fracture pattern,length of hospital stay and treatment outcome were recorded.Statistical analyses were conducted using SPSS software.The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale,visual analogue scale (VAS),and arthritis scale were used to evaluate outcome.Results Of 235 patients with ankle fractures,105 were male with an average age of 37.8 years and 130 were female with an average age of 47.3 years.The average follow-up period was 55.7 months.There were significant differences in the ratios of patients in different age groups between males and females,and in mechanisms of injury among different age groups.There were also significant differences in the length of hospital stay among different fracture types and mechanisms of injury.In healed fractures,the average AOFAS ankle-hindfoot score was 95.5,with an excellence rate of 99.6%,the average VAS score was 0.17,and the average arthritis score was 0.18.Movement of the injured ankle was significantly different to that of the uninjured ankle.There were no significant differences between AO fracture types,fracture patterns or follow-up periods and AOFAS score,but there were some significant differences between these parameters and ankle joint movements,pain VAS score and arthritis score.Conclusions Ankle fractures occur most commonly in middle-aged and young males aged 20-39 years and in elderly females aged 50-69 years.The most common mechanisms of

  20. Cone-Beam Computed Tomographic Assessment of Mandibular Condylar Position in Patients with Temporomandibular Joint Dysfunction and in Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Maryam Paknahad

    2015-01-01

    Full Text Available Statement of the Problem. The clinical significance of condyle-fossa relationships in the temporomandibular joint is a matter of controversy. Different studies have evaluated whether the position of the condyle is a predictor of the presence of temporomandibular disorder. Purpose. The purpose of the present study was to investigate the condylar position according to gender in patients with temporomandibular disorder (TMD and healthy controls using cone-beam computed tomography. Materials and Methods. CBCT of sixty temporomandibular joints in thirty patients with TMD and sixty joints of thirty subjects without TMJ disorder was evaluated in this study. The condylar position was assessed on the CBCT images. The data were analyzed using Pearson chi-square test. Results. No statistically significant differences were found regarding the condylar position between symptomatic and asymptomatic groups. Posterior condylar position was more frequently observed in women and anterior condylar position was more prevalent in men in the symptomatic group. However, no significant differences in condylar position were found in asymptomatic subjects according to gender. Conclusion. This study showed no apparent association between condylar positioning and clinical findings in TMD patients.

  1. Cone-Beam Computed Tomographic Assessment of Mandibular Condylar Position in Patients with Temporomandibular Joint Dysfunction and in Healthy Subjects.

    Science.gov (United States)

    Paknahad, Maryam; Shahidi, Shoaleh; Iranpour, Shiva; Mirhadi, Sabah; Paknahad, Majid

    2015-01-01

    Statement of the Problem. The clinical significance of condyle-fossa relationships in the temporomandibular joint is a matter of controversy. Different studies have evaluated whether the position of the condyle is a predictor of the presence of temporomandibular disorder. Purpose. The purpose of the present study was to investigate the condylar position according to gender in patients with temporomandibular disorder (TMD) and healthy controls using cone-beam computed tomography. Materials and Methods. CBCT of sixty temporomandibular joints in thirty patients with TMD and sixty joints of thirty subjects without TMJ disorder was evaluated in this study. The condylar position was assessed on the CBCT images. The data were analyzed using Pearson chi-square test. Results. No statistically significant differences were found regarding the condylar position between symptomatic and asymptomatic groups. Posterior condylar position was more frequently observed in women and anterior condylar position was more prevalent in men in the symptomatic group. However, no significant differences in condylar position were found in asymptomatic subjects according to gender. Conclusion. This study showed no apparent association between condylar positioning and clinical findings in TMD patients.

  2. Treatment of a Fracture-dislocation of the Ankle Using RALCA® External Fixator

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodriguez

    2016-06-01

    Full Text Available The association of ankle fractures with a dislocation modifies their therapeutic management since the joint must not remain in such abnormal position for more than six hours and therefore, urgent surgical treatment is needed. The case of a 30-year-old woman treated at the Dr. Gustavo Aldereguía Lima Hospital in Cienfuegos is presented. The patient presented with a severe fracture-dislocation of the right ankle with a supra-syndesmotic fibular fracture, a syndesmotic injury, a deltoid ligament injury and a tibial plafond fracture resulting from a bicycle fall. The fracture-dislocation was stabilized by using a RALCA® external mini-fixator. Full recovery was achieved five months after surgery. In our service, we may not have the devices most commonly used for fixation of ankle injuries at a given moment; therefore, external fixation becomes a viable option to correct this type of fractures. For this reason, we decided to present this case that demonstrates the effectiveness of the RALCA® external fixator.

  3. The effectiveness of mobilisation with movement for chronic medial ankle pain: a case study

    Directory of Open Access Journals (Sweden)

    M. Penso

    2008-02-01

    Full Text Available Introduction and Purpose: It has been shown that approximatelythirty percent of those sustaining an ankle sprain are likely to develop chronicfunctional limitations. Mulligan has developed mobilisation with movement (MWMfor treatment of joint dysfunction and suggests that it is a positional fault of the jointthat causes pain and movement restriction. Method: This single case reports on the effects of a MWM technique on chronicmedial ankle pain. The patient was a 25-year-old female runner who had experiencedpain since an initial ankle sprain at 8 years of age. The main findings of the subjective and physical examinations were decrease in active and passive dorsiflexion and eversion range of motion (ROM, shortening of gastrocnemiusand soleus muscles and the functional limitation of pain when running. The patient was treated twice with the MWMtechnique.Results: Outcomes of immediate reduction in pain, restoration of full dorsiflexion and eversion ROM, increase in calfmuscle length and pain free running were observed. This was maintained over a four-month follow up period.Conclusion: This case concurs with previous studies detailing increases in range of motion and restoration of painfree movement as well as adding new support for the resolution of chronic pain with MWM.

  4. Analysis and simulation of fully ankle actuated planar bipedal robots

    NARCIS (Netherlands)

    Franken, Michel; Oort, van Gijs; Stramigioli, Stefano

    2008-01-01

    This paper deals with the analysis of planar bipedal robots, based on passive dynamic walkers, which are actuated only by actuation of the ankle joints. An overview of the major design characteristics of such robots and their influence on the feasibility of a stable limit cycle is presented. It is s

  5. Gait Training and Ankle Dorsiflexors in Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2015-03-01

    Full Text Available Investigators at University of Copenhagen, Denmark, evaluated whether 4 weeks of 30 min daily treadmill training with an incline may facilitate corticospinal transmission and improve control of the ankle joint in 16 children, aged 5-14 years, with cerebral palsy.

  6. Short-term effects of kinesio tape on joint position sense, isokinetic measurements, and clinical parameters in patellofemoral pain syndrome

    Science.gov (United States)

    Kurt, Emine Eda; Büyükturan, Öznur; Erdem, Hatice Rana; Tuncay, Figen; Sezgin, Hicabi

    2016-01-01

    [Purpose] To evaluate the short-term effects of kinesio tape on joint position sense, isokinetic measurements, kinesiophobia, symptoms, and functional limitations in patients with patellofemoral pain syndrome. [Subjects and Methods] A total of 90 patients (112 knees) with patellofemoral pain syndrome were randomized into a kinesio tape group (n=45) or placebo kinesio tape group (n=45). Baseline isokinetic quadriceps muscle tests and measurements of joint position sense were performed in both groups. Pain was measured with a Visual Analog Scale, kinesiophobia with the Tampa kinesiophobia scale, and symptoms and functional limitations with the Kujala pain scale. Measurements were repeated 2 days after kinesio tape application. [Results] No differences were found between baseline isokinetic muscle measurements and those taken 2 days after application. However, significant improvements were observed in the kinesio tape group, with regard to joint position sense, pain, kinesiophobia, symptoms, and functional limitations after treatment. Examination of the differences between pre- and post-treatment values in both groups revealed that the kinesio tape group demonstrated greater improvements compared to the placebo kinesio tape group. [Conclusion] Although short-term kinesio tape application did not increase hamstring muscle strength, it may have improved joint position sense, pain, kinesiophobia, symptoms, and daily limitations. PMID:27512259

  7. Learning Disabilites: Issues in the Preparation of Professional Personnel. A Position Paper of the National Joint Committee on Learning Disabilites.

    Science.gov (United States)

    National Joint Committee on Learning Disabilities, Baltimore, MD.

    Issues involved in personnel preparation are addressed in the position paper developed by the National Joint Committee on Learning Disabilities. Among problems cited in this area are obstacles to making changes in policy, curricula, and practica; territorality among professional training programs; lack of interdisciplinary education and training;…

  8. Short-term effects of kinesio tape on joint position sense, isokinetic measurements, and clinical parameters in patellofemoral pain syndrome.

    Science.gov (United States)

    Kurt, Emine Eda; Büyükturan, Öznur; Erdem, Hatice Rana; Tuncay, Figen; Sezgin, Hicabi

    2016-07-01

    [Purpose] To evaluate the short-term effects of kinesio tape on joint position sense, isokinetic measurements, kinesiophobia, symptoms, and functional limitations in patients with patellofemoral pain syndrome. [Subjects and Methods] A total of 90 patients (112 knees) with patellofemoral pain syndrome were randomized into a kinesio tape group (n=45) or placebo kinesio tape group (n=45). Baseline isokinetic quadriceps muscle tests and measurements of joint position sense were performed in both groups. Pain was measured with a Visual Analog Scale, kinesiophobia with the Tampa kinesiophobia scale, and symptoms and functional limitations with the Kujala pain scale. Measurements were repeated 2 days after kinesio tape application. [Results] No differences were found between baseline isokinetic muscle measurements and those taken 2 days after application. However, significant improvements were observed in the kinesio tape group, with regard to joint position sense, pain, kinesiophobia, symptoms, and functional limitations after treatment. Examination of the differences between pre- and post-treatment values in both groups revealed that the kinesio tape group demonstrated greater improvements compared to the placebo kinesio tape group. [Conclusion] Although short-term kinesio tape application did not increase hamstring muscle strength, it may have improved joint position sense, pain, kinesiophobia, symptoms, and daily limitations.

  9. Effects of Compression by Means of Sports Socks on the Ankle Kinesthesia

    Directory of Open Access Journals (Sweden)

    Tatsuya Hayami

    2011-10-01

    Full Text Available The purpose of this study was to clarify the effects of compression by means of sports socks (CG socks on the ankle knesthesia. Thirteen subjects were participated. In order to accomplish the purpose, we assessed a position sense, movement sense, force sense, and sensorymotor function during under three different conditions: subjects wore the normal socks that are distributed generally (normal socks condition, wore the CG socks (CG socks condition, and did not wear any socks (barefoot condition. The position sense and force sense were assessed in a reproduction task of ankle joint angle and force output during plantar/dorsiflexion, respectively. The movement sense was assessed by the threshold of detection for passive movement. The sensory motor function was assessed during our original Kinetic–Equilibrating task. The results showed that the movement sense, force sense, and sensorymotor function significantly improved in the CG socks condition compared to the other two conditions. These results suggested that the compression by means of the CG socks might improve the perception of the changes of joint angle and the extent of force output. Therefore, improvement of these senses enhanced the sensorymotor function based on these senses.

  10. Evidence for a time-invariant phase variable in human ankle control.

    Directory of Open Access Journals (Sweden)

    Robert D Gregg

    Full Text Available Human locomotion is a rhythmic task in which patterns of muscle activity are modulated by state-dependent feedback to accommodate perturbations. Two popular theories have been proposed for the underlying embodiment of phase in the human pattern generator: a time-dependent internal representation or a time-invariant feedback representation (i.e., reflex mechanisms. In either case the neuromuscular system must update or represent the phase of locomotor patterns based on the system state, which can include measurements of hundreds of variables. However, a much simpler representation of phase has emerged in recent designs for legged robots, which control joint patterns as functions of a single monotonic mechanical variable, termed a phase variable. We propose that human joint patterns may similarly depend on a physical phase variable, specifically the heel-to-toe movement of the Center of Pressure under the foot. We found that when the ankle is unexpectedly rotated to a position it would have encountered later in the step, the Center of Pressure also shifts forward to the corresponding later position, and the remaining portion of the gait pattern ensues. This phase shift suggests that the progression of the stance ankle is controlled by a biomechanical phase variable, motivating future investigations of phase variables in human locomotor control.

  11. Ankle mechanics during sidestep cutting implicates need for 2-degrees of freedom powered ankle-foot prostheses.

    Science.gov (United States)

    Ficanha, Evandro M; Rastgaar, Mohammad; Kaufman, Kenton R

    2015-01-01

    The ankle joint of currently available powered prostheses is capable of controlling one degree of freedom (DOF), focusing on improved mobility in the sagittal plane. To increase agility, the requirements of turning in prosthesis design need to be considered. Ankle kinematics and kinetics were studied during sidestep cutting and straight walking. There were no significant differences between the ankle sagittal plane mechanics when comparing sidestep cutting and straight walking; however, significant differences were observed in ankle frontal plane mechanics. During straight walking, the inversion-eversion (IE) angles were smaller than with sidestep cutting. The ankle that initiated the sidestep cutting showed progressively increasing inversion from 2 to 13 degrees while the following contralateral step showed progressively decreasing inversion from 8 to -4 degrees during normal walking speed. The changes in IE kinematics were the most significant during sidestep cutting compared with straight walking. The IE moments of the step that initiated the sidestep cutting were always in eversion, acting as a braking moment opposing the inverting motion. This suggests that an ankle-foot prosthesis with active DOFs in the sagittal and frontal planes will increase the agility of gait for patients with limb loss.

  12. Ankle mechanics during sidestep cutting implicates need for 2-degrees of freedom powered ankle-foot prostheses

    Directory of Open Access Journals (Sweden)

    Evandro M. Ficanha

    2015-04-01

    Full Text Available The ankle joint of currently available powered prostheses is capable of controlling one degree of freedom (DOF, focusing on improved mobility in the sagittal plane. To increase agility, the requirements of turning in prosthesis design need to be considered. Ankle kinematics and kinetics were studied during sidestep cutting and straight walking. There were no significant differences between the ankle sagittal plane mechanics when comparing sidestep cutting and straight walking; however, significant differences were observed in ankle frontal plane mechanics. During straight walking, the inversion-eversion (IE angles were smaller than with sidestep cutting. The ankle that initiated the sidestep cutting showed progressively increasing inversion from 2 to 13 degrees while the following contralateral step showed progressively decreasing inversion from 8 to –4 degrees during normal walking speed. The changes in IE kinematics were the most significant during sidestep cutting compared with straight walking. The IE moments of the step that initiated the sidestep cutting were always in eversion, acting as a braking moment opposing the inverting motion. This suggests that an ankle-foot prosthesis with active DOFs in the sagittal and frontal planes will increase the agility of gait for patients with limb loss.

  13. The mid-term outcome of total ankle arthroplasty and ankle fusion in rheumatoid arthritis: a systematic review

    Science.gov (United States)

    2013-01-01

    Background While arthrodesis is the standard treatment of a severely arthritic ankle joint, total ankle arthroplasty has become a popular alternative. This review provides clinical outcomes and complications of both interventions in patients with rheumatoid arthritis. Methods Studies were obtained from Pubmed, Embase and Web of Science (January 1980 – June 2011) and additional manual search. Inclusion criteria: original clinical study, > 5 rheumatoid arthritis (population), internal fixation arthrodesis or three-component mobile bearing prosthesis (intervention), ankle scoring system (outcome). The clinical outcome score, complication- and failure rates were extracted and the methodological quality of the studies was analysed. Results 17 observational studies of 868 citations were included. The effect size concerning total ankle arthroplasty ranged between 1.9 and 6.0, for arthrodesis the effect sizes were 4.0 and 4.7. Reoperation due to implant failure or reoperation due to non-union, was 11% and 12% for respectively total ankle arthroplasty and arthrodesis. The methodological quality of the studies was low (mean 6.4 out of a maximum of 14 points) and was lower for arthrodesis (mean 4.8) as compared to arthroplasty (mean 7.8) (p = 0.04). Conclusions 17 observational and no (randomized) controlled clinical trials are published on the effectiveness of arthroplasty or arthrodesis of the ankle in rheumatoid arthritis. Regardless of the methodological limitations it can be concluded that both interventions show clinical improvement and in line with current literature neither procedure is superior to the other. PMID:24161014

  14. [Long-term results of active-passive ligament repair of the external lateral ligament of the ankle].

    Science.gov (United States)

    Farizon, F; Paris, D; Azoulai, J J; Bousquet, G

    1996-03-01

    We reviewed 95 ankles at an average of 9 years after an "activo-passive" operation performed for chronic lateral instability. All the patients had suffered recurrent ankle sprain or instability, with pain in 67 patients. Ten ankles showed a subtalar injury at operation. Degenerative changes were noted in 11 ankle joints. On review, 81 ankles (85%) were stable. The 14 cases with persistent instability had developed the problem one to five years after operation. Two cases presented with limitation in mobility. Osteoarthritis, found in 15 ankles, was severe in only two, and had been present on preoperative films. We found no correlation between functional results (talar tilt, anterior-drawer test) and radiological evaluation. The "activo-passive" operation provides long-term stabilization with preservation of the ankle and of subtalar mobility without severe osteoarthritis.

  15. Predicting functional recovery after acute ankle sprain.

    Directory of Open Access Journals (Sweden)

    Sean R O'Connor

    Full Text Available INTRODUCTION: Ankle sprains are among the most common acute musculoskeletal conditions presenting to primary care. Their clinical course is variable but there are limited recommendations on prognostic factors. Our primary aim was to identify clinical predictors of short and medium term functional recovery after ankle sprain. METHODS: A secondary analysis of data from adult participants (N = 85 with an acute ankle sprain, enrolled in a randomized controlled trial was undertaken. The predictive value of variables (age, BMI, gender, injury mechanism, previous injury, weight-bearing status, medial joint line pain, pain during weight-bearing dorsiflexion and lateral hop test recorded at baseline and at 4 weeks post injury were investigated for their prognostic ability. Recovery was determined from measures of subjective ankle function at short (4 weeks and medium term (4 months follow ups. Multivariate stepwise linear regression analyses were undertaken to evaluate the association between the aforementioned variables and functional recovery. RESULTS: Greater age, greater injury grade and weight-bearing status at baseline were associated with lower function at 4 weeks post injury (p<0.01; adjusted R square=0.34. Greater age, weight-bearing status at baseline and non-inversion injury mechanisms were associated with lower function at 4 months (p<0.01; adjusted R square=0.20. Pain on medial palpation and pain on dorsiflexion at 4 weeks were the most valuable prognostic indicators of function at 4 months (p< 0.01; adjusted R square=0.49. CONCLUSION: The results of the present study provide further evidence that ankle sprains have a variable clinical course. Age, injury grade, mechanism and weight-bearing status at baseline provide some prognostic information for short and medium term recovery. Clinical assessment variables at 4 weeks were the strongest predictors of recovery, explaining 50% of the variance in ankle function at 4 months. Further

  16. Acupuncture Combined with Biofeedback Treatment of Hemiplegia in Patients with Ankle Joint Dysfunction in Clinical Research%电针配合肌电生物反馈治疗偏瘫患者踝关节功能障碍临床研究

    Institute of Scientific and Technical Information of China (English)

    张涛军; 朱黎明; 冯克辉; 郝权

    2013-01-01

    目的:观察电针结合生物反馈治疗仪治疗偏瘫患者踝关节功能障碍的临床疗效.方法:将60例患者随机分为治疗组30例和对照组30例,对照组给予肌电生物反馈治疗,治疗组在对照组的基础上辅以电针治疗,两组分别于治疗前和治疗6周后进行简式Fugl-Meyer下肢运动功能积分、踝关节主动活动范围评测(AROM-T)、测定踝关节最大背屈时胫前肌等长收缩的肌电积分值(iEMG).结果:治疗后,两组简易Fugl-Meyer下肢运动积分、踝关节活动范围及iEMG较治疗前均有提高,治疗组各项指标均优于对照组,差异具有统计学意义(P<0.05).结论:电针结合肌电生物反馈治疗仪能改善偏瘫患者踝关节背屈功能.%Objective:To observe the effect of electroacupuncture combined with biofeedback therapy for the treatment of patients with hemiplegia rehabilitation effects of ankle joint dysfunction. Methods:60 cases were randomly divided into the treatment group 30 cases and control group 30 cases, control group was given conventional rehabilitation therapy and biofeedback therapy biofeedback treatment, combined treatment group and in the control group on the basis of electroacupuncture, two groups respectively before treatment and simple Fugl-Meyer lower extremity functional integration, ankle active range of motion evaluation after 6 weeks (AROM-T), determination of maximum dorsiflexion ankle anterior tibial EMG muscle isometric contraction integral value (iEMG). Results: After treatment, two groups of simple Fugl-the lower limb motion of Meyer integral, the range of motion of the ankle and iEMG compared with those before treatment were increased, the index of the treatment group were superior to the control group, and have statistical significance (P < 0. 05). Conclusion: Electroacupuncture combined with EMG biofeedback treatment can improve the hemiplegic patients with ankle dorsiflexion function.

  17. The Eccentric Torque Production Capacity of the Ankle, Knee, and Hip Muscle Groups in Patients with Unilateral Chronic Ankle Instability

    Science.gov (United States)

    Negahban, Hossein; Moradi-Bousari, Aida; Naghibi, Saeed; Sarrafzadeh, Javad; Shaterzadeh-Yazdi, Mohammad-Jafar; Goharpey, Shahin; Etemadi, Malihe; Mazaheri, Masood; Feizi, Awat

    2013-01-01

    Purpose The aim of this study was to investigate eccentric torque production capacity of the ankle, knee and hip muscle groups in patients with unilateral chronic ankle instability (CAI) as compared to healthy matched controls. Methods In this case-control study, 40 participants (20 with CAI and 20 controls) were recruited based on convenient non-probability sampling. The average peak torque to body weight (APT/BW) ratio of reciprocal eccentric contraction of ankle dorsi flexor/plantar flexor, ankle evertor/invertor, knee flexor/extensor, hip flexor/extensor and hip abductor/adductor was determined using an isokinetic dynamometer. All subjects participated in two separate sessions with a rest interval of 48 to 72 hours. In each testing session, the torque production capacity of the ankle, knee, and hip muscle groups of only one lower limb was measured. At first, 3 repetitions of maximal eccentric-eccentric contraction were performed for the reciprocal muscles of a joint in a given movement direction. Then, the same procedure of practice and testing trials was repeated for the next randomly-ordered muscle group or joint of the same limb. Results There was no significant interaction of group (CAI and healthy controls) by limb (injured and non-injured) for any muscle groups. Main effect of limb was not significant. Main effect of group was only significant for eccentric torque production capacity of ankle dorsi flexor and hip flexor muscle groups. The APT/BW ratio of these muscles was significantly lower in the CAI group than the healthy controls (P<0.05). Conclusion CAI is associated with eccentric strength deficit of ankle dorsi flexor and hip flexor muscles as indicated by reduction in torque production capacity of these muscles compared to healthy controls. This strength deficit appeared to exist in both the injured and non-injured limbs of the patients. PMID:23802057

  18. Radiographic evaluation of INBONE total ankle arthroplasty: a retrospective analysis of 30 cases

    Energy Technology Data Exchange (ETDEWEB)

    Datir, Abhijit [Emory University Hospital, Musculoskeletal Division, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Emory Orthopaedics and Spine Center, Division of Musculoskeletal Radiology, Atlanta, GA (United States); Xing, Minzhi; Kakarala, Aparna; Terk, Michael R. [Emory University Hospital, Musculoskeletal Division, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Labib, Sameh A. [Emory University Hospital, Department of Orthopaedic Surgery, Atlanta, GA (United States)

    2013-12-15

    The objectives of this work were to retrospectively describe the radiographic assessment of INBONE total ankle arthroplasty in 30 patients using validated linear and angular measurements and to correlate these findings with the final surgical outcome over a 2-year follow-up period. Thirty consecutive patients (21 females, nine males; mean age, 64.8 years) underwent INBONE total ankle arthroplasty during 2007-2011. After IRB approval, a retrospective pre- and post-operative radiographic analysis was performed using validated linear and angular measurements. The pre- and post-operative assessment included the tibial angle, talar angle, tibial slope, and coronal deformity. Post-operative measurements also included the talocalcaneal angle, joint space height, talar height, lateral tibial component angle, lateral talar component angle, and anteroposterior tibial component angle. The post-operative bone loss, subluxation, positioning, and subsidence were also assessed. Statistical analysis was performed using two-sample t test and Fisher's exact test. Out of 30 patients, 23 had a successful clinical outcome with intact prosthesis at a 2-year follow-up. The only variables with significant correlation (p < 0.05) to the post-surgical outcome were the lateral talar component angle (p = 0.002) and the mean difference between pre- and post-operative tibial slope (p = 0.001). The coronal deformity had significant mean difference between pre- and post-operative values (p < 0.001); however, it lacked a significant correlation to the final surgical outcome. None of the categorical variables had a significant correlation with post-surgical outcome. In our retrospective study, only the lateral talar component angle and the mean difference between the pre- and post-operative tibial slope had significant correlation with post-surgical outcome in INBONE ankle arthroplasty. These measurements may be helpful in radiographic assessment of the INBONE ankle arthroplasty. (orig.)

  19. Effect of medial arch-heel support in inserts on reducing ankle eversion: a biomechanics study

    Directory of Open Access Journals (Sweden)

    Yung Patrick SH

    2008-02-01

    Full Text Available Abstract Background Excessive pronation (or eversion at ankle joint in heel-toe running correlated with lower extremity overuse injuries. Orthotics and inserts are often prescribed to limit the pronation range to tackle the problem. Previous studies revealed that the effect is product-specific. This study investigated the effect of medial arch-heel support in inserts on reducing ankle eversion in standing, walking and running. Methods Thirteen pronators and 13 normal subjects participated in standing, walking and running trials in each of the following conditions: (1 barefoot, and shod condition with insert with (2 no, (3 low, (4 medium, and (5 high medial arch-heel support. Motions were captured and processed by an eight-camera motion capture system. Maximum ankle eversion was calculated by incorporating the raw coordinates of 15 anatomical positions to a self-compiled Matlab program with kinematics equations. Analysis of variance with repeated measures with post-hoc Tukey pairwise comparisons was performed on the data among the five walking conditions and the five running conditions separately. Results Results showed that the inserts with medial arch-heel support were effective in dynamics trials but not static trials. In walking, they successfully reduced the maximum eversion by 2.1 degrees in normal subjects and by 2.5–3.0 degrees in pronators. In running, the insert with low medial arch support significantly reduced maximum eversion angle by 3.6 and 3.1 degrees in normal subjects and pronators respectively. Conclusion Medial arch-heel support in inserts is effective in reducing ankle eversion in walking and running, but not in standing. In walking, there is a trend to bring the over-pronated feet of the pronators back to the normal eversion range. In running, it shows an effect to restore normal eversion range in 84% of the pronators.

  20. The position of the condyle and the disc in temporomandibular joint dysfunction. Comparison between tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Naoki; Kawaguchi, Shinichi; Kudo, Takaharu; Hosoki, Hidehiko; Uemura, Shusaburo [Tokushima Univ. (Japan). School of Dentistry

    1999-03-01

    To evaluate for the position of the condylar head in the glenoid fossa (condylar position), authors designed a new, simple method. Furthermore, the correlation between the condylar position and articular disc displacement was examined. A total of 160 TMJs of 80 TMD patients examined by tomography and MRI were included in this study. Three segments, the anterior (=a), posterior (=b) and superior (=c) joint spaces as shown by tomography were measured. To evaluate the condylar position, 3 acquired values were substituted for 2 numerical expressions. Each antero-posterior and supero-inferior condylar position was expressed in APR and SIR quantitatively. APR=(b-a)/(b+a) x 100 SIR=(((a+b)/2-c)/((a+b)/2+c)) x 100 Articular disc positions were evaluated in 3 positions by MRI. The 3 positions were as follows; superior disc position, slightly anterior disc position, completely anterior disc position. The differences among the condylar position of the TMJs of the 3 positions were statistically examined. A total of 157 TMJs were quantitatively evaluated in 2 directions. Three TMJs could not be evaluated with this evaluation method. Significant differences were found concerning the antero-posterior direction between the superior disc position and the slightly anterior disc position, as well as the superior disc position and the completely anterior disc position. Significant differences were detected in the supero-inferior direction between the superior disc position and the completely anterior disc position, as well as the slightly anterior disc position and the completely anterior disc position. This method was useful to evaluate the condylar position. A correlation between the condylar position and articular disc displacement was found. (K.H.)

  1. Effects of 24-week Tai Chi exercise on the knee and ankle proprioception of older women.

    Science.gov (United States)

    Chang, Shuwan; Zhou, Jihe; Hong, Youlian; Sun, Wei; Cong, Yan; Qin, Meiqin; Lian, Jianhua; Yao, Jian; Li, Weiping

    2016-01-01

    This study examined the effects of regular Tai Chi (TC) exercise on the kinaesthesia of the knee and ankle joints of older women. A total of 43 women aged 55-68 years participated in this study. In a 24-week study period, the TC group (n = 22) underwent an organized TC exercise, whereas the control group (n = 21) maintained a sedentary lifestyle. Customized instruments were used to measure the threshold for the detection of the passive motion of the knee and ankle joints. After 24 weeks, the TC group showed a significantly smaller threshold for the detection of passive motion of knee extension (31.4%, p = 0.009), knee flexion (27.0%, p = 0.044), and ankle dorsal flexion (28.9%, p = 0.014) than the control group. Other comparisons showed no significant differences. The 24-week TC exercise benefited the lower-limb kinaesthesia of the knee joint flexion and extension and ankle dorsal flexion.

  2. Application of Dongqi acupuncture(动气针法)to postoperative rehabilitation in the middle-late period in pa-tients with ankle joint fractures%动气针法在踝关节骨折术后中后期康复中的应用

    Institute of Scientific and Technical Information of China (English)

    江涛; 江林; 史俊德; 易李梅

    2015-01-01

    (动气针法)on postoperative rehabilitation in the middle-late period in patients with ankle joint fractures.Methods:Sixty patients with ankle joint fractures were randomly divided into 2 groups,30 cases in each group.The patients were treated with Dongqi acupuncture and medium-frequency electrotherapy respectively for ankle rehabilitation in the middle-late period after surgery.The ankle pain visual analogue score(VAS)and Mazur ankle function score were recorded and com-pared between the 2 groups before the treatment and after 15 -day treatment,and the clinical curative effects was also compared between the 2 groups after 15 -day treatment.Results:There was no statistical difference in ankle VAS score and Mazur ankle function score be-tween the 2 groups before the treatment(6.83 +/-1.68 vs 6.33 +/-1.53 points,t =-1.201,P =0.235;4.03 +/-1.07 vs 4.07 +/-1.55 points,t =-0.085,P =0.932).The ankle VAS score decreased while the Mazur ankle function score increased in both of the 2 groups af-ter 15 -day treatment(3.90 +/-1.94 vs 6.83 +/-1.68 points,t =-4.853,P =0.000;2.30 +/-1.44 vs 6.33 +/-1.53 points, t =-4.818,P =0.000;5.50 +/-1.66 vs 4.03 +/-1.07 points,t =-1.981,P =0.048;6.60 +/-1.23 vs 4.07 +/-1.55 points, t =-2.067,P =0.039).The decreased ankle VAS score and the increased Mazur ankle function score were greater in Dongqi acupuncture group than in medium -frequency electrotherapy group(4.03 +/-1.22 vs 2.93 +/-1.72 points,t =3.561,P =0.001;2.53 +/-0.78 vs 1.47 +/-0.73 points,t =2.375,P =0.011).According to Mazur evaluation criteria for ankle function,Four patients obtained an excellent result,11 good,12 fair and 3 poor in the Dongqi acupuncture group;while 1 patients obtained an excellent result,6 good,16 fair and 7 poor in the medium-frequency electrotherapy group.The Dongqi acupuncture group surpassed the medium-frequency electrotherapy group in the total curative effect(Z =-2.209,P =0.022).Conclusion:Dongqi acupuncture can relieve ankle pain and improve ankle function in the middle -late

  3. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    Science.gov (United States)

    2011-01-01

    Background Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient. PMID:21995682

  4. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    Directory of Open Access Journals (Sweden)

    Hintermann Beat

    2011-10-01

    Full Text Available Abstract Background Simultaneous osteoarthritis (OA of the ankle joint complicates primary total knee arthroplasty (TKA. In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week and hospital stay (12 days of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient.

  5. In vivo kinematics of two-component total ankle arthroplasty during non-weightbearing and weightbearing dorsiflexion/plantarflexion.

    Science.gov (United States)

    Yamaguchi, Satoshi; Tanaka, Yasuhito; Kosugi, Shinichi; Takakura, Yoshinori; Sasho, Takahisa; Banks, Scott A

    2011-04-07

    Relatively high rates of loosening and implant failure have been reported after total ankle arthroplasty, especially in first and second generation implants. Abnormal kinematics and incongruency of the articular surface may cause increased loads applied to the implant with concomitant polyethylene wear, resulting in loosening and implant failure. The purpose of this study was to measure three-dimensional kinematics of two-component total ankle arthroplasty during non-weightbearing and weightbearing activities, and to investigate incongruency of the articular surfaces during these activities. Forty-seven patients with a mean age of 71 years were enrolled. Radiographs were taken at non-weightbearing maximal dorsiflexion and plantarflexion, and weightbearing maximal dorsiflexion, plantarflexion, and neutral position. 3D-2D model-image registration was performed using the radiographs and the three-dimensional implant models, and three-dimensional joint angles were determined. The implanted ankles showed 18.1±8.6° (mean±standard deviation) of plantarflexion, 0.1±0.7° of inversion, 1.2±2.0° of internal rotation, and 0.8±0.6mm of posterior translation of the talar component in the non-weightbearing activity, and 17.8±7.5° of plantarflexion, 0.4±0.5° of inversion, 1.8±2.0° of internal rotation, and 0.7±0.5mm of posterior translation in the weightbearing activity. There were no significant differences between the non-weightbearing and weightbearing kinematics except for the plantarflexion angle. Incongruency of the articular surface occurred in more than 75% of the ankles. Our observations will provide useful data against which kinematics of other implant designs, such as three-component total ankle arthroplasty, can be compared.

  6. 不同级别竞技健美操运动员髋、膝和踝关节等速肌力特征研究%Isokinetic Test and Characteristics of Hip,Knee and Ankle Joint Muscle Strength of Aerobics Gymnastics with Different Levels

    Institute of Scientific and Technical Information of China (English)

    岳建军

    2014-01-01

    The purpose of this study is to research the hip ,knee ,ankle flexion muscle group of national team training base of competitive aerobics in China by using BIODEX isokinetic testing instrument .We came to an overall conclusion that compared with a national level athletes ,the international athletes have better hip joint and knee joint muscle’s strength endurance ,explo-sive force and power control and the relative weight of peak torque has no difference ;Ankle joint flexor muscle force control ,extensor explosive force and power control is better .Vertical jump height and peak torque with hip hop number percent leg have high correlation with knee joint time and acceleration time ,percentage of fatigue ,the number of maximum work ,especial under the high speed situation and low relevance with ankle joint ;The indicators have certain relevance between adjacent joints .World-class athletes hip and knee flexion extend strength ra-tio is bigger than the national athletes ,there is no difference for ankle ;among them ,the inter-national athletes knee flexion extend strength ratio is biggest under high speed .%运用BIODEX等速测试仪对我国竞技健美操国家队训练基地男运动员髋、膝、踝关节屈伸肌群及其相关素质进行测试与分析。研究认为,竞技健美操国际级运动员与国家一级运动员相比,髋关节与膝关节肌肉的力量耐力更好,爆发力与力量控制能力更强,而相对体重峰力矩没有差别;踝关节屈肌力量控制能力更好,伸肌爆发力与力量控制能力更好。纵跳高度与髋膝关节峰力矩时间、加速时间有较高相关性,30 s分腿跳次数与髋膝关节肌肉疲劳百分数和最大功次数有较高相关性,其中,高速度情况下呈现非常显著相关性,与踝关节各项指标相关性较低;相邻关节各项指标有一定的相关性。国际级运动员髋关节与膝关节屈伸肌力比国家一级运动员要大,而踝关节没

  7. Design and characterization of a biologically inspired quasi-passive prosthetic ankle-foot.

    Science.gov (United States)

    Mooney, Luke M; Lai, Cara H; Rouse, Elliott J

    2014-01-01

    By design, commonly worn energy storage and release (ESR) prosthetic feet cannot provide biologically realistic ankle joint torque and angle profiles during walking. Additionally, their anthropomorphic, cantilever architecture causes their mechanical stiffness to decrease throughout the stance phase of walking, opposing the known trend of the biological ankle. In this study, the design of a quasi-passive pneumatic ankle-foot prosthesis is detailed that is able to replicate the biological ankle's torque and angle profiles during walking. The prosthetic ankle is comprised of a pneumatic piston, bending spring and solenoid valve. The mechanical properties of the pneumatic ankle prosthesis are characterized using a materials testing machine and the properties are compared to those from a common, passive ESR prosthetic foot. The characterization spanned a range of ankle equilibrium pressures and testing locations beneath the foot, analogous to the location of center of pressure within the stance phase of walking. The pneumatic ankle prosthesis was shown to provide biologically appropriate trends and magnitudes of torque, angle and stiffness behavior, when compared to the passive ESR prosthetic foot. Future work will focus on the development of a control system for the quasi-passive device and clinical testing of the pneumatic ankle to demonstrate efficacy.

  8. Ankle Arthritis: You Can't Always Replace It.

    Science.gov (United States)

    Hayes, Brandon J; Gonzalez, Tyler; Smith, Jeremy T; Chiodo, Christopher P; Bluman, Eric M

    2016-02-01

    End-stage arthritis of the tibiotalar joint is disabling and causes substantial functional impairment. Most often it is the residual effect of a previous traumatic injury. Nonsurgical treatment of end-stage arthritis of the ankle includes bracing, shoe-wear modifications, and selective joint injections. For patients who fail to respond to nonsurgical modalities, the two primary treatment options are arthroplasty and arthrodesis. Each has its proponents. Although no ideal treatment of ankle arthritis exists, high-quality studies can help guide treatment in patients of varying demographics. Inherent risks are linked with each treatment option, but those of greatest concern are early implant loosening that requires revision following arthroplasty and the acceleration of adjacent joint degeneration associated with arthrodesis.

  9. Effects of Acupuncture-moxibustion Intervention on Proprioception in Athletes with Lateral Collateral Ligament Injury of Ankle Joint%针灸对踝关节外侧韧带损伤后期本体感觉恢复的影响

    Institute of Scientific and Technical Information of China (English)

    唐文江; 蒋垂刚; 陈丽容; 庞勇; 李杰; 黄昀

    2013-01-01

    Objective To compare the efficacy differences between acupuncture-moxibustion and physiotherapy interventions in improving proprioception of athletes with lateral collateral ligament injury of the ankle joint.Methods Thirty patients with injured lateral collateral ligament of ankle joint were randomly divided into acupuncture group (n =15) and physiotherapy group (n =15).Patients of the acupuncture group were treated by acupuncture and moxibustion stimulation of Qiuxu(GB 40),Kunlun(BL 60),Shenmai (BL 62),Jiexi (ST 41),and Ashi-points,etc.,and those of the physiotherapy group treated with TDP irradiation of the regional lateral malleolus.The treatment of the two groups was conducted once the other day,3 times each week,continuously for 8 weeks.Before and after the treatment,the ankle-joint's active and passive repositioning error angles were measured by using a joint angle ruler.Results The average error angle values of active and passive reposition tests of the injured ankle-joint were 4.98 ± 1.11 and 4.78± 1.13 before the treatment,and 3.67± 0.58 and 3.51 ± 0.64 after the treatment,respectively in the acupuncture group,being reduced significantly after the treatment (both P<0.01).No significant changes of the average error angle values of both active and passive reposition tests of the ankle-joint were found after the treatment in the physiotherapy group (P>0.05).Comparison between two groups showed that the average error angle,average active and passive reposition angles of the injured ankle in the acupuncture group were evidently lower than those in the physiotherapy group (P<0.01).Conclusion Acupuncture and moxibustion can effectively improve the proprioception of the injured lateral collateral ligament of the ankle joint in athletes,which is superior to conventional physiotherapy in the therapeutic effect.%目的:观察针灸与常规理疗对踝关节外侧韧带损伤后本体感觉恢复影响的差异.方法:30例踝关节外侧韧带损伤后

  10. The use of a neoprene knee sleeve to compensate the deficit in knee joint position sense caused by muscle fatigue.

    Science.gov (United States)

    Van Tiggelen, D; Coorevits, P; Witvrouw, E

    2008-02-01

    The importance of good proprioceptive abilities is stressed in many rehabilitation protocols. In contrast, it has been shown that muscle fatigue has a negative influence on proprioception. The objective of this study was to evaluate the effects of a neoprene knee sleeve (NKS) on the joint position sense in a fatigued knee joint. Sixty-four healthy subjects underwent four successive assessments of the same active joint repositioning test (AJRT) in an open kinetic chain setting under different conditions. First, each subject performed the AJRT without brace. One knee was braced during the second assessment. Subjects wore the brace for 6 h and were submitted to a fatigue protocol, followed by the third assessment under the same conditions as the previous one. The fourth and last AJRT was performed immediately after the third one but both knees were non-braced. When the subjects wore an NKS, significant differences in repositioning error were demonstrated between both sides. On the braced side, no significant differences were observed between the baseline assessment and the third assessment. NKS compensate the deficit in joint position sense due to fatigue. The use of NKS could be justified as a preventive measure or treatment in subjects to enhance proprioception.

  11. Effects of hip joint position and intra-capsular volume on hip joint intra-capsular pressure: a human cadaveric model

    Directory of Open Access Journals (Sweden)

    Tse Paul

    2009-04-01

    Full Text Available Abstract Background Increase in hip intra-capsular pressure has been implicated in various hip pathologies, such as avascular necrosis complicating undisplaced femoral neck fracture. Our study aimed at documenting the relationship between intra-capsular volume and pressure in various hip positions. Methods Fifty-two cadaveric hips were studied. An electronic pressure-monitoring catheter recorded the intra-capsular hip pressure after each instillation of 2 ml of normal saline and in six hip positions. Results In neutral hip position, the control position for investigation, intra-capsular pressure remained unchanged when its content was below 10 ml. Thereafter, it increased exponentially. When the intra-capsular volume was 12 ml, full abduction produced a 2.1-fold increase (p = 0.028 of the intra-capsular hip joint pressure; full external rotation and full internal rotation increased the pressure by at least 4-fold (p Conclusion Intra-capsular pressure increases with its volume, but with a wide variation with different positions. It would be appropriate to recommend that hips with haemarthrosis or effusion should be positioned in 45-degree flexion.

  12. Comparison of reliability of five patellar position indices at various stifle joint angles in pelvic limbs obtained from cadavers of red foxes (Vulpes vulpes)

    DEFF Research Database (Denmark)

    Miles, James E; Nielsen, Dorte H; Jensen, Bente Rona

    2012-01-01

    To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use.......To compare 5 patellar position indices at various stifle joint angles in cadavers of red foxes, determine measurement reliability, and assess the suitability of these indices for clinical use....

  13. Salto Talaris fixed-bearing total ankle replacement system.

    Science.gov (United States)

    Rush, Shannon M; Todd, Nicholas

    2013-01-01

    The Salto Talaris total ankle replacement is an anatomically designed fixed bearing prosthesis available in the United States based on the successful design of the mobile-bearing Salto prosthesis available outside the United States. The original mobile-bearing design was modified and the mobile-bearing was transferred to the precision instrumentation at the trial phase evaluation. Instrumentation and technique allow the surgeon to determine the functional joint axis before final implantation. The Salto Talaris total ankle replacement design blends minimal bone resection and optimizes surface area, cortical contact, and ultra-high molecular weight polyethylene conformity. The authors present an overview of the Salto Talaris total ankle replacement surgical technique and pearls for successful application.

  14. A tomographic study of positional and bony changes in the temporomandibular joint following orthognathic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Song, Nam Kyu; Kim Min Suk; Koh, Kwang Joon [Dept. of Oral Radiology, College of Dentistry, Chonpook National University, Chonju (Korea, Republic of)

    1992-08-15

    The purpose of this study was to aid in the evaluation of prognosis of temporomandibular joint following orthognathic surgery. For this study, 20 patients (40 TMJ) who undergone orthognathic surgery were examined. Preoperative and postoperative tomograms of TMJ were taken. And the subjects were divided into 3 groups according to postoperative periods. The obtained results were as follows : 1. There were no significant differences between preoperative and postoperative changes in joint spaces in each group and between groups (P<0.05). 2. There were no significant differences between preoperative and postoperative ratio of joint spaces (P<0.05).3. There were no significant differences between preoperative and postoperative changes in the range of motion of condylar head (P<0.05). 4. The bony changes of condylar head were observed in 14 (35%) condyles (6 erosion, 2 flattening, 5 double contour, 1 osteophyte).

  15. RELIABILITY AND ACCURACY OF JOINT POSITION SENSE MEASUREMENT IN THE LABORATORY AND CLINIC; UTILISING A NEW SYSTEM

    Directory of Open Access Journals (Sweden)

    N. Nasseri

    2007-08-01

    Full Text Available Measurement of the joint angles is used to assess the joint position sense (JPS. The aim of this study was to introduce a simple, fast, less expensive and objective method of measurement for JPS. In the current research, the accuracy and reliability of a system, consist of digital photography, nonreflective markers and manual analysis were evaluated. For this purpose, digital photos were taken from 72 angles of the knee positions of twenty four healthy subjects. The angles were measured by using transparent sheets and goniometers as manual method. AutoCAD software was used to evaluate the accuracy of the manual results. The values of Pearson correlation coefficient (r, and intraclass correlation coefficients were used to establish reliability. It was noted that the AutoCAD measurements, as a new system, was reliable and precise enough so it could be utilised for evaluating the JPS.

  16. Antimicrobial-Loaded Bone Cement Does Not Negatively Influence Sonicate Fluid Culture Positivity for Diagnosis of Prosthetic Joint Infection.

    Science.gov (United States)

    Park, Kyung-Hwa; Greenwood-Quaintance, Kerryl E; Hanssen, Arlen D; Abdel, Matthew P; Patel, Robin

    2016-06-01

    We compared culture results to investigate the influence of antimicrobial-loaded cement on sonicate fluid culture positivity for the diagnosis of prosthetic joint infection. Fifty-four subjects were assessed. The sensitivities of sonicate fluid culture were 77.8% (14 of 18) in subjects with an antimicrobial-loaded cemented prosthesis and 58.3% (21 of 36) in subjects with an antimicrobial-free prosthesis.

  17. Short-term adaptation of joint position sense occurs during and after sustained vibration of antagonistic muscle pairs

    Directory of Open Access Journals (Sweden)

    Tomas I Gonzales

    2014-11-01

    Full Text Available Proprioception is critical for the control of many goal-directed activities of daily living. While contributions from skin and joint receptors exist, the muscle spindle is thought to play a critical role in allowing accurate judgments of limb position and movement to occur. The discharges elicited from muscle spindles can be degraded by simultaneous agonist-antagonist tendon vibration, causing proprioception to be distorted. Despite this, changes in limb perception that may result from sensory adaptation to this stimulus remain misunderstood. The purpose of this study was, therefore, to investigate proprioceptive adaptation resulting from vibration of antagonistic muscle pairs. We measured elbow joint position sense in twenty healthy young adults while 80Hz vibration was applied simultaneously to the distal tendons of the elbow flexor and extensor muscles. Matching errors were analyzed during early and late adaptation phases to assess short-term adaption to the vibration stimuli. Participants committed significant undershoot errors during the early adaptation phase, but were comparable to baseline measurements during the late adaptation phase. When we removed the vibration stimuli and conducted a second joint position matching task, matching variability increased significantly and participants committed overshoot errors. These results bring into question the efficacy of simultaneous agonist-antagonist tendon vibration to degrade proprioceptive acuity.

  18. Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2014-01-01

    Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.

  19. Total ankle replacement or ankle fusion in painful advanced hemophilic arthropathy of the ankle.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-12-01

    In advanced painful hemophilic arthropathy of the ankle, the last resort is surgical treatment (ankle arthrodesis [AA] or total ankle replacement [TAR]). There is a controversy in the literature on which of the two procedures is more appropriate. A review of the literature was performed to clarify such a controversy. The first search engine was MedLine (keywords: total ankle replacement, ankle arthrodesis). Seventy articles were found in MedLine. Of these, only 16 were selected and reviewed because they were strictly focused on the topic of this article. The second search engine was the Cochrane Library, where only nine systematic reviews were found on the role of TAR and AA in non-hemophilia patients. TAR and AA provide pain relief and patient satisfaction in hemophilia patients in the short term. The available non-hemophilia literature is insufficient to conclude which treatment is superior. My current view is that AA may be preferable in most hemophilia patients.

  20. Development and experimental validation of a finite element model of total ankle replacement.

    Science.gov (United States)

    Terrier, Alexandre; Larrea, Xabier; Guerdat, Jonas; Crevoisier, Xavier

    2014-02-07

    Total ankle replacement remains a less satisfactory solution compared to other joint replacements. The goal of this study was to develop and validate a finite element model of total ankle replacement, for future testing of hypotheses related to clinical issues. To validate the finite element model, an experimental setup was specifically developed and applied on 8 cadaveric tibias. A non-cemented press fit tibial component of a mobile bearing prosthesis was inserted into the tibias. Two extreme anterior and posterior positions of the mobile bearing insert were considered, as well as a centered one. An axial force of 2kN was applied for each insert position. Strains were measured on the bone surface using digital image correlation. Tibias were CT scanned before implantation, after implantation, and after mechanical tests and removal of the prosthesis. The finite element model replicated the experimental setup. The first CT was used to build the geometry and evaluate the mechanical properties of the tibias. The second CT was used to set the implant position. The third CT was used to assess the bone-implant interface conditions. The coefficient of determination (R-squared) between the measured and predicted strains was 0.91. Predicted bone strains were maximal around the implant keel, especially at the anterior and posterior ends. The finite element model presented here is validated for future tests using more physiological loading conditions.

  1. Development of a revolute-joint robot for the precision positioning of an x-ray detector

    Science.gov (United States)

    Preissner, Curt A.; Royston, Thomas J.; Shu, Deming

    2003-10-01

    This paper profiles the initial phase in the development of a six degree-of-freedom robot, with 1 μm dynamic positioning uncertainty, for the manipulation of x-ray detectors or test specimens at the Advanced Photon Source (APS). While revolute-joint robot manipulators exhibit a smaller footprint along with increased positioning flexibility compared to Cartesian manipulators, commercially available revolute-joint manipulators do not meet our size, positioning, or environmental specifications. Currently, a robot with 20 μm dynamic positioning uncertainty is functioning at the APS for cryogenic crystallography sample pick-and-place operation. Theoretical, computational and experimental procedures are being used to (1) identify and (2) simulate the dynamics of the present robot system using a multibody approach, including the mechanics and control architecture, and eventually to (3) design an improved version with a 1 μm dynamic positioning uncertainty. We expect that the preceding experimental and theoretical techniques will be useful design and analysis tools as multi-degree-of-freedom manipulators become more prevalent on synchrotron beamlines.

  2. Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle

    Directory of Open Access Journals (Sweden)

    Jarvis Hannah L

    2012-06-01

    Full Text Available Abstract Background There is no consensus on which protocols should be used to assess foot and lower limb biomechanics in clinical practice. The reliability of many assessments has been questioned by previous research. The aim of this investigation was to (i identify (through consensus what biomechanical examinations are used in clinical practice and (ii evaluate the inter-assessor reliability of some of these examinations. Methods Part1: Using a modified Delphi technique 12 podiatrists derived consensus on the biomechanical examinations used in clinical practice. Part 2: Eleven podiatrists assessed 6 participants using a subset of the assessment protocol derived in Part 1. Examinations were compared between assessors. Results Clinicians choose to estimate rather than quantitatively measure foot position and motion. Poor inter-assessor reliability was recorded for all examinations. Intra-class correlation coefficient values (ICC for relaxed calcaneal stance position were less than 0.23 and were less than 0.14 for neutral calcaneal stance position. For the examination of ankle joint dorsiflexion, ICC values suggest moderate reliability (less than 0.61. The results of a random effects ANOVA highlight that participant (up to 5.7°, assessor (up to 5.8° and random (up to 5.7° error all contribute to the total error (up to 9.5° for relaxed calcaneal stance position, up to 10.7° for the examination of ankle joint dorsiflexion. Kappa Fleiss values for categorisation of first ray position and mobility were less than 0.05 and for limb length assessment less than 0.02, indicating slight agreement. Conclusion Static biomechanical assessment of the foot, leg and lower limb is an important protocol in clinical practice, but the key examinations used to make inferences about dynamic foot function and to determine orthotic prescription are unreliable.

  3. Demonstration of long-pulse acceleration of high power positive ion beam with JT-60 positive ion source in Japan–Korea joint experiment

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, A., E-mail: kojima.atsushi@jaea.go.jp [Japan Atomic Energy Agency, Naka (Japan); Hanada, M. [Japan Atomic Energy Agency, Naka (Japan); Jeong, S.H. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Bae, Y.S. [National Fusion Research Institute, Daejeon (Korea, Republic of); Chang, D.H.; Kim, T.S.; Lee, K.W.; Park, M.; Jung, B.K. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Mogaki, K.; Komata, M.; Dairaku, M.; Kashiwagi, M.; Tobari, H.; Watanabe, K. [Japan Atomic Energy Agency, Naka (Japan)

    2016-01-15

    The long-pulse acceleration of the high-power positive ion beam has been demonstrated with the JT-60 positive ion source in the joint experiment among Japan Atomic Energy Agency (JAEA), Korea Atomic Energy Research Institute (KAERI) and National Fusion Research Institute (NFRI) under the collaboration program for the development of plasma heating and current drive systems. In this joint experiment, the increase of the heat load and the breakdowns induced by the degradation of the beam optics due to the gas accumulation was one of the critical issues for the long-pulse acceleration. As a result of development of the long-pulse operation techniques of the ion source and facilities of the neutral beam test stand in KAERI, 2 MW 100 s beam has been achieved for the first time. The achieved beam performance satisfies the JT-60SA requirement which is designed to be a 1.94 MW ion beam power from an ion source corresponding to total neutral beam power of 20 MW with 24 ion sources. Therefore, it was found that the JT-60 positive ion sources were applicable in the JT-60SA neutral beam injectors. Moreover, because this ion source is planned to be a backup ion source for KSTAR, the operational region and characteristic has been clarified to apply to the KSTAR neutral beam injector.

  4. Treatment of Unstable Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Yaniel Truffín Rodríguez

    2015-11-01

    Full Text Available Patients with unstable ankle fractures frequently attend the emergency rooms. It is estimated that there are 122 ankle fractures per 100 000 people a year. Surgical treatment of those that are unstable is inevitable since they can not be corrected in a conservative way. Several surgical procedures for repair of such lesions have been described and all of them constitute important tools for the orthopedic surgeon. Therefore, we conducted a literature review to discuss the current management of unstable ankle fractures based on the analysis of the published literature and the experiences in the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos.

  5. The hematoma block: a simple, effective technique for closed reduction of ankle fracture dislocations.

    Science.gov (United States)

    Ross, Adrianne; Catanzariti, Alan R; Mendicino, Robert W

    2011-01-01

    Management of a dislocated ankle fracture can be challenging because of instability of the ankle mortise, a compromised soft tissue envelope, and the potential neurovascular compromise. Every effort should be made to quickly and efficiently relocate the disrupted ankle joint. Within the emergency department setting, narcotics and benzodiazepines can be used to sedate the patient before attempting closed reduction. The combination of narcotics and benzodiazepines provides relief of pain and muscle guarding; however, it conveys a risk of seizure as well as respiratory arrest. An alternative to conscious sedation is the hematoma block, or an intra-articular local anesthetic injection in the ankle joint and the associated fracture hematoma. The hematoma block offers a comparable amount of analgesia to conscious sedation without the additional cardiovascular risk, hospital cost, and procedure time.

  6. Reproducibility of and sex differences in common orthopaedic ankle and foot tests in runners

    NARCIS (Netherlands)

    Worp, M.P. van der; Wijer, A de; Staal, J.B.; Nijhuis-Van der Sanden, M.W.

    2014-01-01

    BACKGROUND: For future etiologic cohort studies in runners it is important to identify whether (hyper)pronation of the foot, decreased ankle joint dorsiflexion (AJD) and the degree of the extension of the first Metatarsophalangeal joint (MTP1) are risk factors for running injuries and to determine p

  7. Dynamic high-resolution US of ankle and midfoot ligaments: normal anatomic structure and imaging technique.

    Science.gov (United States)

    Sconfienza, Luca Maria; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Silvestri, Enzo

    2015-01-01

    The ankle is the most frequently injured major joint in the body, and ankle sprains are frequently encountered in individuals playing football, basketball, and other team sports, in addition to occurring in the general population. Imaging plays a crucial role in the evaluation of ankle ligaments. Magnetic resonance imaging has been proven to provide excellent evaluation of ligaments around the ankle, with the ability to show associated intraarticular abnormalities, joint effusion, and bone marrow edema. Ultrasonography (US) performed with high-resolution broadband linear-array probes has become increasingly important in the assessment of ligaments around the ankle because it is low cost, fast, readily available, and free of ionizing radiation. US can provide a detailed depiction of normal anatomic structures and is effective for evaluating ligament integrity. In addition, US allows the performance of dynamic maneuvers, which may contribute to increased visibility of normal ligaments and improved detection of tears. In this article, the authors describe the US techniques for evaluation of the ankle and midfoot ligaments and include a brief review of the literature related to their basic anatomic structures and US of these structures. Short video clips showing dynamic maneuvers and dynamic real-time US of ankle and midfoot structures and their principal pathologic patterns are included as supplemental material. Use of a standardized imaging technique may help reduce the intrinsic operator dependence of US. Online supplemental material is available for this article.

  8. The Effects of Kinesiotape Applied to the Lateral Aspect of the Ankle: Relevance to Ankle Sprains--A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Brendan Wilson

    Full Text Available To identify, evaluate and synthesise evidence on the effect of kinesiotape applied to the lateral aspect of the ankle, through a systematic review of quantitative studies.A search for quantitative studies was undertaken using key terms of "kinesiotape" and "ankle" in seven electronic databases, using the maximum date ranges. Databases included: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Physiotherapy Evidence Database, Scopus, SPORTDiscus and Web of Science.Database hits were evaluated against explicit inclusion criteria. From 107 database hits, 8 quantitative studies were included.Two independent reviewers appraised the methodological rigour of the studies using the McMaster Critical Review Form for Quantitative Studies. Data were extracted on participant characteristics, kinesiotape parameters, comparison interventions, outcome measures and findings.Most studies (n=7 had good to very good methodological rigour. Meta-analysis was not possible due to heterogeneity in participants, interventions and outcome measures. No adverse events were reported. Kinesiotape may produce different effects in healthy and injured ankles. In healthy ankles, kinesiotape may increase postural control, whereas in injured ankles it may improve proprioception, plantarflexor endurance and the performance of activities. These trends were identified from a small body of evidence including 276 participants.It is recommended that kinesiotape may be used in clinical practice to prevent lateral ankle injuries (through its effects on postural control and manage lateral ankle injuries due to its positive effects on proprioception, muscle endurance and activity performance. It appears that kinesiotape may not provide sufficient mechanical support to improve postural control in unstable ankles. Adverse events associated with kinseiotape are unlikely.

  9. Multi-segment foot kinematics after total ankle replacement and ankle arthrodesis during relatively long-distance gait.

    Science.gov (United States)

    Rouhani, H; Favre, J; Aminian, K; Crevoisier, X

    2012-07-01

    This study aimed to investigate the influence of ankle osteoarthritis (AOA) treatments, i.e., ankle arthrodesis (AA) and total ankle replacement (TAR), on the kinematics of multi-segment foot and ankle complex during relatively long-distance gait. Forty-five subjects in four groups (AOA, AA, TAR, and control) were equipped with a wearable system consisting of inertial sensors installed on the tibia, calcaneus, and medial metatarsals. The subjects walked 50-m twice while the system measured the kinematic parameters of their multi-segment foot: the range of motion of joints between tibia, calcaneus, and medial metatarsals in three anatomical planes, and the peaks of angular velocity of these segments in the sagittal plane. These parameters were then compared among the four groups. It was observed that the range of motion and peak of angular velocities generally improved after TAR and were similar to the control subjects. However, unlike AOA and TAR, AA imposed impairments in the range of motion in the coronal plane for both the tibia-calcaneus and tibia-metatarsals joints. In general, the kinematic parameters showed significant correlation with established clinical scales (FFI and AOFAS), which shows their convergent validity. Based on the kinematic parameters of multi-segment foot during 50-m gait, this study showed significant improvements in foot mobility after TAR, but several significant impairments remained after AA.

  10. Hip joint centre position estimation using a dual unscented Kalman filter for computer-assisted orthopaedic surgery.

    Science.gov (United States)

    Beretta, Elisa; De Momi, Elena; Camomilla, Valentina; Cereatti, Andrea; Cappozzo, Aurelio; Ferrigno, Giancarlo

    2014-09-01

    In computer-assisted knee surgery, the accuracy of the localization of the femur centre of rotation relative to the hip-bone (hip joint centre) is affected by the unavoidable and untracked pelvic movements because only the femoral pose is acquired during passive pivoting manoeuvres. We present a dual unscented Kalman filter algorithm that allows the estimation of the hip joint centre also using as input the position of a pelvic reference point that can be acquired with a skin marker placed on the hip, without increasing the invasiveness of the surgical procedure. A comparative assessment of the algorithm was carried out using data provided by in vitro experiments mimicking in vivo surgical conditions. Soft tissue artefacts were simulated and superimposed onto the position of a pelvic landmark. Femoral pivoting made of a sequence of star-like quasi-planar movements followed by a circumduction was performed. The dual unscented Kalman filter method proved to be less sensitive to pelvic displacements, which were shown to be larger during the manoeuvres in which the femur was more adducted. Comparable accuracy between all the analysed methods resulted for hip joint centre displacements smaller than 1 mm (error: 2.2 ± [0.2; 0.3] mm, median ± [inter-quartile range 25%; inter-quartile range 75%]) and between 1 and 6 mm (error: 4.8 ± [0.5; 0.8] mm) during planar movements. When the hip joint centre displacement exceeded 6 mm, the dual unscented Kalman filter proved to be more accurate than the other methods by 30% during multi-planar movements (error: 5.2 ± [1.2; 1] mm).

  11. Candida Parapsilosis Arthritis Involving the Ankle in a Diabetes Patient: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Jin Kyeong; Chun, Kyung Ah [Dept. of Radiology, The Catholic University of Korea Uijeongbu St. Mary' s Hospital, Uijeongbu (Korea, Republic of)

    2011-06-15

    Candida parapsilosis is a rare opportunistic fungal pathogen of the musculoskeletal region. Immune function of almost all patients is severely disturbed. Most reported cases of septic arthritis of joints by Candida involve the knee, especially Candida parapsilosis. To our knowledge, there has been only one case report of Candida parapsilosis involving the ankle presented on only plain radiography. We report a case of Candida parapsilosis arthritis involving the ankle in a diabetes patient which was shown on MR imaging.

  12. Perioperative Physiotherapy for Total Ankle Replacement in Patients with Inherited Bleeding Disorders: Outline of an Algorithm

    OpenAIRE

    Kotela, Andrzej; Wilk-Frańczuk, Magdalena; Jaczewska, Joanna; Żbikowski, Piotr; Łęgosz, Paweł; Ambroziak, Paweł; Kotela, Ireneusz

    2017-01-01

    The treatment of end-stage hemophilic arthropathy of the ankle joint remains a controversial problem, and total ankle replacement (TAR) is considered to be a valuable management option. Physiotherapy continues to be an extremely important part of TAR and has a tremendous impact on the outcomes of this procedure. Given the lack of data on the latter, this study details a protocol of perioperative physiotherapy in TAR in patients with inherited bleeding disorders (IBD). The protocol outlined in...

  13. Power Doppler ultrasonographic assessment of the ankle in patients with inflammatory rheumatic diseases

    OpenAIRE

    Suzuki, Takeshi

    2014-01-01

    Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound (US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler (PD) technology has enabled evaluation of the st...

  14. Effects of ankle balance taping with kinesiology tape for a patient with chronic ankle instability

    Science.gov (United States)

    Kim, Byeong-Jo; Lee, Jung-Hoon; Kim, Chang-Tae; Lee, Sun-Min

    2015-01-01

    [Purpose] To report the effects of ankle balance taping for a patient with chronic ankle instability (CAI). [Subject] A 33-year-old man with a 10 year history of chronic ankle stability. [Methods] ABT with kinesiology tape was performed for 2 months (average, 16 h/day) around the right ankle. [Results] At the end of two months, no ankle instability was noted when ascending and descending the stairs, jumping, turning, operating the pedals while driving, and lifting heavy objects. [Conclusion] The repeated use of kinesiology tape in ankle balance taping may be an effective treatment for recovering the ankle stability of patients with chronic ankle instability. PMID:26311206

  15. THE FEATURES OF TIBIOFIBULAR INJURY IN PATENTS WITH ANKLE FRACTURES

    Directory of Open Access Journals (Sweden)

    N. F. Fomin

    2010-01-01

    Full Text Available The role of interposition of soft tissues into tibiofibular syndesmosis is analyzed as a cause of unsatisfactory outcomes in the ankle joint pronation fracture treatment. The study is based on clinical (452 patients and experimental material (36 experiments including unfixed anatomic objects. The elevator for minimal invasive operative elimination of interposition of stumps of distal tibiofibular syndesmosis anterior and posterior ligaments is developed and tested.

  16. Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions.

    Science.gov (United States)

    Wakahara, Taku; Kanehisa, Hiroaki; Kawakami, Yasuo; Fukunaga, Tetsuo

    2009-10-01

    The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90 degrees flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30 degrees plantar flexed position and then the ankle joint was forcibly dorsiflexed to 15 degrees of dorsiflexion with an isokinetic dynamometer at 30 degrees /s and 150 degrees /s. Tendon force was calculated by dividing the plantar flexion torque by the estimated moment arm of the Achilles tendon. The MG fascicle length was determined with ultrasonography. The tendon forces during eccentric plantar flexions were influenced by the knee joint angle, but not by the angular velocity. The MG fascicle lengths were elongated as the ankle was dorsiflexed in K0, but in K90 they were almost constant despite the identical range of ankle joint motion. These results suggested that MG fascicle behavior during eccentric actions was markedly affected by the knee joint angle. The difference in the fascicle behavior between K0 and K90 could be attributed to the non-linear force-length relations and/or to the slackness of tendinous tissues.

  17. Numerical investigation on the position of holes for reducing stress concentration in composite plates with bolted and riveted joints

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    This paper studies the effects of fiber orientaion and holes position on stress concentration and the determination of weakened areas in the composite of glass fiber reinforced epoxy resin around the hole for joints by using the finite element method.In this study,for the observation of areas affected by stress concentration Tsai-Wu failure criterion is used to determine the failed elements and ANSYS Software is implemented for modeling.In order to compare the effect of geometric parameters on stress concen...

  18. Ankle tenosynovitis in rheumatoid arthritis: clinical and ultrasonographic evaluation

    Directory of Open Access Journals (Sweden)

    Ana Luiza Naves Pereira

    2016-11-01

    Full Text Available Objective: To investigate ankle tenosynovitis in rheumatoid arthritis patients, regarding its presence, the kind of tendon involved and the concordance between clinical and ultrasound findings. Methods: Twenty patients with rheumatoid arthritis and pain or swollen ankle joint were evaluated. Tendon involvement was evaluated with ultrasound imaging. The Health Assessment Questionnaire (HAQ was performed for disability evaluation. Age, sex, disease duration, and vocational activity levels were also obtained. The statistical analysis included Fisher’s exact test. The significance level was 0.05. Results: Tenosynovitis was found in 13 of 20 (65.0% patients in 19 joints, in which 6 were bilaterally (46.1% and unilateral in 7 (53.8%. Tibialis posterior tenosynovitis was seen in nine (45.0% patients, Achilles tenosynovitis in seven (35.0%, tibialis anterior tenosynovitis in three (15.0%, and peroneal tenosynovitis in three (15.0% patients. We found concordance between symptomatic ankle and ultrasonographic findings in 92.3% of the patients with tenosynovitis. Association between severe HAQ with tendon involvement was not found (p>0.05. Disease duration was not associated with tenosynovitis. Patients were predominantly older, female, with mean age around 50.8 years. The long disease duration of patients presented a mean of 11.4 years and, most of them, with no vocational activity (65.0%. Conclusions: The results indicate that ankle tenosynovitis is very common in rheumatoid arthritis patients, both unilateral and bilateral. Tibialis posterior was the most common tendon involvement found. Finally, we found concordance between the clinical and ultrasound findings in almost all rheumatoid arthritis patients with ankle tenosynovitis.

  19. Clinical measurement of mechanical ankle instability.

    Science.gov (United States)

    Parasher, Raju K; Nagy, Dawn R; Em, April L; Phillips, Howard J; Mc Donough, Andrew L

    2012-10-01

    Clinicians commonly use the anterior draw test (ligament laxity) and distal fibular position (lateral malleolus displacement), to measure ankle instability. The purpose of this study was to establish intra-rater and inter-rater reliability for the anterior draw test and distal fibular position in a clinical setting. The anterior draw test (AD) was measured with a plastic Goniometer, and was defined as the linear displacement of the foot as it is drawn anteriorly with the ankle held in 20 degrees of plantar-flexion. Distal fibular position (DFP) was measured in standing using a digital vernier caliper and was the relative linear distance between the lateral and the medial malleoli. 20 participants aged 21-28 volunteered for the study and were measured on both ankles. It was found that Intra-tester reliability (ICC) ranged from 0.88 to 0.97 for AD and DFP; while inter-tester reliability (ICC) was 0.6 for AD and 0.77 for DFP. In addition for measures across trials, the standard error of the measurement (SEM) was, on average 0.66 mm for AD and 1.7 mm for DFP. While the limits of agreement (LOA) was ±0.17 mm for AD and ±4.03 mm for DFP. However, the SEM and LOA between testers was 2.27 mm and ±2.27 mm respectively for AD; and for 3.1 mm and ±10.4 mm for DFP. Overall the results suggest that both measures, as defined in this study exhibit moderate to good reliability and low standard error of measurement, suggesting a high degree of repeatability across trials.

  20. Muscle Activation Differs between Three Different Knee Joint-Angle Positions during a Maximal Isometric Back Squat Exercise

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Marchetti

    2016-01-01

    Full Text Available The purpose of this study was to compare muscle activation of the lower limb muscles when performing a maximal isometric back squat exercise over three different positions. Fifteen young, healthy, resistance-trained men performed an isometric back squat at three knee joint angles (20°, 90°, and 140° in a randomized, counterbalanced fashion. Surface electromyography was used to measure muscle activation of the vastus lateralis (VL, vastus medialis (VM, rectus femoris (RF, biceps femoris (BF, semitendinosus (ST, and gluteus maximus (GM. In general, muscle activity was the highest at 90° for the three quadriceps muscles, yet differences in muscle activation between knee angles were muscle specific. Activity of the GM was significantly greater at 20° and 90° compared to 140°. The BF and ST displayed similar activation at all joint angles. In conclusion, knee position alters muscles activation of the quadriceps and gluteus maximus muscles. An isometric back squat at 90° generates the highest overall muscle activation, yet an isometric back squat at 140° generates the lowest overall muscle activation of the VL and GM only.

  1. The management of hip fracture in the older population. Joint position statement by Gruppo Italiano Ortogeriatria (GIOG).

    Science.gov (United States)

    Pioli, Giulio; Barone, A; Mussi, C; Tafaro, L; Bellelli, G; Falaschi, P; Trabucchi, M; Paolisso, G

    2014-10-01

    This document is a Joint Position Statement by Gruppo Italiano di OrtoGeriatria (GIOG) supported by Società Italiana di Gerontologia e Geriatria (SIGG), and Associazione Italiana Psicogeriatria (AIP) on management of hip fracture older patients. Orthogeriatric care is at present the best model of care to improve results in older patients after hip fracture. The implementation of orthogeriatric model of care, based on the collaboration between orthopaedic surgeons and geriatricians, must take into account the local availability of resources and facilities and should be integrated into the local context. At the same time the programme must be based on the best available evidences and planned following accepted quality standards that ensure the efficacy of the intervention. The position paper focused on eight quality standards for the management of hip fracture older patients in orthogeriatric model of care. The GIOG promotes the development of a clinic database with the aim of obtaining a qualitative improvement in the management of hip fracture.

  2. The Effects of Kinesiotape Applied to the Lateral Aspect of the Ankle: Relevance to Ankle Sprains – A Systematic Review

    Science.gov (United States)

    Wilson, Brendan; Bialocerkowski, Andrea

    2015-01-01

    Objective To identify, evaluate and synthesise evidence on the effect of kinesiotape applied to the lateral aspect of the ankle, through a systematic review of quantitative studies. Data Sources A search for quantitative studies was undertaken using key terms of “kinesiotape” and “ankle” in seven electronic databases, using the maximum date ranges. Databases included: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Physiotherapy Evidence Database, Scopus, SPORTDiscus and Web of Science. Study Selection Database hits were evaluated against explicit inclusion criteria. From 107 database hits, 8 quantitative studies were included. Data Extraction Two independent reviewers appraised the methodological rigour of the studies using the McMaster Critical Review Form for Quantitative Studies. Data were extracted on participant characteristics, kinesiotape parameters, comparison interventions, outcome measures and findings. Data Syntheses Most studies (n=7) had good to very good methodological rigour. Meta-analysis was not possible due to heterogeneity in participants, interventions and outcome measures. No adverse events were reported. Kinesiotape may produce different effects in healthy and injured ankles. In healthy ankles, kinesiotape may increase postural control, whereas in injured ankles it may improve proprioception, plantarflexor endurance and the performance of activities. These trends were identified from a small body of evidence including 276 participants. Conclusions It is recommended that kinesiotape may be used in clinical practice to prevent lateral ankle injuries (through its effects on postural control) and manage lateral ankle injuries due to its positive effects on proprioception, muscle endurance and activity performance. It appears that kinesiotape may not provide sufficient mechanical support to improve postural control in unstable ankles. Adverse events associated with kinseiotape are unlikely. PMID

  3. Reconstructive foot and ankle surgeries in diabetic patients

    Directory of Open Access Journals (Sweden)

    Ajit Kumar Varma

    2011-01-01

    Full Text Available Diabetic foot and ankle deformities are secondary to long-standing diabetes and neglected foot care. The concept of surgical correction for these deformities is quite recent. The primary objective of reconstructive foot and ankle surgery is the reduction of increased plantar pressures, reduction of pain and the restoration of function, stability and proper appearance. Foot and ankle deformities can result in significant disability, loss of life style, employment and even the loss of the lower limb. Therefore, restoration of normal, problem free foot function and activities will have a significant impact on peoples′ lives. Reconstructive surgical procedures are complex and during reconstruction, internal and external fixation devices, including pins, compression screws, staples, and wires, may be used for repair and stabilization. The surgeries performed depend on the type and severity of the condition. Surgery can involve any part of the foot and ankle, and may involve tendon, bone, joint, tissue or skin repair. Corrective surgeries can at times be performed on an outpatient basis with minimally invasive techniques. Recovery time depends on the type of condition being treated.

  4. TOTAL ANKLE ARTHROPLASTY: BRAZILIAN EXPERIENCE WITH THE HINTEGRA PROSTHESIS.

    Science.gov (United States)

    Nery, Caio; Fernandes, Túlio Diniz; Réssio, Cibele; Fuchs, Mauro Luiz; Godoy Santos, Alexandre Leme de; Ortiz, Rafael Trevisan

    2010-01-01

    Ankle arthrosis is becoming more and more common. The search for solutions that preserve joint function has led to a new generation of prosthesis with three components and more degrees of freedom. This paper presents the results achieved for ten patients treated with the HINTEGRA Prosthesis (Integra, New Deal), through collaborative action between the Foot and Ankle Groups of the Orthopedics and Traumatology divisions of Escola Paulista de Medicina, Unifesp, and the School of Medicine of the University of São Paulo (USP). The ten patients (six women and four men, aged between 29 and 66 years), underwent a surgical procedure consisting of Hintermann's technique, between January and June 2005. They were evaluated at prearranged intervals, and the data were subjected to statistical analysis. The surgery led to a significant improvement in ankle mobility. Radiological evaluation showed no signs of loosening or failure in the prosthetic components in any of the patients studied. Although the complication rate in our sample was high, it was equivalent to the rates found by other authors, and directly represents the learning curve associate with this kind of procedure. Four years after the procedure, it was found that the patients pain levels had significantly decreased, and that their functional patterns had significantly improved, with AOFAS and Hintermann scores indicating results that were excellent for 20%, good for 70% and poor for 10%. Treatment of ankle arthritis by means of total arthroplasty using the HINTEGRA prosthesis was capable of providing good results over an average observation period of four years.

  5. Limb position sense, proprioceptive drift and muscle thixotropy at the human elbow joint.

    Science.gov (United States)

    Tsay, A; Savage, G; Allen, T J; Proske, U

    2014-06-15

    These experiments on the human forearm are based on the hypothesis that drift in the perceived position of a limb over time can be explained by receptor adaptation. Limb position sense was measured in 39 blindfolded subjects using a forearm-matching task. A property of muscle, its thixotropy, a contraction history-dependent passive stiffness, was exploited to place muscle receptors of elbow muscles in a defined state. After the arm had been held flexed and elbow flexors contracted, we observed time-dependent changes in the perceived position of the reference arm by an average of 2.8° in the direction of elbow flexion over 30 s (Experiment 1). The direction of the drift reversed after the arm had been extended and elbow extensors contracted, with a mean shift of 3.5° over 30 s in the direction of elbow extension (Experiment 2). The time-dependent changes could be abolished by conditioning elbow flexors and extensors in the reference arm at the test angle, although this led to large position errors during matching (±10°), depending on how the indicator arm had been conditioned (Experiments 3 and 4). When slack was introduced in the elbow muscles of both arms, by shortening muscles after the conditioning contraction, matching errors became small and there was no drift in position sense (Experiments 5 and 6). These experiments argue for a receptor-based mechanism for proprioceptive drift and suggest that to align the two forearms, the brain monitors the difference between the afferent signals from the two arms.

  6. Obesity is not associated with increased knee joint torque and power during level walking.

    Science.gov (United States)

    DeVita, Paul; Hortobágyi, Tibor

    2003-09-01

    While it is widely speculated that obesity causes increased loads on the knee leading to joint degeneration, this concept is untested. The purpose of the study was to identify the effects of obesity on lower extremity joint kinetics and energetics during walking. Twenty-one obese adults were tested at self-selected (1.29m/s) and standard speeds (1.50m/s) and 18 lean adults were tested at the standard speed. Motion analysis and force platform data were combined to calculate joint torques and powers during the stance phase of walking. Obese participants were more erect with 12% less knee flexion and 11% more ankle plantarflexion in self-selected compared to standard speeds (both pKnee and ankle torques were 17% and 11% higher (pknee work and positive ankle work were 68% and 11% higher (ppowers were statistically identical at the hip and knee but were 88% and 61% higher (both pknee torque and power at their self-selected walking speed and equal knee torque and power while walking at the same speed as lean individuals. We propose that the ability to reorganize neuromuscular function during gait may enable some obese individuals to maintain skeletal health of the knee joint and this ability may also be a more accurate risk indicator for knee osteoarthritis than body weight.

  7. American Orthopaedic Foot and Ankle Society

    Science.gov (United States)

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  8. Use of Soft-Tissue Procedures for Managing Varus and Valgus Malalignment with Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Elliott, Andrew D

    2015-10-01

    Achieving frontal plane alignment of the ankle joint during total ankle replacement is essential for long-term success. Tendon and ligament lengthening, ligament reinforcement, tendon transfer, nonanatomic tendon transfer ligament reconstruction, and periarticular osteotomies are safe, straightforward, minimally invasive, and reproducible procedures to correct varus and valgus deformities associated with end-stage degenerative joint disease. Using reproducible topographic anatomic landmarks is essential to these techniques properly and limit complications. The approach to frontal plane deformities is stepwise, with liberal use of tendon and ligament lengthening and reconstruction, a low threshold for nonanatomic tendon transfer ligament reconstructions, and tendon transfers and/or periarticular osteotomies.

  9. Ankle and midfoot kinetics during normal gait: a multi-segment approach.

    Science.gov (United States)

    Dixon, Philippe C; Böhm, Harald; Döderlein, Leonhard

    2012-04-01

    Multi-segment foot models are increasingly being used to evaluate intra and inter-segment foot kinematics such as the motion between the hindfoot/tibia (ankle) and the forefoot/hindfoot (midfoot) during walking. However, kinetic analysis have been mainly restricted to one-segment foot models and could be improved by considering a multi-segment approach. Therefore, the aims of this study were to (1) implement a kinetic analysis of the ankle and theoretical midfoot joints using the existing Oxford Foot Model (OFM) through a standard inverse dynamics approach using only marker, force plate and anthropometric data and (2) to compare OFM ankle joint kinetics to those output by the one-segment foot plugin-gait model (PIG). 10 healthy adolescents fitted with both the OFM and PIG markers performed barefoot comfortable speed walking trials over an instrumented walkway. The maximum ankle power generation was significantly reduced by approximately 40% through OFM calculations compared to PIG estimates (psegment foot models overestimate ankle power, and may also overestimate the contribution of the triceps surae. A multi-segment approach may help quantify the important contribution of the midfoot ligaments and musculature to power generation. We therefore recommend the use of multi-segment foot models to estimate ankle and midfoot kinetics, especially when surgical decision-making is based on the results of three-dimensional gait analysis.

  10. Computerized Neuropsychological Assessment Devices: Joint Position Paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology†

    Science.gov (United States)

    Bauer, Russell M.; Iverson, Grant L.; Cernich, Alison N.; Binder, Laurence M.; Ruff, Ronald M.; Naugle, Richard I.

    2012-01-01

    This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting. These statements address (a) device marketing and performance claims made by developers of CNADs; (b) issues involved in appropriate end-users for administration and interpretation of CNADs; (c) technical (hardware/software/firmware) issues; (d) privacy, data security, identity verification, and testing environment; (e) psychometric development issues, especially reliability, and validity; (f) cultural, experiential, and disability factors affecting examinee interaction with CNADs; (g) use of computerized testing and reporting services; and (h) the need for checks on response validity and effort in the CNAD environment. This paper is intended to provide guidance for test developers and users of CNADs that will promote accurate and appropriate use of computerized tests in a way that maximizes clinical utility and minimizes risks of misuse. The positions taken in this paper are put forth with an eye toward balancing the need to make validated CNADs accessible to otherwise underserved patients with the need to ensure that such tests are developed and utilized competently, appropriately, and with due concern for patient welfare and quality of care. PMID:22382386

  11. Computerized neuropsychological assessment devices: joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology.

    Science.gov (United States)

    Bauer, Russell M; Iverson, Grant L; Cernich, Alison N; Binder, Laurence M; Ruff, Ronald M; Naugle, Richard I

    2012-05-01

    This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting. These statements address (a) device marketing and performance claims made by developers of CNADs; (b) issues involved in appropriate end-users for administration and interpretation of CNADs; (c) technical (hardware/software/firmware) issues; (d) privacy, data security, identity verification, and testing environment; (e) psychometric development issues, especially reliability, and validity; (f) cultural, experiential, and disability factors affecting examinee interaction with CNADs; (g) use of computerized testing and reporting services; and (h) the need for checks on response validity and effort in the CNAD environment. This paper is intended to provide guidance for test developers and users of CNADs that will promote accurate and appropriate use of computerized tests in a way that maximizes clinical utility and minimizes risks of misuse. The positions taken in this paper are put forth with an eye toward balancing the need to make validated CNADs accessible to otherwise underserved patients with the need to ensure that such tests are developed and utilized competently, appropriately, and with due concern for patient welfare and quality of care.

  12. Treatment of unilateral composite external fixator for fracture-dislocation of ankle joint with soft tissue defect%单侧组合式外固定架治疗踝关节骨折脱位并软组织缺损

    Institute of Scientific and Technical Information of China (English)

    吴浩俊; 陈航; 陈光华

    2014-01-01

    Objective To evaluate the outcome of unilateral composite external fixator for the treatment of fracture-dislocation of ankle joint with soft tissue defect. Methods From July 2008 to July 2012, 15 patients suffered from fracture-dislocation of ankle joint with soft tissue defect were treated in the Affiliated Hospital of Guangdong Medical College. All patients received emergency surgery of debridement and external fixation with unilateral composite external fixator after admission, and the open wound achieved two-stage repair. X-ray were taken for follow-up after the surgery, and at the last follow-up, function of ankle joint was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) scoring. Results The average operative time was (79 ± 24) min (40-120 min). There were stamp skin grafting in 13 cases and flap transplantation in 2 cases, and skin graft survived in all patients. The average wound healing time was(23 ± 7)d ( 17-42 d), and the average follow-up was (20 ± 6) months (12-36 months). No necrosis of skin, osteomyelitis, pin loosening or external fixation failure occurred. There were only 3 patients of mild infection of pin site or Kirschner wire who were cured shortly after symptomatic therapy. The average bone union time was (8.2 ± 1.8) months (5-11 months). According to AOFAS scoring, there were excellent in 9 cases, good in 4 cases and fair in 2 cases at the last follow-up. Conclusion For fracture-dislocation of ankle joint with soft tissue defect, unilateral composite external fixator allows for transarticular fixation, rapid wound repair, as well as early weight-bearing and functional excise..%目的:探讨单侧组合式外固定架治疗踝关节骨折脱位并软组织缺损的疗效。方法回顾性分析2008年7月至2012年7月广东医学院附属医院收治的15例踝关节骨折脱位并软组织缺损患者的临床资料。入院行急诊清创、单侧组合式外固定架固定,创面二期修复,术后定期复

  13. Robust tracking control for a class of flexible-joint time-delay robots using only position measurements

    Science.gov (United States)

    Chang, Yeong-Chan; Wu, Ming-Fang

    2016-10-01

    In this paper, robust tracking control is investigated for a class of uncertain flexible-joint robots with time delays and time-varying perturbations. By employing the Lyapunov--Krasovskii functional technique and backstepping design technique, a novel robust tracking control scheme using only position measurements is developed such that all the states and signals of the closed-loop flexible-joint time-delay robot system remain bounded and the tracking error can asymptotically converge to a small neighbourhood around the origin. By appropriately choosing the weighting gains in the Lyapunov-Krasovskii functionals, the circular phenomenon in the controller design is overcome. Due to suitably designing the velocity observer and the virtual control input, the link-side dynamics does not need to be incorporated into the actuator-side tracking error dynamics, and so the complexity in the backstepping design is avoided. Consequently, we can easily construct the Lyapunov-Krasovskii functionals, and, in turn, the robust tracking control scheme developed here is a linear time-varying controller and can be simply implemented. Simulation examples are provided to verify the effectiveness of the proposed control algorithm.

  14. Acute paediatric ankle trauma: MRI versus plain radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lohman, M. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Radiological Dept., Helsinki University Central Hospital (Finland); Kivisaari, A.; Kivisaari, L. [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Kallio, P.; Puntila, J. [Dept. of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki Univ. Central Hospital, Helsinki (Finland); Vehmas, T. [Finnish Institute of Occupational Health, Helsinki (Finland)

    2001-09-01

    Objective: To evaluate the diagnosis of acute physeal ankle fractures on plain radiographs using MRI as the gold standard. Methods: Sixty consecutive children, 29 with a clinical diagnosis of lateral ligament injury and 31 with physeal ankle fractures, were examined using both radiographs and MRI in the acute period. The imaging data were reviewed by three ''masked'' radiologists. The fracture diagnosis and Slater-Harris classification of radiographs were compared with findings on MRI. Results: Plain radiography produced five of 28 (18%) false negative and 12 of 92 (13%) false positive fracture diagnoses compared with MRI. Six of the 12 false positive fractures were due to a misclassification of lateral ligament disruption as SH1 fractures. Altogether a difference was found in 21% of cases in either the diagnosis or the classification of the fractures according to Salter- Harris. All bone bruises in the distal tibia and fibula and 64% of bone bruises in the talus were seen in association with lateral ligament injuries. Talar bone bruises in association with fractures occurred on the same side as the malleolar fracture; talar bone bruises in association with lateral ligament disruption were seen in different locations. The errors identified on radiographs by MRI did not affect the management of the injury. Conclusions: The incidence of false negative ankle fractures in plain radiographs was small and no complex ankle fractures were missed on radiographs. The total extent of complex fractures was, however, not always obvious on radiographs. In an unselected series of relatively mild ankle injuries, we were unable to show a single case where the treatment or prognosis based on plain radiography should have been significantly altered after having done a routine MRI examination. Plain radiography is still the diagnostic cornerstone of paediatric ankle injuries. (orig.)

  15. Acute Ankle Sprains in Primary Care

    NARCIS (Netherlands)

    R.M. van Rijn (Rogier)

    2010-01-01

    textabstractOf all injuries of the musculoskeletal system, 25% are acute lateral ankle sprains.1 In the USA and the UK there are about 23,000 and 5000 ankle sprains, respectively, each day. In the Netherlands approximately 600,000 people sustain an ankle injury each year, of those 120,000 occur duri

  16. The Incidence of Ankle Sprains in Orienteering.

    Science.gov (United States)

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  17. An EMG-to-force processing approach for determining ankle muscle forces during normal human gait.

    Science.gov (United States)

    Bogey, R A; Perry, J; Gitter, A J

    2005-09-01

    Muscle forces move our limbs. These forces must be estimated with indirect techniques, as direct measurements are neither generally possible nor practical. An electromyography (EMG)-to-force processing technique was developed. Ankle joint moments and, by extension, ankle muscle forces were calculated. The ankle moment obtained by inverse dynamics was calculated for ten normal adults during free speed gait. There was close correlation between inverse dynamics ankle moments and moments determined by the EMG-to-force processing approach. Muscle forces were determined. The gait peak Achilles tendon force occurred in late single limb support. Peak force observed (2.9 kN) closely matched values obtained where force transducers were used to obtain in vivo muscle forces (2.6 kN). The EMG-to-force processing model presented here appears to be a practical means to determine in vivo muscle forces.

  18. Power Doppler ultrasonographic assessment of the ankle in patients with inflammatory rheumatic diseases.

    Science.gov (United States)

    Suzuki, Takeshi

    2014-11-18

    Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound (US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler (PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.

  19. American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance.

    Science.gov (United States)

    Thomas, D Travis; Erdman, Kelly Anne; Burke, Louise M

    2016-03-01

    It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

  20. Joint QTL mapping and gene expression analysis identify positional candidate genes influencing pork quality traits

    Science.gov (United States)

    González-Prendes, Rayner; Quintanilla, Raquel; Cánovas, Angela; Manunza, Arianna; Figueiredo Cardoso, Tainã; Jordana, Jordi; Noguera, José Luis; Pena, Ramona N.; Amills, Marcel

    2017-01-01

    Meat quality traits have an increasing importance in the pig industry because of their strong impact on consumer acceptance. Herewith, we have combined phenotypic and microarray expression data to map loci with potential effects on five meat quality traits recorded in the longissimus dorsi (LD) and gluteus medius (GM) muscles of 350 Duroc pigs, i.e. pH at 24 hours post-mortem (pH24), electric conductivity (CE) and muscle redness (a*), lightness (L*) and yellowness (b*). We have found significant genome-wide associations for CE of LD on SSC4 (~104 Mb), SSC5 (~15 Mb) and SSC13 (~137 Mb), while several additional regions were significantly associated with meat quality traits at the chromosome-wide level. There was a low positional concordance between the associations found for LD and GM traits, a feature that reflects the existence of differences in the genetic determinism of meat quality phenotypes in these two muscles. The performance of an eQTL search for SNPs mapping to the regions associated with meat quality traits demonstrated that the GM a* SSC3 and pH24 SSC17 QTL display positional concordance with cis-eQTL regulating the expression of several genes with a potential role on muscle metabolism. PMID:28054563

  1. Analysis of wear of polyethylene hip joint cup related to its positioning in patient's body.

    Science.gov (United States)

    Rońda, Jacek; Wojnarowski, Paweł

    2013-01-01

    Polyethylene parts of endoprosthesis are the weakest parts of each medical implant. They can be worn out within several years. During this period, a patient can enjoy good physical efficiency until the wear of polyethylene part limits his/her mobility. Then the reoperation is necessary and positioning of all parts of endoprosthesis has an effect on future patient's mobility and durability of implant. Elements of endoprosthesis during exploitation are heavily loaded both by normal and tangential forces and moments. In this paper, the dependence of wear of polyethylene cup on its positioning in pelvis is the major problem. Wear of the cup is determined by two measures: the depth and volume of a material rubbed off from the contact surface. The sensitivity of the depth of rubbing off is evaluated relative to two angles of anteversion and abduction, and radii of the cup. Numerical results are obtained by using Abaqus FE system with data related to patient's activity identified on the basis of medical reports.

  2. Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position

    Directory of Open Access Journals (Sweden)

    Luciana Fonseca MERIGUE

    2016-01-01

    Full Text Available Abstract The aim of this study was to investigate condyle concentricity and morphology, and their association with Class I and II malocclusions (Angle. The sample consisted of 49 individuals of both genders, between 11 and 35 years old, divided into two groups, G1: 26 patients with Class I malocclusion, and G2: 23 patients with Class II malocclusion, selected for orthodontic treatment. Evaluation of the condyle morphology and position was performed by the same previously calibrated examiner using cone-beam computed tomography (CBCT images of the subjects. The CBCT scans were analyzed by means of a 3D program (Dolphin 11.5, Dolphin Imaging & Management Solutions, Chatsworth, CA, USA, with a 25% level of sensitivity. The images obtained from the coronal slices were employed for the condyle morphology analysis, which classified the condyle form as rounded, as flat or convex, and as triangular or angled. The sagittal slices were used to classify further the condyles as concentric and displaced anteriorly or posteriorly. A clinical examination was also performed, including TMJ and muscle palpation. The kappa test was used to evaluate investigator calibration; the Chi-square and paired t-tests were used for analysis. The convex and anteriorly positioned condyles were found most frequently, regardless of the type of malocclusion. No association was observed between the groups regarding condylar characteristics.

  3. Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position

    Energy Technology Data Exchange (ETDEWEB)

    Merigue, Luciana Fonseca; Oltramari-Navarro, Paula Vanessa Pedron; Alemida, Marcio Rodrigues [Universidade do Norte do Parana (UNOPAR), Londrina, PR (Brazil). Faculdade de Odontologia; Conti, Ana Claudia de Castro Ferreira [Universidade do Sagrado Coracao (USC), Bauru, SP (Brazil). Faculdade de Odontologia; Navarro, Ricardo de Lima, E-mail: accfconti@uol.com.br [Universidade Estadual de Maringa (UEM), Maringa, P (Brazil). Departamento de Odontologia

    2016-06-01

    The aim of this study was to investigate condyle concentricity and morphology, and their association with Class I and II malocclusions (Angle). The sample consisted of 49 individuals of both genders, between 11 and 35 years old, divided into two groups, G1: 26 patients with Class I malocclusion, and G2: 23 patients with Class II malocclusion, selected for orthodontic treatment. Evaluation of the condyle morphology and position was performed by the same previously calibrated examiner using cone-beam computed tomography (CBCT) images of the subjects. The CBCT scans were analyzed by means of a 3D program (Dolphin 11.5, Dolphin Imaging and Management Solutions, Chatsworth, CA, USA), with a 25% level of sensitivity. The images obtained from the coronal slices were employed for the condyle morphology analysis, which classified the condyle form as rounded, as flat or convex, and as triangular or angled. The sagittal slices were used to classify further the condyles as concentric and displaced anteriorly or posteriorly. A clinical examination was also performed, including TMJ and muscle palpation. The kappa test was used to evaluate investigator calibration; the Chi-square and paired t-tests were used for analysis. The convex and anteriorly positioned condyles were found most frequently, regardless of the type of malocclusion. No association was observed between the groups regarding condylar characteristics. (author)

  4. 中药熏洗对痉挛型脑瘫患儿踝关节活动度影响临床观察%Clinical Observation on Chinese Medicine Fumigation to Improve Range of Ankle Joint Situation of Children with Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    李楠; 王雪峰; 胡晓丽

    2012-01-01

    目的:观察中药熏洗对痉挛型脑瘫患儿踝关节活动度的改善情况.方法:本研究采用分层随机对照研究方法.选择2009年6月——2010年12月辽宁中医药大学附属医院小儿脑瘫康复中心进行康复治疗的痉挛型脑瘫患儿,符合纳入标准的随机分为治疗组与对照组,治疗组采用中药熏洗配合基础治疗(推拿+运动疗法),对照组采用中药稀释液熏洗配合基础治疗(推拿+运动疗法).每周6次,1个月为1疗程.以踝关节活动度为主要观察指标,在患儿入组时、每个治疗周的1、3、5天治疗前后及出组时记录患儿踝关节活动度.结果:关节活动度显效率治疗组95.83%,对照组65.22%,两组比较具有统计学差异(P<0.05);治疗组治疗前后在踝背屈、踝跖屈的活动度即时疗效要优于对照组,具有统计学差异(P<0.05).结论:中药熏洗治疗痉挛型脑瘫患儿踝关节活动度疗效明显优于对照组;中药熏洗具有较好的即刻疗效,主要表现为治疗前后踝关节活动度的即时效应改善明显,因此在推拿及功能训练之前进行熏洗治疗,可以有效放松痉挛的肌肉、肌腱,对于异常姿势的纠正更有利,同时可以减少患儿的疼痛,增强患儿的康复配合度,提高康复疗效.%Objective : To observe the range of ankle joint improved situation of children with cerebral palsy before and after Chinese, medicine fumigation. Methods : In this study, the stratified random control study was adopted. The children with CP from June 2009 to December 2010 in pediatrics of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were chosen. The children fit the criteria were divided into the treatment group and control group, the treatment group used herbal fumigation treatment with foundation ( massage +exercise therapy ), the control group used Chinese medicine with diluted fumigation based therapy ( massage+exercise therapy ), six times a week, a

  5. The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury.

    Science.gov (United States)

    Han, Jia; Anson, Judith; Waddington, Gordon; Adams, Roger; Liu, Yu

    2015-01-01

    Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.

  6. The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury

    Directory of Open Access Journals (Sweden)

    Jia Han

    2015-01-01

    Full Text Available Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.

  7. A Study on the Causes of Basketball Harm on Ankle Joint and Its Prevention%篮球运动对人体踝关节损伤的原因及预防的研究

    Institute of Scientific and Technical Information of China (English)

    李晓峰

    2012-01-01

      篮球运动作为高校体育教育专业的主干课程之一,在体育教育专业课程体系中占有重要地位。通过对我院篮球普修课上人体易伤部位的踝关节进行了调查分析的探究,试找出损伤原因。最大限度地减少和避免篮球普修课上篮球运动中损伤的发生,为今后的教学、训练和体育锻炼提供科学的理论依据。%  Basketball as one of the main course of physical education plays an important role in the physical education curriculum system. Through the easy parts of the ankle injury hospital basketball general course on human investigation and analysis to explore, to try to find out the cause of the injury. Minimize and avoid the occurrence of general basketball course of injury in basketball, and provide scientific and theoretical basis of teaching, training and sports training.

  8. Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

    Science.gov (United States)

    Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

    2013-01-01

    Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in

  9. Ultrasound measurement of joint cartilage thickness in large and small joints in healthy children: a clinical pilot study assessing observer variability

    Directory of Open Access Journals (Sweden)

    Pfeiffer-Jensen Mogens

    2007-04-01

    Full Text Available Abstract Background Loss of joint cartilage is a feature of destructive disease in JIA. The cartilage of most joints can be visualized with ultrasonography (US. Our present study focuses on discriminant validity of US in children. We studied reproducibility between and within a skilled and a non-skilled investigator of US assessment of cartilage thickness in small and large joints in healthy children. Methods and results In 11 healthy children (5 girls/6 boys, aged 9.6 years (9.3–10 years, 110 joints were examined. Cartilage thickness of the right and left hip, knee, ankle, 2nd metacarpophalangeal (MCP, and 2nd proximal interphalangeal (PIP joint independently. The joints were examined twice, two days apart by a skilled and a non-skilled investigator. Mean cartilage thickness in the five joints was: hip 2.59 ± 0.41, knee 3.67 ± 0.64, ankle 1.08 ± 0.31, MCP 1.52 ± 0.27 and PIP 0.73 ± 0.15 mm. We found the same mean differences in CTh of 0.6 mm in the inter-observer part with regard of the PIP joint. Within investigators (intra-observer, the smallest mean difference of CTh was found in the MCP joint with -0.004 (skilled and 0.013 mm (non-skilled. Conclusion We found the level of agreement between observers within a 95% Confidence Interval in assessment of cartilage thickness in hip-, knee-, ankle-, MCP-, and PIP joints in healthy children. Observer variability seems not to relate to joint size but to the positioning of the joints and the transducer. These factors seem to be of major importance for reproducible US measurements. The smallest difference in measurement of cartilage thickness between observers was found in the PIP joint, and within observers in the MCP joint and it seems that using EULAR standard US guidelines is feasible for a pediatric setting. The use of US in children is promising. Studies on larger groups of children are needed to confirm the validation and variability of US in children as well as determining the smallest

  10. Myoelectric neural interface enables accurate control of a virtual multiple degree-of-freedom foot-ankle prosthesis.

    Science.gov (United States)

    Tkach, D C; Lipschutz, R D; Finucane, S B; Hargrove, L J

    2013-06-01

    Technological advances have enabled clinical use of powered foot-ankle prostheses. Although the fundamental purposes of such devices are to restore natural gait and reduce energy expenditure by amputees during walking, these powered prostheses enable further restoration of ankle function through possible voluntary control of the powered joints. Such control would greatly assist amputees in daily tasks such as reaching, dressing, or simple limb repositioning for comfort. A myoelectric interface between an amputee and the powered foot-ankle prostheses may provide the required control signals for accurate control of multiple degrees of freedom of the ankle joint. Using a pattern recognition classifier we compared the error rates of predicting up to 7 different ankle-joint movements using electromyographic (EMG) signals collected from below-knee, as well as below-knee combined with above-knee muscles of 12 trans-tibial amputee and 5 control subjects. Our findings suggest very accurate (5.3 ± 0.5%SE mean error) real-time control of a 1 degree of freedom (DOF) of ankle joint can be achieved by amputees using EMG from as few as 4 below-knee muscles. Reliable control (9.8 ± 0.7%SE mean error) of 3 DOFs can be achieved using EMG from 8 below-knee and above-knee muscles.

  11. 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.

  12. Anterior Approach Total Ankle Arthroplasty: Superficial Peroneal Nerve Branches at Risk.

    Science.gov (United States)

    McAlister, Jeffrey E; DeMill, Shyler L; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    In ankle arthroplasty, little attention has been given to intraoperative nerve injury and its postoperative sequelae. The aim of the present anatomic study was to determine the relationship of the superficial peroneal nerve to the standard anterior approach for total ankle arthroplasty. The superficial peroneal nerve was dissected in 10 below-the-knee cadaver specimens. The medial and intermediate dorsal cutaneous branches were identified. A needle was placed at the ankle joint. The following measurements were recorded: bifurcation into the medial and intermediate dorsal cutaneous branches, reference needle to the branches of the medial and intermediate superficial peroneal nerve, and the crossing branches of the medial dorsal cutaneous nerve. Two specimens (20%) had a medial dorsal cutaneous branch cross from medially to laterally. Eight specimens (80%) had a crossing branch of the medial dorsal cutaneous branch within 5 cm of the incision. No intermediate dorsal cutaneous branches were within the incision. The results from the present cadaver study suggest that during an anterior ankle approach, aberrant branches of the superficial peroneal nerve could require transection in 20% of patients at the joint level and ≤80% of patients with distal extension >35 mm from the ankle joint. The risk of injury to branches of the superficial peroneal nerve is substantial. The risk of nerve injury can be decreased with meticulous operative technique, smaller incisions, and the avoidance of aggressive retraction.

  13. Biochemical T2* MR quantification of ankle arthrosis in pes cavovarus.

    Science.gov (United States)

    Krause, Fabian G; Klammer, Georg; Benneker, Lorin M; Werlen, Stefan; Mamisch, Tallal C; Weber, Martin

    2010-12-01

    Pes cavovarus affects the ankle biomechanics and may lead to ankle arthrosis. Quantitative T2 STAR (T2*) magnetic resonance (MR) mapping allows high resolution of thin cartilage layers and quantitative grading of cartilage degeneration. Detection of ankle arthrosis using T2* mapping in cavovarus feet was evaluated. Eleven cavovarus patients with symptomatic ankle arthrosis (13 feet, mean age 55.6 years, group 1), 10 cavovarus patients with no or asymptomatic, mild ankle arthrosis (12 feet, mean age 41.8 years, group 2), and 11 controls without foot deformity (18 feet, mean age 29.8 years, group 3) had quantitative T2* MR mapping. Additional assessment included plain radiographs and the American Orthopaedic Foot and Ankle Society (AOFAS) score (groups 1 and 2 only). Mean global T2* relaxation time was significantly different between groups 1 and 2 (p = 0.001) and groups 1 and 3 (p = 0.017), but there was no significance for decreased global T2* values in group 2 compared to group 3 (p = 0.345). Compared to the medial compartment T2* values of the lateral compartment were significantly (p = 0.025) higher within group 1. T2* values in the medial ankle joint compartment of group 2 were significantly lower than those of group 1 (p = 0.019). Ankle arthrosis on plain radiographs and the AOFAS score correlated significantly with T2* values in the medial compartment of group 1 (p = 0.04 and 0.039, respectively). Biochemical, quantitative T2* MR mapping is likely effective to evaluate ankle arthrosis in cavovarus feet but further studies are required.

  14. Three-dimensional ankle moments and nonlinear summation of rat triceps surae muscles.

    Science.gov (United States)

    Tijs, Chris; van Dieën, Jaap H; Baan, Guus C; Maas, Huub

    2014-01-01

    The Achilles tendon and epimuscular connective tissues mechanically link the triceps surae muscles. These pathways may cause joint moments exerted by each muscle individually not to sum linearly, both in magnitude and direction. The aims were (i) to assess effects of sagittal plane ankle angle (varied between 150° and 70°) on isometric ankle moments, in both magnitude and direction, exerted by active rat triceps surae muscles, (ii) to assess ankle moment summation between those muscles for a range of ankle angles and (iii) to assess effects of sagittal plane ankle angle and muscle activation on Achilles tendon length. At each ankle angle, soleus (SO) and gastrocnemius (GA) muscles were first excited separately to assess ankle-angle moment characteristics and subsequently both muscles were excited simultaneously to investigate moment summation. The magnitude of ankle moment exerted by SO and GA, the SO direction in the transverse and sagittal planes, and the GA direction in the transverse plane were significantly affected by ankle angle. SO moment direction in the frontal and sagittal planes were significantly different from that of GA. Nonlinear magnitude summation varied between 0.6±2.9% and -3.6±2.9%, while the nonlinear direction summation varied between 0.3±0.4° and -0.4±0.7° in the transverse plane, between 0.5±0.4° and 0.1±0.4° in the frontal plane, and between 3.0±7.9° and 0.3±2.3° in the sagittal plane. Changes in tendon length caused by SO contraction were significantly lower than those during contraction of GA and GA+SO simultaneously. Thus, moments exerted by GA and SO sum nonlinearly both in the magnitude and direction. The limited degree of nonlinear summation may be explained by different mechanisms acting in opposite directions.

  15. Three-dimensional ankle moments and nonlinear summation of rat triceps surae muscles.

    Directory of Open Access Journals (Sweden)

    Chris Tijs

    Full Text Available The Achilles tendon and epimuscular connective tissues mechanically link the triceps surae muscles. These pathways may cause joint moments exerted by each muscle individually not to sum linearly, both in magnitude and direction. The aims were (i to assess effects of sagittal plane ankle angle (varied between 150° and 70° on isometric ankle moments, in both magnitude and direction, exerted by active rat triceps surae muscles, (ii to assess ankle moment summation between those muscles for a range of ankle angles and (iii to assess effects of sagittal plane ankle angle and muscle activation on Achilles tendon length. At each ankle angle, soleus (SO and gastrocnemius (GA muscles were first excited separately to assess ankle-angle moment characteristics and subsequently both muscles were excited simultaneously to investigate moment summation. The magnitude of ankle moment exerted by SO and GA, the SO direction in the transverse and sagittal planes, and the GA direction in the transverse plane were significantly affected by ankle angle. SO moment direction in the frontal and sagittal planes were significantly different from that of GA. Nonlinear magnitude summation varied between 0.6±2.9% and -3.6±2.9%, while the nonlinear direction summation varied between 0.3±0.4° and -0.4±0.7° in the transverse plane, between 0.5±0.4° and 0.1±0.4° in the frontal plane, and between 3.0±7.9° and 0.3±2.3° in the sagittal plane. Changes in tendon length caused by SO contraction were significantly lower than those during contraction of GA and GA+SO simultaneously. Thus, moments exerted by GA and SO sum nonlinearly both in the magnitude and direction. The limited degree of nonlinear summation may be explained by different mechanisms acting in opposite directions.

  16. Running with a powered knee and ankle prosthesis.

    Science.gov (United States)

    Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

    2015-05-01

    This paper presents a running control architecture for a powered knee and ankle prosthesis that enables a transfemoral amputee to run with a biomechanically appropriate running gait and to intentionally transition between a walking and running gait. The control architecture consists firstly of a coordination level controller, which provides gait biomechanics representative of healthy running, and secondly of a gait selection controller that enables the user to intentionally transition between a running and walking gait. The running control architecture was implemented on a transfemoral prosthesis with powered knee and ankle joints, and the efficacy of the controller was assessed in a series of running trials with a transfemoral amputee subject. Specifically, treadmill trials were conducted to assess the extent to which the coordination controller provided a biomechanically appropriate running gait. Separate trials were conducted to assess the ability of the user to consistently and reliably transition between walking and running gaits.

  17. Robotic Ankle for Omnidirectional Rock Anchors

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

    rotary DC motor that can drag the microspine arrays across the surface to engage them with asperities, as well as a linear actuator to disengage the hooks from the surface. Additionally, the ankle allows the gripper to rotate freely about all three axes so that when the robot takes a step, the gripper may optimally orient itself with respect to the wall or ground. Finally, the ankle contains some minimal elasticity, so that between steps, the gripper returns to a default position that is roughly parallel to the wall.

  18. 肌内效布贴扎联合 Aircast加压冷疗系统对急性踝关节扭伤的临床疗效%The clinical efficacy of Kinesio taping cloth joint Aircast pressurized cold therapy system for acute ankle sprain

    Institute of Scientific and Technical Information of China (English)

    王自力

    2014-01-01

    Objective To explore the clinical efficacy of Kinesio taping cloth joint Aircast pressurized cold therapy system for acute ankle sprain .Methods From January 2012 to June 2013 in our hospital 74 patients of the early acute ankle sprain were randomly divided into observation group and control group ,the control group accepted Kinesio taping cloth , conventional cold and compression therapy , on the basis the observation group accepted Aircast pressurized cold therapy system .After treatment ,48 h ,1 week ,efficacy ,VAS score ,assess the degree of swelling were assessed .Results In the control group after treatment ,the total effective rate at 48 h efficacy and one week efficacy than the control group showed significant statistical difference (P0 .05) .Swelling time of the observation group than in the control group were significantly reduced ( P<0 .05) .Conclusion Kinesio taping cloth joint Air‐cast pressurized cold therapy system can effectively promote the recovery of patients with acute ankle sprains and re‐lieve pain compared with single using Kinesio taping therapy .%目的:探讨肌内效布贴扎联合Aircast加压冷疗系统对急性踝关节扭伤的临床疗效。方法选择2012年1月至2013年6月就诊于本院的早期急性踝关节扭伤患者74例,随机分为观察组及对照组,对照组采用肌内效布贴扎、常规冷敷及加压治疗,观察组在此基础上采用Aircast加压冷疗系统进行治疗。治疗后48 h、1周对疗效、VAS评分、肿胀程度进行评估。结果对照组治疗后48 h总有效率、48 h疗效及1周疗效较对照组均存在统计学意义( P<0.05)。对照组治疗后重度疼痛2例,观察组治疗后无重度疼痛患者。两组患者治疗后疼痛程度,观察组较对照组存在统计学意义(P<0.05)。治疗48 h、4 d后观察组跟骨围减少程度较对照组具有统计学意义(P<0.05),治疗1周后观察组跟骨围变化较对

  19. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.

    Directory of Open Access Journals (Sweden)

    Ann M Simon

    Full Text Available Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent. The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140 had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

  20. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.

    Science.gov (United States)

    Simon, Ann M; Ingraham, Kimberly A; Fey, Nicholas P; Finucane, Suzanne B; Lipschutz, Robert D; Young, Aaron J; Hargrove, Levi J

    2014-01-01

    Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

  1. Effect of altering neural, muscular and tendinous factors associated with aging on balance recovery using the ankle strategy: a simulation study.

    Science.gov (United States)

    Barrett, R S; Lichtwark, G A

    2008-10-07

    Aging is associated with declines in neuromuscular function and reduced ability to recover balance from an imbalance episode. However, little is known about the relations amongst these factors. The purpose of this study was to determine the relative influence of age-related changes in neural, muscular and tendinous properties on the ability to recovery balance from a forward leaning position using the ankle strategy. A computer simulation was developed which consisted of an inverted pendulum with one rotational degree of freedom controlled by two muscles representing the ankle joint plantar flexor (PF) and dorsi flexor (DF) muscle groups. Model parameter values were adjusted so that the isometric torque-angle relation was in agreement with experimental ankle joint torque-angle curves from the literature. Muscle excitation was adjusted to match an experimentally determined maximum recoverable lean angle (MRLA) of 7.2 degrees (baseline condition). The effect of 20% alterations to maximum isometric force, optimum muscle fibre length, maximum shortening velocity, tendon stiffness, reaction time delay (RTD), activation time constant and the maximum excitation of the PF muscles, and maximum excitation of the DF muscles (co-activation) on MRLA was then assessed. The parameters that had the greatest influence on MRLA were maximum isometric force, the maximum excitation of the ankle joint PFs and RTD, which, respectively, resulted in 19.0%, 17.8% and 4.6% reductions in MRLA. Individual changes to other parameters influenced MRLA by less than 1.9%. When selected parameter values were adjusted in accordance with age-related changes reported in the literature, MRLA was reduced to 5.3 degrees , a value in relative agreement with experimental values reported in the literature (4.6+/-1.8 degrees ). In general, these results suggest that MRLA is most sensitive to PF muscle mass and the ability to maximally activate the PFs, and that the combined effect of multiple changes in

  2. Use of infrared thermography for the diagnosis and grading of sprained ankle injuries

    Science.gov (United States)

    Oliveira, João; Vardasca, Ricardo; Pimenta, Madalena; Gabriel, Joaquim; Torres, João

    2016-05-01

    Ankle joint sprains are a common medical condition estimated to be responsible for 15-25% of all musculoskeletal injuries worldwide. The pathophysiology of the lesion can represent considerable time lost to injury, as well as long-term disability in up to 60% of patients. A percentage between 10% and 20% may complicate with chronic instability of the ankle joint and disability in walking, contributing to morbidity and poor life quality. Ankle sprains can be classified as grade I, II, or III, based on the extent of damage and number of ligaments affected. The diagnostic grading is important for setting further treatment and rehabilitation, since more severe injuries carries risk of recurrence, added morbidity and decrease in life quality. The aim of this work was to evaluate the adequacy of infrared thermography as a potential complimentary diagnostic tool of the distinct lesions grades. Evaluation of different thermographic values of the ankle region (in both affected and non-affected foot) was conducted for this purpose. The principal results to be highlighted are that some of the regions, namely anterior view for non defined time after injury analysis, and anterior, frontal, posterior and anterior talofibular ligament regions and proximal calcaneofibular ligament regions in acute lesions (herein defined as less than 6 h post-traumatic event) presented consistent profiles of variation. The analyses were performed considering affected and non-affected ankles results on plotted graphics representing termographic evaluation and grading of these lesions performed using ultrasound by experimented medical radiologists. An increase in temperature values was observed when progressing from mild to severe ankle sprain injuries, with these regions presenting lower values for the affected ankle when compared to the non-affected ankle in all the analysis performed. The remaining analysed regions did not present the same variations. Statistical analysis using Kruskal

  3. A multiple degree of freedom lower extremity isometric device to simultaneously quantify hip, knee, and ankle torques

    NARCIS (Netherlands)

    Sánchez, N.; Acosta, A.M.; Stienen, A.H.A.; Dewald, J.P.A.

    2015-01-01

    Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and

  4. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Andersen, Jacob Buus; Sinkjær, Thomas;

    2014-01-01

    It is commonly assumed that exaggerated stretch reflex activity and the resulting increased muscle tone in ankle plantar flexors contribute to reduced ankle joint movement during gait in children with cerebral palsy (CP). We investigated the contribution of sensory feedback mechanisms to ankle...... in a similar proportion in both groups. Shortening of the plantar flexors in swing caused a larger drop in Soleus EMG in control children than in children with CP. The lack of age related decline in stretch reflexes in the stance phase and the inability to suppress the reflex in the swing phase is likely...

  5. Effects of Two Football Stud Types on Knee and Ankle Kinetics of Single-Leg Land-Cut and 180° Cut Movements on Infilled Synthetic Turf.

    Science.gov (United States)

    Bennett, Hunter J; Brock, Elizabeth; Brosnan, James T; Sorochan, John C; Zhang, Songning

    2015-10-01

    Higher ACL injury rates have been recorded in cleats with higher torsional resistance in American football, which warrants better understanding of shoe/stud-dependent joint kinetics. The purpose of this study was to determine differences in knee and ankle kinetics during single-leg land cuts and 180° cuts on synthetic infilled turf while wearing 3 types of shoes. Fourteen recreational football players performed single-leg land cuts and 180° cuts in nonstudded running shoes (RS) and in football shoes with natural (NTS) and synthetic turf studs (STS). Knee and ankle kinetic variables were analyzed with a 3 × 2 (shoe × movement) repeated-measures ANOVA (P < .05). A significant shoe-by-movement interaction was found in loading response peak knee adduction moments, with NTS producing smaller moments compared with both STS and RS only in 180° cuts. Reduced peak negative plantar flexor powers were also found in NTS compared with STS. The single-leg land cut produced greater loading response and push-off peak knee extensor moments, as well as peak negative and positive extensor and plantar flexor powers, but smaller loading peak knee adduction moments and push-off peak ankle eversion moments than 180° cuts. Overall, the STS and 180° cuts resulted in greater frontal plane knee loading and should be monitored for possible increased ACL injury risks.

  6. The effects of gastrocnemius-soleus muscle forces on ankle biomechanics during triple arthrodesis

    DEFF Research Database (Denmark)

    Hejazi, Shima; Rouhi, Gholamreza; Rasmussen, John

    2016-01-01

    This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major a...

  7. Analysis of Ankle Kinetics during Walking in Individuals with Down Syndrome.

    Science.gov (United States)

    Cioni, Matteo; Cocilovo, Anna; Rossi, Fabio; Paci, Domenico; Valle, Maria Stella

    2001-01-01

    The biomechanical characteristics of the ankle during gait of 17 participants with Down syndrome (ages 8-36) were investigated. Participants showed significant decreases of plantar-flexor moments and of A1 and A2 joint powers. Correlation between kinetic and temporal spatial parameters was markedly reduced or weak in comparison to 10 controls.…

  8. 针刺丘墟透申脉治疗脑卒中后踝关节功能障碍临床观察%Clinical Observation of Point-toward-point Acupuncture from Qiuxu (GB40) to Shenmai (BL62) for Post-stroke Ankle Joint Dysfunction

    Institute of Scientific and Technical Information of China (English)

    黄迟艺

    2016-01-01

    ObjectiveTo observe the clinical efficacyand safety of the point-toward-point needling respectively from Qiuxu (GB40) to Shenmai (BL62) and from Qiuxu to Zhaohai (KI6) in treating post-stroke ankle joint dysfunction.MethodThirty-six patients with post-stroke ankle dysfunction were randomizedinto a treatment group of 18 cases and a control group of 18 cases. The treatment group was majorly treated with point-toward-point needling from Qiuxu to Shenmai, while the control group was by needling from Qiuxu to Zhaohai.ResultRegarding the spasm intensity of the triceps surae, the change of the Modified Ashworth Scale (MAS) score in the treatment group after treatment was significantly different from that in the control group (P<0.05), and the treatment group was superior to the control group.ConclusionPoint-toward-point needling from Qiuxu to Shenmai is better than that from Qiuxu to Zhaohai in relieving the spasm of triceps surae, and it’s an safe and effective needling method.%目的:对比观察丘墟透申脉与丘墟透照海为主治疗脑卒中后踝关节功能障碍的临床疗效及安全性。方法将36例脑卒中后踝关节功能障碍患者随机分为治疗组18例,对照组18例。治疗组采用丘墟透申脉为主治疗,对照组采用丘墟透照海为主治疗。结果在小腿三头肌的痉挛情况(MAS)方面,治疗组与对照组的治疗前后差值组间比较差异具有统计学意义(P<0.05),治疗组优于对照组。结论在缓解小腿三头肌痉挛方面,丘墟透申脉优于丘墟透照海,是一种安全有效的针刺方法。

  9. Mechanical instability after acute ankle ligament injury: randomized prospective comparison of two forms of conservative treatment

    Directory of Open Access Journals (Sweden)

    Marcelo Pires Prado

    2013-08-01

    Full Text Available OBJECTIVE: This trial has the objective to investigate the incidence of mechanical ankle instability after the conservative treatment of first episode, severe ankle ligamentar lesions. This common lesion affects young, professional and physical active patients, causing important personal and economic consequences. There are difficulties related to adequate diagnosis and treatment for these lesions. METHOD: 186 patients with severe ankle ligament lesions were included in this trial. They were randomized in two treatment options. In group A patients were treated using ankle long orthoosis, weight bearing allowed as confortable, pain care, ice, elevation with restricted joint mobilization for three weeks. After that they were maintained in short, functional orthosis (air cast, starting the reabilitation program. In group B patients were immobilized using a functional orthosis (air cast, following the same other sequences that patients in group A. RESULTS: We did not find significant differences in relation to the residual mechanical ankle instability between both groups. We did not find differences in the intensity of pain, but the functional evaluation using AOFAS score system showed better results in the functional treatment group. CONCLUSION: The functional treatment (Group B had better AOFAS score and few days off their professional activities, comparing with patients treated with rigid orthosis (Group A, without increased chance in developing ankle mechanical instability.

  10. Comparative analyses of rider position according to skill levels during walk and trot in Jeju horse.

    Science.gov (United States)

    Kang, Ok-Deuk; Ryu, Youn-Chul; Ryew, Che-Cheong; Oh, Woon-Yong; Lee, Chong-Eon; Kang, Min-Soo

    2010-12-01

    The purpose of this study was to evaluate the rider position at walk and trot as a function of rider skill level by analyzing joint angles. Participants included three advanced riders and six beginners, and training was conducted for one hour, twice a week for 24 weeks. In the walk stage of the beginners' group, the elbows and shoulders sustained postures comparable to those of the advanced riders group; the trunk tilted forwards at first, but later it tilted slightly behind the vertical. The knee, ankle, and left-right angle kept stable postures after 12 weeks of training (priders group after 24 weeks of training (priders, the ankle joint sustained a forward point posture. The ankle joint maintained dorsiflexion posture with 83.9°±5.3 in the advanced riders group, while the beginners group had plantar flexion posture with 98.7°±6.0. This study suggested that the correlation between the joint and body segment angles could be an important indicator in the evaluation of rider proficiency.

  11. Annular lipoatrophy of the ankles.

    Science.gov (United States)

    Dimson, Otobia G; Esterly, Nancy B

    2006-02-01

    Lipoatrophic panniculitis likely represents a group of disorders characterized by an inflammatory panniculitis followed by lipoatrophy. It occurs locally in a variety of settings and has been reported in the literature under various terms, including annular atrophic connective tissue panniculitis of the ankles, annular and semicircular lipoatrophy, abdominal lipoatrophy, and connective tissue panniculitis. Herein, a case of annular lipoatrophy of the ankles is described in a 6-year-old girl with autoimmune thyroid disease. Histologically, a mixed lobular panniculitis with lipophages was present. This pattern resembles that seen in lipoatrophic panniculitis. After a single, acute episode of an inflammatory process with subsequent lipoatrophy, her skin lesions have stabilized for 2 years requiring no treatment.

  12. Design and development of ankle-foot prosthesis with delayed release of plantarflexion

    Directory of Open Access Journals (Sweden)

    Michael Mitchell, MSc

    2013-05-01

    Full Text Available A computer-controlled mechanism that fits a standard ankle-foot prosthesis was designed to capture the absorbed energy in the ankle and delay its release until specific times in the gait cycle. This mechanism used a direct current motor to take up and hold the compression of a carbon-fiber ankle joint. Based on the timing of the contact forces between the foot and the ground, a microprocessor released the spring at preset times later in the gait cycle. This mechanism was added to a Talux prosthetic foot and was employed by a user of a conventional energy-storage ankle-foot prosthesis. His gait was recorded using a motion analysis system. Five settings: 0, 55, 65, 75, and 85 ms delay were tested on separate days, and the standard kinematic and kinetic gait data were recorded. The user reported some settings were more comfortable than others. When these preferences were tested with a randomized double-blind trial, the preferences were not consistent. A second user showed a preference for the 55 ms delay. The modifications to the device resulted in changes to the gait of the subjects, including increased cadence and kinematics of the unaffected joints and a longer, slower push from the ankle, which was noticed by both of the subjects.

  13. Design and development of ankle-foot prosthesis with delayed release of plantarflexion.

    Science.gov (United States)

    Mitchell, Michael; Craig, Katelynn; Kyberd, Peter; Biden, Edmund; Bush, Greg

    2013-01-01

    A computer-controlled mechanism that fits a standard ankle-foot prosthesis was designed to capture the absorbed energy in the ankle and delay its release until specific times in the gait cycle. This mechanism used a direct current motor to take up and hold the compression of a carbon-fiber ankle joint. Based on the timing of the contact forces between the foot and the ground, a microprocessor released the spring at preset times later in the gait cycle. This mechanism was added to a Talux prosthetic foot and was employed by a user of a conventional energy-storage ankle-foot prosthesis. His gait was recorded using a motion analysis system. Five settings: 0, 55, 65, 75, and 85 ms delay were tested on separate days, and the standard kinematic and kinetic gait data were recorded. The user reported some settings were more comfortable than others. When these preferences were tested with a randomized double-blind trial, the preferences were not consistent. A second user showed a preference for the 55 ms delay. The modifications to the device resulted in changes to the gait of the subjects, including increased cadence and kinematics of the unaffected joints and a longer, slower push from the ankle, which was noticed by both of the subjects.

  14. Characteristics of peak muscle torques of the knee and ankle joints of excellent men’s freestyle wrestlers in China%我国优秀男子自由式摔跤运动员膝、踝关节肌力矩峰值的特征

    Institute of Scientific and Technical Information of China (English)

    张丽艳; 李光欣

    2013-01-01

    The authors tested and analyzed muscle torques of the lower limb knee and ankle joints of national men’s free-style wrestlers who prepared for the London Olympic Games by using ISOMed-2000 isokinetic test system, and revealed the following findings:1) from the perspective of torque, with the increase of test speed, there was a significant difference (P<0.05) in the characteristics of muscle power of the knee and ankle joints between key and non key wrestlers, and the torque angles of flexor and extensor muscles presented different characteristics respectively, which means quick power is particularly important to low limbs;2) from the perspective of peak torque ratio, in low speed motion, both key and non key wrestlers of team China had such a problem as that the ratio of flexion torque to extension torque was unbalanced, i.e. there was a sign of irrational development of flexor and extensor muscle groups in terms of maximum power (<50%);with the increase of test speed, although the ratio of flexion toque to extension torque tended to rational (in the range of 50%-80%), it was low generally;3) there was a sign of unbalance as well in the comparison of designation identical muscle groups at both sides of knee joints, especially, there was a big difference between extensor muscles at both sides;4) there was a similar sign in the characteristics of muscle power of knee joints (refer to the text for details), but flexor muscle power is significantly weaker than extensor muscle power. The said findings indicated that men’s freestyle wrestlers should practice more for the balance of power of flexor and extensor muscle groups at the left and right sides, and in terms of ankle joint, give priority to flexor muscle power training.%  运用ISOMed-2000等速测试系统对备战伦敦奥运会的国家男子自由式摔跤运动员下肢膝关节、踝关节肌力矩进行测试与分析。结果发现:1)从力矩角度来看,随着测试

  15. Management accounting control systems’ impact on joint venture performance: the positive role of managers’ experience

    Directory of Open Access Journals (Sweden)

    Marcela Porporato

    2016-04-01

    Full Text Available This study explores the impact of management planning and control systems’ use on 50/50 joint venture’s performance operating in the auto industry. It explores the effect of the use of these systems by organizations operating in turbulent environments through an analysis of the impact that managers’ experience has on the intensity and purpose of use of management planning and control systems. The study of this topic emerges as the results of previous exploratory field studies of JVs (Groot and Merchant 2000 and of JVs in the auto industry (Porporato 2013 where it is suggested that management planning and control systems’ do not have a central effect on JV performance. A survey of 35 international JVs with shared ownership (50/50 shows that organizational performance improves when the uncertainty of factors perceived as controllable by managers is reduced; a factor is perceived as controllable when the manager has a high level of past experience with it. Uncertainty as it is defined by Galbraith (1973 is reduced through an intensive use of management planning and control systems, which in turn positively affects organizational performance.

  16. 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.

  17. Total Ankle Arthroplasty: A Brief Review

    Directory of Open Access Journals (Sweden)

    Roger A. Mann

    2012-12-01

    Full Text Available Ankle fusion has long been the standard of treatment for end-stage ankle arthritis, and a successful arthroplasty has been a long sought alternative. It is a motion sparing procedure and may greatly reduce the potential for adjacent level degeneration as seen with arthrodesis. The typical candidate for arthroplasty is a healthy low demand patient, although the indications are widening as the success of the procedure has increased. Nevertheless, it is not fail-safe, technical expertise and experience are necessary to achieve a successful result. We have been treating ankle arthritis with the Scandinavian Total Ankle Replacement (STAR ankle replacement prosthesis for over ten years. We believe that arthroplasty will surpass arthrodesis as the standard of care for severe ankle arthritis.

  18. Experimental and computational analysis of composite ankle-foot orthosis.

    Science.gov (United States)

    Zou, Dequan; He, Tao; Dailey, Michael; Smith, Kirk E; Silva, Matthew J; Sinacore, David R; Mueller, Michael J; Hastings, Mary K

    2014-01-01

    Carbon fiber (CF) ankle-foot orthoses (AFOs) can improve gait by increasing ankle plantar-flexor power and improving plantar-flexor ankle joint moment and energy efficiency compared with posterior leaf spring AFOs made of thermoplastic. However, fabricating a CF AFO to optimize the performance of the individual user may require multiple AFOs and expensive fabrication costs. Finite element analysis (FEA) models were developed to predict the mechanical behavior of AFOs in this study. Three AFOs, two made of CF composite material and one made of thermoplastic material, were fabricated and then mechanically tested to produce force-displacement data. The FEA models were validated by comparing model predictions with mechanical testing data performed under the same loading and boundary conditions. The actual mechanical testing demonstrated that CF performs better than thermoplastic. The simulation results showed that FEA models produced accurate predictions for both types of orthoses. The relative error of the energy return ratio predicted by the CF AFO FEA model developed in this study is less than 3%. We conclude that highly accurate FEA models will allow orthotists to improve CF AFO fabrication without wasting resources (time and money) on trial and error fabrications that are expensive and do not consistently improve AFO and user performance.

  19. Experimental and computational analysis of composite ankle-foot orthosis

    Directory of Open Access Journals (Sweden)

    Dequan Zou, DSc

    2015-03-01

    Full Text Available Carbon fiber (CF ankle-foot orthoses (AFOs can improve gait by increasing ankle plantar-flexor power and improving plantar-flexor ankle joint moment and energy efficiency compared with posterior leaf spring AFOs made of thermoplastic. However, fabricating a CF AFO to optimize the performance of the individual user may require multiple AFOs and expensive fabrication costs. Finite element analysis (FEA models were developed to predict the mechanical behavior of AFOs in this study. Three AFOs, two made of CF composite material and one made of thermoplastic material, were fabricated and then mechanically tested to produce force-displacement data. The FEA models were validated by comparing model predictions with mechanical testing data performed under the same loading and boundary conditions. The actual mechanical testing demonstrated that CF performs better than thermoplastic. The simulation results showed that FEA models produced accurate predictions for both types of orthoses. The relative error of the energy return ratio predicted by the CF AFO FEA model developed in this study is less than 3%. We conclude that highly accurate FEA models will allow orthotists to improve CF AFO fabrication without wasting resources (time and money on trial and error fabrications that are expensive and do not consistently improve AFO and user performance.

  20. Ultrasound of the ankle and foot in rheumatology.

    Science.gov (United States)

    Micu, Mihaela C; Nestorova, Rodina; Petranova, Tzvetanka; Porta, Francesco; Radunovic, Goran; Vlad, Violeta; Iagnocco, Annamaria

    2012-03-01

    In the last years musculoskeletal ultrasound (US) has become a very useful imaging tool for the evaluation of rheumatic patients and a natural extension of the clinical examination of the ankle and foot. Musculoskeletal US allows the evaluation of the symptomatic and asymptomatic ankle and foot with a detailed analysis of a wide range of elementary lesions at the level of different anatomical structures and their distribution in early or long standing disease. In inflammatory pathology, it helps in the assessment of the disease activity and severity at the joint, tendon or entheseal level and in the detection of subclinical pathological features in early disease or residual activity after therapy. Moreover, US guided procedures allow accurate diagnostic and therapeutic interventions. It is a valuable imaging method that can be also used in the follow up of the treated patients (systemic and/ or local therapies or surgical procedures), being a patient friendly, non-invasive, and quick to perform method. The aim of this paper is to review the US technique of scanning and the indications of US in the analysis of the ankle and foot in rheumatic diseases.

  1. Analysis of lateral stress on paratrooper's ankle joint under simulated squat-style landing attitude%模拟空降兵半蹲式跳伞着陆踝关节侧方应力分析

    Institute of Scientific and Technical Information of China (English)

    王鹏; 伍骥; 郑超; 黄蓉蓉; 吴迪; 李毅; 滕泽

    2014-01-01

    Objective To study the internal and external maximum malleolus stresses when they landing from different heights with squat-style.Methods The subjects were 18 male professional paratroopers,wearing military special parachute boots,respectively jumped from 60 cm and 150 cm height platforms and landed with squat-style attitude to test their internal and external maximum malleolus stresses.Results For 60 cm height jumping,the average maximum stress of internal malleolus was 328.71 kPa,the average maximum stress of external malleolus was 205.92 kPa,the average maximum stress of internal malleolus was significantly greater than that of the external malleolus (t=4.005,P<0.01).For 150 cm height jumping,the average maximum stress of internal malleolus was 365.39 kPa,the average maximum stress of external malleolus was 77.28 kPa.The average maximum stress of internal malleolus was significantly greater than that of the external malleolus (t=13.935,P<0.01).Conclusions The height does not significantly affect the variation of internal and external maximum malleolus stress as the paratroopers landing with squat-style.The left and right maximum internal malleolus stress is respectively greater than the left and right maximum external malleolus stress.The stress differences lead to paratroopers' excessive foot pronation and are the major biomechanical mechanisms that caused ankle injury.%目的 研究空降兵在不同高度以半蹲式着陆时,内、外踝关节的最大应力关系. 方法 18名男性伞兵穿06伞兵作训靴,踝关节佩戴贴片式应力传感器,分别从60 cm及150 cm两种不同高度平台跳落,模拟空降兵跳伞半蹲式着陆,检测比较内、外踝关节所受的最大应力. 结果 60 cm高度模拟空降兵跳伞半蹲式着陆,双足内踝最大应力平均值为328.71 kPa,外踝最大应力平均值为205.92 kPa,内踝最大应力平均值显著大于外踝最大应力平均值(t=4.005,P<0.01).150 cm高度模拟空降兵跳伞半蹲

  2. Learning Disabilities: Issues in the Preparation of Professional Personnel. A Position Paper of the National Joint Committee on Learning Disabilities, September 26, 1982.

    Science.gov (United States)

    Journal of Learning Disabilities, 1987

    1987-01-01

    The 1982 position paper of the National Joint Committee on Learning Disabilities provides recommendations concerning preparation of professional personnel. Major recommendations include periodic evaluations of training programs and faculty, establishment of interdisciplinary training programs, structuring of practica to enable students to…

  3. Effectiveness of Hindfoot Arthrodesis by Stable Internal Fixation in Various Eichenholtz Stages of Neuropathic Ankle Arthropathy.

    Science.gov (United States)

    Sundararajan, Silvampatty R; Srikanth, Kanchana P; Nagaraja, Handenahally S; Rajasekaran, Shanmuganathan

    The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012. All patients underwent ankle arthrodesis, autologous iliac crest bone grafting, and subtalar joint arthrodesis, with or without talonavicular joint arthrodesis, fixed internally with an intramedullary hindfoot nail, with or without an additional plate or cancellous screws. Of the 33 enrolled patients, 9 (27.3%) had stage I, 13 (39.4%) had stage II, and 11 (33.3%) had stage III Charcot arthropathy. The cause of arthropathy was diabetes mellitus in 25 (75.8%) patients. The duration of symptoms ranged from 1 to 120 (median 7) months. The mean follow-up period was 40 (range 12 to 76) months and did not differ markedly among the groups. The hindfoot scores, rate of salvage or amputation, or complication rates did not differ significantly across Eichenholtz stage. For the patients with stage I, II, and III, the preoperative hindfoot score was 50, 49, and 48, respectively (p = .9). The corresponding postoperative scores were 68, 68, and 70 (p = .5). We found no evidence that the effectiveness of hindfoot arthrodesis by stable fixation varied across the Eichenholtz stage of Charcot arthropathy involving ankle and peritalar joint. Furthermore, we found that stable internal fixation and bone grafting using a hindfoot nail results in an 84.84% union rate and salvages the unstable and disabled foot in 90.9% of patients with ankle and peritalar Charcot arthropathy.

  4. Verification of selected anatomic landmarks used as reference points for universal goniometer positioning during knee joint mobility range measurements.

    Science.gov (United States)

    Szulc, P; Lewandowski, J; Marecki, B

    2001-01-01

    The study was concerned with verification of the selection of reference points used for knee joint mobility range goniometry. The verification was based on photometric and electrogoniometric methods of femorotibial angle measurements. The material for measurements were three knee joint preparations. The obtained data were subjected to descriptive analysis; photographic documentation of geometric relations between the reference points was also prepared. Considerable divergence of measurement results was observed with respect to the actual knee joint flexion angle, amounting even to 16 degrees. The differences are due to the selection of anatomic landmarks, and depend in particular on the distance of the point to which the goniometer axis is applied from the approximate location of the mechanical joint axis. The corrections of knee joint flexion angle measurements were also estimated on the basis of data obtained from the photographs and the derived mathematical formula.

  5. Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound-guided steroid injection in the ankle region. A descriptive interventional study

    Directory of Open Access Journals (Sweden)

    Boesen Mikael

    2011-01-01

    Full Text Available Abstract Background The ankle region is frequently involved in juvenile idiopathic arthritis (JIA but difficult to examine clinically due to its anatomical complexity. The aim of the study was to evaluate the role of ultrasonography (US of the ankle and midfoot (ankle region in JIA. Doppler-US detected synovial hypertrophy, effusion and hyperemia and US was used for guidance of steroid injection and to assess treatment efficacy. Methods Forty swollen ankles regions were studied in 30 patients (median age 6.5 years, range 1-16 years with JIA. All patients were assessed clinically, by US (synovial hypertrophy, effusion and by color Doppler (synovial hyperemia before and 4 weeks after US-guided steroid injection. Results US detected 121 compartments with active disease (joints, tendon sheaths and 1 ganglion cyst. Multiple compartments were involved in 80% of the ankle regions. The talo-crural joint, posterior subtalar joint, midfoot joints and tendon sheaths were affected in 78%, 65%, 30% and 55% respectively. Fifty active tendon sheaths were detected, and multiple tendons were involved in 12 of the ankles. US-guidance allowed accurate placement of the corticosteroid in all 85 injected compartments, with a low rate of subcutaneous atrophy (4,7%. Normalization or regression of synovial hypertrophy was obtained in 89%, and normalization of synovial hyperemia in 89%. Clinical resolution of active arthritis was noted in 72% of the ankles. Conclusions US enabled exact anatomical location of synovial inflammation in the ankle region of JIA patients. The talo-crural joint was not always involved. Disease was frequently found in compartments difficult to evaluate clinically. US enabled exact guidance of steroid injections, gave a low rate of subcutaneous atrophy and was proved valuable for follow-up examinations. Normalization or regression of synovial hypertrophy and hyperemia was achieved in most cases, which supports the notion that US is an important

  6. Maisonneuve-hyperplantarflexion variant ankle fracture.

    Science.gov (United States)

    Hinds, Richard M; Tran, Wesley H; Lorich, Dean G

    2014-11-01

    Maisonneuve fractures are rare ankle injuries, accounting for up to 7% of all ankle fractures. They consist of a proximal third fibula fracture, syndesmotic disruption, and medial ankle injury (either a deltoid ligament disruption or a medial malleolus fracture), and are often successfully managed with nonoperative treatment of the proximal fibula fracture and open reduction and internal fixation (ORIF) of the medial ankle injury and syndesmotic disruption. The hyperplantarflexion variant ankle fracture comprises approximately 7% of all ankle fractures and features dual posterior tibial lip fractures featuring a posterolateral fragment and a posteromedial fragment. Good functional results have been reported in the literature after ORIF of both the posterolateral and posteromedial fragments of this variant fracture that is not described by the Lauge-Hansen classification. In this report, the authors present the unique case of an isolated ankle fracture demonstrating characteristics of both a Maisonneuve fracture and a hyperplantarflexion variant ankle fracture. They also highlight the diagnostic imaging characteristics, including magnetic resonance imaging (MRI) and preoperative radiograph findings, surgical treatment, and postoperative clinical outcome for this patient with a Maisonneuve-hyperplantarflexion variant ankle fracture. To the authors' knowledge, this unique fracture pattern has not been reported previously in the literature. The authors conclude that although good results were seen postoperatively in this case, the importance of ORIF of both the posteromedial and posterolateral fragments of variant fractures cannot be overstated. They also found MRI to be a particularly helpful adjunct in formulating the correct diagnosis and treatment plan.

  7. Fusion following failed total ankle replacement.

    Science.gov (United States)

    Wünschel, Markus; Leichtle, Ulf G; Leichtle, Carmen I; Walter, Christian; Mittag, Falk; Arlt, Eva; Suckel, Andreas

    2013-04-01

    Although mid- to long-term results after total ankle replacement have improved because of available second- and third-generation devices, failure of total ankle replacement is still more common compared with total hip replacement and total knee replacement. The portfolio of available total ankle replacement revision component options is small. Furthermore, the bone stock of the tibiotalar region is scarce making it difficult and in some situations impossible to perform revision total ankle replacement. In these cases tibiotalar and tibiotalocalcaneal fusions are valuable options. This article describes which surgical procedures should be performed depending on the initial situation and gives detailed advice on surgical technique, postoperative care, and clinical results.

  8. Total Ankle Arthroplasty: An Imaging Overview.

    Science.gov (United States)

    Kim, Da-Rae; Choi, Yun Sun; Potter, Hollis G; Li, Angela E; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice.

  9. Total ankle arthroplasty: An imaging overview

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Da Rae; Choi, Yun Sun; Chun, Ka Young; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won [Eulji Hospital, Eulji University, Seoul (Korea, Republic of); Potter, Hollis G.; Li, Angela E. [Dept. of Radiology and Imaging, Hospital for Special Surgery, New York (United States)

    2016-06-15

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice.

  10. 早期被动关节运动结合良肢位摆放对偏瘫患者关节运动的影响%Effects of Early Passive Joint Movement and Good Limb Position on Articular Movement of Hemiplegic Patients

    Institute of Scientific and Technical Information of China (English)

    郭淑红; 赵琼

    2015-01-01

    目的:探讨早期被动关节运动结合良肢位摆放对偏瘫患者关节运动的影响。方法:将80例患者随机分为观察组和对照组各40例,对照组进行关节被动活动,观察组则在对照组的基础上采用良肢位摆放,随访3个月,比较2组患者踝关节及肩关节活动情况、肌力情况及所发生的并发症。结果:随访3个月时观察组踝关节活动度、肩关节内旋角度、肩关节外旋角度及肩关节上举角度均显著高于对照组(P<0.05),观察组肌力上肢Ⅳ级及以上和下肢Ⅳ级及以上的比例均显著高于对照组(P<0.05),发生肩关节半脱位、髋关节半脱位及足畸形的比例均显著低于对照组(P<0.05)。结论:早期的被动关节运动结合良肢位摆放,可提高患肢肌力,利于偏瘫患者关节功能的恢复。%To explore the influence of early passive joint movement combined with good limb position on articular movement of hemiplegic patients. Methods: Totally 80 patients with paralysis were randomly divided into the observation group and the control group with 40 cases in each. Passive movement was performed in the control group to improve the rehabilitation efficacy and on the basis of the control group, good limb position was put to the patients in the observation group. All the patients were followed up for three months, and comparisons between both groups in ankle motion, shoulder joint motion, muscular force and related complications were made. Results: During the follow-ups, compared with the control group, the range of ankle motion, the internal and external rotation of shoulder joint and the range of rising shoulder joint in the observation group significantly improved (P<0.05); the proportion of the upper limb and the lower limb muscle strength reaching Ⅳand above in the observa-tion group were markedly higher than those in the control group(P<0.05); the incidence of shoulder joint subluxa-tion, hip sub

  11. 应用 Lauge-Hansen分型手术治疗踝关节骨折%Application of Lauge-Hansen classification for surgical treatment of ankle fractures

    Institute of Scientific and Technical Information of China (English)

    赵广超; 薛双桃; 桂召柳; 吴天亮; 林志祥; 曹松松; 夏太保

    2016-01-01

    目的:探讨应用Lauge-Hansen分型手术治疗踝关节骨折的临床疗效。方法对30例踝关节骨折患者按Lauge-Hansen分型行手术治疗。术中按分型的损伤机制进行复位,根据骨折特征选择合适内固定。对踝关节术后疗效使用Baird-Jackson评分标准评价。结果术后X线片显示骨折复位良好,踝穴形态恢复正常,内固定位置满意。患者均获得随访,时间3~46个月。按踝关节Baird-Jackson评分标准评价:优20例,良7例,可2例,差1例,优良率90%。结论应用Lauge-Hansen分型手术治疗踝关节骨折,可指导术中骨折复位,选择合适内固定,判断下胫腓联合损伤情况,提高手术疗效。%Objective To evaluate the clinical efficacy of surgical treatment of ankle fracture by Lauge -Hansen classi-fication.Methods Thirty cases of ankle fractures underwent surgical treatment according to Lauge -Hansen classifi-cation.Intraoperative reduction according to fractural mechanism of damage , the internal fixation was selected accord-ing to the fracture characteristic .The ankle postoperative curative effect was evaluated by Baird-Jackson criteria .Re-sults The postoperative X-ray film showed good fracture reduction , the ankle mortise shape was recoved to normal , internal fixation position satisfaction .All patients were followed up for 3~46 months.According to ankle Baird-Jack-son score criteria, the result was excellent in 20 cases, good in 7, fair in 2, and poor in 1, with the excellent-good rate of 90%.Conclusions Surgical treatment of ankle fracture by Lauge-Hansen classification can guide fracture re-duction of operation , select the appropriate internal fixation , judge the joint injury of the lower tibia and fibula , and improve surgery efficacy .

  12. Contributions of knee swing initiation and ankle plantar flexion to the walking mechanics of amputees using a powered prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2014-01-01

    Recently developed powered prostheses are capable of producing near-physiological joint torque at the knee and/or ankle joints. Based on previous studies of biological joint impedance and the mechanics of able-bodied gait, an impedance-based controller has been developed for a powered knee and ankle prosthesis that integrates knee swing initiation and powered plantar flexion in late stance with increasing ankle stiffness throughout stance. In this study, five prosthesis configuration conditions were tested to investigate the individual contributions of each sub-strategy to the overall walking mechanics of four unilateral transfemoral amputees as they completed a clinical 10-m walk test using a powered knee and ankle prosthesis. The baseline condition featured constant ankle stiffness and no swing initiation or powered plantar flexion. The four remaining conditions featured knee swing initiation alone (SI) or in combination with powered plantar flexion (SI+PF), increasing ankle stiffness (SI+IK), or both (SI+PF+IK). Self-selected walking speed did not significantly change between conditions, although subjects tended to walk the slowest in the baseline condition compared to conditions with swing initiation. The addition of powered plantar flexion resulted in significantly higher ankle power generation in late stance irrespective of ankle stiffness. The inclusion of swing initiation resulted in a significantly more flexed knee at toe off and a significantly higher average extensor knee torque following toe off. Identifying individual contributions of intrinsic control strategies to prosthesis biomechanics could help inform the refinement of impedance-based prosthesis controllers and simplify future designs of prostheses and lower-limb assistive devices alike.

  13. 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

  14. Variable Joint Elasticities in Running

    Science.gov (United States)

    Peter, Stephan; Grimmer, Sten; Lipfert, Susanne W.; Seyfarth, Andre

    In this paper we investigate how spring-like leg behavior in human running is represented at joint level. We assume linear torsion springs in the joints and between the knee and the ankle joint. Using experimental data of the leg dynamics we compute how the spring parameters (stiffness and rest angles) change during gait cycle. We found that during contact the joints reveal elasticity with strongly changing parameters and compare the changes of different parameters for different spring arrangements. The results may help to design and improve biologically inspired spring mechanisms with adjustable parameters.

  15. Surgical outcomes after excision of pigmented villonodular synovitis localized to the ankle and hindfoot without adjuvant therapy.

    Science.gov (United States)

    Sung, Ki-Sun; Ko, Kyung Rae

    2015-01-01

    Although a benign disorder, pigmented villonodular synovitis (PVNS) has a high rate of recurrence. Because of the high incidence of recurrence and concern about destruction of the affected joint, several adjuvant therapies have been promoted without a clear standard treatment strategy. We reviewed cases of PVNS affecting the ankle and hindfoot joints (ankle and/or subtalar joints) treated with surgical resection without adjuvant therapy in an effort to identify the incidence of PVNS recurrence after excision without adjuvant therapy. Of the 10 cases with a mean follow-up duration of 33.2 ± 19.8 months, 4 (40%) developed a recurrence, with a mean interval of 6 (range 3 to 14) months. At the final follow-up visit, the mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 86.6 ± 12. The clinical outcomes of PVNS affecting the ankle and hindfoot joints are associated with a relatively high incidence of recurrence, and additional clinical investigation comparing the incidence of recurrence in patients undergoing excision versus excision with adjuvant therapy is needed for us to better understand this condition and provide more informed recommendations to our patients.

  16. A Multiple Degree of Freedom Lower Extremity Isometric Device to Simultaneously Quantify Hip, Knee, and Ankle Torques.

    Science.gov (United States)

    Sánchez, Natalia; Acosta, Ana Maria; Stienen, Arno H A; Dewald, Julius P A

    2015-09-01

    Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and ankle of a single leg during maximum voluntary torque generation. Thus, joint-torque coupling strategies in the hip, knee, and concurrent torques at ankle and/or coupling patterns at the hip and knee driven by the ankle have yet to be quantified. This manuscript describes the design, implementation, and validation of a multiple degree of freedom, lower extremity isometric device (the MultiLEIT) that accurately quantifies simultaneous torques at the hip, knee, and ankle. The system was mechanically validated and then implemented with two healthy control individuals and two post-stroke individuals to test usability and patient acceptance. Data indicated different joint torque coupling strategies used by both healthy individuals. In contrast, data showed the same torque coupling patterns in both post-stroke individuals, comparable to those described in the clinic. Successful implementation of the MultiLEIT can contribute to the understanding of the underlying mechanisms responsible for abnormal movement patterns and aid in the design of therapeutic interventions.

  17. Provocative mechanical tests of the peripheral nervous system affect the joint torque-angle during passive knee motion.

    Science.gov (United States)

    Andrade, R J; Freitas, S R; Vaz, J R; Bruno, P M; Pezarat-Correia, P

    2015-06-01

    This study aimed to determine the influence of the head, upper trunk, and foot position on the passive knee extension (PKE) torque-angle response. PKE tests were performed in 10 healthy subjects using an isokinetic dynamometer at 2°/s. Subjects lay in the supine position with their hips flexed to 90°. The knee angle, passive torque, surface electromyography (EMG) of the semitendinosus and quadriceps vastus medialis, and stretch discomfort were recorded in six body positions during PKE. The different maximal active positions of the cervical spine (neutral; flexion; extension), thoracic spine (neutral; flexion), and ankle (neutral; dorsiflexion) were passively combined for the tests. Visual analog scale scores and EMG were unaffected by body segment positioning. An effect of the ankle joint was verified on the peak torque and knee maximum angle when the ankle was in the dorsiflexion position (P Upper trunk positioning had an effect on the knee submaximal torque (P cervical and thoracic spines were flexed (P angle response since different positions of head, upper trunk, and foot induce dissimilar knee mechanical responses during passive extension.

  18. Current Concepts in the Management of Ankle Osteoarthritis: A Systematic Review.

    Science.gov (United States)

    Bloch, Benjamin; Srinivasan, Suresh; Mangwani, Jitendra

    2015-01-01

    Ankle osteoarthritis is less common than hip or knee osteoarthritis; however, it is a relatively common presentation and is predominantly related to previous trauma. Treatments have traditionally consisted of temporizing measures such as analgesia, physiotherapy, and injections until operative treatment in the form of arthrodesis is required. More recently, interest has been increasing in both nonoperative and alternative operative options, including joint-sparing surgery, minimal access arthrodesis, and new arthroplasty designs. The present systematic instructional review has summarized the current evidence for the treatment options available for ankle osteoarthritis.

  19. One year follow-up after operative ankle fractures: a prospective gait analysis study with a multi-segment foot model.

    Science.gov (United States)

    Wang, Ruoli; Thur, Charlotte K; Gutierrez-Farewik, Elena M; Wretenberg, Per; Broström, Eva

    2010-02-01

    Ankle fractures are one of the most common lower limb traumas. Several studies reported short- and long-term post-operative results, mainly determined by radiographic and subjective functional evaluations. Three-dimensional gait analysis with a multi-segment foot model was used in the current study to quantify the inter-segment foot motions in 18 patients 1 year after surgically treated ankle fractures. Data were compared to that from gender- and age-matched healthy controls. The correlations between Olerud/Molander ankle score and kinematics were also evaluated. Patients with ankle fractures showed less plantarflexion and smaller range of motion in the injured talocrural joint, which were believed to be a sign of residual joint stiffness after surgery and immobilization. Moreover, the forefoot segment had smaller sagittal and transverse ranges of motion, less plantarflexion and the hallux segment had less dorsiflexion and smaller sagittal range of motion. The deviations found in the forefoot segment may contribute to the compensation mechanisms of the injured ankle joint. Findings of our study show that gait analysis with a multi-segment foot model provides a quantitative and objective way to perform the dynamic assessment of post-operative ankle fractures, and makes it possible to better understand not only how the injured joint is affected, but also the surrounding joints.

  20. Measurement of torque during passive and active ankle movements in patients with muscle hypertonia. A methodological study.

    Science.gov (United States)

    Broberg, C; Grimby, G

    1983-01-01

    Torque curves were recorded during passive and active ankle joint movements at three preset angular velocities (30, 60 and 120 degrees/s) with the subject in the supine position and 45 degrees hip and knee angles. Recordings were performed in normal subjects (n = 11), patients with clinical spasticity (n = 10) and patients with Parkinson's disease (n = 7). The torque curves recorded during passive dorsiflexion followed by plantar flexion showed a counterclockwise hysteresis loop with minimal area in the normal subjects and a large area in patients, especially at the highest velocity. The torque increase during dorsiflexion was proportional to the angular velocity in the patients with spasticity but not in the patients with Parkinson's disease. In the patients with spasticity, a good correlation was found between clinical assessment of hypertonia and measurements of torque during passive movements but not torque values during maximal voluntary dorsiflexion. A model for data reduction and estimation of instant slope values on different parts of the torque-angle curve is suggested. The use of ankle torque recordings for evaluation of treatment effects is exemplified.

  1. Six degree-of-freedom analysis of hip, knee, ankle and foot provides updated understanding of biomechanical work during human walking.

    Science.gov (United States)

    Zelik, Karl E; Takahashi, Kota Z; Sawicki, Gregory S

    2015-03-01

    Measuring biomechanical work performed by humans and other animals is critical for understanding muscle-tendon function, joint-specific contributions and energy-saving mechanisms during locomotion. Inverse dynamics is often employed to estimate joint-level contributions, and deformable body estimates can be used to study work performed by the foot. We recently discovered that these commonly used experimental estimates fail to explain whole-body energy changes observed during human walking. By re-analyzing previously published data, we found that about 25% (8 J) of total positive energy changes of/about the body's center-of-mass and >30% of the energy changes during the Push-off phase of walking were not explained by conventional joint- and segment-level work estimates, exposing a gap in our fundamental understanding of work production during gait. Here, we present a novel Energy-Accounting analysis that integrates various empirical measures of work and energy to elucidate the source of unexplained biomechanical work. We discovered that by extending conventional 3 degree-of-freedom (DOF) inverse dynamics (estimating rotational work about joints) to 6DOF (rotational and translational) analysis of the hip, knee, ankle and foot, we could fully explain the missing positive work. This revealed that Push-off work performed about the hip may be >50% greater than conventionally estimated (9.3 versus 6.0 J, P=0.0002, at 1.4 m s(-1)). Our findings demonstrate that 6DOF analysis (of hip-knee-ankle-foot) better captures energy changes of the body than more conventional 3DOF estimates. These findings refine our fundamental understanding of how work is distributed within the body, which has implications for assistive technology, biomechanical simulations and potentially clinical treatment.

  2. Explosive Resistance Training Increases Rate of Force Development in Ankle Dorsiflexors and Gait Function in Adults With Cerebral Palsy.

    Science.gov (United States)

    Kirk, Henrik; Geertsen, Svend S; Lorentzen, Jakob; Krarup, Kasper B; Bandholm, Thomas; Nielsen, Jens B

    2016-10-01

    Kirk, H, Geertsen, SS, Lorentzen, J, Krarup, KB, Bandholm, T, and Nielsen, JB. Explosive resistance training increases rate of force development in ankle dorsiflexors and gait function in adults with cerebral palsy. J Strength Cond Res 30(10): 2749-2760, 2016-Alterations in passive elastic properties of muscles and reduced ability to quickly generate muscle force contribute to impaired gait function in adults with cerebral palsy (CP). In this study, we investigated whether 12 weeks of explosive and progressive heavy-resistance training (PRT) increases rate of force development of ankle dorsiflexors (RFDdf), improves gait function, and affects passive ankle joint stiffness in adults with CP. Thirty-five adults (age: 36.5; range: 18-59 years) with CP were nonrandomly assigned to a PRT or nontraining control (CON) group in this explorative trial. The PRT group trained ankle dorsiflexion, plantarflexion, leg press, hamstring curls, abdominal curls, and back extension 3 days per week for 12 weeks, with 3 sets per exercise and progressing during the training period from 12 to 6 repetition maximums. RFDdf, 3-dimensional gait analysis, functional performance, and ankle joint passive and reflex-mediated muscle stiffness were evaluated before and after. RFDdf increased significantly after PRT compared to CON. PRT also caused a significant increase in toe lift late in swing and a significantly more dorsiflexed ankle joint at ground contact and during stance. The increased toe-lift amplitude was correlated to the increased RFDdf (r = 0.73). No other between-group differences were observed. These findings suggest that explosive PRT may increase RFDdf and facilitate larger range of movement in the ankle joint during gait. Explosive PRT should be tested in clinical practice as part of a long-term training program for adults with CP.

  3. Current concepts review: ankle fractures.

    Science.gov (United States)

    Arastu, M H; Demcoe, R; Buckley, R E

    2012-01-01

    Ankle fractures are common injuries that require meticulous technique in order to optimise outcome. The Lauge-Hansen and Danis-Weber classifications in addition to careful evaluation of the injury mechanism can help guide treatment but surgeons must be aware that there are injury patterns that will not always fit the afore mentioned patterns. The principles of atraumatic soft tissue handling, rigid internal fixation and early range of motion exercises are critical for successfully treating these injuries. There are still areas of treatment uncertainty and future directed research is needed in order to address some of these questions.

  4. Validating a new computed tomography atlas for grading ankle osteoarthritis.

    Science.gov (United States)

    Cohen, Michael M; Vela, Nathan D; Levine, Jason E; Barnoy, Eran A

    2015-01-01

    As the most common joint disease, osteoarthritis (OA) poses a significant source of pain and disability. It can be defined by classic radiographic findings, particular symptoms, or a combination of the 2. Although specific grading scales have been developed to evaluate OA in various joints, such as the shoulder, hip, and knee, no definitive classification system is available for grading OA in the ankle. The purpose of the present study was to create and validate a standardized atlas for grading (or staging) ankle osteoarthritis using computed tomography (CT) and "hallmark" findings noted on coronal, sagittal, and axial views extrapolated from the Kellgren-Lawrence radiographic scale. The CT scans of 226 patients at the Miami Veterans Affairs Medical Center were reviewed. An atlas was derived from a retrospective review of 30 remaining CT scans taken from July 2008 to November 2011. After this review, 3 orthogonal static CT images, obtained from 11 remaining patients, were chosen to represent the various stages on the OA scale and were used to test the validity of the atlas developed by 2 of us (M.M.C. and N.D.V.). A multispecialty panel of 9 examiners, excluding ourselves, independently rated the 11 CT scan subjects. The differences among examiners and specialties were calculated, including an intra-examiner agreement for 2 separate readings spaced 9 months apart. Although the small number of subspecialty examiners made the intraspecialty comparisons difficult to validate, the findings nevertheless indicated excellent agreement among all specialty groups, with good intra-investigational (intraclass correlation coefficient 0.962 and 1) inter-investigational (intraclass correlation coefficient 0.851) values. These results appeared to validate the CT ankle OA atlas, which we believe will be a valuable clinical and research tool, one that will likely be more beneficial than less relevant generalized OA grading scales in use today.

  5. Osteochondral defects in the ankle: why painful?

    NARCIS (Netherlands)

    van Dijk, C.N.; Reilingh, M.L.; Zengerink, M.; van Bergen, C.J.A.

    2010-01-01

    Osteochondral defects of the ankle can either heal and remain asymptomatic or progress to deep ankle pain on weight bearing and formation of subchondral bone cysts. The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone pl

  6. Radiological aspects of sprained ankle syndrome

    NARCIS (Netherlands)

    Sijbrandij, E.S.

    2002-01-01

    This thesis addresses several problems related to sprained ankle syndrome. The purpose of this thesis is to evaluate the imaging features of sprained ankles, found on new radiological modalities, and to assess the additional diagnostic understanding and treatment planning of helical CT as well as M

  7. Assessment of acute foot and ankle sprains.

    Science.gov (United States)

    Lynam, Louise

    2006-07-01

    Acute ankle and foot trauma is a regular emergency presentation and prompt strategic assessment skills are required to enable nurses to categorise and prioritise these injuries appropriately. This article provides background information on the anatomy and physiology of the lower limb to help nurses to identify various grades of ankle sprain as well as injuries that are limb threatening

  8. Efeito agudo do calçado de diferentes alturas sobre o comportamento angular do tornozelo Acute effect of shoes with different heights on the ankle angular behavior

    Directory of Open Access Journals (Sweden)

    Mirieli Denardi Limana

    2012-09-01

    Full Text Available Estudos descrevem que o uso de salto alto exige do corpo uma série de ajustes compensatórios, a fim de manter os seus movimentos e equilíbrio próximos à normalidade. No andar, a interferência do salto alto sobre o pé e sobre a articulação do tornozelo parece desencadear uma postura diferente da posição anatômica. O presente estudo teve como objetivos comparar a cinemática sagital do tornozelo em diferentes calçados e verificar a existência de um limite de altura de salto que possa levar a articulação do tornozelo a adaptações durante o andar. Esta pesquisa, caracterizada como experimental, foi constituída por uma análise cinemática bidimensional do tornozelo no plano sagital. A amostra foi composta por dez universitárias, com média de idade de 19,2 (±1,8 anos, que caminharam sobre uma esteira utilizando um tênis e três sandálias do tipo tamanco, com saltos de 3, 7 e 10 cm. Para cada ciclo de passada, foram identificados picos de movimento do tornozelo referentes à dorsiflexão e à flexão plantar. Os resultados mostraram que na flexão plantar, com o aumento da altura do salto, há uma tendência de acentuação do pico angular do tornozelo. Concluiu-se que saltos acima de 3 cm de altura induzem a articulação do tornozelo a realizar uma flexão plantar sustentada, mudando as características da marcha na fase de apoio e de balanço. Tais evidências sugerem alturas de saltos menores de 3 cm como limites de segurança para manutenção do padrão normal da marcha em mulheres jovens.Studies have described that using high heels requires a series of compensatory adjustments of the body to keep its movements and balance close to normality. When walking, the interference of high heels on the foot and on the ankle joint seems to initiate a different posture from the anatomical position. The present study aimed at comparing the sagittal kinematics of the ankle in different shoes and at verifying the existence of a height

  9. The instantaneous helical axis of the subtalar and talocrural joints: a non-invasive in vivo dynamic study

    Directory of Open Access Journals (Sweden)

    Sheehan Frances T

    2010-07-01

    Full Text Available Abstract Background An understanding of rear-foot (talocrural and subtalar joints kinematics is critical for diagnosing foot pathologies, designing total ankle implants, treating rear-foot injuries and quantifying gait abnormalities. The majority of kinematic data available have been acquired through static cadaver work or passive in vivo studies. The applicability of these data to dynamic in vivo situations remains unknown. Thus, the purpose of this study was to fully quantify subtalar, talocrural and calcaneal-tibial in vivo kinematics in terms of the instantaneous helical axis (IHA in twenty-five healthy ankles during a volitional activity that simulated single-leg toe-raises with partial-weight support, requiring active muscle control. Methods Subjects were each placed supine in a 1.5 T MRI and asked to repeat this simulated toe-raise while a full sagittal-cine-phase contrast (dynamic MRI dataset was acquired. From the cine-phase contrast velocity a full kinematic description for each joint was derived. Results Nearly all motion quantified at the calcaneal-tibial joint was attributable to the talocrural joint. The subtalar IHA orientation and position were highly variable; whereas, the talocrural IHA orientation and position were extremely consistent. Conclusion The talocrural was well described by the IHA and could be modeled as a fixed-hinge joint, whereas the subtalar could not be.

  10. Simulation of an ankle rehabilitation system based on scotch- yoke mechanism

    Science.gov (United States)

    Racu (Cazacu, C. M.; Doroftei, I.; Plesu, Ghe; Doroftei, I. A.

    2016-08-01

    Due to injuries that occur on the ankle joint, everyday all around the world, more and more rehabilitation devices have been developed in recent years. The prices for ankle rehabilitation systems are still high, thus we developed a new device that we indented to be low cost and easy to manufacture. A model of an ankle rehabilitation device is presented in this paper. The device has two degrees of freedom, for flexion-extension and inversion-eversion move, and will ensure functionality with minimum dimensions. For the 3D model that we design, the dimensions are taken so that the proposed system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg.

  11. Effect of laser beam position on mechanical properties of F82H/SUS316L butt-joint welded by fiber laser

    Energy Technology Data Exchange (ETDEWEB)

    Serizawa, Hisashi, E-mail: serizawa@jwri.osaka-u.ac.jp [Joining and Welding Research Institute, Osaka University, 11-1 Mihogaoka, Ibaraki, Osaka 567-0047 (Japan); Mori, Daiki; Ogiwara, Hiroyuki; Mori, Hiroaki [Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 (Japan)

    2014-10-15

    Highlights: • The micro hardness of weld metal in F82H/SUS316L joint partially decreases after PWHT by shifting beam position to SUS316L. • Charpy impact energy of F82H/SUS316L joint obviously increases after PWHT due to the release of residual stress. • The tensile strength of weld metal in F82H/SUS316L joint is higher than that of SUS316L. • The fiber laser welding seems to be one of the most candidate methods to join between F82H and SUS316L pipes practically. - Abstract: A dissimilar butt-joint between reduced activation ferritic/martensitic steel F82H and SUS316L austenitic stainless steel was made by 4 kW fiber laser and the influence of laser beam position on its mechanical properties before and after post-weld heat treatment (PWHT) was examined at room temperature. From the nano-indentation measurements and the microstructural observations, it is found that the micro hardness of weld metal partially decreases after PWHT by shifting beam position to SUS316L because its phase seems to move from only the martensitic phase to the mixture of austenitic and martensitic phases. In addition, Charpy impact test suggests that the impact energy slightly increases by shifting beam position before PWHT and obviously increases after PWHT due to the release of residual stress. Moreover, the tensile test indicates that the tensile strength of weld metal is higher than that of SUS316L and the fracture occurs at the base metal of SUS316L regardless of laser beam position.

  12. Effects of Figure of"8"Word Bandage in Ankle and Foot Joint on Gait of Hemiplegic Stroke Patients%踝足关节“8”字绷带对脑卒中后偏瘫患者步态的影响

    Institute of Scientific and Technical Information of China (English)

    范华桥; 李娟娟; 李冬; 张瑞丽

    2013-01-01

    observation group daily used with control group the same training method ,and in walk training used elastic bandage 20min.Two groups of patients in the treatment of all ,before and after the adoption of improved Barthel index (modified Barthel index ,MBI),Holden walking function classification ,10 meters maxium walking velocity evaluation respectively the life ability ,walking function,maximum walking speed of the patients .At the same time,foot-prints method and the camera analysis were taken to the gait analysis .Results:The observation group patients used “8”word bandage ,rest ankle dorsiflexion Angle obviously improved ,by the before average 8.91+/-6.11 degrees to 5.23+/-4.11 degrees,the average foot valgus Angle by 15.22+/-5.12 degrees to 2.52+/-2.34 degrees.Walk cycle swing phase ankle dorsiflexion Angle is obviously im-proved and the touchdown initial ankle dorsiflexion foot to follow .Step by step length ,step speed obviously improved ,including long step by 0.47+/-0.18m increased to 0.59+/-0.12m,pace from 0.61+/-0.13m/s increased to 0.78+/-0.08m/s.After treatment,the Barthel index,Holden walking function classification ,10meters walking speed of the largest in the group of the patients of the two groups were remarkably improved ,compared to the before treatment .Their difference was statistically significant ( p <0.05 ) .Conclusion:“8”word bandage can significantly improve ankle foot joint prolapse and introversive degree of hemiplegia patients so as to improve the gait and the walking ability .

  13. Are joint torque models limited by an assumption of monoarticularity?

    Science.gov (United States)

    Lewis, Martin G C; King, Mark A; Yeadon, Maurice R; Conceição, Filipe

    2012-11-01

    This study determines whether maximal voluntary ankle plantar flexor torque could be more accurately represented using a torque generator that is a function of both knee and ankle kinematics. Isovelocity and isometric ankle plantar flexor torques were measured on a single participant for knee joint angles of 111° to 169° (approximately full extension) using a Contrex MJ dynamometer. Maximal voluntary torque was represented by a 19-parameter two-joint function of ankle and knee joint angles and angular velocities with the parameters determined by minimizing a weighted root mean square difference between measured torques and the two-joint function. The weighted root mean square difference between the two-joint function and the measured torques was 10 N-m or 3% of maximum torque. The two-joint function was a more accurate representation of maximal voluntary ankle plantar flexor torques than an existing single-joint function where differences of 19% of maximum torque were found. It is concluded that when the knee is flexed by more than 40°, a two-joint representation is necessary.

  14. Effect of end-stage hip, knee, and ankle osteoarthritis on walking mechanics.

    Science.gov (United States)

    Schmitt, Daniel; Vap, Alexander; Queen, Robin M

    2015-09-01

    This study tested the hypothesis that the presence of isolated ankle (A-OA; N=30), knee (K-OA; N=20), or hip (H-OA; N=30) osteoarthritis (OA) compared to asymptomatic controls (N=15) would lead to mechanical changes in the affected joint but also in all other lower limb joints and gait overall. Stride length, stance and swing times, as well as joint angles and moments at the hip, knee, and ankle were derived from 3-D kinematic and kinetic data collected from seven self-selected speed walking trial. Values were compared across groups using a 1×4 ANCOVA, covarying for walking speed. With walking speed controlled, the results indicated a reduction in hip and knee extension and ankle plantar flexion in accordance with the joint affected. In addition, OA in one joint had strong effects on other joints. In both H-OA and K-OA groups the hip never passed into extension, and A-OA subjects significantly changed hip kinematics to compensate for lack of plantar flexion. Finally, OA in any joint led to lower peak vertical forces as well as extension and plantar flexion moments compared to controls. The presence of end-stage OA at various lower extremity joints results in compensatory gait mechanics that cause movement alterations throughout the lower extremity. This work reinforces our understanding of the complex interaction of joints of the lower limb and the importance of focusing on the mechanics of the entire lower limb when considering gait disability and potential interventions in patients with isolated OA.

  15. Imaging study of ankle injury in professional soccer player of males%男性职业足球运动员踝关节损伤影像学特征分析

    Institute of Scientific and Technical Information of China (English)

    李绍林; 赵文吉; 郝帅; 胡绍勇; 张锐; 张鑫涛

    2015-01-01

    Objective To analyze the imaging abnormal findings of ankle injuries in professional soccer player of males.Methods The thirty-two professional soccer players in local region soccer club had been selected as research objects from March 2014 to January 2015,and all were men.Average age was 22.03 + 3.0 years old (19-33 years);the average age was 8.6 + 2.0 years old that began to engage in professional football training,and average time of engaged in football sports was 13 ±+4 years(7-27 years).X-ray examination was used VM DR (Philips Co.),anteroposterior and lateral position of ankle joints.CT scan was used MSCT of 64 rows detector(Aquilion 64,TOSHIBA Co.).After routine scan,raw data was transmitted to the workstation and then reconstructed to be axial,sagittal,coronal imaging.MR examination was used 1.5 T superconducting equipment system(Achieva Dual,Philips Co.) and with ankle joint special phased array coil.TSE sequence be used to scan routine axial T2-weighted imaging;coronal T1-weighted imaging;coronal PWI;and sagittal T2-weighted imaging with fat suppressed.The sagittal PWI scan was used with Isotropic with fat suppressed FFE sequence.Results The X-ray examination was finished for 28 person and 51 ankle joints.26 person and 52 ankle joints were completed CT scan and reconstructed imaging for all joints.MR examination was finished in 30 person and 51 ankle joints.On X-ray and CT display that the abnormal changes of the talus is most commonly found that the incidence of "dolphin mouth" like protrusion at posterior edge was 35 ankles (rate of occurrence was 68.6%),the triangle prominence at out edge was 45 ankles (rate of occurrence was 88.2%).It also was found that 8 lateral malleolus have osteophytes,5 ankles have medial malleolus osteophytes and 12 ankles have loose bodies at posterior ankle.MRI showed that 30 ankles were the anterior talofibular ligaments injury and incidence was 58.82%,26 ankles were posterior talofibular ligaments injury (incidence

  16. Joint Motion Control of a Powered Lower Limb Orthosis for Rehabilitation

    Institute of Scientific and Technical Information of China (English)

    Nelson Costa; Milan Bezdicek; Michael Brown; John O. Gray; Darwin G. Caldwell; Stephen Hutchins

    2006-01-01

    Many patients with spinal injures are confined to wheelchairs, leading to a sedentary lifestyle with secondary pathologies and increased dependence on a carer. Increasing evidence has shown that locomotor training reduces the incidence of these secondary pathologies, but the physical effort involved in this training is such that there is poor compliance. This paper reports on the design and control of a new "human friendly" orthosis (exoskeleton), powered by high power pneumatic Muscle Actuators (pMAs). The combination of a highly compliant actuation system, with an intelligent embedded control mechanism which senses hip, knee, and ankle positions, velocity, acceleration and force, produces powerful yet inherently safe operation for paraplegic patients. This paper analyzes the motion of ankle, knee, and hip joints under zero loading, and loads which simulate human limb mass, showing that the use of "soft" actuators can provide a smooth user friendly motion.The application of this technology will greatly improve the rehabilitative protocols for paraplegic patients.

  17. Within-socket myoelectric prediction of continuous ankle kinematics for control of a powered transtibial prosthesis

    Science.gov (United States)

    Farmer, Samuel; Silver-Thorn, Barbara; Voglewede, Philip; Beardsley, Scott A.

    2014-10-01

    Objective. Powered robotic prostheses create a need for natural-feeling user interfaces and robust control schemes. Here, we examined the ability of a nonlinear autoregressive model to continuously map the kinematics of a transtibial prosthesis and electromyographic (EMG) activity recorded within socket to the future estimates of the prosthetic ankle angle in three transtibial amputees. Approach. Model performance was examined across subjects during level treadmill ambulation as a function of the size of the EMG sampling window and the temporal ‘prediction’ interval between the EMG/kinematic input and the model’s estimate of future ankle angle to characterize the trade-off between model error, sampling window and prediction interval. Main results. Across subjects, deviations in the estimated ankle angle from the actual movement were robust to variations in the EMG sampling window and increased systematically with prediction interval. For prediction intervals up to 150 ms, the average error in the model estimate of ankle angle across the gait cycle was less than 6°. EMG contributions to the model prediction varied across subjects but were consistently localized to the transitions to/from single to double limb support and captured variations from the typical ankle kinematics during level walking. Significance. The use of an autoregressive modeling approach to continuously predict joint kinematics using natural residual muscle activity provides opportunities for direct (transparent) control of a prosthetic joint by the user. The model’s predictive capability could prove particularly useful for overcoming delays in signal processing and actuation of the prosthesis, providing a more biomimetic ankle response.

  18. A pneumatic power harvesting ankle-foot orthosis to prevent foot-drop

    Directory of Open Access Journals (Sweden)

    Chin Robin

    2009-06-01

    Full Text Available Abstract Background A self-contained, self-controlled, pneumatic power harvesting ankle-foot orthosis (PhAFO to manage foot-drop was developed and tested. Foot-drop is due to a disruption of the motor control pathway and may occur in numerous pathologies such as stroke, spinal cord injury, multiple sclerosis, and cerebral palsy. The objectives for the prototype PhAFO are to provide toe clearance during swing, permit free ankle motion during stance, and harvest the needed power with an underfoot bellow pump pressurized during the stance phase of walking. Methods The PhAFO was constructed from a two-part (tibia and foot carbon composite structure with an articulating ankle joint. Ankle motion control was accomplished through a cam-follower locking mechanism actuated via a pneumatic circuit connected to the bellow pump and embedded in the foam sole. Biomechanical performance of the prototype orthosis was assessed during multiple trials of treadmill walking of an able-bodied control subject (n = 1. Motion capture and pressure measurements were used to investigate the effect of the PhAFO on lower limb joint behavior and the capacity of the bellow pump to repeatedly generate the required pneumatic pressure for toe clearance. Results Toe clearance during swing was successfully achieved during all trials; average clearance 44 ± 5 mm. Free ankle motion was observed during stance and plantarflexion was blocked during swing. In addition, the bellow component repeatedly generated an average of 169 kPa per step of pressure during ten minutes of walking. Conclusion This study demonstrated that fluid power could be harvested with a pneumatic circuit built into an AFO, and used to operate an actuated cam-lock mechanism that controls ankle-foot motion at specific periods of the gait cycle.

  19. Estimation of quasi-stiffness and propulsive work of the human ankle in the stance phase of walking.

    Directory of Open Access Journals (Sweden)

    Kamran Shamaei

    Full Text Available Characterizing the quasi-stiffness and work of lower extremity joints is critical for evaluating human locomotion and designing assistive devices such as prostheses and orthoses intended to emulate the biological behavior of human legs. This work aims to establish statistical models that allow us to predict the ankle quasi-stiffness and net mechanical work for adults walking on level ground. During the stance phase of walking, the ankle joint propels the body through three distinctive phases of nearly constant stiffness known as the quasi-stiffness of each phase. Using a generic equation for the ankle moment obtained through an inverse dynamics analysis, we identify key independent parameters needed to predict ankle quasi-stiffness and propulsive work and also the functional form of each correlation. These parameters include gait speed, ankle excursion, and subject height and weight. Based on the identified form of the correlation and key variables, we applied linear regression on experimental walking data for 216 gait trials across 26 subjects (speeds from 0.75-2.63 m/s to obtain statistical models of varying complexity. The most general forms of the statistical models include all the key parameters and have an R(2 of 75% to 81% in the prediction of the ankle quasi-stiffnesses and propulsive work. The most specific models include only subject height and weight and could predict the ankle quasi-stiffnesses and work for optimal walking speed with average error of 13% to 30%. We discuss how these models provide a useful framework and foundation for designing subject- and gait-specific prosthetic and exoskeletal devices designed to emulate biological ankle function during level ground walking.

  20. Estimation of quasi-stiffness and propulsive work of the human ankle in the stance phase of walking.

    Science.gov (United States)

    Shamaei, Kamran; Sawicki, Gregory S; Dollar, Aaron M

    2013-01-01

    Characterizing the quasi-stiffness and work of lower extremity joints is critical for evaluating human locomotion and designing assistive devices such as prostheses and orthoses intended to emulate the biological behavior of human legs. This work aims to establish statistical models that allow us to predict the ankle quasi-stiffness and net mechanical work for adults walking on level ground. During the stance phase of walking, the ankle joint propels the body through three distinctive phases of nearly constant stiffness known as the quasi-stiffness of each phase. Using a generic equation for the ankle moment obtained through an inverse dynamics analysis, we identify key independent parameters needed to predict ankle quasi-stiffness and propulsive work and also the functional form of each correlation. These parameters include gait speed, ankle excursion, and subject height and weight. Based on the identified form of the correlation and key variables, we applied linear regression on experimental walking data for 216 gait trials across 26 subjects (speeds from 0.75-2.63 m/s) to obtain statistical models of varying complexity. The most general forms of the statistical models include all the key parameters and have an R(2) of 75% to 81% in the prediction of the ankle quasi-stiffnesses and propulsive work. The most specific models include only subject height and weight and could predict the ankle quasi-stiffnesses and work for optimal walking speed with average error of 13% to 30%. We discuss how these models provide a useful framework and foundation for designing subject- and gait-specific prosthetic and exoskeletal devices designed to emulate biological ankle function during level ground walking.

  1. Design and validation of a platform robot for determination of ankle impedance during ambulation.

    Science.gov (United States)

    Rouse, Elliott J; Hargrove, Levi J; Peshkin, Michael A; Kuiken, Todd A

    2011-01-01

    In order to provide natural, biomimetic control to recently developed powered ankle prostheses, we must characterize the impedance of the ankle during ambulation tasks. To this end, a platform robot was developed that can apply an angular perturbation to the ankle during ambulation and simultaneously acquire ground reaction force data. In this study, we detail the design of the platform robot and characterize the impedance of the ankle during quiet standing. Subjects were perturbed by a 3° dorsiflexive ramp perturbation with a length of 150 ms. The impedance was defined parametrically, using a second order model to map joint angle to the torque response. The torque was determined using the inverted pendulum assumption, and impedance was identified by the least squares best estimate, yielding an average damping coefficient of 0.03 ± 0.01 Nms/° and an average stiffness coefficient of 3.1 ± 1.2 Nm/°. The estimates obtained by the proposed platform robot compare favorably to those published in the literature. Future work will investigate the impedance of the ankle during ambulation for powered prosthesis controller development.

  2. A brief history of total ankle replacement and a review of the current status.

    Science.gov (United States)

    Vickerstaff, John A; Miles, Anthony W; Cunningham, James L

    2007-12-01

    Total ankle replacement (TAR) was first attempted in the early 1970s, but poor early results lead to it being abandoned in favour of arthrodesis. Arthrodesis is not totally satisfactory, often causing further hindfoot arthritis and this has lead to a resurgence of interest in joint replacement. New designs which more closely approximated the natural anatomy of the ankle and associated biomechanics have produced more encouraging results and led to renewed interest in total ankle replacement. Three prostheses dominate the market: Agility, Buechel-Pappas and STAR, and improving clinical results with these devices have led to more designs appearing on the market. Modern designs of prosthetic ankles almost exclusively consist of three part prostheses with a mobile bearing component, similar to the Buechel-Pappas and STAR. Clinical results of these newer designs are limited and short-term and have often been carried out by the designers of the implants. This paper presents a brief history of the development of total ankle replacement and a review of the current status.

  3. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability.

    Science.gov (United States)

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-05-01

    [Purpose] The aim of the present study was to construct an integrated rehabilitation exercise program to prevent chronic pain and improve motor ability in cases of ankle injury and re-injury. [Subjects and Methods] Twenty-six male soccer players who required functional strength exercises due to repeated ankle injury were the subjects. A 12-week rehabilitation exercise program was constructed with the aim of improving muscle strength in the ankle and dynamic coordination of the lower limb. Muscle strength and dynamic coordination were evaluated using the Y Balance Test, and isokinetic muscle strength of ankle dorsiflexion, plantarflexion, inversion, and eversion were measured before and after the 12-week program. [Results] Following 12 weeks of rehabilitation exercise, there were statistically significant improvements in the ratios of dorsiflexor strength to plantarflexor strength, eversion strength, and inversion strength on the left side. The other variables showed no significant changes. [Conclusion] The rehabilitation exercise program for chronic ankle instability helped to reduce pain, and to restore normal joint range of motion, muscle strength and endurance, and functional ability. Active protocols to improve complex functions need to be developed to complement these results.