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Sample records for ankle joint stiffness

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

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    Chino, Kintaro; Takashi, Hideyuki

    2017-11-15

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

  2. EFFECTS OF ACUTE ECCENTRIC CONTRACTIONS ON RAT ANKLE JOINT STIFFNESS

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    Ochi Eisuke

    2007-12-01

    Full Text Available The sensation of joint stiffness is frequently observed after eccentric contractions (ECs in human, but the joint stiffness of animals after ECs has not been examined previously. This study tested whether a bout of ECs affects rat ankle joint stiffness. We also evaluate muscle passive tension in the rat hindlimb to examine the relationships of ankle joint stiffness with muscle passive tension. Anesthetized male Wistar rats (n = 23 were firmly secured on a platform in the prone position. A bout of ECs was performed on the gastrocnemius muscle with a combination of electrically induced tetanic contractions via a skin electrode and simultaneous forced dorsiflexion of the ankle joint (velocity, 15°/s; from 0°to 45°. Passive resistive torque (PRT of the ankle joint was measured to evaluate joint stiffness. Passive tension of the exposed gastrocnemius muscle was also measured when the maximum value of joint stiffness was obtained. The PRT on days 2, 3, and 4 was significantly higher than the pre-treatment value (days 2 and 4; p < 0.001, days 3; p < 0.01. The passive tension on day 4 was significantly higher than that of the sham-operated group. The muscle wet mass was identical in both groups, suggesting the absence of edema. We conclude PRT increases after ECs in rat ankle joint. We also show the possibility that it is associated with muscle passive tension, independent of edema formation

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

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

    2017-12-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Foot drop and toe walking are frequent concerns in children with cerebral palsy (CP). Increased stiffness of the ankle joint muscles may contribute to these problems. OBJECTIVE: Does four weeks of daily home based treadmill training with incline reduce ankle joint stiffness...... in stiffness following training (P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003) increased significantly following the training during both treadmill and over-ground walking. CONCLUSIONS: Daily intensive gait training may influence the elastic properties of ankle joint muscles...

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

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    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.

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

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    Argunsah Bayram, Hande; Bayram, Mehmed B

    2018-03-30

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

  7. Measurement of the passive stiffness of ankle joint in 3 DOF using stewart platform type ankle foot device.

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    Nomura, Kenta; Yonezawa, Teru; Mizoguchi, Hiroshi; Takemura, Hiroshi

    2016-08-01

    This paper presents a method to measure the passive stiffness of an ankle joint in three degrees of freedom (DOF) under two motion speeds (1 Hz and 5 degree/s) using a developed Stewart platform-type device. The developed device can reproduce input motions of the foot in 6 DOF by controlling six pneumatic linear motion actuators. We used the device to measure the passive stiffness of an ankle joint undergoing three kinds of motion, namely dorsi-plantar flexion, inversion-eversion, and adduction-abduction. The measured values of the passive stiffness of the ankle joint in dorsiflexion that we obtained agreed well with that obtained in a previous study, indicating that the developed device is useful for measuring the passive stiffness of ankle joint. In addition, the developed device can be used to measure the stiffness in inversion-eversion and adduction-abduction motions as well, parameters that have never been measured. The results we obtained demonstrated certain interesting features as we varied both the direction and pace of motion (e.g., there were significant differences in the stiffness not only between adduction and abduction during the faster pace, but also between these and the other motions).

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Ankle work and dynamic joint stiffness in high- compared to low-arched athletes during a barefoot running task.

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    Powell, Douglas W; Williams, D S Blaise; Windsor, Brett; Butler, Robert J; Zhang, Songning

    2014-04-01

    High- (HA) and low-arched (LA) athletes have an exaggerated risk of injury. Ankle joint stiffness is a potential underlying mechanism for the greater rate of injury within these two functionally different groups. An alternative candidate mechanism of injury in HA and LA athletes pertains to the efficacy of the foot as a rigid lever during propulsion. The purpose of this study was to quantify the differences in ankle dynamic joint stiffness, and ankle braking work and ankle propulsive work during stance phase of running. Ten HA and ten LA athletes performed five barefoot running trials while ground reaction forces and three-dimensional kinematics were recorded. Ankle dynamic joint stiffness was calculated as the slope of the ankle joint moment-ankle joint angle plot during load attenuation. Ankle braking and propulsive work values were calculated for the stance phase. HA athletes had significantly greater ankle dynamic joint stiffness and significantly smaller ankle net and propulsive work than LA athletes. These data demonstrate that HA and LA athletes exhibit unique biomechanical patterns during running. These patterns may be related to lower extremity injury. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

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

  11. Effect of passive stretching and jogging on the series elastic muscle stiffness and range of motion of the ankle joint

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    McNair, Peter J; Stanley, Stephen N

    1996-01-01

    Objective To determine the effect of stretching and jogging on the series elastic muscle stiffness of the plantar flexors and on the range of dorsiflexion at the ankle joint. Methods 24 healthy subjects participated in this study. Each subject undertook all of the following protocols, in random order: (1) stretching protocol: five 30 s static stretches with 30 s rest between stretches; (2) aerobic jogging protocol: subjects ran on a treadmill for 10 min at 60% of their maximum age predicted heart rate; (3) combined protocol: subjects ran first and then stretched. A damped oscillation technique was used to measure the series elastic stiffness of the plantar flexors. Dorsiflexion of the ankle was assessed with a weights and pulley system that moved the ankle joint from a neutral position into dorsiflexion passively. Electromyography was used to monitor the activity of the plantar and dorsiflexors during these procedures. The statistical analysis of these data involved an analysis of covariance Results For decreasing series elastic muscle stiffness running was more effective than stretching (Pjogging and static stretching exercises appear to be beneficial to individuals participating in sporting activities. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6 PMID:9015593

  12. Assessment of a portable device for the quantitative measurement of ankle joint stiffness in spastic individuals

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Grey, Michael J; Geertsen, Svend Sparre

    2012-01-01

    was measured with the portable device and a stationary torque motor. Inter- and intra-rater reliability was assessed with the intra-class correlation coefficient (ICC). RESULTS: Stiffness measures with the portable and stationary devices were significantly correlated for controls and MS participants (p...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    of gait were obtained before and after the intervention/control period. Intervention subjects trained 31.4 SD 10.1 days for 29.0 SD 2.3 min (total) 15.2 h. RESULTS: Passive ankle joint stiffness was reduced (F = 5.1; p = 0.031), maximal gait speed increased (F = 42.8, p 

  14. Measurement of passive ankle stiffness in subjects with chronic hemiparesis using a novel ankle robot

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    Roy, Anindo; Bever, Christopher T.; Forrester, Larry W.; Macko, Richard F.; Hogan, Neville

    2011-01-01

    Our objective in this study was to assess passive mechanical stiffness in the ankle of chronic hemiparetic stroke survivors and to compare it with those of healthy young and older (age-matched) individuals. Given the importance of the ankle during locomotion, an accurate estimate of passive ankle stiffness would be valuable for locomotor rehabilitation, potentially providing a measure of recovery and a quantitative basis to design treatment protocols. Using a novel ankle robot, we characterized passive ankle stiffness both in sagittal and in frontal planes by applying perturbations to the ankle joint over the entire range of motion with subjects in a relaxed state. We found that passive stiffness of the affected ankle joint was significantly higher in chronic stroke survivors than in healthy adults of a similar cohort, both in the sagittal as well as frontal plane of movement, in three out of four directions tested with indistinguishable stiffness values in plantarflexion direction. Our findings are comparable to the literature, thus indicating its plausibility, and, to our knowledge, report for the first time passive stiffness in the frontal plane for persons with chronic stroke and older healthy adults. PMID:21346215

  15. Medial gastrocnemius muscle stiffness cannot explain the increased ankle joint range of motion following passive stretching in children with cerebral palsy.

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    Kalkman, Barbara M; Bar-On, Lynn; Cenni, Francesco; Maganaris, Constantinos N; Bass, Alfie; Holmes, Gill; Desloovere, Kaat; Barton, Gabor J; O'Brien, Thomas D

    2018-03-01

    What is the central question of this study? Can the increased range of motion seen acutely after stretching in children with cerebral palsy be explained by changes in the stiffness of the medial gastrocnemius fascicles? What is the main finding and its importance? We show, for the first time, that passive muscle and tendon properties are not changed acutely after a single bout of stretching in children with cerebral palsy and, therefore, do not contribute to the increase in range of motion. This contradicts common belief and what happens in healthy adults. Stretching is often used to increase or maintain the joint range of motion (ROM) in children with cerebral palsy (CP), but the effectiveness of these interventions is limited. Therefore, our aim was to determine the acute changes in muscle-tendon lengthening properties that contribute to increased ROM after a bout of stretching in children with CP. Eleven children with spastic CP [age 12.1 (3 SD) years, 5/6 hemiplegia/diplegia, 7/4 gross motor function classification system level I/II] participated. Each child received three sets of five × 20 s passive, manual static dorsiflexion stretches separated by 30 s rest, with 60 s rest between sets. Before and immediately after stretching, ultrasound was used to measure medial gastrocnemius fascicle lengthening continuously over the full ROM and an individual common ROM pre- to post-stretching. Simultaneously, three-dimensional motion of two marker clusters on the shank and the foot was captured to calculate ankle angle, and ankle joint torque was calculated from manually applied torques and forces on a six degrees-of-freedom load cell. After stretching, the ROM was increased [by 9.9 (12.0) deg, P = 0.005]. Over a ROM common to both pre- and post-measurements, there were no changes in fascicle lengthening or torque. The maximal ankle joint torque tolerated by the participants increased [by 2.9 (2.4) N m, P = 0.003], and at this highest passive torque the

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

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    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.

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

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

    2015-06-01

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

  18. Gait Selection and Transition of Passivity-Based Bipeds with Adaptable Ankle Stiffness

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    Yan Huang

    2012-10-01

    Full Text Available Stable bipedal walking is one of the most important components of humanoid robot design, which can help us better understand natural human walking. In this paper, to study gait selection and gait transition of efficient bipedal walking, we proposed a dynamic bipedal walking model with an upper body, flat feet and compliant joints. The model can achieve stable cyclic motion with different walking gaits. The hip actuation and ankle stiffness behavior of the model are quite similar to those of human normal walking. In simulation, we studied the influence of hip actuation and ankle stiffness on walking performance of each gait. The effects of ankle stiffness on gait selection are also analyzed. Gait transition is realized by adjusting ankle stiffness during walking.

  19. Kinematic analysis of ankle stiffness in subjects with and without flat foot.

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    Sung, Paul S

    2016-03-01

    Although the magnitude of ankle motion is influenced by joint congruence and ligament elasticity, there is a lack of understanding on ankle stiffness between subjects with and without flat foot. This study investigated a quantified ankle stiffness difference between subjects with and without flat foot. There were forty-five age- and gender-matched subjects who participated in the study. Each subject was seated upright with the tested foot held firmly onto a footplate that was attached to a torque sensor by the joint-driving device. The flat foot group (mean ± standard deviation) demonstrated increased stiffness during ankle dorsiflexion (0.37 ± 0.16 for flat foot group, 0.28 ± 0.10 for control group; t=-2.11, p=0.04). However, there was no significant group difference during plantar flexion (0.35 ± 0.15 for flat foot group, 0.33 ± 0.07 for control group; t=0.64, p=0.06). The results of this study indicated that the flat foot group demonstrated increased ankle stiffness during dorsiflexion regardless of demographic factors. This study highlights the need for kinematic analyses and joint stiffness measures during ankle dorsiflexion in subjects with flat foot. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Osteoligamentous injuries of the medial ankle joint.

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

    2015-12-01

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

  1. Arthrography of the ankle joint

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

    1984-02-01

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

  2. Functional Instability of the Ankle Joint: Etiopathogenesis

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    Aydan ÖRSÇELİK

    2016-09-01

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

  3. Arthrography of the foot and ankle. Ankle and subtalar joint.

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    Trnka, H J; Ivanic, G; Trattnig, S

    2000-03-01

    Arthrography is the intra-articular injection of contrast media. This article reviews the normal and pathologic findings of standard arthrography and MR imaging arthrography of the ankle and subtalar joint. Standard arthrography is used primarily after acute ankle sprains, whereas MR imaging arthrography is used for staging and detecting osteochondritis dissecans of the talus, anterolateral soft tissue impingement, and chronic lateral ankle instability.

  4. Effects of proprioceptive neuromuscular facilitation stretching on stiffness and force-producing characteristics of the ankle in active women.

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    Rees, Sven S; Murphy, Aron J; Watsford, Mark L; McLachlan, Ken A; Coutts, Aaron J

    2007-05-01

    The purpose of this study was to examine the effect of proprioceptive neuromuscular facilitation (PNF) stretching on musculotendinous unit (MTU) stiffness of the ankle joint. Twenty active women were assessed for maximal ankle range of motion, maximal strength of planter flexors, rate of force development, and ankle MTU stiffness. Subjects were randomly allocated into an experimental (n = 10) group or control group (n = 10). The experimental group performed PNF stretching on the ankle joint 3 times per week for 4 weeks, with physiological testing performed before and after the training period. After training, the experimental group significantly increased ankle range of motion (7.8%), maximal isometric strength (26%), rate of force development (25%), and MTU stiffness (8.4%) (p < 0.001). Four weeks of PNF stretching contributed to an increase in MTU stiffness, which occurred concurrently with gains to ankle joint range of motion. The results confirm that MTU stiffness and joint range of motion measurements appear to be separate entities. The increased MTU stiffness after the training period is explained by adaptations to maximal isometric muscle contractions, which were a component of PNF stretching. Because a stiffer MTU system is linked with an improved the ability to store and release elastic energy, PNF stretching would benefit certain athletic performance due to a reduced contraction time or greater mechanical efficiency. The results of this study suggest PNF stretching is a useful modality at increasing a joint's range of motion and its strength.

  5. Hydrocolonotherapy ankle joints after injuries

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    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.

  6. Arthrography of the ankle joint

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

    1984-01-01

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

  7. Osteoligamentous injuries of the medial ankle joint

    OpenAIRE

    L?tscher, P.; Lang, T. H.; Zwicky, L.; Hintermann, B.; Knupp, M.

    2015-01-01

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

  8. Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training.

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    Gruber, M; Bruhn, S; Gollhofer, A

    2006-08-01

    The aim of this study was to examine how fixations of the ankle joint during sensorimotor training (SMT) influence adaptations in mechanical stiffness and neuromuscular control of the knee joint. Sixty-three healthy subjects were randomly assigned to three training groups that differed in their degree of ankle joint fixation, which was either barefooted, with an ankle brace or with a ski boot. Mechanical knee joint stiffness and reflex control of m. vastus medialis, m. vastus lateralis, m. biceps femoris, and m. semitendinosus were tested during force controlled anterior tibial displacements. This force was applied as both a fast and a slow stimulus. After the training period the group that trained barefooted showed an increase in mechanical stiffness of the knee joint from 79 +/- 21 (Mean +/- SD) N/mm to 110 +/- 38 N/mm (p boots was able to improve knee joint stiffness from 67 +/- 26 N/mm to 96 +/- 47 N/mm (p knee joint injuries.

  9. Sex Differences in Limb and Joint Stiffness in Recreational Runners

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    Sinclair Jonathan

    2015-09-01

    Full Text Available Purpose. Female runners are known to be at greater risk from chronic running injuries than age-matched males, although the exact mechanisms are often poorly understood. The aim of the current investigation was to determine if female recreational runners exhibit distinct limb and joint stiffness characteristics in relation to their male counterparts. Methods. Fourteen male and fourteen female runners ran over a force platform at 4.0 m · s-1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system operating at 250 Hz. Measures of limb and joint stiffness were calculated as a function of limb length and joint moments divided by the extent of limb and joint excursion. All stiffness and joint moment parameters were normalized to body mass. Sex differences in normalized limb and knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that normalized limb (male = 0.18 ± 0.07, female = 0.37 ± 0.10 kN · kg · m-1 and knee stiffness (male = 5.59 ± 2.02, female = 7.34 ± 1.78 Nm · kg · rad-1 were significantly greater in female runners. Conclusions. On the basis that normalized knee and limb stiffness were shown to be significantly greater in female runners, the findings from the current investigation may provide further insight into the aetiology of the distinct injury patterns observed between sexes.

  10. Ultrasonography of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-10-15

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

  11. Ultrasonography of the ankle joint

    International Nuclear Information System (INIS)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

  13. Arch structure is associated with unique joint work, relative joint contributions and stiffness during landing.

    Science.gov (United States)

    Powell, Douglas W; Queen, Robin M; Williams, D S Blaise

    2016-10-01

    To examine lower extremity joint contributions to a landing task in high-(HA) and low-arched (LA) female athletes by quantifying vertical stiffness, joint work and relative joint contributions to landing. Twenty healthy female recreational athletes (10 HA and 10 LA) performed five barefoot drop landings from a height of 30cm. Three-dimensional kinematics (240Hz) and ground reaction forces (960Hz) were recorded simultaneously. Vertical stiffness, joint work values and relative joint work values were calculated using Visual 3D and MatLab. HA athletes had significantly greater vertical stiffness compared to LA athletes (p=0.013). Though no differences in ankle joint work were observed (p=0.252), HA athletes had smaller magnitudes of knee (p=0.046), hip (p=0.019) and total lower extremity joint work values (p=0.016) compared to LA athletes. HA athletes had greater relative contributions of the ankle (p=0.032) and smaller relative contributions of the hip (p=0.049) compared to LA athletes. No differences in relative contributions of the knee were observed (p=0.255). These findings demonstrate that aberrant foot structure is associated with unique contributions of lower extremity joints to load attenuation during landing. These data may provide insight into the unique injury mechanisms associated with arch height in female athletes. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Effect of boot shaft stiffness on stability joint energy and muscular co-contraction during walking on uneven surface.

    Science.gov (United States)

    Böhm, Harald; Hösl, Matthias

    2010-09-17

    Increased boot shaft stiffness may have a noticeable impact on the range of motion of the ankle joint. Therefore, the ability of the ankle joint to generate power for propulsion might be impaired. This might result in compensatory changes at the knee and hip joint. Besides, adaptability of the subtalar joint to uneven surface might be reduced, which could in turn affect stability. The aim of the study was therefore to investigate the influence of boot shaft stiffness on biomechanical gait parameters. Fifteen healthy young adults walked over coarse gravel wearing two different hiking boots that differed by 50% in passive shaft stiffness. Leg kinematics, kinetics and electromyography were measured. Gait velocity and indicators for stability were not different when walking with the hard and soft boot shaft over the gravel surface. However, the hard boot shaft decreased the ankle range of motion as well as the eccentric energy absorbed at the ankle joint. As a consequence, compensatory changes at the knee joint were observed. Co-contraction was increased, and greater eccentric energy was absorbed. Therefore, the efficiency of gait with hard boots might be decreased and joint loading at the knee might be increased, which might cause early fatigue of knee muscles during walking or hiking. The results of this study suggest that stiffness and blocking of joint motion at the ankle should not be equated with safety. A trade-off between lateral stiffness and free natural motion of the ankle joint complex might be preferable.

  15. A study of function and residual joint stiffness after functional bracing of tibial shaft fractures.

    Science.gov (United States)

    Pun, W K; Chow, S P; Fang, D; Ip, F K; Leong, J C; Ng, C

    1991-06-01

    Ninety-eight diaphyseal tibial fractures were treated with custom made functional braces in 97 patients older than 14 years of age. The average follow-up period was 1.86 years, and 53 patients had more than two years' evaluation (average, 2.83 years). The majority of the patients did not have full range of movement in the ankle and subtalar joints when the brace was removed after fracture healing. Although the stiffness decreased with time, a significant number of patients were left with residual joint stiffness. At an average follow-up period of 1.86 years, 68.4% of the patients had normal ankle motion and 60% had normal inversion and eversion of the hindfoot. In patients with more than two years' evaluation, 75.5% had normal ankle movement and 71.1% had normal inversion and eversion of the foot. In the knee joint, the incidence of residual joint stiffness was small and the amount of stiffness was clinically insignificant. Patients with an abnormal walking pattern after fracture healing had a high incidence of ankle and subtalar joint stiffness.

  16. MR arthrography of the ankle joint

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  17. Predictive simulation of diabetic gait: Individual contribution of ankle stiffness and muscle weakening.

    Science.gov (United States)

    Santos, Gilmar F; Gomes, Aline A; Sacco, Isabel C N; Ackermann, Marko

    2017-10-01

    Diabetic neuropathic individuals present massive muscle strength reduction at the ankle plantar- and dorsiflexors and increased joint stiffness. Our aim is to investigate the adaptation strategies to these musculoskeletal alterations during walking by means of predictive simulations. We used a seven segment planar musculoskeletal model actuated by eight Hill-type muscles in each leg. The effect of all passive tissue in muscles and other joint structures was modeled by net passive joint moment curves. The predictive simulations were generated by solving an optimal control problem that minimized a cost function, including effort and tracking terms, using direct collocation and a commercial optimal control package. We simulate four conditions to represent the weakening of the distal muscles triceps sural (TS) and tibialis anterior (TA), and five conditions to represent the effect of increasing nonlinear ankle stiffness in flexion. The weakening of the distal muscles leads to a delayed action of the TS and a progressive decrease of the gastrocnemius peak force in the push-off phase. This distal deficit is compensated by a larger hip flexion moment resulting from an increase in the iliopsoas muscle force in this phase, known as the hip strategy. The adaptation mechanisms observed in response to an increase in ankle stiffness include the hip strategy and the exploitation of the passive joint structures as springs, which store energy during midstance and release it during push-off, reducing TS force and power in this phase and leading to a consistent decrease in the overall muscle force levels. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2017-09-01

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

  19. Distinguishing active from passive components of ankle plantar flexor stiffness in stroke, spinal cord injury and multiple sclerosis

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Grey, Michael James; Crone, Clarissa

    2010-01-01

    to distinguish the contribution of active reflex mechanisms from passive muscle properties to ankle joint stiffness in 31 healthy, 10 stroke, 30 multiple sclerosis and 16 spinal cord injured participants. The results were compared to routine clinical evaluation of spasticity. METHODS: A computer......-controlled robotic device applied stretches to the ankle plantar flexor muscles at different velocities (8-200deg/s; amplitude 6 degrees ). The reflex threshold was determined by soleus EMG. Torque and EMG data were normalized to the maximal torque and EMG evoked by supramaximal stimulation of the tibial nerve...

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Science.gov (United States)

    Gao, Fan; Carlton, William; Kapp, Susan

    2011-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Amirhesam Amerinatanzi

    2017-12-01

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

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

    Science.gov (United States)

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

    2017-12-07

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

  4. Leg and Joint Stiffness in Children with Spastic Diplegic Cerebral Palsy during Level Walking.

    Science.gov (United States)

    Wang, Ting-Ming; Huang, Hsing-Po; Li, Jia-Da; Hong, Shih-Wun; Lo, Wei-Ching; Lu, Tung-Wu

    2015-01-01

    Individual joint deviations are often identified in the analysis of cerebral palsy (CP) gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in children with diplegic CP in terms of their leg stiffness, both skeletal and muscular components, and associated joint stiffness during gait. Twelve children with spastic diplegia CP and 12 healthy controls walked at a self-selected pace in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, mid-stance, terminal stance and pre-swing. For calculating the leg stiffness, each of the lower limbs was modeled as a non-linear spring, connecting the hip joint center and the corresponding center of pressure, with varying stiffness that was calculated as the slope (gradient) of the axial force vs. the deformation curve. The leg stiffness was further decomposed into skeletal and muscular components considering the alignment of the lower limb. The ankle, knee and hip of the limb were modeled as revolute joints with torsional springs whose stiffness was calculated as the slope of the moment vs. the angle curve of the joint. Independent t-tests were performed for between-group comparisons of all the variables. The CP group significantly decreased the leg stiffness but increased the joint stiffness during stance phase, except during terminal stance where the leg stiffness was increased. They appeared to rely more on muscular contributions to achieve the required leg stiffness, increasing the muscular demands in maintaining the body posture against collapse. Leg stiffness plays a critical role in modulating the kinematics and kinetics of the locomotor system during gait in the diplegic CP.

  5. Leg and Joint Stiffness in Children with Spastic Diplegic Cerebral Palsy during Level Walking.

    Directory of Open Access Journals (Sweden)

    Ting-Ming Wang

    Full Text Available Individual joint deviations are often identified in the analysis of cerebral palsy (CP gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in children with diplegic CP in terms of their leg stiffness, both skeletal and muscular components, and associated joint stiffness during gait. Twelve children with spastic diplegia CP and 12 healthy controls walked at a self-selected pace in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, mid-stance, terminal stance and pre-swing. For calculating the leg stiffness, each of the lower limbs was modeled as a non-linear spring, connecting the hip joint center and the corresponding center of pressure, with varying stiffness that was calculated as the slope (gradient of the axial force vs. the deformation curve. The leg stiffness was further decomposed into skeletal and muscular components considering the alignment of the lower limb. The ankle, knee and hip of the limb were modeled as revolute joints with torsional springs whose stiffness was calculated as the slope of the moment vs. the angle curve of the joint. Independent t-tests were performed for between-group comparisons of all the variables. The CP group significantly decreased the leg stiffness but increased the joint stiffness during stance phase, except during terminal stance where the leg stiffness was increased. They appeared to rely more on muscular contributions to achieve the required leg stiffness, increasing the muscular demands in maintaining the body posture against collapse. Leg stiffness plays a critical role in modulating the kinematics and kinetics of the locomotor system during gait in the diplegic CP.

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

    Lee, Raymond P; Cheng, Sally H S

    2017-06-01

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

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

    Science.gov (United States)

    Zhao, Yong; Wang, Gang

    2015-04-01

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

  9. Research on static angular stiffness measurement of flexible joint

    Directory of Open Access Journals (Sweden)

    Yongchao HUANG

    2016-10-01

    Full Text Available Measurement accuracy of the angular stiffness of flexible joint is directly related to the control accuracy and sensitivity of gyro, but the traditional measurement methods have many problems. According to the principle of angular stiffness measurement of flexible joint, two static measurement methods of angular stiffness are proposed based on different loading ways, namely mechanical loading angular stiffness measurement and piezoelectric loading angular stiffness measurement. The mechanical loading angular stiffness measurement system is built by using a motor driven indexing feeding tilting table, the measure experiment if the angular stiffness of flexible joint is conducted, and the angular stiffness of flexible joint is measured. For the excessive fluctuation problem of the measure result in mechanical load test, a piezoelectric loading structure is designed and a measurement method employing piezoelectric actuator is proposed for angular stiffness measurement of flexible joint. Based on ANSYS Workbench, the displacement output of the piezoelectric loading structure is analyzed by simulations. The simulation results illustrate that the displacement output meets the requirement of static loading angular stiffness measurement of flexible joint, and the theoretical feasibility of piezoelectric loading angular stiffness measurement method is validated.

  10. Effect of Reduced Stiffness Dance Flooring on Lower Extremity Joint Angular Trajectories During a Ballet Jump.

    Science.gov (United States)

    Hackney, James; Brummel, Sara; Newman, Mary; Scott, Shannon; Reinagel, Matthew; Smith, Jennifer

    2015-09-01

    We carried out a study to investigate how low stiffness flooring may help prevent overuse injuries of the lower extremity in dancers. It was hypothesized that performing a ballet jump (sauté) on a reduced stiffness dance floor would decrease maximum joint flexion angles and negative angular velocities at the hips, knees, or ankles compared to performing the same jump on a harder floor. The participants were 15 young adult female dancers (age range 18 to 28, mean = 20.89 ± 2.93 years) with at least 5 years of continuous ballet experience and without history of serious lower body injury, surgery, or recent pain. They performed sautés on a (low stiffness) Harlequin ® WoodSpring Floor and on a vinyl-covered hardwood on concrete floor. Maximum joint flexion angles and negative velocities at bilateral hips, knees, and ankles were measured with the "Ariel Performance Analysis System" (APAS). Paired one-tailed t-tests yielded significant decreases in maximum knee angle (average decrease = 3.4° ± 4.2°, p = 0.026) and angular negative velocity of the ankles (average decrease = 18.7°/sec ± 27.9°/sec, p = 0.009) with low stiffness flooring. If the knee angle is less acute, then the length of the external knee flexion moment arm will also be shorter and result in a smaller external knee flexion moment, given an equal landing force. Also, high velocities of eccentric muscle contraction, which are necessary to control negative angular velocity of the ankle joint, are associated with higher risk of musculotendinous injury. Hence, our findings indicate that reduced floor stiffness may indeed help decrease the likelihood of lower extremity injuries.

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

    International Nuclear Information System (INIS)

    Wu Jun; Zhang Qiang

    2003-01-01

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

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

    Science.gov (United States)

    Kipp, Kristof; Palmieri-Smith, Riann M

    2013-06-01

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

  13. A variable stiffness joint with electrospun P(VDF-TrFE-CTFE) variable stiffness springs

    NARCIS (Netherlands)

    Carloni, Raffaella; Lapp, Valerie I.; Cremonese, Andrea; Belcari, Juri; Zucchelli, Andrea

    This letter presents a novel rotational variable stiffness joint that relies on one motor and a set of variable stiffness springs. The variable stiffness springs are leaf springs with a layered design, i.e., an electro-active layer of electrospun aligned nanofibers of poly(vinylidene

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

    Science.gov (United States)

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

    2017-09-20

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

  15. Triceps surae short latency stretch reflexes contribute to ankle stiffness regulation during human running.

    Directory of Open Access Journals (Sweden)

    Neil J Cronin

    Full Text Available During human running, short latency stretch reflexes (SLRs are elicited in the triceps surae muscles, but the function of these responses is still a matter of controversy. As the SLR is primarily mediated by Ia afferent nerve fibres, various methods have been used to examine SLR function by selectively blocking the Ia pathway in seated, standing and walking paradigms, but stretch reflex function has not been examined in detail during running. The purpose of this study was to examine triceps surae SLR function at different running speeds using Achilles tendon vibration to modify SLR size. Ten healthy participants ran on an instrumented treadmill at speeds between 7 and 15 km/h under 2 Achilles tendon vibration conditions: no vibration and 90 Hz vibration. Surface EMG from the triceps surae and tibialis anterior muscles, and 3D lower limb kinematics and ground reaction forces were simultaneously collected. In response to vibration, the SLR was depressed in the triceps surae muscles at all speeds. This coincided with short-lasting yielding at the ankle joint at speeds between 7 and 12 km/h, suggesting that the SLR contributes to muscle stiffness regulation by minimising ankle yielding during the early contact phase of running. Furthermore, at the fastest speed of 15 km/h, the SLR was still depressed by vibration in all muscles but yielding was no longer evident. This finding suggests that the SLR has greater functional importance at slow to intermediate running speeds than at faster speeds.

  16. The Effect of Fatigue on the Stiffness Changes in Legs, Ankle and Knee Joints in Lower Limb During a Thirty-Second Continuous Vertical Jump Test in Female Volleyball Players

    Directory of Open Access Journals (Sweden)

    zahra Hatami Joushghan

    2015-12-01

    Conclusion: As the height of the jump and stiffness changes in lower body parts is an important factor in fields such as volleyball, coaches need to pay due attention to stiffness changes and improve their training techniques.

  17. Effect of static foot posture on the dynamic stiffness of foot joints during walking.

    Science.gov (United States)

    Sanchis-Sales, E; Sancho-Bru, J L; Roda-Sales, A; Pascual-Huerta, J

    2018-03-17

    The static foot posture has been related to the development of lower limb injuries. This study aimed to investigate the dynamic stiffness of foot joints during gait in the sagittal plane to understand the role of the static foot posture in the development of injuries. Seventy healthy adult male subjects with different static postures, assessed by the Foot Posture Index (FPI) (30 normal, 20 highly pronated and 20 highly supinated), were recruited. Kinematic and kinetic data were recorded using an optical motion capture system and a pressure platform, and dynamic stiffness at the different stages of the stance was calculated from the slopes of the linear regression on the flexion moment-angle curves. The effect of foot type on dynamic stiffness and on ranges of motion and moments was analysed using ANOVAs and post-hoc tests, and linear correlation between dynamic stiffness and FPI was also tested. Highly pronated feet showed a significantly smaller range of motion at the ankle and metatarsophalangeal joints and also a larger range of moments at the metatarsophalangeal joint than highly supinated feet. Dynamic stiffness during propulsion was significantly greater at all foot joints for highly pronated feet, with positive significant correlations with the squared FPI. Highly supinated feet showed greater dynamic stiffness than normal feet, although to a lesser extent. Highly pronated feet during normal gait experienced the greatest decrease in the dorsiflexor moments during propulsion, normal feet being the most balanced regarding work generated and absorbed. Extreme static foot postures show greater dynamic stiffness during propulsion and greater absorbed work, which increases the risk of developing injuries. The data presented may be used when designing orthotics or prostheses, and also when planning surgery that modifies joint stiffness. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  20. Terrain stiffness and ankle biomechanics during simulated half-squat parachute landing.

    Science.gov (United States)

    Niu, Wenxin; Fan, Yubo

    2013-12-01

    A hard surface is potentially one of the risk factors for ankle injuries during parachute landing, but this has never been experimentally validated. This study was designed to evaluate the effects of terrain stiffness on ankle biomechanics during half-squat parachute landing (HSPL). Eight male and eight female healthy participants landed on three surfaces with standard HSPL technique. The three surfaces were cushioned mats with different thicknesses (0 mm, 4 mm, and 8 mm). The effects of terrain hardness and gender and their interaction with ground reaction forces, ankle kinematics, and electromyograms of selected lower-extremity muscles were statistically analyzed with multivariate analysis of variance. The effects of terrain stiffness and the interaction between factors on all variables were not statistically significant. The effects of gender were not statistically significant on most variables. The peak angular velocity of the ankle dorsiflexion was significantly lower in men (mean 1345 degree x s(-1)) than in women (mean 1965 degree x s(-1)). A spongy surface even eliminated the differences between men compared to women in the activity of their tibialis anterior during simulated HSPL. Terrain stiffness, in the ranges tested, did not appear to influence ankle biomechanics among individuals performing HSPL. Additional studies are required to know whether this finding is applicable to realistic parachuting.

  1. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

  2. Chimpanzee ankle and foot joint kinematics: Arboreal versus terrestrial locomotion.

    Science.gov (United States)

    Holowka, Nicholas B; O'Neill, Matthew C; Thompson, Nathan E; Demes, Brigitte

    2017-09-01

    Many aspects of chimpanzee ankle and midfoot joint morphology are believed to reflect adaptations for arboreal locomotion. However, terrestrial travel also constitutes a significant component of chimpanzee locomotion, complicating functional interpretations of chimpanzee and fossil hominin foot morphology. Here we tested hypotheses of foot motion and, in keeping with general assumptions, we predicted that chimpanzees would use greater ankle and midfoot joint ranges of motion during travel on arboreal supports than on the ground. We used a high-speed motion capture system to measure three-dimensional kinematics of the ankle and midfoot joints in two male chimpanzees during three locomotor modes: terrestrial quadrupedalism on a flat runway, arboreal quadrupedalism on a horizontally oriented tree trunk, and climbing on a vertically oriented tree trunk. Chimpanzees used relatively high ankle joint dorsiflexion angles during all three locomotor modes, although dorsiflexion was greatest in arboreal modes. They used higher subtalar joint coronal plane ranges of motion during terrestrial and arboreal quadrupedalism than during climbing, due in part to their use of high eversion angles in the former. Finally, they used high midfoot inversion angles during arboreal locomotor modes, but used similar midfoot sagittal plane kinematics across all locomotor modes. The results indicate that chimpanzees use large ranges of motion at their various ankle and midfoot joints during both terrestrial and arboreal locomotion. Therefore, we argue that chimpanzee foot anatomy enables a versatile locomotor repertoire, and urge caution when using foot joint morphology to reconstruct arboreal behavior in fossil hominins. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

    Lewis, John S; DeOrio, James K

    2015-04-01

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

  5. Static Stiffness Modeling of Parallel Kinematics Machine Tool Joints

    OpenAIRE

    O. K. Akmaev; B. A. Enikeev; A. I. Nigmatullin

    2015-01-01

    The possible variants of an original parallel kinematics machine-tool structure are explored in this article. A new Hooke's universal joint design based on needle roller bearings with the ability of a preload setting is proposed. The bearing stiffness modeling is carried out using a variety of methods. The elastic deformation modeling of a Hook’s joint and a spherical rolling joint have been developed to assess the possibility of using these joints in machine tools with parallel k...

  6. Radiology of chronic diseases of the ankle joint

    International Nuclear Information System (INIS)

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

    1999-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Acute injury of the ankle joint

    International Nuclear Information System (INIS)

    Breitenseher, M.J.

    1999-01-01

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

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

    Science.gov (United States)

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

    2012-06-01

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

  11. Injury of the ankle joint ligaments

    International Nuclear Information System (INIS)

    Breitenseher, M.J.

    2007-01-01

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

  12. Ankle pain

    Science.gov (United States)

    Pain - ankle ... Ankle pain is often due to an ankle sprain. An ankle sprain is an injury to the ligaments, which ... the joint. In addition to ankle sprains, ankle pain can be caused by: Damage or swelling of ...

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

    Science.gov (United States)

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

    2014-01-01

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

  14. Arthrography of the ankle joint in chronic instability

    Energy Technology Data Exchange (ETDEWEB)

    Dory, M.A.

    1986-05-01

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

  15. Arthrography of the ankle joint in chronic instability

    International Nuclear Information System (INIS)

    Dory, M.A.

    1986-01-01

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

  16. 21 CFR 888.3120 - Ankle joint metal/polymer non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

    Ju, Sung-Bum; Park, Gi Duck

    2017-02-01

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

  18. Static Stiffness Modeling of Parallel Kinematics Machine Tool Joints

    Directory of Open Access Journals (Sweden)

    O. K. Akmaev

    2015-09-01

    Full Text Available The possible variants of an original parallel kinematics machine-tool structure are explored in this article. A new Hooke's universal joint design based on needle roller bearings with the ability of a preload setting is proposed. The bearing stiffness modeling is carried out using a variety of methods. The elastic deformation modeling of a Hook’s joint and a spherical rolling joint have been developed to assess the possibility of using these joints in machine tools with parallel kinematics.

  19. Primary stability and stiffness in ankle arthrodes-crossed screws versus anterior plating.

    Science.gov (United States)

    Betz, Michael M; Benninger, Emanuel E; Favre, Philipp P; Wieser, Karl K; Vich, Magdalena M; Espinosa, Norman

    2013-09-01

    Ankle arthrodesis is commonly used for the treatment of osteoarthritis or failed arthroplasty. Screw fixation is the predominant technique to perform ankle arthrodesis. Due to a considerable frequency of failures research suggests the use of an anatomically shaped anterior double plate system as a reliable method for isolated tibiotalar arthrodesis. The purpose of the present biomechanical study was to compare two groups of ankle fusion constructs - three screw fixation and an anterior double plate system - in terms of primary stability and stiffness. Six matched-pairs human cadaveric lower legs (Thiel fixated) were used in this study. One specimen from each pair was randomly assigned to be stabilized with the anterior double plate system and the other with the three-screw technique. The different arthrodesis methods were tested by dorsiflexing the foot until failure of the system, defined as rotation of the talus relative to the tibia in the sagittal plane. Experiments were performed on a universal materials testing machine. The force required to make arthrodesis fail was documented. For calculation of the stiffness, a linear regression was fitted to the force-displacement curve in the linear portion of the curve and its slope taken as the stiffness. For the anatomically shaped double-plate system a mean load of 967N was needed (range from 570N to 1400N) to make arthrodesis fail. The three-screw fixation method resisted a mean load of 190N (range from 100N to 280N) (p=0.005). In terms of stiffness a mean of 56N/mm (range from 35N/mm to 79N/mm) was achieved for the anatomically shaped double-plate system whereas a mean of 10N/mm (range from 6N/mm to 18N/mm) was achieved for the three-screw fixation method (p=0.004). Our biomechanical data demonstrates that the anterior double-plate system is significantly superior to the three-screw fixation technique for ankle arthrodesis in terms of primary stability and stiffness. Copyright © 2013 European Foot and Ankle

  20. Lubrication of the Human Ankle Joint in Walking

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2010-01-01

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

  1. Lubrication of the human ankle joint in running

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2009-01-01

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

  2. Impact attenuation properties of jazz shoes alter lower limb joint stiffness during jump landings.

    Science.gov (United States)

    Fong Yan, Alycia; Smith, Richard M; Hiller, Claire E; Sinclair, Peter J

    2017-05-01

    To quantify the impact attenuation properties of the jazz shoes, and to investigate the in-vivo effect of four jazz shoe designs on lower limb joint stiffness during a dance-specific jump. Repeated measures. A custom-built mechanical shoe tester similar to that used by athletic shoe companies was used to vertically impact the forefoot and heel region of four different jazz shoe designs. Additionally, dancers performed eight sautés in second position in bare feet and the shoe conditions. Force platforms and 3D-motion capture were used to analyse the joint stiffness of the midfoot, ankle, knee and hip during the jump landings. Mechanical testing of the jazz shoes revealed significant differences in impact attenuation characteristics among each of the jazz shoe designs. Gross knee and midfoot joint stiffness were significantly affected by the jazz shoe designs in the dancers' jump landings. The tested jazz shoe designs altered the impact attenuating capacity of jump landing technique in dancers. The cushioned jazz shoes are recommended particularly for injured dancers to reduce impact on the lower limb. Jazz shoe design should consider the impact attenuation properties of the forefoot region, due to the toe-strike landing technique in dance movement. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Computed tomography in complex fractures of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-09-01

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

  4. Modelling, simulation and experiment of the spherical flexible joint stiffness

    Directory of Open Access Journals (Sweden)

    S. Li

    2018-02-01

    Full Text Available The spherical flexible joint is extensively used in engineering. It is designed to provide flexibility in rotation while bearing vertical compression load. The linear rotational stiffness of the flexible joint is formulated. The rotational stiffness of the bonded rubber layer is related to inner radius, thickness and two edge angles. FEM is used to verify the analytical solution and analyze the stiffness. The Mooney–Rivlin, Neo Hooke and Yeoh constitutive models are used in the simulation. The experiment is taken to obtain the material coefficient and validate the analytical and FEM results. The Yeoh model can reflect the deformation trend more accurately, but the error in the nearly linear district is bigger than the Mooney–Rivlin model. The Mooney–Rivlin model can fit the test result very well and the analytical solution can also be used when the rubber deformation in the flexible joint is small. The increase of Poisson's ratio of the rubber layers will enhance the vertical compression stiffness but barely have effect on the rotational stiffness.

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

    Science.gov (United States)

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

    2016-04-01

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

  6. Effect of kinesio-taping on ankle joint stability

    Directory of Open Access Journals (Sweden)

    Mervat A. Mohamed

    2016-05-01

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

  7. Arthroscopic Anatomy of the Ankle Joint.

    Science.gov (United States)

    Ray, Ronald G

    2016-10-01

    There are a number of variations in the intra-articular anatomy of the ankle which should not be considered pathological under all circumstances. The anteromedial corner of the tibial plafond (between the anterior edge of the tibial plafond and the medial malleolus) can have a notch, void of cartilage and bone. This area can appear degenerative arthroscopically; it is actually a normal variant of the articular surface. The anterior inferior tibiofibular ligament (AITF) can possess a lower, accessory band which can impinge on the anterolateral edge of the talar dome. In some cases it can cause irritation along this area of the talus laterally. If it is creating local irritation it can be removed since it does not provide any additional stabilization to the syndesmosis. There is a beveled region at the anterior leading edge of the lateral and dorsal surfaces of the talus laterally. This triangular region is void of cartilage and subchondral bone. The lack of talar structure in this region allows the lower portion of the AITF ligament to move over the talus during end range dorsiflexion of the ankle, preventing impingement. The variation in talar anatomy for this area should not be considered pathological. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Static ankle joint equinus: toward a standard definition and diagnosis.

    Science.gov (United States)

    Charles, James; Scutter, Sheila D; Buckley, Jonathan

    2010-01-01

    Equinus is characterized by reduced dorsiflexion of the ankle joint, but there is a lack of consensus regarding criteria for definition and diagnosis. This review examines the literature relating to the definition, assessment, diagnosis, prevalence, and complications of equinus. Articles on equinus and assessment of ankle joint range of motion were identified by searching the EMBASE, Medline, PubMed, EBSCOhost, Cinahl, and Cochrane databases and by examining the reference lists of the articles found. There is inconsistency regarding the magnitude of reduction in dorsiflexion required to constitute a diagnosis of equinus and no standard method for assessment; hence, the prevalence of equinus is unknown. Goniometric assessment of ankle joint range of motion was shown to be unreliable, whereas purpose-built tools demonstrated good reliability. Reduced dorsiflexion is associated with alterations in gait, increased forefoot pressure, and ankle injury, the magnitude of reduction in range of motion required to predispose to foot or lower-limb abnormalities is not known. In the absence of definitive data, we propose a two-stage definition of equinus: the first stage would reflect dorsiflexion of less than 10 degrees with minor compensation and a minor increase in forefoot pressure, and the second stage would reflect dorsiflexion of less than 5 degrees with major compensation and a major increase in forefoot pressure. This proposed definition of equinus will assist with standardizing the diagnosis and will provide a basis for future studies of the prevalence, causes, and complications of this condition.

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

    International Nuclear Information System (INIS)

    Zhang Zhenyu; Wang Wei

    2011-01-01

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

  10. Passive stiffness of the ankle and plantar flexor muscle performance after Achilles tendon repair: a cross-sectional study.

    Science.gov (United States)

    Borges, Pollyana R T; Santos, Thiago R T; Procópio, Paula R S; Chelidonopoulos, Jessica H D; Zambelli, Roberto; Ocarino, Juliana M

    Deficits in ankle muscle strength and ankle stiffness may be present in those subjects who underwent surgical treatment for an Achilles tendon rupture. The presence of these long-term deficits may contribute to a lower performance during daily activities and may be linked to future injuries. To compare the ankle passive stiffness and the plantar flexor muscle performance in patients who underwent unilateral surgical treatment of Achilles tendon rupture with nonsurgical subjects. Twenty patients who underwent unilateral surgical treatment of Achilles tendon rupture [surgical (SU) group], and twenty nonsurgical subjects [non-surgical (NS) group] participated in this study. The ankle passive stiffness was evaluated using a clinical test. The concentric and eccentric plantar flexors performance (i.e. peak torque and work) was evaluated using an isokinetic dynamometer at 30°/s. The surgical ankle of the surgical group presented lower stiffness compared to the non-surgical ankle (mean difference=3.790; 95%CI=1.23-6.35) and to the non-dominant ankle of the non-surgical group (mean difference=-3.860; 95%CI=-7.38 to -0.33). The surgical group had greater absolute asymmetry of ankle stiffness (mean difference=-2.630; 95%CI=-4.61 to -0.65) and greater absolute asymmetry of concentric (mean difference=-8.3%; 95%CI=-13.79 to -2.81) and eccentric (mean difference=-6.9%; 95%CI=-12.1 to -1.7) plantar flexor work compared to non-surgical group. There was no other difference in stiffness and plantar flexor performance. Patients who underwent surgical repair of the Achilles tendon presented with long-term (1 year or more) deficits of ankle stiffness and asymmetries of ankle stiffness and plantar flexor work in the affected ankle compared to the uninjured side in the surgical group and both sides on the nonsurgical group. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

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

    Science.gov (United States)

    2014-01-01

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

  12. Possible precisioning of radiodiagnosis of upper ankle joint injuries

    International Nuclear Information System (INIS)

    Drasnar, V.

    1980-01-01

    The necessity is stressed of making pictures of traumas of the upper ankle joint in three projections. For this purpose a device was constructed for standard adjusting positions of the leg for two anteroposterior and one lateral projections according to the inclination of outer edge of the leg. The reliability of even the first examinations and checks of repositions of dislocations was greatly enhanced. (author)

  13. Effect of Shoes on Stiffness and Energy Efficiency of Ankle-Foot Orthosis: Bench Testing Analysis.

    Science.gov (United States)

    Kobayashi, Toshiki; Gao, Fan; LeCursi, Nicholas; Foreman, K Bo; Orendurff, Michael S

    2017-12-01

    Understanding the mechanical properties of ankle-foot orthoses (AFOs) is important to maximize their benefit for those with movement disorders during gait. Though mechanical properties such as stiffness and/or energy efficiency of AFOs have been extensively studied, it remains unknown how and to what extent shoes influence their properties. The aim of this study was to investigate the effect of shoes on stiffness and energy efficiency of an AFO using a custom mechanical testing device. Stiffness and energy efficiency of the AFO were measured in the plantar flexion and dorsiflexion range, respectively, under AFO-alone and AFO-Shoe combination conditions. The results of this study demonstrated that the stiffness of the AFO-Shoe combination was significantly decreased compared to the AFO-alone condition, but no significant differences were found in energy efficiency. From the results, we recommend that shoes used with AFOs should be carefully selected not only based on their effect on alignment of the lower limb, but also their effects on overall mechanical properties of the AFO-Shoe combination. Further study is needed to clarify the effects of differences in shoe designs on AFO-Shoe combination mechanical properties.

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

    Science.gov (United States)

    Fan, Ka Yuk; Lui, Tun Hing

    2014-01-01

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

  15. 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.

  16. 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.

  17. Ankle and shoulder joint reconstruction using soft tissue allografts

    International Nuclear Information System (INIS)

    Nather, A.; Singh, G.

    2008-01-01

    Full text: Lateral Collateral Ligament Insufficiency is a common complication of injury to the ankle joint. This needs reconstruction of the torn ligament as the joint instability gives rise to frequent giving way at the ankle joint. It can be reconstructed using autologous peroneus brevis tendon. The authors prefer to reconstruct using deep frozen (-80 degree C) non-gamma irradiated tibialis anterior or tibialis posterior tendon allograft procured by NUH Tissue Bank. The graft must be at least between 18-22 cm long. The procedure employed is a first stage Brostrom Procedure repairing the anterior talo-fibula ligament using Mitek sutures. In the second stage the Calcaneofibular ligament is reconstructed using a figure of eight tendon reconstruction via drill holes in the fibular above and the calcaneum below. Twelve cases have been reconstructed this way with good results. When injury is sustained to the Acromia-clavicular (AC) Joint, for type 3 to 5 AC Joint Dislocation and in manual labourers, reconstruction is needed. The author's preferred method is a 2 stage procedure using deep frozen (-80 degree C), non gamma-irradiated fascia lata allografts procured by NUH Tissue Bank. In the first stage the dislocated AC Joint is reduced and held in position by transfixation using 2 baby Steinmann Pins and repair of torn corac clavicular ligaments. The second stage consisted of reconstruction with rolled-up fascia lata figure of eight allograft tendon between the clavicle and the coracoid process. The 2 pins are removed after 6 weeks and the shoulder mobilised. 10 cases have been done with good results. Two cases showed mild subluxation of the AC joint due to slight loss of the reduction performed during the operation. (Author)

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  20. Joint variable stiffness of musculoskeletal leg mechanism for quadruped robot

    OpenAIRE

    Lei, J; Zhu, J; Xie, P; Tokhi, MO

    2017-01-01

    © The Author(s) 2017. When the quadruped robot is in locomotion such as jumping and running with higher speed, there is non-continuous contact force between the foot and the environment inevitably. In order to achieve the flexible force interaction of the bionic legs with the environment, it is necessary to analyze the joint angular stiffness of the bionic leg. In this article, based on the designing principles of the bionics, light-weighted, and flexible, a kind of musculoskeletal bionic leg...

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

    Science.gov (United States)

    Schoepp, C; Rixen, D

    2013-04-01

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

  2. An acoustic startle alters knee joint stiffness and neuromuscular control.

    Science.gov (United States)

    DeAngelis, A I; Needle, A R; Kaminski, T W; Royer, T R; Knight, C A; Swanik, C B

    2015-08-01

    Growing evidence suggests that the nervous system contributes to non-contact knee ligament injury, but limited evidence has measured the effect of extrinsic events on joint stability. Following unanticipated events, the startle reflex leads to universal stiffening of the limbs, but no studies have investigated how an acoustic startle influences knee stiffness and muscle activation during a dynamic knee perturbation. Thirty-six individuals were tested for knee stiffness and muscle activation of the quadriceps and hamstrings. Subjects were seated and instructed to resist a 40-degree knee flexion perturbation from a relaxed state. During some trials, an acoustic startle (50 ms, 1000 Hz, 100 dB) was applied 100 ms prior to the perturbation. Knee stiffness, muscle amplitude, and timing were quantified across time, muscle, and startle conditions. The acoustic startle increased short-range (no startle: 0.044 ± 0.011 N·m/deg/kg; average startle: 0.047 ± 0.01 N·m/deg/kg) and total knee stiffness (no startle: 0.036 ± 0.01 N·m/deg/kg; first startle 0.027 ± 0.02 N·m/deg/kg). Additionally, the startle contributed to decreased [vastus medialis (VM): 13.76 ± 33.6%; vastus lateralis (VL): 6.72 ± 37.4%] but earlier (VM: 0.133 ± 0.17 s; VL: 0.124 ± 0.17 s) activation of the quadriceps muscles. The results of this study indicate that the startle response can significantly disrupt knee stiffness regulation required to maintain joint stability. Further studies should explore the role of unanticipated events on unintentional injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. A huge earthquake hardened arterial stiffness monitored with cardio-ankle vascular index.

    Science.gov (United States)

    Shimizu, Kazuhiro; Takahashi, Mao; Shirai, Kohji

    2013-01-01

    The incidence of cardiovascular events increases after a large earthquake, but the mechanism is not fully understood. The cardio-ankle vascular index (CAVI) reflects the stiffness of the artery from the origin of the aorta to the ankles and is independent of blood pressure. To determine the effect of a major earthquake on CAVI in healthy volunteers and in patients with cardiovascular risks. Our hospital is situated about 300 km from the epicenter of the earthquake that occurred in Japan in 2011. In study 1, healthy volunteers were included. In study 2, patients with cardiovascular factors were included. In study 1, the mean CAVI was 7.3±1.0 just after the earthquake. After 7-14 days, the mean CAVI had decreased to 6.8±1.1 (compared to firstt measurement, pearthquake was 7.0±1.1. The blood pressure did not change during these 30 days. In study 2, the mean CAVI 12 and 6 months before the earthquake were 8.95±0.76 and 8.99±0.83, respectively. The CAVI was 9.34±1.0 just after the earthquake and had decreased to 8.83±0.76 6 months later (compared to after the earthquake, pearthquake, but was not significantly different from before the earthquake. CAVI increased in healthy people and also in patients with cardiovascular risks just after the earthquake, even far from the epicenter.

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

    Directory of Open Access Journals (Sweden)

    Henry Wang

    2017-09-01

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

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

    Science.gov (United States)

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

    2018-06-01

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

  6. Arthroscopic autologous chondrocyte implantation in the ankle joint.

    Science.gov (United States)

    Giannini, Sandro; Buda, Roberto; Ruffilli, Alberto; Cavallo, Marco; Pagliazzi, Gherardo; Bulzamini, Maria Chiara; Desando, Giovanna; Luciani, Deianira; Vannini, Francesca

    2014-06-01

    Autologous chondrocyte implantation (ACI) is an established procedure in the ankle providing satisfactory results. The development of a completely arthroscopic ACI procedure in the ankle joint made the technique easier and reduced the morbidity. The purpose of this investigation was to report the clinical results of a series of patients who underwent arthroscopic ACI of the talus at a mean of 7 ± 1.2-year follow-up. Forty-six patients (mean age 31.4 ± 7.6) affected by osteochondral lesions of the talar dome (OLT) received arthroscopic ACI between 2001 and 2006. Patients were clinically evaluated using AOFAS score pre-operatively and at 12, 36 months and at final follow-up of 87.2 ± 14.5 months. The mean pre-operative AOFAS score was 57.2 ± 14.3. At the 12-month follow-up, the mean AOFAS score was 86.8 ± 13.4 (p = 0.0005); at 36 months after surgery, the mean score was 89.5 ± 13.4 (p = 0.0005); whereas at final follow-up of 87.2 ± 14.5 months it was 92.0 ± 11.2 (p = 0.0005). There were three failures. Histological and immunohistochemical evaluations of specimens harvested from failed implants generally showed several aspects of a fibro-cartilaginous tissue associated with some aspects of cartilage tissue remodelling as indicated by the presence of type II collagen expression. This study confirmed the ability of arthroscopic ACI to repair osteochondral lesions in the ankle joint with satisfactory clinical results after mid-term follow-up. IV, retrospective case series.

  7. [Short-term effectiveness of Swanson artificial joint replacement in treating posttraumatic metacarpophalangeal joint stiffness].

    Science.gov (United States)

    Lu, Hui; Shen, Xiangqian; Xu, Jihua; Huang, Xin; Ye, Po; Wu, Shoucheng

    2011-11-01

    To investigate the short-term effectiveness of Swanson artificial joint replacement in treating post-traumatic metacarpophalangeal joint stiffness. Between August 2007 and May 2010, 11 cases (13 fingers) of metacarpophalangeal joint stiffness with soft tissue defects underwent Swanson artificial joint replacement. There were 7 males (9 fingers) and 4 females (4 fingers), aged 43 to 65 years with an average of 49 years. The involved fingers included 4 thumbs, 4 index fingers, 3 middle fingers, and 2 ring fingers. The types of injury included open and crush injury in 8 fingers, fracture of the metacarpophalangeal joint in 3 fingers, metacarpophalangeal joint severing in 2 fingers. The time from joint stiffness to hospitalization was 12 to 48 weeks (mean, 24 weeks). The joint activity was (136.82 +/- 28.96) degrees. According to total active motion (TAM) assessment, included good in 1 finger, fair in 6 fingers, and poor in 6 fingers before operation. The activities of daily living were assessed by Sollerman score, which was 45.64 +/- 11.04. The X-ray films and CT scan showed traumatic arthritis of the metacarpophalangeal joint. The incision healed by first intention. All patients were followed up 12 to 34 months (mean, 24.1 months). At last follow-up, the joint activity was (194.64 +/- 28.86) degrees, showing significant difference when compared with preoperative value (t = 25.214, P = 0.000). According to TAM assessment, including excellent in 1 finger, good in 4 fingers, fair in 7 fingers, and poor in 1 finger. The Sollerman score was 67.45 +/- 8.20 postoperatively, showing significant difference when compared with the preoperative score (t = -10.470, P = 0.000). X-ray examination showed no prosthesis fracture, periprosthetic fracture, or joint dislocation occurred at last follow-up. Swanson artificial joint replacement can be applied to treat post-traumatic metacarpophalangeal joint stiffness, which can improve the joint activity and has satisfactory short

  8. Influence of running velocity on vertical, leg and joint stiffness : modelling and recommendations for future research.

    Science.gov (United States)

    Brughelli, Matt; Cronin, John

    2008-01-01

    Human running can be modelled as either a spring-mass model or multiple springs in series. A force is required to stretch or compress the spring, and thus stiffness, the variable of interest in this paper, can be calculated from the ratio of this force to the change in spring length. Given the link between force and length change, muscle stiffness and mechanical stiffness have been areas of interest to researchers, clinicians, and strength and conditioning practitioners for many years. This review focuses on mechanical stiffness, and in particular, vertical, leg and joint stiffness, since these are the only stiffness types that have been directly calculated during human running. It has been established that as running velocity increases from slow-to-moderate values, leg stiffness remains constant while both vertical stiffness and joint stiffness increase. However, no studies have calculated vertical, leg or joint stiffness over a range of slow-to-moderate values to maximum values in an athletic population. Therefore, the effects of faster running velocities on stiffness are relatively unexplored. Furthermore, no experimental research has examined the effects of training on vertical, leg or joint stiffness and the subsequent effects on running performance. Various methods of training (Olympic style weightlifting, heavy resistance training, plyometrics, eccentric strength training) have shown to be effective at improving running performance. However, the effects of these training methods on vertical, leg and joint stiffness are unknown. As a result, the true importance of stiffness to running performance remains unexplored, and the best practice for changing stiffness to optimize running performance is speculative at best. It is our hope that a better understanding of stiffness, and the influence of running speed on stiffness, will lead to greater interest and an increase in experimental research in this area.

  9. The effects of prosthetic ankle stiffness on ankle and knee kinematics, prosthetic limb loading, and net metabolic cost of trans-tibial amputee gait.

    Science.gov (United States)

    Major, Matthew J; Twiste, Martin; Kenney, Laurence P J; Howard, David

    2014-01-01

    Previous studies of commercially-available trans-tibial prosthetic components have been unable to provide clear insight into the relationships between prosthetic mechanical properties and user performance (i.e., gait quality and energy expenditure), the understanding of which is key to improving prosthesis design and prescription. Many of these studies have been limited by not characterising the mechanical properties of the tested prostheses and/or only considered level walking at self-selected speeds. The aim of this study was to conduct a systematic investigation of the effects of ankle rotational stiffness on trans-tibial amputee gait during various walking conditions reflective of those encountered during daily ambulation. Ankle and knee kinematics, prosthetic limb normal ground reaction forces, and net metabolic cost were measured in five traumatic unilateral trans-tibial amputees during treadmill walking on the level, a 5% incline and a 5% decline whilst using an experimental articulated prosthetic foot with four different rotational stiffness setups and without changes in alignment between conditions. Overall, lower dorsiflexion stiffness resulted in greater prosthetic side dorsiflexion motion and sound side knee flexion, reduced normal ground reaction force during the loading phase of prosthetic stance and reduced net metabolic cost. Few differences were observed with changes in plantarflexion stiffness, most likely due to the foot achieving early foot flat. Low dorsiflexion stiffness generally improved gait performance seemingly due to easier tibial progression during stance. However, observed differences were small, suggesting that a wider range of walking and stiffness conditions would be useful to fully explore these effects in future studies. © 2013.

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  11. 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.

  12. Analysis of muscle activity and ankle joint movement during the side-hop test.

    Science.gov (United States)

    Yoshida, Masahiro; Taniguchi, Keigo; Katayose, Masaki

    2011-08-01

    Functional performance tests (FPTs) that consist of movements, such as hopping, landing, and cutting, provide useful measurements. Although some tests have been established for kinematic studies of the knee joint, very few tests have been established for the ankle joint. To use the FPT as a test battery for patients with an ankle sprain, it is necessary to document typical patterns of muscle activation and range of motion (ROM) of the ankle joint during FPTs. Therefore, the purpose of this study was to investigate the pattern of the ROM of the ankle inversion/eversion and the muscle activity of the peroneus longus muscle (PL) and the tibial anterior muscle (TA) in normal subjects during the side-hop test. To emphasize the characteristics of ROM and electromyography (EMG) at each phase, the side-hop tests were divided into 4 phases: lateral-hop contact phase (LC), lateral-hop flight phase (LF), medial hop contact phase (MC), and medial hop flight phase (MF), and the ROM of ankle inversion/eversion, a peak angle of ankle inversion, and Integral EMG (IEMG) of PL and TA compared among 4 phases. Fifteen male subjects with no symptoms of ankle joint problems participated in this research. The ROM of ankle inversion/eversion during the side-hop test was 27 ± 3.8° (mean ± SD), and there was a significant difference in the ROM of ankle inversion/eversion among 4 phases (p sprain.

  13. 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.

  14. Soluble Flt-1 improves the repair of ankle joint injury in rats.

    Science.gov (United States)

    Tian, Jing; Xie, Bing; Xiang, Liangbi; Zhao, Yong; Zhou, Dapeng

    2016-01-01

    The ankle injuries create great pain to a great number of patients worldwide. Past studies have focused on the development of practical treatments to relieve pain and improve recovery, but the molecular mechanisms underlying the ankle injuries, especially the local inflammation in the damaged ankle joint, have been rarely studied. Moreover, although reduction of production and secretion of pro-inflammatory cytokines may reduce the pain and promote the recovery, a practical approach is currently lacking. Here, we detected significantly higher levels of placental growth factor (PLGF) and pro-inflammatory cytokines in the joint fluid from the patients of acute ankle joint injury (AAJI). Interestingly, the levels of PLGF and pro-inflammatory cytokines in the joint fluid strongly correlated. In order to examine whether PLGF may regulate the production and secretion of pro-inflammatory cytokines in the injured joint, we used a rat carrageenan-induced ankle injury model for AAJI in humans. We injected soluble Flt-1 (sFlt-1) into the articular cavity of the injured ankle joint to block PLGF signaling and found that injection of sFlt-1 significantly improved the rat behavior in activity wheels test, which appeared to result from reduced secretion of the pro-inflammatory cytokines in the ankle joint. Thus, our study suggests that blocking PLGF signaling may be a novel therapeutic approach for treating AAJI in humans.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  16. Comparison of 3 different methods to analyze ankle plantarflexor stiffness in children with spastic diplegia cerebral palsy.

    Science.gov (United States)

    Ross, Sandy A; Foreman, Matthew; Engsberg, Jack R

    2011-12-01

    To compare 3 different methods of measuring plantarflexor stiffness in children with spastic diplegia cerebral palsy (CP) and children without disability. Case-control study. Human performance laboratory. A retrospective analysis was conducted with children with spastic diplegia (n=121; mean age, 8.4y) and children with typical development (TD) (n=48; mean age, 9.7y). Not applicable. An isokinetic dynamometer was used to measure ankle plantarflexor stiffness at 10°/s using 3 methods: (1) end-range method, which applied a linear slope to the end of the torque-angle curve; (2) set-range method, which applied a linear slope from 30° to 10° plantarflexion; and (3) a linear method, which applied a slope only to the linear portion of the curve. Two-way analysis of variance revealed significant main effects for group and stiffness method. The end-range method showed no significant difference between groups for plantarflexor stiffness (P=.62), the set-range method showed the CP group with 120% greater stiffness than the TD group (P<.046), and the linear method showed the CP group with 35% greater stiffness than the TD group (P<.001). The linear method appeared to resolve the issues with the previous methods; applying a linear slope to a nonlinear curve or applying a linear slope to the same range of motion for each child regardless of their range limitations. It is clear that children with CP have limited range of motion; therefore, stiffness occurs earlier in the range than would be expected for a typically developing child. Using the linear method, children with CP were 35% stiffer in the ankle plantarflexors than typically developing peers. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Dengel, H.

    1982-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  20. The effect of ankle foot orthosis stiffness on the energy cost of walking : A simulation study

    NARCIS (Netherlands)

    Bregman, D.J.J.; Van der Krogt, M.M.; De Groot, V.; Harlaar, J.; Wisse, M.; Collins, S.H.

    2011-01-01

    Background In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot

  1. The effect of ankle foot orthosis stiffness on the energy cost of walking: A simulation study.

    NARCIS (Netherlands)

    Bregman, D.J.J.; van der Krogt, M.M.; de Groot, V.; Harlaar, J.; Wisse, M.; Collins, S.H.

    2011-01-01

    Background: In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot

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

    Directory of Open Access Journals (Sweden)

    Mei-Chun Chou

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  4. Effect of ankle braces on lower extremity joint energetics in single-leg landings.

    Science.gov (United States)

    Gardner, Jacob K; McCaw, Steven T; Laudner, Kevin G; Smith, Peter J; Stafford, Lindsay N

    2012-06-01

    Ankle sprains are one of the most common injuries in competitive and recreational athletics. Studies have shown that the use of prophylactic ankle braces effectively reduces the frequency of ankle sprains in athletes. However, although it is generally accepted that the ankle braces are effective at reducing frontal plane motion, some researchers report that the design of the brace may also reduce ankle sagittal plane motion. The purpose of this study was to quantify lower extremity joint contributions to energy absorption during single-legged drop landings in three ankle brace conditions (no brace, boot brace, and hinged brace). Eleven physically active females experienced in landing and free of lower extremity injury (age = 22.3 ± 1.7 yr, height = 1.66 ± 0.04 m, mass = 58.43 ± 5.83 kg) performed 10 single-leg drop landings in three conditions (one unbraced, two braced) from a 0.33-m height. Measurements taken were hip, knee, and ankle joint impulse; hip, knee, ankle, and total work; and hip, knee, and ankle joint relative work. Total energy absorption remained consistent across the braced conditions (P = 0.057). Wearing the boot brace reduced relative ankle work (P = 0.04, Cohen d = 0.43) but did not change relative knee (P = 0.08, Cohen d = 0.32) or hip (P = 0.14, Cohen d = 0.20) work compared with the no-brace condition. In an ankle-braced condition, ankle, knee, and hip energetics may be altered depending on the design of the brace.

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

    Science.gov (United States)

    Mondal, Subrata; Ghosh, Rajesh

    2017-09-01

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

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

    Science.gov (United States)

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

    2017-11-14

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

  7. A robot-assisted study of intrinsic muscle regulation on proximal interphalangeal joint stiffness by varying metacarpophalangeal joint position.

    Science.gov (United States)

    Li, Zong-Ming; Davis, Gregg; Gustafson, Norm P; Goitz, Robert J

    2006-03-01

    The tightness of intrinsic hand muscles is a common cause of finger joint stiffness. The purposes of this study were to develop a robot-assisted methodology to obtain torque-angle data of a finger joint, and to investigate the regulation of the intrinsic muscles on finger joint stiffness. Our robot system features the integration of a low payload robot arm, a controller, and a force/torque transducer. The system provided highly reproducible torque-angle curves. Torque-angle data of the proximal interphalangeal joint with the metacarpophalangeal joint at 0 and 60 degrees were obtained from eight asymptomatic hands. The torque-angle curve shifted with the position of the metacarpophalangeal joint. As the metacarpophalangeal joint flexion angle changed from 60 to 0 degrees, the equilibrium of the proximal interphalangeal joint increased more than 20 degrees, and joint stiffness increased more than 50%. The dependence of the stiffness of the proximal interphalangeal joint on metacarpophalangeal joint position supports the regulatory role of the intrinsic muscles on finger joint mechanics. This regulatory mechanics is likely amplified in hands with intrinsic muscle tightness, justifying the commonly used Bunnell Intrinsic Tightness Test. Copyright 2005 Orthopaedic Research Society.

  8. A mechanism to compensate undesired stiffness in joints of prosthetic hands.

    Science.gov (United States)

    Smit, Gerwin; Plettenburg, Dick; Van der Helm, Frans

    2014-04-01

    Cosmetic gloves that cover a prosthetic hand have a parasitic positive stiffness that counteracts the flexion of a finger joint. Reducing the required input torque to move a finger of a prosthetic hand by compensating the parasitic stiffness of the cosmetic glove. Experimental, test bench. The parasitic positive stiffness and the required input torques of a polyvinyl chloride glove and a silicone glove were measured when flexing a metacarpophalangeal finger joint for 90°. To compensate this positive stiffness, an adjustable compensation mechanism with a negative stiffness was designed and built. A MATLAB model was created to predict the optimal settings of the mechanism, based on the measured stiffness, in order to minimize the required input torque of the total system. The mechanism was tested in its optimal setting with an applied glove. The mechanism reduced the required input torque by 58% for the polyvinyl chloride glove and by 52% for the silicone glove. The total energy dissipation of the joint did not change significantly. This study shows that the undesired positive stiffness in the joint can be compensated with a relatively simple negative stiffness mechanism, which fits inside a finger of a standard cosmetic glove. Clinical relevance This study presents a mechanism that compensates the undesired stiffness of cosmetic gloves on prosthetic hands. As a result, it requires less input force, torque and energy to move the fingers. Application of this mechanism in body-powered hands will reduce the control effort of the user.

  9. Diagnosis of ligament injuries in the superior ankle joint

    International Nuclear Information System (INIS)

    Gebing, R.; Fiedler, V.

    1991-01-01

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

  10. The effects of tibiofibularis anterior ligaments on ankle joint biomechanics.

    Science.gov (United States)

    Karakaşlı, Ahmet; Erduran, Mehmet; Baktıroğlu, Lütfü; Büdeyri, Aydın; Yıldız, Didem Venüs; Havıtçıoğlu, Hasan

    2015-03-01

    The aim of this study was to evaluate the biomechanical behavior of anterior inferior tibiofibularis ligament (AITFL) deficient human ankle under axial loading of ankle at stance phase of gait. In order to investigate the contribution of AITFL to ankle stability, an in vitro sequential experimental setup was simulated. The measurement of posterior displacement of distal tibia and anterior displacement of the foot, in neutral position, secondary to axial compression, was performed by two non-contact video extensometers. Eight freshly frozen, anatomically intact, cadaveric human ankle specimens were included and tested. An axial compression test machine was utilized from 0 to 800 Newtonswith a loading speed of 5 mm/min in order to simulate the axial weight-bearing sequence of the ankle at stance phase of human gait. There was a statistically significant difference between anteroposterior displacement values for AITFL-Intact and AITFL-Dissected specimens (p≤0.05). Mean AITFL-Intact and mean AITFL-Dissected ankle anteroposterior displacement was 1.28±0.47 mm and 2.06±0.7 mm, respectively. This study determined some numerical and quantitative data about the biomechanical properties of AITFL in neutral foot position. In the emergency department, diagnosis and treatment of AITFL injury, due to ankle distortion, is important. In AITFL injuries, ankle biomechanics is affected, and ankle instability occurs.

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

    Science.gov (United States)

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

    2017-06-02

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

  12. Primary stability and stiffness in ankle arthrodes-crossed screws versus anterior plating

    OpenAIRE

    Betz, Michael M; Benninger, Emanuel E; Favre, Philipp P; Wieser, Karl K; Vich, Magdalena M; Espinosa, Norman

    2013-01-01

    BACKGROUND: Ankle arthrodesis is commonly used for the treatment of osteoarthritis or failed arthroplasty. Screw fixation is the predominant technique to perform ankle arthrodesis. Due to a considerable frequency of failures research suggests the use of an anatomically shaped anterior double plate system as a reliable method for isolated tibiotalar arthrodesis. The purpose of the present biomechanical study was to compare two groups of ankle fusion constructs - three screw fixation and an ant...

  13. Research regarding stiffness optimization of wires used for joints actuation from an elephant's trunk robotic arm

    Science.gov (United States)

    Ciofu, C.; Stan, G.

    2016-11-01

    Elephant's trunk robotic arms driven by wires and pulley mechanisms have issues with wires stiffness because of the entailed elastic deformations that is causing errors of positioning. Static and dynamic loads from each joint of the robotic arm affect the stiffness of driving wires and precision positioning. The influence of wires elastic deformation on precision positioning decreases with the increasing of wires stiffness by using different pre-tensioning devices. In this paper, we analyze the variation of driving wires stiffness particularly to each wire driven joint. We obtain optimum wires stiffness variation by using an analytical method that highlights the efficiency of pre-tensioning mechanism. The analysis of driving wires stiffness is necessary for taking appropriate optimization measures of robotic arm dynamic behavior and, thus, for decreasing positioning errors of the elephant's trunk robotic arm with inner actuation through wires/cables.

  14. Synovial Chondromatosis of the Ankle Joint: Clinical, Radiological, and Intraoperative Findings

    Directory of Open Access Journals (Sweden)

    Sedeek Mohamed Sedeek

    2015-01-01

    Full Text Available Synovial chondromatosis, also termed synovial osteochondromatosis, is a rare benign disorder characterized by the presence of cartilaginous nodules in the synovium of the joints, tendon sheaths, and bursae. It most commonly involves large joints, such as the knee, hip, and shoulder, but its presence in smaller joints has also been reported. Nevertheless, ankle involvement is unusual. The diagnosis is commonly made following a thorough history, clinical, physical, and radiographic examination. We report a case of a young patient with primary synovial chondromatosis of the ankle joint and present the clinical, radiographic, and intraoperative findings.

  15. 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

    2003-01-01

    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. PMID:17987212

  16. 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.

  17. Sagittal plane position of the functional joint centre of prosthetic foot/ankle mechanisms.

    Science.gov (United States)

    Rusaw, David; Ramstrand, Nerrolyn

    2010-08-01

    The use of motion analysis techniques in amputee rehabilitation often utilizes kinematic data from the prosthetic limb. A problem with methods currently used is that the joint positions of the prosthetic ankle are assumed to be in the same position as that of an intact ankle. The aim of this study was to identify both traditional anatomical joint centres as well as functional joint centres in a selection of commonly used prosthetic feet. These coordinates were then compared across feet and compared to the contralateral intact ankle joint. Six prosthetic feet were fit to a unilateral trans-tibial amputee on two separate occasions. The subject's intact limb was used as a control. Three-dimensional kinematics were collected to determine the sagittal position of the functional joint centre for the feet investigated. None of the prosthetic feet had a functional joint centre that was within the 95% CI for that of an intact ankle (both x- and y-coordinate position), nor any of the other prosthetic feet investigated. The repeatability of the method was found to be adequate, with 95% CI of the difference (test-retest) of the prosthetic feet similar to that for the intact ankle and within clinically accepted levels of variability. The motion of the prosthetic feet tested is clearly different from that of an intact ankle. Kinematic methods that assume ankle constraints based on an intact ankle are subject to systematic error as this does not reflect the real motion of the prosthetic foot. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Kleipool, Roeland P; Blankevoort, Leendert

    2010-05-01

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

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

    Science.gov (United States)

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

    2017-09-09

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

  20. Self-reported knee joint instability is related to passive mechanical stiffness in medial knee osteoarthritis

    Science.gov (United States)

    2013-01-01

    Background Self-reported knee joint instability compromises function in individuals with medial knee osteoarthritis and may be related to impaired joint mechanics. The purpose of this study was to evaluate the relationship between self-reported instability and the passive varus-valgus mechanical behaviour of the medial osteoarthritis knee. Methods Passive varus-valgus angular laxity and stiffness were assessed using a modified isokinetic dynamometer in 73 participants with medial tibiofemoral osteoarthritis. All participants self-reported the absence or presence of knee instability symptoms and the degree to which instability affected daily activity on a 6-point likert scale. Results Forward linear regression modelling identified a significant inverse relationship between passive mid-range knee stiffness and symptoms of knee instability (r = 0.27; P  0.05). Conclusions Conceivably, a stiffer passive system may contribute toward greater joint stability during functional activities. Importantly however, net joint stiffness is influenced by both active and passive stiffness, and thus the active neuromuscular system may compensate for reduced passive stiffness in order to maintain joint stability. Future work is merited to examine the role of active stiffness in symptomatic joint stability. PMID:24252592

  1. 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.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  3. Ankle replacement - discharge

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  6. Ankle instability

    NARCIS (Netherlands)

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

    2006-01-01

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

  7. Evaluation of Ankle Joint Proprioception and Balance in Patients with Type 2 Diabetes and Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Farzaneh Moslemi-Haghighi

    2015-03-01

    Full Text Available Background: Joint proprioception plays an important role in limb movement and awareness of position sense. Diabetes has a lot of complications such as loss of sensory function, which can lead to impaired balance, thus the aim of this study to evaluated joint proprioception and balance in diabetic patients. Methods: Twenty type II diabetic patients and 20 healthy controls participated in this case-controlled study. Standing balance in various positions and ankle joint proprioception were measured. The data were analyzed using MannWhitney and chi-square test. Results: It was observed that the ankle joint proprioception and balance in diabetic patients were significantly less than control groups. (P<0.05 Conclusion: Joint proprioception and balance functions impair in diabetic patients. Thus improvement of joint proprioception for prevention of fall is important.

  8. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion.

    Science.gov (United States)

    Kerkum, Yvette L; Buizer, Annemieke I; van den Noort, Josien C; Becher, Jules G; Harlaar, Jaap; Brehm, Merel-Anne

    2015-01-01

    Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A spring-like AFO may enhance push-off power, which may come at the cost of reducing the knee flexion less effectively. Optimizing this trade-off between enhancing push-off power and normalizing knee flexion in stance is expected to maximize gait efficiency. This study investigated the effects of varying AFO stiffness on gait biomechanics and efficiency in children with CP who walk with excessive knee flexion in stance. Fifteen children with spastic CP (11 boys, 10±2 years) were prescribed with a ventral shell spring-hinged AFO (vAFO). The hinge was set into a rigid, or spring-like setting, using both a stiff and flexible performance. At baseline (i.e. shoes-only) and for each vAFO, a 3D-gait analysis and 6-minute walk test with breath-gas analysis were performed at comfortable speed. Lower limb joint kinematics and kinetics were calculated. From the 6-minute walk test, walking speed and the net energy cost were determined. A generalized estimation equation (pchildren with spastic CP, the vAFO stiffness that maximizes gait efficiency is primarily determined by its effect on knee kinematics and kinetics rather than by its effect on push-off power. Dutch Trial Register NTR3418.

  9. Syndesmotic ankle sprain.

    Science.gov (United States)

    Childs, Sharon G

    2012-01-01

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

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

    International Nuclear Information System (INIS)

    Schmidt, C.

    1983-01-01

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

  11. [Current concepts in surgical treatment of chronic ankle joint instability].

    Science.gov (United States)

    Chojecki, Łukasz; Płomiński, Janusz; Pepłoński, Artur; Pawlik, JarosŁaw; Jeśkiewicz, Mateusz

    2015-04-01

    Ankle sprain is one of the most common musculoskeletal injuries. Initial treatment of choice in acute injury is conservative and is obtained by immobilization. The goal of such treatment is to heal ruptured capsular-ligamentous complex. However, despite the conservative treatment some patients develop chronic ankle instability as a result of injury. In those cases, surgical anatomical and non-anatomical ligamentous reconstruction is advised. Aim of the study was evaluation of the results obtained with various surgical techniques in view of published data. According to most authors, in patients who experienced chronic ankle instability, surgical technique of anatomical repair is preferred. In cases when anatomical repair might not be undertaken due to technical capabilities, anatomical reconstruction using autoor allografts is advised. © 2015 MEDPRESS.

  12. An under-actuated origami gripper with adjustable stiffness joints for multiple grasp modes

    Science.gov (United States)

    Firouzeh, Amir; Paik, Jamie

    2017-05-01

    Under-actuated robots offer multiple degrees of freedom without much added complexity to the actuation and control. Utilizing adjustable stiffness joints in these robots allows us to control their stable configurations and their mode of interaction with the environment. In this paper, we present the design of tendon-driven robotic origami (robogami) joints with adjustable stiffness. The proposed designs allow us to place joints along any direction in the plane of the robot and in the normal direction to the plane. The layer-by-layer manufacturing of robogamis facilitates the design and manufacturing of robots with different arrangement of joints for different applications. We use thermally activated shape memory polymer to control the joint stiffness. The manufacturing of the polymer layer is compatible with the layer-by-layer manufacturing process of the robogamis which results in scalable and customizable robots. To demonstrate, we prototyped an under-actuated gripper with three fingers and only one input actuation. The grasp mode of the gripper is set by adjusting the configuration of the locked joints and modulating the stiffness of the active joints. We present a model to estimate the configuration and the contact forces of the gripper at different settings that will assist us in design and control of future generation of under-actuated robogamis.

  13. The Activities of the Muscles around the Ankle Joint during Foot-gripping are Affected by the Angle of the Ankle

    OpenAIRE

    Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yosuke

    2014-01-01

    [Purpose] The purpose of this study was to determine the activities of the muscles around the ankle joint during foot gripping. [Subjects] The subjects of this study were 17 healthy females. [Methods] We measured the maximum voluntary contraction (MVC) activities of the soleus muscle, the medial head of the gastrocnemius muscle, and the tibialis anterior muscle, and calculated %IEMG during foot gripping in 3 different ankle joint positions: 10° of plantar flexion, 0°, and 10° of dorsiflexion....

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

    Science.gov (United States)

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

    2018-02-05

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

  15. Knee joint laxity and passive stiffness in meniscectomized patients compared with healthy controls.

    Science.gov (United States)

    Thorlund, Jonas B; Creaby, Mark W; Wrigley, Tim V; Metcalf, Ben R; Bennell, Kim L

    2014-10-01

    Passive mechanical behavior of the knee in the frontal plane, measured as angular laxity and mechanical stiffness, may play an important role in the pathogenesis of knee osteoarthritis (OA). Little is known about knee laxity and stiffness prior to knee OA onset. We investigated knee joint angular laxity and passive stiffness in meniscectomized patients at high risk of knee OA compared with healthy controls. Sixty patients meniscectomized for a medial meniscal tear (52 men, 41.4 ± 5.5 years, 175.3 ± 7.9 cm, 83.6 ± 12.8 kg, mean ± SD) and 21 healthy controls (18 men, 42.0 ± 6.7 years, 176.8 ± 5.7 cm, 77.8 ± 13.4 kg) had their knee joint angular laxity and passive stiffness assessed twice ~2.3 years apart. Linear regression models including age, sex, height and body mass as covariates in the adjusted model were used to assess differences between groups. Greater knee joint varus (-10.1 vs. -7.3°, pknee joint angular laxity and reduced passive stiffness ~3 months post surgery compared with controls. In addition, the results indicated that knee joint laxity may increase over time in meniscectomized patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Motion Stabilization by Using Laser Distance Sensor for Biped Walking Robot with Flexible Ankle Joints

    Science.gov (United States)

    Ito, Masanori; Oda, Naoki

    This paper describes an approach to motion stabilization by using laser distance sensors for biped robots with flexible ankle joints. To avoid the vibrated zero moment point (ZMP) behavior caused by mechanical resonance, a vibration control method is proposed in the paper. In our approach, the deformation of the ankle joint is measured by using laser distance sensors, and the detected deformation is translated into the equivalent reaction force at the center of gravity. The feedback of the reaction force enables the stabilization of the walking motion in a manner similar to resonance ratio control. The validity of the proposed method is evaluated by several experimental results.

  17. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion.

    Directory of Open Access Journals (Sweden)

    Yvette L Kerkum

    Full Text Available Rigid Ankle-Foot Orthoses (AFOs are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP. While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A spring-like AFO may enhance push-off power, which may come at the cost of reducing the knee flexion less effectively. Optimizing this trade-off between enhancing push-off power and normalizing knee flexion in stance is expected to maximize gait efficiency. This study investigated the effects of varying AFO stiffness on gait biomechanics and efficiency in children with CP who walk with excessive knee flexion in stance. Fifteen children with spastic CP (11 boys, 10±2 years were prescribed with a ventral shell spring-hinged AFO (vAFO. The hinge was set into a rigid, or spring-like setting, using both a stiff and flexible performance. At baseline (i.e. shoes-only and for each vAFO, a 3D-gait analysis and 6-minute walk test with breath-gas analysis were performed at comfortable speed. Lower limb joint kinematics and kinetics were calculated. From the 6-minute walk test, walking speed and the net energy cost were determined. A generalized estimation equation (p<0.05 was used to analyze the effects of different conditions. Compared to shoes-only, all vAFOs improved the knee angle and net moment similarly. Ankle power generation and work were preserved only by the spring-like vAFOs. All vAFOs decreased the net energy cost compared to shoes-only, but no differences were found between vAFOs, showing that the effects of spring-like vAFOs to promote push-off power did not lead to greater reductions in walking energy cost. These findings suggest that, in this specific group of children with spastic CP, the vAFO stiffness that maximizes gait efficiency is primarily determined by its effect on knee kinematics and kinetics rather than by its effect on push-off power

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

  20. No correlation between joint position sense and force sense for measuring ankle proprioception in subjects with healthy and functional ankle instability.

    Science.gov (United States)

    Kim, Chang-Yong; Choi, Jong-Duk; Kim, Hyeong-Dong

    2014-11-01

    In general, ankle proprioception is most often evaluated by assessing joint position sense and force sense. However, in contrast to observational studies of joint position sense and force sense, no studies have examined the correlations between joint position sense and force sense. Therefore, the objective of this study was to investigate the correlations between joint position sense and force sense in subjects with healthy and functional ankle instability. Of the sixty nine subjects enrolled in the cross-sectional laboratory study, 35 had functional ankle instability and 34 were healthy subjects. Angle reproduction and force matching methods were used to quantify joint position sense and force sense of the ankle proprioception. These methods were also measured by using a flexible twin axis electrogoniometer and linear force, respectively. Three trials were performed at each angle and force. And then, absolute errors were calculated. Significant differences between the functional ankle instability and healthy group were found for absolute errors of plantar flexion, dorsiflexion, inversion, and eversion (P0.05). These findings suggest that it could be explained for deficits of ankle proprioception when angle reproduction and force matching tests to quantify joint position sense and force sense were applied and presented at the same time, not individually. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  2. The Activities of the Muscles around the Ankle Joint during Foot-gripping are Affected by the Angle of the Ankle.

    Science.gov (United States)

    Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yosuke

    2013-12-01

    [Purpose] The purpose of this study was to determine the activities of the muscles around the ankle joint during foot gripping. [Subjects] The subjects of this study were 17 healthy females. [Methods] We measured the maximum voluntary contraction (MVC) activities of the soleus muscle, the medial head of the gastrocnemius muscle, and the tibialis anterior muscle, and calculated %IEMG during foot gripping in 3 different ankle joint positions: 10° of plantar flexion, 0°, and 10° of dorsiflexion. [Results] The maximal force of foot gripping achived by the crural muscles in any ankle position was 30-50% IMEG of the MVC. Repeated analysis of variance showed that the %IEMG was significantly lower in 10°of dorsiflexion than in the other 2 positions for all muscles. [Conclusion] These results suggested that the crural muscles help the ankle joint by co-contracting during foot gripping.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-03-15

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

  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. [Ultrasound in complex of radiological studies in diagnosis of ankle joint medial aspect pathologies].

    Science.gov (United States)

    Gurgenidze, T; Mizandari, M

    2011-10-01

    The aim of the research is to study sonosemiotics of ankle joint pathology by means of ultrasound in order to optimize the diagnostic process and improve the treatment. 130 patients (age ranges from 5 to 70 years) underwent the radiological study of ankle joint medial aspect. Pathology types: degenerative-dystrophic diseases - 39 (30%), inflammatory pathology - 21 (16.2%), traumatic injuries - 20 (15.2%), vascular pathologies - 26 (20%), neurogenic problems -7 (5.4%), soft tissue neoplasms - 5 (3.8%), congenital anomalies - 7 (5.4%) and vertebral pathology - 5 (4.0%). The diagnostic studies include: a) Ultrasound, performed on digital ultrasound system using high frequency (7.5-12.0 MHz) linear probe with Doppler capability (all patients); b) X-Ray filming in antero-posterior and lateral projections (6 patients- 4.5%); c) MRI - T1 and T2 weighted images in saggital and transverse planes 10 patients (10.0%) and d) CT - 2 patients (1.5%); To 2 (1.5%) patient biopsy has been performed. This study showed that ultrasound was successful in ankle joint medial aspect pathology diagnosis in 108 cases (84.0%); It was ineffective in osseous pathology definition. In final diagnosis of impingment syndrom MRI was required in 4 (3.6%) cases. It is concluded that ultrasound should be used as a Gold Standard in diagnosis of localized pain and swelling in the ankle joint.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-01-01

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

  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 velocityankle joint power and fascicle velocity patterns were observed for MG muscle. In humans, like cats, the patterns of ankle joint power and MTU velocity of SO and MG were similar. Unlike the cat, there were substantial differences between patterns of fascicle velocity and ankle joint power during stance in both muscles. These results indicate that during walking, only a small fraction of mechanical work of the ankle moment is either generated or absorbed by the muscle fascicles, thus confirming the contribution of in-series elastic structures and/or energy transfer via two-joint muscles. We conclude that ankle joint negative power does not necessarily indicate eccentric action of muscle fibers and that positive power cannot be exclusively attributed to muscle concentric action, especially in humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability.

    Science.gov (United States)

    Gustafson, Jonathan A; Gorman, Shannon; Fitzgerald, G Kelley; Farrokhi, Shawn

    2016-01-01

    Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (pknee flexion excursions (pknee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Osteochondral lesions of the ankle joint in professional soccer players: treatment with autologous matrix-induced chondrogenesis.

    Science.gov (United States)

    Valderrabano, Victor; Barg, Alexej; Alattar, Abdulhameed; Wiewiorski, Martin

    2014-12-01

    Acute and recurrent ankle sprains and other trauma to the ankle joint are common injuries in soccer and can be accompanied by or result in osteochondral lesions of the ankle joint, majorly of the talus. Conservative treatment frequently fails. Several operative treatment techniques exist; however, the choice of the right procedure is difficult due to lack of literature with a high level of evidence. We present our treatment method for acute and chronic ankle osteochondral lesions with cystic formation approached by a new surgical technique combining bone plasty and a collagen matrix (autologous matrix-induced chondrogenesis). Therapeutic, Level IV: Case series. © 2014 The Author(s).

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

    Science.gov (United States)

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

    2017-03-01

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

  12. Design of an automated device to measure sagittal plane stiffness of an articulated ankle-foot orthosis.

    Science.gov (United States)

    Kobayashi, Toshiki; Leung, Aaron K L; Akazawa, Yasushi; Naito, Hisashi; Tanaka, Masao; Hutchins, Stephen W

    2010-12-01

    The purpose of this study was to design a new automated stiffness measurement device which could perform a simultaneous measurement of both dorsi- and plantarflexion angles and the corresponding resistive torque around the rotational centre of an articulated ankle-foot orthosis (AAFO). This was achieved by controlling angular velocities and range of motion in the sagittal plane. The device consisted of a hydraulic servo fatigue testing machine, a torque meter, a potentiometer, a rotary plate and an upright supporter to enable an AAFO to be attached to the device via a surrogate shank. The accuracy of the device in reproducing the range of motion and angular velocity was within 4% and 1% respectively in the range of motion of 30° (15° plantarflexion to 15° dorsiflexion) at the angular velocity of 10°/s, while that in the measurement of AAFO torque was within 8% at the 0° position. The device should prove useful to assist an orthotist or a manufacturer to quantify the stiffness of an AAFO and inform its clinical use.

  13. Effects of density profile of MDF on stiffness and strength of nailed joints

    OpenAIRE

    Sawata, Kei; Shibusawa, Tatsuya; Ohashi, Kazuo; Sotomayor Castellanos, Javier Ramon; Hatano, Yasunori

    2008-01-01

    Nail-head pull-through, lateral nail resistance, and single shear nailed joint tests were conducted on medium density fiberboard (MDF) with different density profiles, and the relations between the results of these tests and the density profiles of MDF were investigated. The maximum load of nail-head pull-through and the maximum load of nailed joints were little affected by the density profile. However, the ultimate strength of lateral nail resistance, the stiffness, and the yield strength of...

  14. Effect of sex and fatigue on muscle stiffness and musculoarticular stiffness of the knee joint in a young active population.

    Science.gov (United States)

    Wang, Dan; De Vito, Giuseppe; Ditroilo, Massimiliano; Delahunt, Eamonn

    2017-08-01

    The purpose of this study was to investigate the influence of sex and fatigue on knee extensor peak torque (PT), muscle stiffness (MS) of the vastus lateralis (VL) and knee joint musculoarticular stiffness (MAS) in young adults. Twenty-two male and 22 female recreational athletes participated. Males were characterised by higher relaxed [pre-: males 364.43 (52.00) N · m -1 , females 270.27 (37.25) N · m -1 ; post-: males 446.75 (83.27) N · m -1 , females 307.39 (38.58) N · m -1 ] and contracted [pre-: males 495.07 (71.04) N · m -1 , females 332.34 (85.42) N · m -1 ; post-: males 546.37 (90.74) N · m -1 , females 349.21 (85.55) N · m -1 ] MS of the VL, and knee joint MAS [pre-: males 1450.11 (507.98) N · m -1 , females 1027.99 (227.33) N · m -1 ; post-: males 1345.81 (404.90) N · m -1 , females 952.78 (192.38) N · m -1 ] than females pre- and post-fatigue. A similar finding was observed in pre-fatigue normalised knee extensor PT [pre-: males 2.77 (0.42) N · m kg -1 , females 2.41 (0.40) N · m kg -1 , post-: males 2.53 (0.54) N · m kg -1 , females 2.26 (0.44) N · m kg -1 ]. After the fatigue protocol, normalised knee extensor PT and knee joint MAS decreased, whilst relaxed and contracted MS of the VL increased in both sexes. These observed differences may contribute to the higher risk of knee injury in females and following the onset of fatigue.

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

    Science.gov (United States)

    Bączkowicz, Dawid; Falkowski, Krzysztof; Majorczyk, Edyta

    2017-08-01

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

  16. Prevention of the knee and ankle joint injury for basketball players from the perspective of physiotherapy

    OpenAIRE

    KRŠKOVÁ, Adéla

    2017-01-01

    The topic of this work is about the prevention of knee and ankle injuries to basketball players from the perspective of physiotherapy. I have set two goals for this work, namely the setting up of a therapy to prevent injuries to the knee and ankle joint and then the detection of the effectiveness of this therapy. In connection with the goals, I have determined the research question: Whether the effect of the therapy will improve the monitored areas? In the theoretical part of my work, I dealt...

  17. Effect of a lateral wedge on joint moments during gait in subjects with recurrent ankle sprain.

    Science.gov (United States)

    Kakihana, Wataru; Torii, Suguru; Akai, Masami; Nakazawa, Kimitaka; Fukano, Mako; Naito, Kenji

    2005-11-01

    This study assessed the biomechanic effects of wearing a lateral wedge on the subtalar joint moment during gait in athletes with and without an unstable lateral ankle. A crossover design was applied whereby 50 collegiate males walked with two different wedges: a 0 degrees control wedge and a 6 degrees lateral wedge. We investigated frontal plane angles and moments at the subtalar joint and the knee joint, as well as ground reaction forces and center of pressure excursion. Moments were derived using a three-dimensional inverse dynamics model of the lower extremity. The 6 degrees lateral wedge significantly increased the subtalar joint valgus moment (P knee joint varus moment (P < 0.001) when compared with no wedge. The differences between wedge conditions were associated with a laterally shifted location of the center of pressure during stance phase. However, there were diverse, sometimes reversed effects with the wedge among the athletes with an unstable lateral ankle. These results indicate that biomechanical indications and limitations of lateral wedges in unstable lateral ankles should be analyzed in more detail, possibly leading to new guidelines for the use of such foot orthoses.

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Science.gov (United States)

    Kosik, Kyle B; Gribble, Phillip A

    2018-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  1. 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.

  2. How Does Ankle-foot Orthosis Stiffness Affect Gait in Patients With Lower Limb Salvage?

    Science.gov (United States)

    2014-05-10

    1.78 97.3 7.5 R LE tissue loss/trauma 4 40 1.81 81.0 9.3 L ankle fracture and osteoarthritis 5 30 1.75 79.1 9.8 L tibia/ fibula fracture 6 30 1.76 78.2...11.0 L LE neuropathy, crushed tibia/ fibula 7 36 1.78 75.5 4.4 L LE talar fracture , multiple fractures 8 22 1.64 80.3 9.0 R LE tissue loss/trauma 9 27...1.82 92.0 6.4 R equinovarus, LE tissue loss/trauma, neuropathy 10 23 1.74 84.1 5.0 L LE tibia/ fibula fracture 11 36 1.95 80.9 20.8 L LE fractures

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

    Science.gov (United States)

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

    2016-10-01

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

  4. Altering Shank-Rear-Foot Joint Coupling During Gait With Ankle Taping in Patients With Chronic Ankle Instability and Healthy Controls.

    Science.gov (United States)

    Herb, C Collin; Chinn, Lisa; Hertel, Jay

    2016-02-01

    Lateral ankle sprain (LAS) is one of the most common injuries in active individuals. Chronic ankle instability (CAI) is a condition that commonly occurs after LAS and is associated with long-term disability and a high risk of multiple ankle sprains. Ankle taping is a commonly used intervention for the prevention of ankle sprains. To analyze the ankle-joint coupling using vector coding during walking and jogging gait with the application of ankle tape and without ankle tape in young adults with and without CAI. Observational laboratory study design. Patients walked and jogged on an instrumented treadmill while taped and not taped. Fifteen strides for each subject were collected and analyzed using a vector-coding technique to compare magnitude coupled motion, ratio of coupled motion, and the variability (VCV) within groups. Within-group means and 90% confidence intervals (CI) were compared between the taped and nontaped condition, and where the CIs did not overlap was considered significant. A 12-camera 3D motion-capture system with instrumented treadmill. 12 patients with CAI and 11 healthy controls. Magnitude to coupled motion, ratio of coupled motion, and the VCV of shank-rear-foot joint coupling. Magnitude of coupled motion and VCV were significantly lower in the taped condition than in the nontaped condition in both groups. Magnitude differences were identified near initial contact during walking and during swing phase of jogging. VCV differences were identified throughout the gait cycle at both walking and jogging. No differences were identified in theta between tape and nontaped conditions. A decrease in the magnitude of coupled motion and VCV may represent a protective mechanism of ankle taping in CAI and healthy patients during gait.

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

    Science.gov (United States)

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

    2018-01-24

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Science.gov (United States)

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

    2002-03-01

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

  8. [On the forensic medical estimation of the harm to health in the case of the ankle joint injury].

    Science.gov (United States)

    Khabova, Z S; Fetisov, V A

    2012-01-01

    This paper is focused on the forensic medical evaluation of the severity of the harm to health of the subjects suffering an ankle joint (AJ) injury. The retrospective data pertinent to the forensic medical evaluation of ankle joint injuries are presented in conjunction with the methods for their clinical diagnostics currently applied in traumatology and orthopedics and by the specialists in socio-medical expertise for the assessment of the efficacy of the surgical treatment, prognosis, and rehabilitation of the affected patients.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. The Design, Development, and Reliability Testing of a New Innovative Device to Measure Ankle Joint Dorsiflexion.

    Science.gov (United States)

    Charles, James

    2016-09-02

    In clinical and research settings, ankle joint dorsiflexion needs to be reliably measured. Dorsiflexion is often measured by goniometry, but the intrarater and interrater reliability of this technique have been reported to be poor. Many devices to measure dorsiflexion have been developed for clinical and research use. An evaluation of 12 current tools showed that none met all of the desirable criteria. The purpose of this study was to design and develop a device that rates highly in all of the criteria and that can be proved to be highly reliable. While supine on a treatment table, 14 participants had a foot placed in the Charles device and ankle joint dorsiflexion measured and recorded three times with a digital inclinometer. The mean of the three readings was determined to be the ankle joint dorsiflexion. The analysis used was intraclass correlation coefficient (ICC). There was very little difference in ICC single or average measures between left and right feet, so data were pooled (N = 28). The single-measure ICC was 0.998 (95% confidence interval, 0.996-0.998). The average-measure ICC was 0.998 (95% confidence interval, 0.995-0.999). Limits of agreement for the average measure were also very good: -1.30° to 1.65°. The Charles device meets all of the desirable criteria and has many innovative features, increasing its appropriateness for clinical and research applications. It has a suitable design for measuring dorsiflexion and high intrarater and interrater reliability.

  11. 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

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

    International Nuclear Information System (INIS)

    Li Zhaoli; Liang Jingyin; Pan Zhifeng

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Matthias Aurich

    2014-12-01

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

  15. Dynamic Evaluation of the Contact Characteristics and Three-Dimensional Motion for the Ankle Joint with Lateral Ligament Injuries

    Science.gov (United States)

    Kawakami, Kensaku; Omori, Go; Terashima, Shojiro; Sakamoto, Makoto; Hara, Toshiaki

    The purpose of this study was to clarify the dynamic changes in contact pressure distribution and three-dimensional ankle joint motion before and after lateral ligament injuries. Five fresh and frozen intact cadaveric ankles were examined. Each ankle was mounted on a specially designed frame that preserved five degrees of freedom motion. The direct linear transformation technique was used to measure the three-dimensional ankle motion, and a pressure-sensitive conductive rubber sensor was inserted into the talocrural joint space to determine the contact pressure distribution. The contact area on the talus for intact ankle moved anteriorly and laterally with increasing dorsiflexion. An area of high pressure was observed in the medial aspect of the articular surface after the ligament was cut. Supination significantly increased after a combined anterior talofibular ligament (ATF) and calcaneofibular ligament (CF) were cut in comparison with after only an ATF was cut, and no significant differences were observed in motional properties under each experimental condition.

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

    Science.gov (United States)

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

    2014-04-01

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

  17. Summary of Human Ankle Mechanical Impedance During Walking.

    Science.gov (United States)

    Lee, Hyunglae; 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.

  18. Mechanical performance of dovetail joint related to the global stiffness of timber roof structures

    Czech Academy of Sciences Publication Activity Database

    Kunecký, Jiří; Arciszewska-Kędzior, Anna; Sebera, V.; Hasníková, Hana

    2016-01-01

    Roč. 49, č. 6 (2016), s. 2315-2327 ISSN 1359-5997 R&D Projects: GA MK(CZ) DF12P01OVV004 Keywords : dovetail * FEM * stiffness * carpentry joint * digital image correlation Subject RIV: AL - Art, Architecture, Cultural Heritage Impact factor: 2.607, year: 2016 http://link.springer.com/article/10.1617%2Fs11527-015-0651-1

  19. 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.

  20. Clinical Benefits of Joint Mobilization on Ankle Sprains: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Weerasekara, Ishanka; Osmotherly, Peter; Snodgrass, Suzanne; Marquez, Jodie; de Zoete, Rutger; Rivett, Darren A

    2017-09-04

    To assess the clinical benefits of joint mobilization for ankle sprains. MEDLINE, MEDLINE In-Process, Embase, AMED, PsycINFO, CINAHL, Cochrane Library, PEDro, Scopus, SPORTDiscus, and Dissertations and Theses were searched from inception to June 2017. Studies investigating humans with grade I or II lateral or medial sprains of the ankle in any pathologic state from acute to chronic, who had been treated with joint mobilization were considered for inclusion. Any conservative intervention was considered as a comparator. Commonly reported clinical outcomes were considered such as ankle range of movement, pain, and function. After screening of 1530 abstracts, 56 studies were selected for full-text screening, and 23 were eligible for inclusion. Eleven studies on chronic sprains reported sufficient data for meta-analysis. Data were extracted using the participants, interventions, comparison, outcomes, and study design approach. Clinically relevant outcomes (dorsiflexion range, proprioception, balance, function, pain threshold, pain intensity) were assessed at immediate, short-term, and long-term follow-up points. Methodological quality was assessed independently by 2 reviewers, and most studies were found to be of moderate quality, with no studies rated as poor. Meta-analysis revealed significant immediate benefits of joint mobilization compared with comparators on improving posteromedial dynamic balance (P=.0004), but not for improving dorsiflexion range (P=.16), static balance (P=.96), or pain intensity (P=.45). Joint mobilization was beneficial in the short-term for improving weight-bearing dorsiflexion range (P=.003) compared with a control. Joint mobilization appears to be beneficial for improving dynamic balance immediately after application, and dorsiflexion range in the short-term. Long-term benefits have not been adequately investigated. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Inter-individual similarities and variations in muscle forces acting on the ankle joint during gait.

    Science.gov (United States)

    Błażkiewicz, Michalina; Wiszomirska, Ida; Kaczmarczyk, Katarzyna; Naemi, Roozbeh; Wit, Andrzej

    2017-10-01

    Muscle forces acting over the ankle joint play an important role in the forward progression of the body during gait. Yet despite the importance of ankle muscle forces, direct in-vivo measurements are neither possible nor practical. This makes musculoskeletal simulation useful as an indirect technique to quantify the muscle forces at work during locomotion. The purpose of this study was to: 1) identify the maximum peaks of individual ankle muscle forces during gait; 2) investigate the order over which the muscles are sorted based on their maximum peak force. Three-dimensional kinematics and ground reaction forces were measured during the gait of 10 healthy subjects, and the data so obtained were input into the musculoskeletal model distributed with the OpenSim software. In all 10 individuals we observed that the soleus muscle generated the greatest strength both in dynamic (1856.1N) and isometric (3549N) conditions, followed by the gastrocnemius in dynamic conditions (1232.5N). For all other muscles, however, the sequence looks different across subjects, so the k-means clustering method was used to obtain one main order over which the muscles' peak-forces are sorted. The results indicate a common theme, with some variations in the maximum peaks of ankle muscle force across subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2009-10-01

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

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Shigeki Yokoyama

    2008-12-01

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

  5. Use of self-selected postures to regulate multi-joint stiffness during unconstrained tasks.

    Directory of Open Access Journals (Sweden)

    Randy D Trumbower

    Full Text Available The human motor system is highly redundant, having more kinematic degrees of freedom than necessary to complete a given task. Understanding how kinematic redundancies are utilized in different tasks remains a fundamental question in motor control. One possibility is that they can be used to tune the mechanical properties of a limb to the specific requirements of a task. For example, many tasks such as tool usage compromise arm stability along specific directions. These tasks only can be completed if the nervous system adapts the mechanical properties of the arm such that the arm, coupled to the tool, remains stable. The purpose of this study was to determine if posture selection is a critical component of endpoint stiffness regulation during unconstrained tasks.Three-dimensional (3D estimates of endpoint stiffness were used to quantify limb mechanics. Most previous studies examining endpoint stiffness adaptation were completed in 2D using constrained postures to maintain a non-redundant mapping between joint angles and hand location. Our hypothesis was that during unconstrained conditions, subjects would select arm postures that matched endpoint stiffness to the functional requirements of the task. The hypothesis was tested during endpoint tracking tasks in which subjects interacted with unstable haptic environments, simulated using a 3D robotic manipulator. We found that arm posture had a significant effect on endpoint tracking accuracy and that subjects selected postures that improved tracking performance. For environments in which arm posture had a large effect on tracking accuracy, the self-selected postures oriented the direction of maximal endpoint stiffness towards the direction of the unstable haptic environment.These results demonstrate how changes in arm posture can have a dramatic effect on task performance and suggest that postural selection is a fundamental mechanism by which kinematic redundancies can be exploited to regulate arm

  6. Use of self-selected postures to regulate multi-joint stiffness during unconstrained tasks.

    Science.gov (United States)

    Trumbower, Randy D; Krutky, Matthew A; Yang, Bing-Shiang; Perreault, Eric J

    2009-01-01

    The human motor system is highly redundant, having more kinematic degrees of freedom than necessary to complete a given task. Understanding how kinematic redundancies are utilized in different tasks remains a fundamental question in motor control. One possibility is that they can be used to tune the mechanical properties of a limb to the specific requirements of a task. For example, many tasks such as tool usage compromise arm stability along specific directions. These tasks only can be completed if the nervous system adapts the mechanical properties of the arm such that the arm, coupled to the tool, remains stable. The purpose of this study was to determine if posture selection is a critical component of endpoint stiffness regulation during unconstrained tasks. Three-dimensional (3D) estimates of endpoint stiffness were used to quantify limb mechanics. Most previous studies examining endpoint stiffness adaptation were completed in 2D using constrained postures to maintain a non-redundant mapping between joint angles and hand location. Our hypothesis was that during unconstrained conditions, subjects would select arm postures that matched endpoint stiffness to the functional requirements of the task. The hypothesis was tested during endpoint tracking tasks in which subjects interacted with unstable haptic environments, simulated using a 3D robotic manipulator. We found that arm posture had a significant effect on endpoint tracking accuracy and that subjects selected postures that improved tracking performance. For environments in which arm posture had a large effect on tracking accuracy, the self-selected postures oriented the direction of maximal endpoint stiffness towards the direction of the unstable haptic environment. These results demonstrate how changes in arm posture can have a dramatic effect on task performance and suggest that postural selection is a fundamental mechanism by which kinematic redundancies can be exploited to regulate arm stiffness in

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  9. Ankle arthrodesis.

    Science.gov (United States)

    Boc, Steven F; Norem, Nathan D

    2012-01-01

    This article presents an overview of current ankle arthrodesis techniques. Surgical indications, pathophysiology of the ankle joint, preoperative assessment of the patient, surgical techniques for ankle fusion, and complications/sequelae are discussed. The surgical techniques section focuses on crossed screws arthrodesis and intramedullary nailing for tibiotalocalcaneal arthrodesis. Other techniques, including arthroscopic fusion, are also discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Pneumatic Artificial Muscles Force Modelling and the Position and Stiffness Control on the Knee Joint of the Musculoskeletal Leg

    OpenAIRE

    Jingtao Lei; Jianmin Zhu

    2017-01-01

    Pneumatic artificial muscles (PAMs) have properties similar to biological muscle and are widely used in robotics as actuators. A musculoskeletal leg mechanism driven by PAMs is presented in this paper. The joint stiffness of the musculoskeletal bionic leg for jumping movement needs to be analysed. The synchronous control on the position and stiffness of the joint is important to improve the flexibility of leg. The accurate force model of PAM is the foundation to achieving better control and d...

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

    Science.gov (United States)

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

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

  12. Effect of Stiffness of Rolling Joints on the Dynamic Characteristic of Ball Screw Feed Systems in a Milling Machine

    Directory of Open Access Journals (Sweden)

    Dazhong Wang

    2015-01-01

    Full Text Available Dynamic characteristic of ball screw feed system in a milling machine is studied numerically in this work. In order to avoid the difficulty in determining the stiffness of rolling joints theoretically, a dynamic modeling method for analyzing the feed system is discussed, and a stiffness calculation method of the rolling joints is proposed based on the Hertz contact theory. Taking a 3-axis computer numerical control (CNC milling machine set ermined as a research object, the stiffness of its fixed joint between the column and the body together with the stiffness parameters of the rolling joints is evaluated according to the Takashi Yoshimura method. Then, a finite element (FE model is established for the machine tool. The correctness of the FE model and the stiffness calculation method of the rolling joints are validated by theoretical and experimental modal analysis results of the machine tool’s workbench. Under the two modeling methods of joints incorporating the stiffness parameters and rigid connection, a theoretical modal analysis is conducted for the CNC milling machine. The natural frequencies and modal shapes reveal that the joints’ dynamic characteristic has an important influence on the dynamic performance of a whole machine tool, especially for the case with natural frequency and higher modes.

  13. What leads to failure of joint-preserving surgery for ankle osteoarthritis?: when this surgery fails, what next?

    Science.gov (United States)

    Espinosa, Norman

    2013-09-01

    This article discusses the lack of scientific evidence regarding the treatment of failed joint-preserving surgery. Most of the concepts of treatment derive from treatment modalities in trauma and orthopedic surgery. The main question for the foot and ankle specialist is whether the joint can be salvaged. The definition of failure is difficult. Therefore pain reported by the patient is the main symptom that dictates the course of treatment. Whenever possible the joint should be maintained. However, if pain is associated with global radiographic osteoarthritis, total ankle replacement or fusions are the only means to solve the problem. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. A review of shear strength models for rock joints subjected to constant normal stiffness

    Directory of Open Access Journals (Sweden)

    Sivanathan Thirukumaran

    2016-06-01

    Full Text Available The typical shear behaviour of rough joints has been studied under constant normal load/stress (CNL boundary conditions, but recent studies have shown that this boundary condition may not replicate true practical situations. Constant normal stiffness (CNS is more appropriate to describe the stress–strain response of field joints since the CNS boundary condition is more realistic than CNL. The practical implications of CNS are movements of unstable blocks in the roof or walls of an underground excavation, reinforced rock wedges sliding in a rock slope or foundation, and the vertical movement of rock-socketed concrete piles. In this paper, the highlights and limitations of the existing models used to predict the shear strength/behaviour of joints under CNS conditions are discussed in depth.

  15. Resistance and elastic stiffness of RHS "T" joints: part I - axial brace loading

    Directory of Open Access Journals (Sweden)

    R.M.M.P. de Matos

    Full Text Available Abstract This paper presents a study on the behaviour of welded "T" joints between RHS sections under brace axial loading. A finite element model was developed to investigate the influence of some geometrical variables on the joint's response. The brace load (always in tension was incremented up to joint failure, while the chord was kept unloaded. In the companion paper (part II a complementary study including chord axial loading is presented. The force-displacement curves corresponding to the different geometries are analyzed and compared, focusing on the failure loads and elastic stiffness. Different failure criteria are discussed and applied to the present curves and a comparison of the numerical results with the Eurocode 3 provisions is presented and discussed.

  16. Numerical simulation of strain-adaptive bone remodelling in the ankle joint

    Directory of Open Access Journals (Sweden)

    Stukenborg-Colsman Christina

    2011-07-01

    Full Text Available Abstract Background The use of artificial endoprostheses has become a routine procedure for knee and hip joints while ankle arthritis has traditionally been treated by means of arthrodesis. Due to its advantages, the implantation of endoprostheses is constantly increasing. While finite element analyses (FEA of strain-adaptive bone remodelling have been carried out for the hip joint in previous studies, to our knowledge there are no investigations that have considered remodelling processes of the ankle joint. In order to evaluate and optimise new generation implants of the ankle joint, as well as to gain additional knowledge regarding the biomechanics, strain-adaptive bone remodelling has been calculated separately for the tibia and the talus after providing them with an implant. Methods FE models of the bone-implant assembly for both the tibia and the talus have been developed. Bone characteristics such as the density distribution have been applied corresponding to CT scans. A force of 5,200 N, which corresponds to the compression force during normal walking of a person with a weight of 100 kg according to Stauffer et al., has been used in the simulation. The bone adaptation law, previously developed by our research team, has been used for the calculation of the remodelling processes. Results A total bone mass loss of 2% in the tibia and 13% in the talus was calculated. The greater decline of density in the talus is due to its smaller size compared to the relatively large implant dimensions causing remodelling processes in the whole bone tissue. In the tibia, bone remodelling processes are only calculated in areas adjacent to the implant. Thus, a smaller bone mass loss than in the talus can be expected. There is a high agreement between the simulation results in the distal tibia and the literature regarding. Conclusions In this study, strain-adaptive bone remodelling processes are simulated using the FE method. The results contribute to a better

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

    Directory of Open Access Journals (Sweden)

    V.V. Vitomskyi

    2017-11-01

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

  18. Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

    DEFF Research Database (Denmark)

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

    2015-01-01

    OBJECTIVE: It is still not clarified whether spasticity contributes to impairments of gait function. Here we compared biomechanical measures of muscle weakness and stiffness of ankle muscles to impairments of gait function in adults with cerebral palsy (CP). METHODS: Twenty-four adults with CP...... analysis of the ankle joint during treadmill walking was obtained by 3-D motion analysis. RESULTS: Passive stiffness was significantly increased in adults with CP compared to controls. Passive stiffness and RFDdf were correlated to reduced toe lift. RFDpf provided the best correlation to push-off velocity......, range of movement in the ankle joint and gait speed. Reflex-mediated stiffness was not correlated to any parameters of impaired gait. CONCLUSIONS: Impaired gait function in adults with CP is associated with reduced RFD and increased passive stiffness of ankle muscles. SIGNIFICANCE: These findings...

  19. Changes in ground reaction force during jump landing in subjects with functional instability of the ankle joint.

    Science.gov (United States)

    Caulfield, Brian; Garrett, Mary

    2004-07-01

    To identify changes in ground reaction force during jump landing in subjects with functional instability of the ankle joint. Comparison of ground reaction force during jump landing between subjects with functional instability and healthy controls. We have recently demonstrated significantly altered patterns of ankle and knee movement immediately pre- and post-impact in subjects with functional instability compared to healthy controls. We now examine the changes in timing and magnitude of forces sustained by the unstable ankle during jump landing. Fourteen subjects with unstable ankles and 10 age, sex and activity matched controls performed five single leg jumps onto a force platform whilst ground reaction forces were sampled. Timing and magnitudes of forces during the first 150 ms following impact were analysed and compared between groups. Lateral and anterior force peaks occurred significantly earlier in subjects with functional instability. Significant differences were seen between groups' time-averaged vertical, frontal and sagittal components of ground reaction force. These ranged from 5% (frontal force) to 100% (vertical force) of body mass. These changes occur immediately post-impact and too early for reflex correction/modification. The disordered force patterns observed in subjects with functional instability are likely to result in repeated injury due to significant increase in stress on ankle joint structures during jump landing. We suggest that they are most likely to result from deficits in feed-forward motor control. These results identify the potentially injurious nature of the changes in the forces applied to the unstable ankle joint during jump landing. The timing of these changes suggests that they are caused by a motor control deficit. Treatment approaches aimed at retraining feed-forward control of ankle joint movement could succeed in restoring more normal patterns of force absorption and reduce the occurrence of repeated micro-trauma to ankle

  20. Effects of balance training on post-sprained ankle joint instability.

    Science.gov (United States)

    Faizullin, I; Faizullina, E

    2015-01-01

    Ankle sprain is a medical condition when ankle ligaments are totally or partially torn. The primary cause of ankle sprain is sharp movements like turning or rolling the foot [1]. The ankle sprain needs to be treated right after the trauma, because if not treated it could lead to decreased stability of the ankle joint and lead to chronic ankle instability, which is characterized by increased risk of the ankle sprain [2] . We suppose that rehabilitation after the ankle sprain could significantly increase the performance of sportsmen. To investigate effects of balance exercise training on instable ankle due to the previous ankle sprain injury. In addition, the secondary aim of this systematic review was to find the effectiveness of different balance training exercises on instable ankle in order to find better opportunities for rehabilitation of sportsmen. The studies were selected from PubMed and Scopus using the library of the Friedrich-Alexander University of Erlangen-Nuremberg (further-UB FAU), we used full texts, and only texts in English were included in this review. The literature search was conducted at the end of December 2014. Texts included randomised controlled trials, which were published in the last 5 years (2009-2014). The literature was included in this review only if it was published in English and if the randomised controlled trial was conducted in the study and if the full text was available from UB FAU. The articles, which were found only in PubMed search, were excluded during Scopus search.PubMed search.First MeSH term was "Balance training for the ankle sprain" and 44 articles were found in PubMed. Then 29 articles were filtered by title and excluded from the study. Remaining 15 articles were assessed reading their abstracts, 6 of them were excluded and only 4 articles were left. The second MeSH term was "Balance training for ankle injury". Four additional articles were found by initial search. Two of them were filtered by the title and 2 were

  1. Quasi-stiffness of the knee joint in flexion and extension during the golf swing.

    Science.gov (United States)

    Choi, Ahnryul; Sim, Taeyong; Mun, Joung Hwan

    2015-01-01

    Biomechanical understanding of the knee joint during a golf swing is essential to improve performance and prevent injury. In this study, we quantified the flexion/extension angle and moment as the primary knee movement, and evaluated quasi-stiffness represented by moment-angle coupling in the knee joint. Eighteen skilled and 23 unskilled golfers participated in this study. Six infrared cameras and two force platforms were used to record a swing motion. The anatomical angle and moment were calculated from kinematic and kinetic models, and quasi-stiffness of the knee joint was determined as an instantaneous slope of moment-angle curves. The lead knee of the skilled group had decreased resistance duration compared with the unskilled group (P knee was lower than that of the trail knee in the skilled group (P knee of the skilled golfers had greater flexible excursion duration than the trail knee of the skilled golfers, and of both the lead and trail knees of the unskilled golfers. These results provide critical information for preventing knee injuries during a golf swing and developing rehabilitation strategies following surgery.

  2. Planar jumping with stable landing through foot orientation design and ankle joint control

    Science.gov (United States)

    Yuan, Qilong; Chen, I.-Ming

    2012-06-01

    This paper introduces a method to generate the planar jumping motion for biped robot. In this work, through determining the upper body posture trajectory in the flight phase, the foot landing posture is made to be flat while landing. Together with properly designing the trajectory for local center of gravity and the foot landing velocity, the soft landing trajectory is generated. A controller on the ankle joint is added to avoid significant impact with the ground and stabilize the robot after landing. Jumping motion with stable landing is achieved in a dynamic simulation environment based on this method.

  3. Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study.

    Science.gov (United States)

    Richard, Vincent; Lamberto, Giuliano; Lu, Tung-Wu; Cappozzo, Aurelio; Dumas, Raphaël

    2016-01-01

    The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix. The deformation energy, computed from the stiffness matrix and joint angles and displacements, is minimised within the MBO. Implemented as a "soft" constraint using a penalty-based method, this elastic joint description challenges the strictness of "hard" constraints. In this study, estimates of knee kinematics obtained using MBO embedding four different knee joint models (i.e., no constraints, spherical joint, parallel mechanism, and elastic joint) were compared against reference kinematics measured using bi-planar fluoroscopy on two healthy subjects ascending stairs. Bland-Altman analysis and sensitivity analysis investigating the influence of variations in the stiffness matrix terms on the estimated kinematics substantiate the conclusions. The difference between the reference knee joint angles and displacements and the corresponding estimates obtained using MBO embedding the stiffness matrix showed an average bias and standard deviation for kinematics of 0.9±3.2° and 1.6±2.3 mm. These values were lower than when no joint constraints (1.1±3.8°, 2.4±4.1 mm) or a parallel mechanism (7.7±3.6°, 1.6±1.7 mm) were used and were comparable to the values obtained with a spherical joint (1.0±3.2°, 1.3±1.9 mm). The study demonstrated the feasibility of substituting an elastic joint for more classic joint constraints in MBO.

  4. 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.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    DEFF Research Database (Denmark)

    Leukel, Christian; Taube, Wolfgang; Rittweger, Jörn

    2015-01-01

    OBJECTIVES: Joint immobilization has previously been shown to modulate corticospinal excitability. The present study investigated changes in the excitability of distinct fractions of the corticospinal pathway by means of conditioning the H-reflex with transcranial magnetic stimulation (TMS......) of the primary motor cortex (Hcond). This method allows assessment of transmission in fast (monosynaptic) and slow(er) (polysynaptic) corticospinal pathways. METHODS: 9 subjects underwent 8weeks of unilateral ankle joint immobilization during daytime, 7 subjects served as controls. The measures obtained before...... and after immobilization included stretch- and H-reflexes assessing excitability of the spinal reflex circuitries, TMS recruitment curves estimating overall changes in corticospinal excitability, and Hcond. RESULTS: TMS recruitment curves showed an overall increase in corticospinal excitability following...

  7. 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.

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  9. Effect on Spasticity After Performance of Dynamic-Repeated-Passive Ankle Joint Motion Exercise in Chronic Stroke Patients

    Directory of Open Access Journals (Sweden)

    Chin-Li Wu

    2006-12-01

    Full Text Available Spasticity associated with abnormal muscle tone is a common motor disorder following stroke, and the spastic ankle may affect ambulatory function. The purpose of this study was to investigate the short-term effect of dynamic-repeated-passive ankle movements with weight loading on ambulatory function and spastic hypertonia of chronic stroke patients. In this study, 12 chronic stroke patients with ankle spasticity and inefficient ambulatory ability were enrolled. Stretching of the plantar-flexors of the ankle in the standing position for 15 minutes was performed passively by a constant-speed and electrically powered device. The following evaluations were done before and immediately after the dynamic-repeated-passive ankle movements. Spastic hypertonia was assessed by the Modified Ashworth Scale (MAS; range, 0–4, Achilles tendon reflexes test (DTR; range, 0–4, and ankle clonus (range, 0–5. Improvement in ambulatory ability was determined by the timed up-and-go test (TUG, the 10-minute walking test, and cadence (steps/minute. In addition, subjective experience of the influence of ankle spasticity on ambulation was scored by visual analog scale (VAS. Subjective satisfaction with the therapeutic effect of spasticity reduction was evaluated by a five-point questionnaire (1 = very poor, 2 = poor, 3 = acceptable, 4 = good, 5 = very good. By comparison of the results before and after intervention, these 12 chronic stroke patients presented significant reduction in MAS and VAS for ankle spasticity, the time for TUG and 10-minute walking speed (p < 0.01. The cadence also increased significantly (p < 0.05. In addition, subjective satisfaction with the short-term therapeutic effect was mainly good (ranging from acceptable to very good. In conclusion, 15 minutes of dynamic-repeated-passive ankle joint motion exercise with weight loading in the standing position by this simple constant-speed machine is effective in reducing ankle spasticity and improving

  10. Dynamic ankle control in athletes with ankle instability during sports maneuvers.

    Science.gov (United States)

    Lin, Cheng-Feng; Chen, Chin-Yang; Lin, Chia-Wei

    2011-09-01

    Ankle sprain is a common sports injury. While the effects of static constraints in stabilizing the ankle joint are relatively well understood, those of dynamic constraints are less clear and require further investigation. This study was undertaken to evaluate the dynamic stability of the ankle joint during the landing phase of running and stop-jump maneuvers in athletes with and without chronic ankle instability (CAI). Controlled laboratory study. Fifteen athletes with CAI and 15 age-matched athletes without CAI performed running and stop-jump landing tasks. The dynamic ankle joint stiffness, tibialis anterior (TA)/peroneus longus (PL) and TA/gastrocnemius lateralis (GL) co-contraction indices, ankle joint angle, and root-mean-square (RMS) of the TA, PL, and GL electromyographic signals were measured during each task. During running, the CAI group exhibited a greater ankle inversion angle than the control group in the pre-landing phase (P = .012-.042) and a lower dynamic ankle joint stiffness in the post-landing phase (CAI: 0.109 ± 0.039 N·m/deg; control: 0.150 ± 0.068 N·m/deg; P = .048). In the stop-jump landing task, athletes with CAI had a significantly lower TA/PL co-contraction index during the pre-landing phase (CAI: 49.1 ± 19; control: 64.8 ± 16; P = .009). In addition, the CAI group exhibited a greater ankle inversion (P = .049), a lower peak eversion (P = .04), and a smaller RMS of the PL electromyographic signal in the post-landing phase (CAI: 0.73 ± 0.32; control: 0.51 ± 0.22; P = .04). Athletes with CAI had a relatively inverted ankle, reduced muscle co-contraction, and a lower dynamic stiffness in the ankle joint during the landing phase of sports maneuvers and this may jeopardize the stability of the ankle. Sports training or rehabilitation programs should differentiate between the pre-landing and post-landing phases of sports maneuvers, and should educate athletes to land with an appropriate ankle position and muscle recruitment.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  12. Resistance and Elastic Stiffness of RHS "T" Joints: Part II - Combined Axial Brace and Chord Loading

    Directory of Open Access Journals (Sweden)

    R.M.M.P. de Matos

    Full Text Available Abstract This paper deals with the behaviour of welded "T" joints between RHS sections submitted to tension brace loading combined with chord axial loading. In the companion paper (part I a finite element model and a study without axial load in the chord, focusing on the joint behaviour as a function of the significant geometrical variables, were presented. In this part II paper, tension loading on the brace is incremented up to the joint failure, but is combined with different chord load levels in tension or compression, that are kept constant for each case. The same geometries and geometric variables as in the companion paper are used, and therefore the influence of these features together with the chord load level (in tension or compression on the connection's response is evaluated. The force-displacement curves from the different geometries and chord load levels are analysed and compared, with a special attention on the influence of the chord load on the joint resistance and stiffness. Finally, a comparison of the numerical results with the (Eurocode 3, 2005 and the newer (ISO 14346, 2013 provisions is presented and discussed.

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

    Science.gov (United States)

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

    2009-12-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  15. Pneumatic Artificial Muscles Force Modelling and the Position and Stiffness Control on the Knee Joint of the Musculoskeletal Leg

    Directory of Open Access Journals (Sweden)

    Jingtao Lei

    2017-03-01

    Full Text Available Pneumatic artificial muscles (PAMs have properties similar to biological muscle and are widely used in robotics as actuators. A musculoskeletal leg mechanism driven by PAMs is presented in this paper. The joint stiffness of the musculoskeletal bionic leg for jumping movement needs to be analysed. The synchronous control on the position and stiffness of the joint is important to improve the flexibility of leg. The accurate force model of PAM is the foundation to achieving better control and dynamic jumping performance. The experimental platform of PAM is conducted, and the static equal pressure experiments are performed to obtain the PAM force model. According to the testing data, parameter identification method is adopted to determine the force model of PAM. A simulation on the position and stiffness control of the knee joint is performed, and the simulation results show the effectiveness of the presented method.

  16. Biomechanical gender differences of the ankle joint during simulated half-squat parachute landing.

    Science.gov (United States)

    Niu, Wenxin; Wang, Yang; He, Yan; Fan, Yubo; Zhao, Qinping

    2010-08-01

    A search of the literature did not reveal known gender differences in biomechanics during parachute landing. Eight male and eight female healthy adults participated in this experiment. Each individual jumped from platforms with three different heights (low: 0.32 m; medium: 0.52 m; and high: 0.72 m) and landed on flat ground in a standard half-squat parachute landing technique. The ground reaction force (GRF) normalized to bodyweight (BW), ankle joint kinematics, and the surface electromyogram (EMG) signals of the tibialis anterior (TA) and lateral gastrocnemius (LG) were measured. Two-way ANOVA was used to analyze the effects of the dropping height and gender factors. The anterior-posterior GRF (men 1.01 BW; women 0.79 BW), rate of loading (men 260 BW x s(-1); women 127 BW x s(-1)), and absolute EMG amplitude of TA (pre-landing: men 219 microv; women 129 microv; post-landing: men 573 microv; women 288 microv) in the men's group were significantly higher than in the women's group, whereas peak angular velocity of dorsiflexion in the women's group (1627 degrees x s(-1)) was significantly higher than in the men's (1188 degrees x s(-1)). Women are prone to transform the kinetic energy to the ankle motion, whereas men are more likely to transform it to friction. The co-contraction of the ankle flexor and extensor differs between genders. These factors may be associated with the higher incidence of parachute injuries among women reported by some authors.

  17. Arthrography and its value in comparison with fixation radiography in the diagnosis of lesions to the capsular ligament of the ankle joint

    International Nuclear Information System (INIS)

    Franke, D.; Weiher, U.; Sossinka, N.P.; Fenn, K.

    1986-01-01

    From May 1981 till May 1982, we consistently performed arthography of the injured joint and fixation radiography according to Scheuba (pressure: 15 kp) of both ankle joints for reasons of comparison in all patients with a distorsion trauma of the ankle joint and with suspected lesions to the ligaments. 259 cases were used for the assessment. Fixation radiography should not be used any more. Mere clinical examination combined with the case history can be assumed to be superior to fixation radiography still. Arthrography clearly is the more sensitive method for the diagnosis of injuries to the external capsular ligament of the ankle joint. (orig./SHA) [de

  18. High resolution ultrasonography and magnetic resonance imaging in the evaluation of tendino-ligamentous injuries around ankle joint

    Directory of Open Access Journals (Sweden)

    Nevien El-Liethy

    2016-06-01

    Conclusion: US is an excellent tool for imaging soft tissue abnormalities, as it allows rapid, in-expensive detailed examination of the structures of the ankle joint. US and MRI are two complementary tools of investigation with the former being used as primary effective tool of investigation and the latter is done to confirm the diagnosis.

  19. Increased delivery stride length places greater loads on the ankle joint in elite male cricket fast bowlers.

    Science.gov (United States)

    Spratford, Wayne; Hicks, Amy

    2014-01-01

    The purpose of this study was to investigate the effect stride length has on ankle biomechanics of the leading leg with reference to the potential risk of injury in cricket fast bowlers. Ankle joint kinematic and kinetic data were collected from 51 male fast bowlers during the stance phase of the final delivery stride. The bowling cohort comprised national under-19, first class and international-level athletes. Bowlers were placed into either Short, Average or Long groups based on final stride length, allowing statistical differences to be measured. A multivariate analysis of variance with a Bonferroni post-hoc correction (α = 0.05) revealed significant differences between peak plantarflexion angles (Short-Long P = 0.005, Average and Long P = 0.04) and negative joint work (Average-Long P = 0.026). This study highlighted that during fast bowling the ankle joint of the leading leg experiences high forces under wide ranges of movement. As stride length increases, greater amounts of negative work and plantarflexion are experienced. These increases place greater loads on the ankle joint and move the foot into positions that make it more susceptible to injuries such as posterior impingement syndrome.

  20. 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.

  1. 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

  2. Biomechanical Evaluation of Strength and Stiffness of Subtalar Joint Arthrodesis Screw Constructs.

    Science.gov (United States)

    Jastifer, James R; Alrafeek, Saif; Howard, Peter; Gustafson, Peter A; Coughlin, Michael J

    2016-04-01

    Subtalar arthrodesis is a common treatment for end-stage subtalar joint arthritis as well as many other clinical problems. The best method of subtalar arthrodesis fixation is unknown. The purpose of this study was to compare the strength of subtalar arthrodesis fixation methods including a single posterior screw (SP), 2 posterior minimally divergent screws (MD) and a 2 screw highly divergent screw (HD) construct for subtalar arthrodesis. A biomechanical study was performed including the three different screw configurations (SP, MD, HD). These surrogate bone specimens were subjected to applied inversion and eversion torques about the subtalar joint axis on a servo-hydraulic load frame. Torsional stiffness of the construct and the maximum torque for each configuration were measured. Additionally, a cadaver study was performed using 5 fresh-frozen cadaver specimens. The perpendicular distance from the divergent screw guide-wire placement was measured from anatomic structures. The HD screw configuration was found to have the highest torsional stiffness in both inversion and eversion, followed by the MD construct and then the SP construct. Similarly, the HD construct had the highest maximum torque versus the MD and SP constructs. All between-group differences were statistically significant (P screw included the sural nerve (13 mm), peroneus brevis tendon (18 mm), tibialis anterior tendon (8 mm), and tibialis posterior tendon (21 mm). This biomechanical and cadaver study supports the use of 2 screws for fixation of subtalar arthrodesis over a single posterior screw. Additionally, we describe a biomechanically superior and potentially safe, alternative 2-screw divergent construct. This study gives biomechanical support for 2 screw, divergent fixation of subtalar arthrodesis or a single over a single screw or two screw minimally divergent construct. © The Author(s) 2015.

  3. Relationship between resistant hypertension and arterial stiffness assessed by brachial-ankle pulse wave velocity in the older patient

    Directory of Open Access Journals (Sweden)

    Chung CM

    2014-09-01

    Full Text Available Chang-Min Chung,1,2 Hui-Wen Cheng,2 Jung-Jung Chang,2 Yu-Sheng Lin,2 Ju-Feng Hsiao,2 Shih-Tai Chang,1 Jen-Te Hsu2,31School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, 2Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, 3Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, TaiwanBackground: Resistant hypertension (RH is a common clinical condition associated with increased cardiovascular mortality and morbidity in older patients. Several factors and conditions interfering with blood pressure (BP control, such as excess sodium intake, obesity, diabetes, older age, kidney disease, and certain identifiable causes of hypertension are common in patients resistant to antihypertensive treatment. Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV, is increasingly recognized as an important prognostic index and potential therapeutic target in hypertensive patients. The aim of this study was to determine whether there is an association between RH and arterial stiffness. Methods: This study included 1,620 patients aged ≥65 years who were referred or self-referred to the outpatient hypertension unit located at a single cardiovascular center. They were separated into normotensive, controlled BP, and resistant hypertension groups. Home BP, blood laboratory parameters, echocardiographic studies and baPWV all were measured. Results: The likelihood of diabetes mellitus was significantly greater in the RH group than in the group with controlled BP (odds ratio 2.114, 95% confidence interval [CI] 1.194–3.744, P=0.010. Systolic BP was correlated in the RH group significantly more than in the group with controlled BP (odds ratio 1.032, 95% CI 1.012–1.053, P=0.001. baPWV (odds ratio 1.084, 95% CI 1.016–1.156, P=0.015 was significantly correlated with the presence of RH. The other factors were negatively correlated with the existence of RH.Conclusion: In

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

    Science.gov (United States)

    Mildren, Robyn L; Bent, Leah R

    2016-04-15

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

  5. Association Between Knee Osteoarthritis and Functional Changes in Ankle Joint and Achilles Tendon.

    Science.gov (United States)

    Elbaz, Avi; Magram-Flohr, Irina; Segal, Ganit; Mor, Amit; Debi, Ronen; Kalichman, Leonid

    Increasing evidence has shown that biomechanical forces often drive the progression of knee osteoarthritis (OA). Attention should be given to the changes in adjacent joints and their relation to knee OA. The purpose of the present study was to examine the changes in Achilles tendon thickness of individuals with knee OA and to evaluate the correlation between Achilles tendon thickness and knee OA severity in a case-control prospective observational study. A total of 93 participants with no previous ankle injuries were recruited. Of the 93 participants, 63 had knee OA of the medial compartment and 30 served as controls. The subjects underwent a clinical examination that included measurements of weight, height, Achilles tendon thickness, and 1-leg heel rise. The subjects also underwent a computerized gait test and completed the Hebrew version of the Western Ontario and McMaster Osteoarthritis Index and 36-item short-form (SF-36) health survey. Significant difference was found in Achilles tendon thickness between the subjects with knee OA and the healthy controls (17.1 ± 3.4 versus 15.1 ± 3.1; p = .009). Significant differences were also found between the 2 groups in the 1-leg heel rise test, Western Ontario and McMaster Osteoarthritis Index scores, SF-36 scores, and all gait measures. Significant correlations were found between the Achilles tendon thickness and the following measures: weight (r = 0.46), body mass index (r = 0.55), Kellgren and Lawrence OA severity grade (r = 0.25), 1-leg heel rises (r = -0.50), and SF-36 score (r = -0.25). Subjects with knee OA presented with a thicker Achilles tendon compared with the healthy controls. Furthermore, a significant correlation between Achilles tendon thickness and knee OA severity was found. A comprehensive assessment of the Achilles tendon and ankle joint should be a part of the knee OA evaluation process. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All

  6. Features of hindfoot 3D kinetics in flat foot in ankle-joint maximal dorsiflexion and plantarflexion.

    Science.gov (United States)

    Imai, Kan; Ikoma, Kazuya; Maki, Masahiro; Kido, Masamitsu; Tsuji, Yoshiro; Takatori, Ryota; Tokunaga, Daisaku; Inoue, Nozomu; Kubo, Toshikazu

    2011-09-01

    It is difficult to evaluate the kinematics of flat foot from 2D images, and no definitive methods have so far been established to diagnose flat foot. This study evaluated hindfoot kinetics through the progression of posterior tibial tendon dysfunction (PTTD) in patients with stages II and III PTTD flat foot compared with those in normal patients under dorsiflexion and plantarflexion conditions using 3D computed tomography (CT) reconstruction images. CT images were taken of 26 normal and 32 flat feet in neutral, plantarflexion, and dorsiflexion positions of the ankle joint, from which 3D virtual models were made of each hindfoot bone. The 3D bone motion of these models was calculated using volume merge methods in three major planes. Tibiotalar-joint motion in ankle-joint plantarflexion became less plantarflexed (normal -41.2°, stage II -33.5°, stage III -25.3°) and less adducted (normal -13.9°, stage II -10.7°, stage III -5.6°) as the stage progressed. Talocalcaneal-joint motion in stage III became more plantarflexed (normal -0.8°, stage II -3.0°, stage III -8.7°) and more adducted (normal -0.3°, stage II -4.7°, stage III -10.3°) as the stage progressed. Talonavicular-joint motion in stage III became more plantarflexed (normal -7.2°, stage II -7.6°, stage III -14.9°) and more adducted (normal 1.0°, stage II -7.3°, stage III -17.9°) as the stage progressed. Tibiotalar-joint plantarflexion decreased and talocalcaneal and talonavicular-joint adduction increased in the maximal ankle-joint plantarflexion in stage II in comparison with normal cases. Tibiotalar-joint plantarflexion and adduction were decreased and of the talocalcaneal and talonavicular joints increased in stage III in comparison with stage II cases.

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

    Directory of Open Access Journals (Sweden)

    Filiz Ateş

    2018-01-01

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

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

    Science.gov (United States)

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

    2016-11-08

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

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

    Science.gov (United States)

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

    2015-07-01

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

  10. Ankle sprain

    NARCIS (Netherlands)

    Struijs, Peter; Kerkhoffs, Gino

    2007-01-01

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

  11. Ankle sprain

    NARCIS (Netherlands)

    Struijs, Peter Aa; Kerkhoffs, Gino Mmj

    2010-01-01

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

  12. Sprained Ankles

    Science.gov (United States)

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

  13. 99mTc-HDP SPECT-CT Aids Localization of Joint Injections in Degenerative Joint Disease of the Foot and Ankle.

    Science.gov (United States)

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

    2015-08-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  15. The Influence of Outdoor Shoe Sole Stiffness on the Metatarsophalangeal Joint Kinematics When Walking and Running in Different Conditions

    Directory of Open Access Journals (Sweden)

    Paolo Mistretta

    2018-02-01

    Full Text Available Understanding the action of the metatarsophalangeal joint (MTP is fundamental to improving the design process of a new outdoor shoe. Coming from the stated consideration, the aim of this research is to study the influence of shoe sole stiffness and terrain slope on the MTP joint angle of subjects walking in different conditions. To pursue this intent, different data collection sessions have been carried out in-vitro and in-vivo, indoor and outdoor. Two different approaches have been used to collect gait kinematics: an IMU (Inertial Measurement Unit based system for the first campaign of tests, and a 2D video analysis for the second. Major findings showed a linear correlation between shoe sole stiffness and peak MTP joint angle during gait, as well as consistency in the value of the slope of the linear regression curves corresponding to the different conditions examined.

  16. Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings.

    Science.gov (United States)

    Cheng, Y; Cai, Y; Wang, Y

    2014-01-01

    The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury. A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings. There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute-chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries. Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain. Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint.

  17. A relation between blood pressure and stiffness of joints and skin

    NARCIS (Netherlands)

    Uiterwaal, C.S.P.M.; Grobbee, D.E.; Sakkers, R.J.B.; Helders, P.J.M.; Bank, R.A.; Engelbert, R.H.H.

    2003-01-01

    Background. Blood pressure, particularly pulse pressure, is associated with arterial wall stiffness, but little is known about its relation to stiffness of other parts of the body. We examined the extent to which blood pressure levels in young healthy children are related to stiffness of various

  18. Ankle-joint mobility and standing squat posture in elite junior cross-country skiers. A pilot study.

    Science.gov (United States)

    Conradsson, D; Fridén, C; Nilsson-Wikmar, L; Ang, B O

    2010-06-01

    Skating technique in cross-country skiing is a complex multi-joint movement with kinematics comparable to those of the standing squat exercise where any restricted joint mobility in the lower extremity-chain may change the movement pattern. The aim of this pilot study was to investigate the effect of ankle mobility on trunk posture during squat exercise in cross-country skiers. Seven elite junior cross-country skiers (age range 17-19 years) performed two different standing squats, one with hands on hips and one with arms extended above the head. The squats were recorded on video and analyzed in selected positions: 90 degrees and maximal knee flexion. Segment angles for shank and trunk were calculated from anatomical references relative to vertical/horizontal orientation in space. Recordings from passive ankle dorsiflexion were correlated with 1) trunk flexion, and 2) angle index (trunk flexion relative to shank angle). Reduced ankle dorsiflexion was moderately associated with increased trunk flexion with hands on hips (r=-0.51 to -0.57), and arms above head (r=-0.61 to -0.64). Further, reduced dorsiflexion was also moderately associated with decreased angle index with hands on hip (r=0.60 to 0.67) but highly associated with decreased angle index with arms above head (r=0.75 to 0.76). The results imply that reduced ankle dorsal mobility is related to decreased angle index as well as increased trunk flexion during squat exercise, thus indicating the relevance of good ankle joint mobility for appropriate upper-body posture during squat exercise.

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

    Science.gov (United States)

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

    2015-10-01

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

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

    International Nuclear Information System (INIS)

    John, F.

    1982-01-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  2. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-15

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

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

    International Nuclear Information System (INIS)

    Kim, Kuk Seon; Lee, Gyung Kyu; Kang, Ik Won; Hwang, Dae Hyun; Lee, Eil Seong; Min, Seon Jung; Han, You Mie; Lee, Eil Seong

    2011-01-01

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

  5. 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

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

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-12-01

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

  8. 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.

  9. Association Between Years of Experience and Ankle Joint Disorder in Male Student Basketball Players Based on Ultrasonography

    Science.gov (United States)

    Fukushima, Yaeko

    2017-01-01

    Purpose The goal of the study was to survey ankle joint disorder in male senior high school and college student basketball players based on the results of an ultrasonographic medical check-up of the ankle joint. Materials and Methods The subjects were 17 senior high school student and 19 college student basketball players. Ultrasonography, evaluation of ATFL injury, and examination of the talocrural joint region were performed. The subjects were grouped based on the presence or absence of old ATFL injury, and subjects with ATFL injury were classified by the injured region: fibular insertion site, parenchyma, and talar insertion site. The talocrural joint region was evaluated based on the areas of the lateral margin, central region, and medial margin, and sites with an irregular bone contour and osteophyte were counted individually. The questionnaire asked about the patients’ history of ankle injuries. Results A questionnaire survey revealed that 70–79% of all subjects had experienced a sprain at least once and 21–29% had frequently sprained the left or right foot 10 or more times in the past. On ultrasonography, there was no significant difference in ligament injury or injured site between the senior high school and college students, but the number of osteochondral findings in the talocrural joint region was significantly higher in the college students. In addition, the number of injured sites significantly increased in those with 10 or more years of playing experience. Conclusion These results suggest that disorder of the talocrural joint region progresses with an increase in years of experience in student basketball players who do not take specific preventive measures against this injury. PMID:28603784

  10. Multivariable Dynamic Ankle Mechanical Impedance With Active Muscles

    Science.gov (United States)

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

    2015-01-01

    Multivariable dynamic ankle mechanical impedance in two coupled degrees-of-freedom (DOFs) was quantified when muscles were active. Measurements were performed at five different target activation levels of tibialis anterior and soleus, from 10% to 30% of maximum voluntary contraction (MVC) with increments of 5% MVC. Interestingly, several ankle behaviors characterized in our previous study of the relaxed ankle were observed with muscles active: ankle mechanical impedance in joint coordinates showed responses largely consistent with a second-order system consisting of inertia, viscosity, and stiffness; stiffness was greater in the sagittal plane than in the frontal plane at all activation conditions for all subjects; and the coupling between dorsiflexion–plantarflexion and inversion–eversion was small—the two DOF measurements were well explained by a strictly diagonal impedance matrix. In general, ankle stiffness increased linearly with muscle activation in all directions in the 2-D space formed by the sagittal and frontal planes, but more in the sagittal than in the frontal plane, resulting in an accentuated “peanut shape.” This characterization of young healthy subjects’ ankle mechanical impedance with active muscles will serve as a baseline to investigate pathophysiological ankle behaviors of biomechanically and/or neurologically impaired patients. PMID:25203497

  11. A 7-year-old with indurated skin and unilateral progressive joint immobility: A case of stiff skin syndrome.

    Science.gov (United States)

    Ogunmakin, Kehinde; Vangipuram, Ramya; Sturgeon, Ashley; Shimizu, Ikue

    2015-09-17

    Stiff skin syndrome is a rare sclerotic condition that presents during infancy or early childhood. It has an insidious chronic course and may lead to significant co-morbidity and reduced quality of life. Often, affected individuals experience impaired ambulation and immobilization related to joint involvement. Clinically, it may resemble other sclerotic diseases, so histopathological evaluation is necessary to establish a diagnosis. As it is a condition with limited treatment options, prompt diagnosis and early initiation of physical therapy is crucial to prevent joint restriction and maintain quality of life. We describe a case of a 7-year-old with stiff skin syndrome, and review the literature to discuss the clinical presentation, histological findings, and management of this condition.

  12. 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

  13. 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.

  14. Ankle sprain - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100209.htm Ankle sprain - Series—Normal anatomy To use the sharing ... to slide 4 out of 4 Overview The ankle joint connects the foot with the leg. The ...

  15. The Effect of Change in Range of Motion of Metal KAFO Ankle Joint on Balance in Patients with Postpolio Syndrome (PPS

    Directory of Open Access Journals (Sweden)

    Seyyedeh Maryam Moslehi

    2015-01-01

    Full Text Available Objective: Knee- ankle foot orthoses are the most commonly orthoses in the post-polio syndrome.Metal KAFOs are the most commonly prescribed orthoses in Iran. However, problems have been reported when using them, during walking. The purpose of the current study was to evaluate the effect of changes in range of motion of metal KAFO ankle joint on balance in patients with Post-polio syndrome. Materials & Methods: 22 post-polio syndrome patients (37-50 yr from Red Crescent Rehabilitation Center participated in this study. Data collection were performed using by the balance master system with the participants wearing the conventional KAFO and KAFO with increased range of motion of the ankle joint. Data collection was performed with a two weeks follow-up period. Result: In KAFO with increased range of motion of ankle joint, the maximal backward excursion of COG (P<0.002, movement velocity toward the backward (P<0.018 increased when compared to conventional KAFO. The time of weight transfer was reduced while wearing KAFO with increased range of motion of ankle joint in comparison with –conventional KAFO (P<0.002. No significant differences were observed at the other parameters such as limit of stability and sit to stand. Conclusion: the results of this study showed that change in ankle joint range of motion of metal KAFO can let in improvement in some indicators related to postural stability in individual with post-polio syndrome.

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

    Science.gov (United States)

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

    2013-06-01

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

  17. LATERAL ANKLE INJURY

    OpenAIRE

    Pollard, Henry; Sim, Patrick; McHardy, Andrew

    2002-01-01

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

  18. Sprained ankle (image)

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2016-12-01

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

  20. Ankle replacement

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2015-02-01

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

  2. Experimental Analysis of Stiffness of the Riveted Steel Railway Bridge Deck Members’ Joints

    Directory of Open Access Journals (Sweden)

    Gocál Jozef

    2014-12-01

    Full Text Available The paper deals with the real behaviour of the riveted steel railway bridge deck members’ connections with respect to their bending stiffness. Attention is paid to the stringer-to-cross beam connection as well as the cross beam-to-main girder connection. The stiffness of the two connections is investigated on the basis of evaluation of the experimentally determined stress response of the observed structural members to the actual traffic load on an existing railway bridge.

  3. Development of a Measuring System Based on LabVIEW for Angular Stiffness of Integrative Flexible Joint

    Science.gov (United States)

    Liu, C. J.; Wan, D. A.

    2006-10-01

    In order to meet the need of development of integrative flexible joint, this paper presents a higher precision measuring system for angular stiffness test of integrative flexible joint. The main parts of the system include PC, precision motorized goniometric stage, precision motorized rotary stage and high accuracy torque sensor. The measuring and control program is developed on the platform of LabVIEW. The measuring system developed has angular resolution at 0.00032° (about 1'') theoretically in determining the angular displacement of the joint round its equatorial axis and torque accuracy at 0.005 mN · m. The developed program, which presents a friendly GUI, can implement the data acquisition and processing, measuring procedure automatically. In comparison with other measuring devices with similar purposes, the measuring device can improve the measuring efficiency and accuracy distinctly while has advantages of simple configuration, low cost and high stability.

  4. Diagnostic value of magnetic resonance imaging of the ankle joint -visualization of ligaments and tendons by standard slice orientations

    International Nuclear Information System (INIS)

    Schroeder, R.J.; Siewert, C.; Maeurer, J.; Vogl, T.J.; Suedkamp, N.; Felix, R.

    1996-01-01

    Purpose: Evaluation of the capability of high field strength MRI in depicting clinically important tendons and ligaments of the ankle joint using slice orientations parallel to the standard space directions without angulation. Materials and methods: 65 patients whose ankle joint complaints were not sufficiently clarified by conventional radiology sphere underwent MRI using plain T 1 -weighted spin echo sequences. Tendons and ligaments were classified by three independent radiologists with regard to their perceptibility on images of the different slice orientations. Results: Good perceptibility of at least two-thirds of each structure with the possibility for a decision regarding continuity or rupture of the remaining part was given most frequently in the following slice orientations: Axially for the tendons of peroneus longus, peroneus brevis, tibialis posterior, flexor digitorum longus, flexor hallucis longus, tibialis anterior, extensor digitorum longus, and extensor hallucis longus muscles, and for the calcanear tendor (each over 94% of cases), anterior (68%) talofibular ligament, deltoid (77%), anterior (63%), and posterior (72%) tibiofibular ligaments and coronally for the calcaneofibular (39%) and posterior talofibular ligaments (70%). The sagittal orientation was never the favoured one. Conclusions: All tendons and ligaments of the ankle joint, except for the calcaneofibular and anterior tibiofibular ligaments, can be sufficiently visualized in the majority of cases by non-angulated spin echo sequences in standard slice orientations if the examination is performed in at least two slice directions. Thus, the minimal examination program should be: one T 2 -weighted sequence, T 1 -weighted sequences axially and in a further orientation, i.e. slightly angulated coronally for depicting the calcaneofibular ligament. (orig.) [de

  5. Lower Extremity Stiffness Changes following Concussion in Collegiate Football Players

    Science.gov (United States)

    DuBose, Dominique F.; Herman, Daniel C.; Jones, Debi L.; Tillman, Susan M.; Clugston, James R.; Pass, Anthony; Hernandez, Jorge A.; Vasilopoulos, Terrie; Horodyski, MaryBeth; Chmielewski, Terese L.

    2016-01-01

    Purpose Recent research indicates that a concussion increases risk of musculoskeletal injury. Neuromuscular changes following concussion might contribute to the increased risk of injury. Many studies have examined gait post-concussion, but few studies have examined more demanding tasks. This study compared changes in stiffness across the lower extremity, a measure of neuromuscular function, during a jump-landing task in athletes with a concussion (CONC) to uninjured athletes (UNINJ). Methods Division I football players (13 CONC, 26 UNINJ) were tested pre- and post-season. A motion-capture system recorded subjects jumping on one limb from a 25.4 cm step onto a force plate. Hip, knee, and ankle joint stiffness were calculated from initial contact to peak joint flexion using the regression line slopes of the joint moment versus joint angle plots. Leg stiffness was (peak vertical ground reaction force (PVGRF)/lower extremity vertical displacement) from initial contact to PVGRF. All stiffness values were normalized to bodyweight. Values from both limbs were averaged. General linear models compared group (CONC, UNINJ) differences in the changes of pre- and post-season stiffness values. Results Average time from concussion to post-season testing was 49.9 days. The CONC group showed an increase in hip stiffness (p=0.03), a decrease in knee (p=0.03) and leg stiffness (p=0.03), but no change in ankle stiffness (p=0.65) from pre- to post-season. Conclusion Lower extremity stiffness is altered following concussion, which could contribute to an increased risk of lower extremity injury. These data provide further evidence of altered neuromuscular function after concussion. PMID:27501359

  6. Lower Extremity Stiffness Changes after Concussion in Collegiate Football Players.

    Science.gov (United States)

    Dubose, Dominique F; Herman, Daniel C; Jones, Deborah L; Tillman, Susan M; Clugston, James R; Pass, Anthony; Hernandez, Jorge A; Vasilopoulos, Terrie; Horodyski, Marybeth; Chmielewski, Terese L

    2017-01-01

    Recent research indicates that a concussion increases the risk of musculoskeletal injury. Neuromuscular changes after concussion might contribute to the increased risk of injury. Many studies have examined gait postconcussion, but few studies have examined more demanding tasks. This study compared changes in stiffness across the lower extremity, a measure of neuromuscular function, during a jump-landing task in athletes with a concussion (CONC) to uninjured athletes (UNINJ). Division I football players (13 CONC and 26 UNINJ) were tested pre- and postseason. A motion capture system recorded subjects jumping on one limb from a 25.4-cm step onto a force plate. Hip, knee, and ankle joint stiffness were calculated from initial contact to peak joint flexion using the regression line slopes of the joint moment versus the joint angle plots. Leg stiffness was (peak vertical ground reaction force [PVGRF]/lower extremity vertical displacement) from initial contact to peak vertical ground reaction force. All stiffness values were normalized to body weight. Values from both limbs were averaged. General linear models compared group (CONC, UNINJ) differences in the changes of pre- and postseason stiffness values. Average time from concussion to postseason testing was 49.9 d. The CONC group showed an increase in hip stiffness (P = 0.03), a decrease in knee (P = 0.03) and leg stiffness (P = 0.03), but no change in ankle stiffness (P = 0.65) from pre- to postseason. Lower extremity stiffness is altered after concussion, which could contribute to an increased risk of lower extremity injury. These data provide further evidence of altered neuromuscular function after concussion.

  7. Elevated Knee Joint Kinetics and Reduced Ankle Kinetics Are Present During Jogging and Hopping After Achilles Tendon Ruptures.

    Science.gov (United States)

    Willy, Richard W; Brorsson, Annelie; Powell, Hayley C; Willson, John D; Tranberg, Roy; Grävare Silbernagel, Karin

    2017-04-01

    Deficits in plantarflexor function are common after an Achilles tendon rupture. These deficits may result in an altered distribution of joint loads during lower extremity tasks. We hypothesized that, regardless of treatment, the Achilles tendon-ruptured limb would exhibit deficits in ankle kinematics and joint power while exhibiting elevated knee joint power and patellofemoral joint loads during walking, jogging, and hopping. We further hypothesized that this loading pattern would be most evident during jogging and hopping. Controlled laboratory study. Thirty-four participants (17 participants treated surgically, 17 treated nonsurgically) were tested at a mean 6.1 ± 2.0 years after an Achilles tendon rupture. Lower extremity kinematics and kinetics were assessed while participants completed walking, jogging, and single-legged hopping trials. Patellofemoral joint stress was calculated via a musculoskeletal model. Data were analyzed via mixed-model repeated analyses of variance (α = .05) and the limb symmetry index (LSI). No differences ( P ≥ .05) were found between the surgical and nonsurgical groups. In both groups, large side-to-side deficits in the plantarflexion angle at toeoff (LSI: 53.5%-73.9%) were noted during walking, jogging, and hopping in the involved limb. Side-to-side deficits in the angular velocity were only present during jogging (LSI: 93.5%) and hopping (LSI: 92.5%). This pattern was accompanied by large deficits in eccentric (LSI: 80.8%-94.7%) and concentric (LSI: 82.2%-84.7%) ankle joint powers in the involved limb during all tasks. Interestingly, only jogging and hopping demonstrated greater knee joint loads when compared with the uninvolved limb. Concentric knee power was greater during jogging (LSI: 117.2%) and hopping (LSI: 115.9%) compared with the uninvolved limb. Similarly, peak patellofemoral joint stress was greater in the involved limb during jogging (LSI: 107.5%) and hopping (LSI: 107.1%), while only hopping had a greater loading

  8. Estimation of Human Ankle Impedance During the Stance Phase of Walking

    Science.gov (United States)

    Rouse, Elliott J.; Hargrove, Levi J.; Perreault, Eric J.; Kuiken, Todd A.

    2018-01-01

    Human joint impedance is the dynamic relationship between the differential change in the position of a perturbed joint and the corresponding response torque; it is a fundamental property that governs how humans interact with their environments. It is critical to characterize ankle impedance during the stance phase of walking to elucidate how ankle impedance is regulated during locomotion, as well as provide the foundation for future development of natural, biomimetic powered prostheses and their control systems. In this study, ankle impedance was estimated using a model consisting of stiffness, damping and inertia. Ankle torque was well described by the model, accounting for 98 ± 1.2% of the variance. When averaged across subjects, the stiffness component of impedance was found to increase linearly from 1.5 Nm/rad/kg to 6.5 Nm/rad/kg between 20% and 70% of stance phase. The damping component was found to be statistically greater than zero only for the estimate at 70% of stance phase, with a value of 0.03 Nms/rad/kg. The slope of the ankle’s torque-angle curve—known as the quasi-stiffness—was not statistically different from the ankle stiffness values, and showed remarkable similarity. Finally, using the estimated impedance, the specifications for a biomimetic powered ankle prosthesis were introduced that would accurately emulate human ankle impedance during locomotion. PMID:24760937

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

    African Journals Online (AJOL)

    ankle joint which aims to relieve pain, and restores function. Ankle arthrodesis, used as surgical treatment for tuberculosis of the ankle joint, is still used for the treatment of ankle joint destruction. Arthrodesis of the ankle joint is an important operation in the treatment of painful arthrosis, chronic infection, and malalignment ...

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

    Science.gov (United States)

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

    2016-02-01

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

  11. Ankle Injuries and Disorders

    Science.gov (United States)

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

  12. [Efficacy of Shangbai ointment in alleviating pain in patients with acute ankle joint lateral collateral ligament injury: a randomized controlled trial].

    Science.gov (United States)

    Zhou, Lin; Sun, Kai; Chen, Yan; Chen, Guo-Liang; Deng, De-Jun; Jiao, Gen-Long; Li, Zhi-Zhong

    2017-03-20

    To investigate the effect of Shangbai ointment in relieving pain in patients with acute ankle joint lateral collateral ligament injury. Fifty patients with unilateral ankle injury were randomized into Shangbai ointment treatment group and control group (n=25). The Visual Analog Scale (VAS) pain scores, ankle joint circumference, Kofoed score and self-rated lower limb function were recorded before and at 3, 7, and 14 days after the treatment. The baseline data were comparable between the two groups. The VAS pain score and swelling elimination in the treatment group were better than those in the control group at 3, 7, and 14 days after treatment; the Kofoed ankle score was higher in the treatment group than in the control group at 7 and 14 days after treatment. The patients in the treatment also reported better self-rated lower limb function than those in the control group at 7 and 14 days after the treatment. Shangbai ointment treatment can rapidly relieve pain in patients with acute ankle joint lateral collateral ligament injury and improve the functional scores of the joint.

  13. External rotational injury of tha ankle joint with displacement of the talus.

    Science.gov (United States)

    Hughes, S. P.

    1977-01-01

    The mechanism of second-degree external rotational injury of the ankle, with fracture of the lower end of the fibula, is discussed with reference to experiments on an anatomical model. It is concluded that with this type of injury there is lateral displacement of the talus because the deltoid ligament is ruptured, but there is no diastasis of the inferior tibiofibular syndesmosis. The results of conservative treatment of 10 patients with second-degree external rotational injury of tha ankle are reviewed. Images Fig. 1 Fig. 2 Fig. 3 PMID:835983

  14. A Review of 399 Total Ankle Replacements: Analysis of Ipsilateral Subtalar Joint Arthrodesis and Associated Talar Component Subsidence.

    Science.gov (United States)

    Prissel, Mark A; Hyer, Christopher F; Berlet, Gregory C

    Total ankle replacement (TAR) is an accepted treatment for end-stage ankle arthritis. When concurrent subtalar joint pathologic features exist, ipsilateral subtalar joint arthrodesis (STJA) can be performed either simultaneous with TAR or as a staged procedure. Limited data exist on the effect of talar component subsidence and prosthesis survivorship. The present study purpose was to evaluate the effect of STJA on talar component subsidence after primary TAR and its effect on TAR survivorship. All patients, a minimum of 18 years old, from a single institution with modern-generation TAR and 1-year minimum follow-up data available were evaluated. The study group included patients who had also undergone STJA, and the control group (no STJA) was matched 1:1 by age, gender, and prosthesis. The initial postoperative weightbearing and most recent weightbearing radiographs were compared for talar component subsidence. We reviewed 399 primary TARs from 2004 to 2012. A total of 33 patients with ipsilateral STJA met the inclusion criteria and had an appropriate control group match. In the study group, 8 patients required a return to the operating room for 4 revisions and 4 reoperations at a median follow-up point of 24.3 months. Of the controls, 9 patients required a return to the operating room, with 4 revisions and 5 reoperations at a median follow-up point of 38.4 months. No statistically significant radiographic differences were found between the 2 groups. Primary TAR and ipsilateral STJA were infrequently required (41 of 399; 10.3%). TAR did not result in decreased survivorship when performed with ipsilateral STJA at an early follow-up point. Further study is warranted to determine any differences among previous, simultaneous, and subsequent STJA with ipsilateral TAR, and a matched longitudinal analysis is needed to determine longer term survivorship. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  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. [Press-fit bone dowel arthrodesis of the ankle or the subtalar joint using a diamond bone cutting system. Surgical technique and initial results in 10 patients].

    Science.gov (United States)

    Dresing, K; Stürmer, K M

    2000-08-01

    Arthrodesis of the ankle (AA) or the subtalar joint (AST) is still a necessary treatment in case of painful posttraumatic arthrosis or paresis of the muscles after compartment syndrome. Today the alloplastic ankle joint replacement does not satisfy. Many treatments of arthrodesis with minimal or extended resection of the joint surface with or without bone transplantation are described in literature. We present in detail a new developed technique of press-fit dowel arthrodesis (KDA) for the ankle and subtalar joint. After adjustment of the joint position and retention with Kirschner wires the surface of both sides of the joint surface and underlying bone is removed by a cannulated diamond bone cutting device. Dowels from the anterior iliac crest are impacted in the cutted joint defect. The dowels are 1/10 mm bigger in dimension than the primary defect in the joint surface. The surgery will be completed with a compression screw osteosynthesis, at the ankle joint transarticular through the lateral and medial malleolus, at the subtalar joint from plantar. Ten patients have treated by press-fit-KDA (female 2, male 8; AA 7, 33.6 +/- 9 y; AST 3.38 +/- 10.9 y). The indication for KDA was in nine cases a severe posttraumatic arthrosis, in one case the paretic malfunction after compartment syndrome. The arthrodesis were clinically and radiologically consolidated after 8.2 +/- 1.9 weeks. At this time the patients showed no symptoms and were fully mobilised with complete weight-bearing. The advantages of KDA: preservation of the outline of joint and hindfoot, preservation of length of the leg and outline of iliac crest, no risk for the soft tissue, quick consolidation of the arthrodesis, no need of external fixation. The technique is also suitable for other indications as presented.

  17. Low tendon stiffness and abnormal ultrastructure distinguish classic Ehlers-Danlos syndrome from benign joint hypermobility syndrome in patients

    DEFF Research Database (Denmark)

    Nielsen, Rie Harboe; Couppé, Christian; Jensen, Jacob Kildevang

    2014-01-01

    There is a clinical overlap between classic Ehlers-Danlos syndrome (cEDS) and benign joint hypermobility syndrome (BJHS), with hypermobility as the main symptom. The purpose of this study was to investigate the role of type V collagen mutations and tendon pathology in these 2 syndromes. In patients...... the patients' hypermobility, whereas no tendon pathology was found that explained the hypermobility in BJHS.-Nielsen, R. H., Couppé, C., Jensen, J. K., Olsen, M. R., Heinemeier, K. M., Malfait, F., Symoens, S., De Paepe, A., Schjerling, P., Magnusson, S. P., Remvig, L., Kjaer, M. Low tendon stiffness...... and abnormal ultrastructure distinguish classic Ehlers-Danlos syndrome from benign joint hypermobility syndrome in patients....

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  19. Effects of Dietary Supplementation with the Plant Alkaloid Anatabine on Joint Pain and Stiffness: Results from an Internet-Based Survey Study

    Directory of Open Access Journals (Sweden)

    Ryan K. Lanier

    2013-01-01

    Full Text Available Anatabine is a Solanaceae plant family alkaloid marketed in the United States as a dietary supplement. It has demonstrated anti-inflammatory effects in vivo and in vitro, and may be useful for musculoskeletal aches and pains. The purpose of this internet-based survey study was to provide more information about anatabine users who report benefits for joint pain or stiffness. Of the 282 survey respondents, 232 (82% reported a benefit from anatabine supplementation for one or more joint pain conditions, most commonly the knee, wrists/hands/fingers, shoulder, and back, most often due to osteoarthritis or injury to the joint. Mean scores of joint pain and stiffness were significantly ( P < 0.0001 reduced after starting anatabine supplementation, and for most respondents joint pain was virtually eliminated. Around 90% of all individuals rated the effect of anatabine supplementation as good or excellent for joint pain, stiffness, functionality, and overall effects. These results provide evidence that anatabine supplementation can lead to substantial improvement of musculoskeletal aches, pains, and stiffness, and can provide benefits in some individuals for various medical conditions in multiple joint locations.

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    masoomeh Veiskarami

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kamizato Iwao

    2014-01-01

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

  4. The influence of landing mat composition on ankle injury risk during a gymnastic landing: a biomechanical quantification.

    Science.gov (United States)

    Xiao, Xiaofei; Hao, Weiya; Li, Xuhong; Wan, Bingjun; Shan, Gongbing

    2017-01-01

    About 70% injury of gymnasts happened during landing - an interaction between gymnast and landing mat. The most injured joint is the ankle. The current study examined the effect of mechanical properties of landing mat on ankle loading with aims to identify means of decreasing the risk of ankle injury. Gymnastic skill - salto backward stretched with 3/2 twist was captured by two high-speed camcorders and digitized by using SIMI-Motion software. A subject-specific, 14-segment rigid-body model and a mechanical landing-mat model were built using BRG.LifeMODTM. The landings were simulated with varied landing-mat mechanical properties (i.e., stiffness, dampness and friction coefficients). Real landing performance could be accurately reproduced by the model. The simulations revealed that the ankle angle was relatively sensitive to stiffness and dampness of the landing mat, the ankle loading rate increased 26% when the stiffness was increased by 30%, and the changing of dampness had notable effect on horizontal ground reaction force and foot velocity. Further, the peak joint-reaction force and joint torque were more sensitive to friction than to stiffness and dampness of landing mat. Finally, ankle muscles would dissipate about twice energy (189%) when the friction was increased by 30%. Loads to ankles during landing would increase as the stiffness and dampness of the landing mat increase. Yet, increasing friction would cause a substantial rise of the ankle internal loads. As such, the friction should be a key factor influencing the risk of injury. Unfortunately, this key factor has rarely attracted attention in practice.

  5. 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

    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......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). Here, we investigated if 12 weeks of progressive and explosive 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 non-randomly assigned to a PRT or non-training control (CON) group in this explorative trial. The PRT group trained ankle...

  6. Understanding acute ankle ligamentous sprain injury in sports

    Directory of Open Access Journals (Sweden)

    Fong Daniel TP

    2009-07-01

    . Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception. Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury.

  7. Kinetic Compensations due to Chronic Ankle Instability during Landing and Jumping.

    Science.gov (United States)

    Kim, Hyunsoo; Son, S Jun; Seeley, Matthew K; Hopkins, J Ty

    2018-02-01

    Skeletal muscles absorb and transfer kinetic energy during landing and jumping, which are common requirements of various forms of physical activity. Chronic ankle instability (CAI) is associated with impaired neuromuscular control and dynamic stability of the lower extremity. Little is known regarding an intralimb, lower-extremity joint coordination of kinetics during landing and jumping for CAI patients. We investigated the effect of CAI on lower-extremity joint stiffness and kinetic and energetic patterns across the ground contact phase of landing and jumping. One hundred CAI patients and 100 matched able-bodied controls performed five trials of a landing and jumping task (a maximal vertical forward jump, landing on a force plate with the test leg only, and immediate lateral jump toward the contralateral side). Functional analyses of variance and independent t-tests were used to evaluate between-group differences for lower-extremity net internal joint moment, power, and stiffness throughout the entire ground contact phase of landing and jumping. Relative to the control group, the CAI group revealed (i) reduced plantarflexion and knee extension and increased hip extension moments; (ii) reduced ankle and knee eccentric and concentric power, and increased hip eccentric and concentric power, and (iii) reduced ankle and knee joint stiffness and increased hip joint stiffness during the task. CAI patients seemed to use a hip-dominant strategy by increasing the hip extension moment, stiffness, and eccentric and concentric power during landing and jumping. This apparent compensation may be due to decreased capabilities to produce sufficient joint moment, stiffness, and power at the ankle and knee. These differences might have injury risk and performance implications.

  8. 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.

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

    Science.gov (United States)

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

    2014-03-06

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

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

    Science.gov (United States)

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

    2014-01-01

    Tissue engineering and regenerative medicine (TERM) has caused a revolution in present and future trends of medicine and surgery. In different tissues, advanced TERM approaches bring new therapeutic possibilities in general population as well as in young patients and high-level athletes, improving restoration of biological functions and rehabilitation. The mainstream components required to obtain a functional regeneration of tissues may include biodegradable scaffolds, drugs or growth factors and different cell types (either autologous or heterologous) that can be cultured in bioreactor systems (in vitro) prior to implantation into the patient. Particularly in the ankle, which is subject to many different injuries (e.g. acute, chronic, traumatic and degenerative), there is still no definitive and feasible answer to ‘conventional’ methods. This review aims to provide current concepts of TERM applications to ankle injuries under preclinical and/or clinical research applied to skin, tendon, bone and cartilage problems. A particular attention has been given to biomaterial design and scaffold processing with potential use in osteochondral ankle lesions. PMID:24352667

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

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

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

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

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

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

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

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    International Nuclear Information System (INIS)

    Zbyn, S.

    2015-01-01

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

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

    Science.gov (United States)

    Nordeck, Shaun M; Koerper, Conrad E; Adler, Aaron; Malhotra, Vidur; Xi, Yin; Liu, George T; Chhabra, Avneesh

    2017-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-05-15

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

  18. Contribution of muscle short-range stiffness to initial changes in joint kinetics and kinematics during perturbations to standing balance: A simulation study.

    Science.gov (United States)

    De Groote, Friedl; Allen, Jessica L; Ting, Lena H

    2017-04-11

    Simulating realistic musculoskeletal dynamics is critical to understanding neural control of muscle activity evoked in sensorimotor feedback responses that have inherent neural transmission delays. Thus, the initial mechanical response of muscles to perturbations in the absence of any change in muscle activity determines which corrective neural responses are required to stabilize body posture. Muscle short-range stiffness, a history-dependent property of muscle that causes a rapid and transient rise in muscle force upon stretch, likely affects musculoskeletal dynamics in the initial mechanical response to perturbations. Here we identified the contributions of short-range stiffness to joint torques and angles in the initial mechanical response to support surface translations using dynamic simulation. We developed a dynamic model of muscle short-range stiffness to augment a Hill-type muscle model. Our simulations show that short-range stiffness can provide stability against external perturbations during the neuromechanical response delay. Assuming constant muscle activation during the initial mechanical response, including muscle short-range stiffness was necessary to account for the rapid rise in experimental sagittal plane knee and hip joint torques that occurs simultaneously with very small changes in joint angles and reduced root mean square errors between simulated and experimental torques by 56% and 47%, respectively. Moreover, forward simulations lacking short-range stiffness produced unreasonably large joint angle changes during the initial response. Using muscle models accounting for short-range stiffness along with other aspects of history-dependent muscle dynamics may be important to advance our ability to simulate inherently unstable human movements based on principles of neural control and biomechanics. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

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

  20. The immediate effect of triceps surae myofascial trigger point therapy on restricted active ankle joint dorsiflexion in recreational runners: a crossover randomised controlled trial.

    Science.gov (United States)

    Grieve, Rob; Cranston, Amy; Henderson, Andrew; John, Rachel; Malone, George; Mayall, Christopher

    2013-10-01

    To investigate the immediate effect on restricted active ankle joint dorsiflexion range of motion (ROM), after a single intervention of myofascial trigger point (MTrP) therapy on latent triceps surae MTrPs in recreational runners. A crossover randomised controlled trial. Twenty-two recreational runners (11 men and 11 women; mean age 24.57; ±8.7 years) with a restricted active ankle joint dorsiflexion and presence of latent MTrPs. Participants were screened for a restriction in active ankle dorsiflexion in either knee flexion (soleus) or knee extension (gastrocnemius) and the presence of latent MTrPs. Participants were randomly allocated a week apart to both the intervention (combined pressure release and 10 s passive stretch) and the control condition. A clinically meaningful (large effect size) and statistically significant increase in ankle ROM in the intervention compared to the control group was achieved, for the soleus (p = 0.004) and the gastrocnemius (p = 0.026). Apart from the statistical significance (p < 0.05), these results are clinically relevant due to the immediate increase in ankle dorsiflexion. These results must be viewed in caution due to the carry-over effect in the RCT crossover design and the combined MTrP therapy approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Applied Joint-Space Torque and Stiffness Control of Tendon-Driven Fingers

    Science.gov (United States)

    Abdallah, Muhammad E.; Platt, Robert, Jr.; Wampler, Charles W.; Hargrave, Brian

    2010-01-01

    Existing tendon-driven fingers have applied force control through independent tension controllers on each tendon, i.e. in the tendon-space. The coupled kinematics of the tendons, however, cause such controllers to exhibit a transient coupling in their response. This problem can be resolved by alternatively framing the controllers in the joint-space of the manipulator. This work presents a joint-space torque control law that demonstrates both a decoupled and significantly faster response than an equivalent tendon-space formulation. The law also demonstrates greater speed and robustness than comparable PI controllers. In addition, a tension distribution algorithm is presented here to allocate forces from the joints to the tendons. It allocates the tensions so that they satisfy both an upper and lower bound, and it does so without requiring linear programming or open-ended iterations. The control law and tension distribution algorithm are implemented on the robotic hand of Robonaut-2.

  2. Stiffness Analysis of Nail-Plate Joints Subjected to Short-Term Loads

    DEFF Research Database (Denmark)

    Nielsen, Jacob

    nail-plates are designed for trusses. For many years, joints were made of boards with nails, but the increasing industrialism and the need for quick and usable assembly had the result that today nearly all trusses are pre-fabricated with nail-plates. The word "nail-plate" has been used for different...

  3. Gastrocnemius operating length with ankle foot orthoses in cerebral palsy.

    Science.gov (United States)

    Choi, Hwan; Wren, Tishya Anne Leong; Steele, Katherine Muterspaugh

    2017-06-01

    Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation. This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy. Case series, within subject comparison of gastrocnemius operating length while walking barefoot and with two types of ankle foot orthoses. We performed gait analyses for 11 children with cerebral palsy. Each child was fit with two types of orthoses: a dynamic ankle foot orthosis (Cascade dynamic ankle foot orthosis) and an adjustable dynamic response ankle foot orthosis (Ultraflex ankle foot orthosis). Musculoskeletal modeling was used to quantify gastrocnemius musculotendon operating length and velocity with each orthosis. Walking with ankle foot orthoses could stretch the gastrocnemius more than barefoot walking for some individuals; however, there was significant variability between participants and orthoses. At least one type of orthosis stretched the gastrocnemius during walking for 4/6 and 3/5 of the Gross Motor Functional Classification System Level I and III participants, respectively. AFOs also reduced peak gastrocnemius lengthening velocity compared to barefoot walking for some participants, with greater reductions among the Gross Motor Functional Classification System Level III participants. Changes in gastrocnemius operating length and lengthening velocity were related to changes in ankle and knee kinematics during gait. Ankle foot orthoses impact gastrocnemius operating length during walking and, with proper design, may assist with stretching tight muscles in daily life. Clinical relevance Determining whether ankle foot orthoses stretch tight muscles can

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

    Science.gov (United States)

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

    2015-04-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  6. The effect of ankle joint adjustment on the path of the centre of pressure and rotation during gait

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Problem Statement: Ankle sprains are one of the most common acute injuries treated by physicians (Pellow & Brantingham, 2001). Most ankle sprains involve the lateral ankle ligaments, with the anterior tibiotalar ligament being the most commonly affected in injuries involving plantarflexion and inversion. These injuries often result in restriction of movements that will limit gait (Crosbie, Green, Refshauge, 1999). Even in the event of injury to one ankle, the sensori...

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    A. Migliore

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Ankle joint range of motion measurements in spastic cerebral palsy children: intraobserver and interobserver reliability and reproducibility of goniometry and visual estimation.

    Science.gov (United States)

    Allington, Nanni J; Leroy, Nathalie; Doneux, Carole

    2002-07-01

    The aim of this study was to assess the intra- and interobserver reliability and reproducibility of goniometry and visual estimation of ankle joint range of motion measurements in children with spastic cerebral palsy. Forty-six ankles of 24 spastic cerebral palsy children were measured under a strict protocol. The global mean measurement error was 5 degrees (SD, 5 degrees) for intra- and interobserver measurements and 3 degrees (SD, 3 degrees) for goniometry versus visual estimation. Statistical analysis showed a high reliability for intra- and interobserver measurements (r>0.75), between visual estimation and goniometry (correlation coefficient, r>0.967; concordance coefficient, r>0.957). Both visual estimation and goniometry ankle range-of-motion measurements are reliable and reproducible in spastic cerebral palsy children if a strict but simple protocol is applied.

  11. 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...... compared to Airex® and floor. This study can serve as guidance for clinicians who wish to implement a gradual progression of ankle rehabilitation and prevention exercises by taking the related ankle kinematics and muscle activity into account. LEVEL OF EVIDENCE: Level 3.......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...

  12. 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…

  13. Single-leg drop landing movement strategies in participants with chronic ankle instability compared with lateral ankle sprain 'copers'.

    Science.gov (United States)

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

    2016-04-01

    To compare the movement patterns and underlying energetics of individuals with chronic ankle instability (CAI) to ankle sprain 'copers' during a landing task. Twenty-eight (age 23.2 ± 4.9 years; body mass 75.5 ± 13.9 kg; height 1.7 ± 0.1 m) participants with CAI and 42 (age 22.7 ± 1.7 years; body mass 73.4 ± 11.3 kg; height 1.7 ± 0.1 m) ankle sprain 'copers' were evaluated 1 year after incurring a first-time lateral ankle sprain injury. Kinematics and kinetics of the hip, knee and ankle joints from 200 ms pre-initial contact (IC) to 200 ms post-IC, in addition to the vertical component of the landing ground reaction force, were acquired during performance of a drop land task. The CAI group adopted a position of increased hip flexion during the landing descent on their involved limb. This coincided with a reduced post-IC flexor pattern at the hip and increased overall hip joint stiffness compared to copers (-0.01 ± 0.05 vs. 0.02 ± 0.05°/Nm kg(-1), p = 0.03). Individuals with CAI display alterations in hip joint kinematics and energetics during a unipodal landing task compared to LAS 'copers'. These alterations may be responsible for the increased risk of injury experienced by individuals with CAI during landing manoeuvres. Thus, clinicians must recognise the potential for joints proximal to the affected ankle to contribute to impaired function following an acute lateral ankle sprain injury and to develop rehabilitation protocols accordingly. Level III.

  14. Effects of repeated ankle stretching on calf muscle-tendon and ankle biomechanical properties in stroke survivors.

    Science.gov (United States)

    Gao, Fan; Ren, Yupeng; Roth, Elliot J; Harvey, Richard; Zhang, Li-Qun

    2011-06-01

    The objective of this study was to investigate changes in active and passive biomechanical properties of the calf muscle-tendon unit induced by controlled ankle stretching in stroke survivors. Ten stroke survivors with ankle spasticity/contracture and ten healthy control subjects received intervention of 60-min ankle stretching. Joint biomechanical properties including resistance torque, stiffness and index of hysteresis were evaluated pre- and post-intervention. Achilles tendon length was measured using ultrasonography. The force output of the triceps surae muscles was characterized via the torque-angle relationship, by stimulating the calf muscles at a controlled intensity across different ankle positions. Compared to healthy controls, the ankle position corresponding to the peak torque of the stroke survivors was shifted towards plantar flexion (Pcalf muscles in stroke survivors under matched stimulations (Pmuscle-tendon level, repeated stretching improved calf muscle force output, which might be associated with decreased muscle fascicle stiffness, increased fascicle length and shortening of the Achilles tendon. The study provided evidence of improvement in muscle tendon properties through stretching intervention. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas

    2016-01-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

  17. Ankle Sprains

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Ankle Sprains KidsHealth / For Teens / Ankle Sprains What's in ... she could play again. What Is a Sprained Ankle? A sprained ankle is a very common injury ...

  18. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion

    NARCIS (Netherlands)

    Kerkum, Y.L.; Buizer, A.I.; van den Noort, J.C.; Becher, J.G.; Harlaar, J.; Brehm, M.A.

    2015-01-01

    Introduction: Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off

  19. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion

    NARCIS (Netherlands)

    Kerkum, Yvette L.; Buizer, Annemieke I.; van den Noort, Josien C.; Becher, Jules G.; Harlaar, Jaap; Brehm, Merel-Anne

    2015-01-01

    Rigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A

  20. Ankle injuries in basketball players.

    Science.gov (United States)

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

    We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential.

  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. LATERAL ANKLE INJURY

    Science.gov (United States)

    Pollard, Henry; Sim, Patrick; McHardy, Andrew

    2002-01-01

    Background: Injury to the ankle joint is the most common peripheral joint injury. The sports that most commonly produce high ankle injury rates in their participating athletes include: basketball, netball, and the various codes of football. Objective: To provide an up to date understanding of manual therapy relevant to lateral ligament injury of the ankle. A discussion of the types of ligament injury and common complicating factors that present with lateral ankle pain is presented along with a review of relevant anatomy, assessment and treatment. Also included is a discussion of the efficacy of manual therapy in the treatment of ankle sprain. Discussion: A detailed knowledge of the anatomy of the ankle as well as the early recognition of factors that may delay the rate of healing are important considerations when developing a management plan for inversion sprains of the ankle. This area appears to be under-researched however it was found that movement therapy and its various forms appear to be the most efficient and most effective method of treating uncomplicated ankle injury. Future investigations should involve a study to determine the effect chiropractic treatment (manipulation) may have on the injured ankle. PMID:17987171

  3. Modified Blair ankle fusion for ankle arthritis

    Directory of Open Access Journals (Sweden)

    Wang Shuangli

    2014-06-01

    Full Text Available 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. Key words: Ankle; Arthritis; Arthrodesis; Fracture fixation, intramedullary

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

    Science.gov (United States)

    Lafontaine, Dany

    2007-09-01

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

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

    DEFF Research Database (Denmark)

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas

    2016-01-01

    BACKGROUND: A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important...... reflective markers and 3-dimensional recordings and expressed as inversion-eversion range of motion variability, peak velocity of inversion and number of inversion-eversion direction changes. Peroneus longus EMG activity was averaged and normalized to maximal activity during maximum voluntary contraction...... to the other surfaces. BOSU® Ball was the most challenging in terms of inversion-eversion variability while wobble board was associated with a higher number of inversion-eversion direction changes. No differences in average muscle activation level were found between these two surfaces, but the BOSU® Ball did...

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

    Science.gov (United States)

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

    2013-07-01

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

  7. Effect of ankle taping and bracing on vertical ground reaction forces during drop landings before and after treadmill jogging.

    Science.gov (United States)

    Riemann, Bryan L; Schmitz, Randy J; Gale, Michael; McCaw, Steven T

    2002-12-01

    Single-group repeated-measures experimental design. The purpose of this study was to evaluate the effects of prophylactic ankle stabilization on vertical ground reaction forces before and after treadmill jogging. Previous research has demonstrated acute effects of ankle taping and bracing on ankle joint kinematics and vertical ground reaction forces during drop landings. Based on the number of investigations demonstrating increased range of motion of the braced or taped ankle following exercise, it may be plausible that the aforementioned landing alterations may return to normal following an exercise bout. Fourteen healthy recreational participants performed stiff and soft drop landings before and after a 20-minute treadmill exercise bout under 3 different ankle stabilizer conditions (no stabilizer, ankle brace, and ankle tape). A forceplate was used to collect ground reaction force data under the dominant foot. The first and second peak impact force, as well as the time to each of the 2 peak forces, were determined for each trial and used as dependent variables. The time to reach peak forces were significantly less under the ankle brace and tape conditions in comparison to the control (no-stabilizer) condition. It appears that ankle taping and bracing decrease the time to reach peak impact forces. These alterations indicate that during dynamic activity the musculoskeletal structures of the body may be subjected to loads within shorter time periods. Whether these effects are detrimental over time remains speculative at this point and requires further research.

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

    Science.gov (United States)

    Iwamoto, Yoshitaka; Takahashi, Makoto; Shinkoda, Koichi

    2017-08-02

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

  9. Ankle sprains and instability in dancers.

    Science.gov (United States)

    O'Loughlin, Padhraig F; Hodgkins, Christopher W; Kennedy, John G

    2008-04-01

    Ankle inversion injuries are the most common traumatic injuries in dancers. Ankle stability is integral to normal mobilization and to minimizing the risk for ankle sprain. The ability of the dynamic and static stabilizers of the ankle joint to maintain their structural integrity is a major component of the normal gait cycle. In the world of dance, this quality assumes even greater importance given the range of movement and stresses imposed on the ankle during various dance routines.

  10. Metabolic and morphometric alterations inherent to neuromuscular electric stimulation in the antagonist muscle submitted to ankle joint immobilization

    Directory of Open Access Journals (Sweden)

    João Luiz Quagliotti Durigan

    2009-02-01

    Full Text Available The aim of this work was to investigate the effect of the neuromuscular electrical stimulation (ES on the metabolic and morfometric profile of the tibialis anterior muscle, antagonist to the soleus muscle which was stimulate, under the joint immobilization condition of the ankle for 7 and 15 days. The immobilization promoted the reduction in the muscle mass (I7: 17.36%, I15: 20.83%, in the glycogen content (I7: 48%, I15: 48%, in the muscle fibers areas (I7: 27%, I15: 40% and increase in intramuscular connective tissue density (I7: 122%, I15: 206%. The EE didn't promote significant alterations in the mass of the immobilized groups, however, promoted increase in the glycogen (IEE7: 31.25%; IEE15: 56.25%, reduction in the muscle fibers areas (IEE7: 14%, IEE15: 24.69% and reduction in the connective tissue density (IEE7: 25.63%, IEE15: 49.09% when compared with the respective immobilized groups.O objetivo desse trabalho foi investigar o efeito da estimulação elétrica neuromuscular (EE sobre o perfil metabólico e morfométrico do músculo tibial anterior, antagonista ao músculo sóleo, o qual foi estimulado, sob a condição de imobilização articular de tornozelo durante 7 e 15 dias. A imobilização promoveu redução na massa muscular (I7: 17,36%, I15: 20,83%, no conteúdo de glicogênio (I7: 48%, I15: 48%, na área das fibras musculares (I7: 27%, I15: 40% e aumento na densidade do tecido conjuntivo intramuscular (I7: 122%, I15: 206%. A EE não promoveu alterações significativas na massa muscular dos grupos imobilizados, porém, promoveu aumento no glicogênio (IEE7: 31,25%; IEE15: 56,25%, redução na área das fibras musculares (IEE7: 14%, IEE15: 24,69% e redução na densidade do tecido conjuntivo de (IEE7: 25,63%, IEE15: 49,09% quando comparado aos respectivos grupos imobilizados.

  11. Biomechanic changes in passive properties of hemiplegic ankles with spastic hypertonia.

    Science.gov (United States)

    Chung, Sun G; Van Rey, Elton; Bai, Zhiqiang; Roth, Elliot J; Zhang, Li-Qun

    2004-10-01

    To investigate quantitatively biomechanic changes in the passive properties of hemiplegic spastic ankles. Evaluation of spastic hypertonia by moving the ankle joint slowly between dorsiflexion and plantarflexion extreme positions under controlled joint torque and position. Institutional research center. Twenty-four stroke patients with spastic ankles and 32 healthy controls. Not applicable. Passive resistance torque at controlled dorsiflexion and plantarflexion positions, dorsiflexion and plantarflexion range of motion (ROM) at controlled torques, and quasistatic stiffness and energy loss in dorsiflexion and plantarflexion. Spastic hypertonic ankles showed significant alterations of the passive properties in plantarflexion (P=.041) as well as in dorsiflexion (P=.016) directions. Compared with healthy controls, spastic ankles showed higher resistance torque (9.51+/-4.79Nm vs 6.21+/-3.64Nm, P=.016), higher quasistatic stiffness (.54+/-.19Nm/deg vs .35+/-.20Nm/deg, P=.001) at 10 degrees of dorsiflexion, larger normalized dorsiflexion energy loss (.068+/-.04J/deg vs .04+/-.02J/deg, P=.037), and decreased dorsiflexion ROM at 10Nm of resistance torque (10.77 degrees +/-8.69 degrees vs 20.02 degrees +/-11.67 degrees , P=.014). The resistance torque, ROM, and stiffness of spastic hypertonic ankles in plantarflexion showed similar changes (Pbiomechanic changes in both plantar- and dorsiflexors are associated with spastic hypertonia of chronic stroke patients, and they can be evaluated quantitatively under well-controlled conditions. With simplifications, the various measures in this study can potentially be used to obtain more comprehensive and quantitative evaluations of spastic hypertonia in a clinical setting.

  12. Correlation between Mechanical Properties of the Ankle Muscles and Postural Sway during the Menstrual Cycle.

    Science.gov (United States)

    Yim, JongEun; Petrofsky, Jerrold; Lee, Haneul

    2018-03-01

    Ankle and foot injuries are common among athletes and physically active individuals. The most common residual disability, ankle sprain, is characterized by instability along with postural sway. If the supporting structures around a joint become lax, posture stability and balance are also affected. Previous studies have examined muscle stiffness and elasticity and postural sway separately; however, the relationship between these factors is yet unknown. It is well known that the levels of sex hormones, especially estrogen, change in women over the phase of the menstrual cycle. Therefore, this study examined the relationship between the mechanical properties of tissue and balance activity using a non-invasive digital palpation device to determine if they undergo any changes over the menstrual cycle in young women. Sixteen young women with regular menstrual cycles completed the study. Tone, stiffness, and elasticity of the ankle muscles (lateral gastrocnemius, peroneus longus, and tibialis anterior) were measured using a non-invasive digital palpation device. Postural sway was recorded while the participants performed balance tasks during ovulation and menstruation. Significantly greater posture sway characteristics and ankle muscle elasticity were found during ovulation than during menstruation; lower tone and stiffness of the ankle muscles were observed at ovulation (p < 0.05). Additionally, weak-to-strong relationships between ankle muscle mechanical properties and postural sway characteristics were found (p < 0.05). These results suggest the effect of estrogen on human connective tissues. We therefore postulate that estrogen increases joint and muscle laxity and affects posture stability according to the phase of the menstrual cycle.

  13. The Acute Effects of Static and Cyclic Stretching on Muscle Stiffness and Hardness of Medial Gastrocnemius Muscle.

    Science.gov (United States)

    Maeda, Noriaki; Urabe, Yukio; Tsutsumi, Shogo; Sakai, Shogo; Fujishita, Hironori; Kobayashi, Toshiki; Asaeda, Makoto; Hirata, Kazuhiko; Mikami, Yukio; Kimura, Hiroaki

    2017-12-01

    This study aimed to clarify the acute effects of static stretching (SS) and cyclic stretching (CS) on muscle stiffness and hardness of the medial gastrocnemius muscle (MG) by using ultrasonography, range of motion (ROM) of the ankle joint and ankle plantar flexor. Twenty healthy men participated in this study. Participants were randomly assigned to SS, CS and control conditions. Each session consisted of a standard 5-minute cycle warm-up, accompanied by one of the subsequent conditions in another day: (a) 2 minutes static stretching, (b) 2 minutes cyclic stretching, (c) control. Maximum ankle dorsiflexion range of motion (ROM max) and normalized peak torque (NPT) of ankle plantar flexor were measured in the pre- and post-stretching. To assess muscle stiffness, muscle-tendon junction (MTJ) displacement (the length changes in tendon and muscle) and MTJ angle (the angle made by the tendon of insertion and muscle fascicle) of MG were measured using ultrasonography at an ankle dorsiflexion angle of -10°, 0°, 10° and 20° before and after SS and CS for 2 minutes in the pre- and post-stretching. MG hardness was measured using ultrasound real-time tissue elastography (RTE). The results of this study indicate a significant effect of SS for ROM maximum, MTJ angle (0°, 10°, 20°) and RTE (10°, 20°) compared with CS (p muscle stiffness and hardness compared with CS. In addition, CS may contribute to the elongation of muscle tissue and increased muscle strength.

  14. [The potential of the modern methods for clinical diagnostics applied in the forensic medical assessment of functional disturbances of the ankle joint in the case of its injury].

    Science.gov (United States)

    Khabova, Z S; Fetisov, V A

    2012-01-01

    The present paper is focused on the problems of clinical diagnostics of the functional disturbances in the locomotor apparatus as exemplified by the injuries to the ankle joint. The results of analysis of the entire range of up-to-date diagnostic tools for the purpose suggest the necessity of revision of obsolete methodological principles still adopted in forensic medicine as regards the problem being condidered. It is proposed based on the recent progress achieved by the specialists in traumatology, orthopedics, medicosocial expertise, and the related areas that a forensic medical expert should not confine oneself to the consideration of the sole criterion, such as "the range of articular movements", for the estimation of the severity of harm to health in the patients presenting with a joint injury.

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

    Science.gov (United States)

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

    2016-10-06

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

  16. 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.

  17. Comparisons of increases in knee and ankle joint moments following an increase in running speed from 8 to 12 to 16km·h(-1.).

    Science.gov (United States)

    Petersen, Jesper; Nielsen, Rasmus O; Rasmussen, Sten; Sørensen, Henrik

    2014-11-01

    Knowledge regarding knee and ankle joint load across a range of running speeds is important, if running related injuries are to be prevented. The purpose of the present study was to test the hypothesis that peak plantar flexion moment increases relatively more than peak knee extension moment when running speed is increased. Kinematic and ground reaction force data were collected from 33 recreational runners during steady-state running at three different speeds: 7.96km·h(-1) (SD 0.18), 11.92km·h(-1) (SD 0.25) and 15.91km·h(-1) (SD 0.36). Peak plantar flexion moment and peak knee extension moment were calculated using a standard three-dimensional inverse dynamics approach. There was a significant interaction between the joint location and the running speed (P=0.03): When running speed increased from 7.96 to 15.91km·h(-1), mean peak plantar flexion moment increased by 0.74N·m·kg(-1) (95% CI: 0.64; 0.85) which was more than the 0.52N·m·kg(-1) (95% CI: 0.42; 0.63) increase in mean peak knee extension moment. A greater increase in biomechanical load occurs for the plantar flexors of the ankle joint than for the extensors of the knee joint when running speed increases. This may indicate that at an excessive running speed, the structures at the posterior part of the lower leg and underneath the foot are relatively more vulnerable to injury compared with the structures at the anterior part of the knee. As a considerable load reduction is achieved, a decrease in running speed may benefit rearfoot striking recreational runners experiencing pain in the posterior lower leg or underneath the foot. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Evaluating the Effects of Ankle-Foot Orthosis Mechanical Property Assumptions on Gait Simulation Muscle Force Results.

    Science.gov (United States)

    Hegarty, Amy K; Petrella, Anthony J; Kurz, Max J; Silverman, Anne K

    2017-03-01

    Musculoskeletal modeling and simulation techniques have been used to gain insights into movement disabilities for many populations, such as ambulatory children with cerebral palsy (CP). The individuals who can benefit from these techniques are often limited to those who can walk without assistive devices, due to challenges in accurately modeling these devices. Specifically, many children with CP require the use of ankle-foot orthoses (AFOs) to improve their walking ability, and modeling these devices is important to understand their role in walking mechanics. The purpose of this study was to quantify the effects of AFO mechanical property assumptions, including rotational stiffness, damping, and equilibrium angle of the ankle and subtalar joints, on the estimation of lower-limb muscle forces during stance for children with CP. We analyzed two walking gait cycles for two children with CP while they were wearing their own prescribed AFOs. We generated 1000-trial Monte Carlo simulations for each of the walking gait cycles, resulting in a total of 4000 walking simulations. We found that AFO mechanical property assumptions influenced the force estimates for all the muscles in the model, with the ankle muscles having the largest resulting variability. Muscle forces were most sensitive to assumptions of AFO ankle and subtalar stiffness, which should therefore be measured when possible. Muscle force estimates were less sensitive to estimates of damping and equilibrium angle. When stiffness measurements are not available, limitations on the accuracy of muscle force estimates for all the muscles in the model, especially the ankle muscles, should be acknowledged.

  19. Following the correction of varus deformity of the knee through total knee arthroplasty, significant compensatory changes occur not only at the ankle and subtalar joint, but also at the foot.

    Science.gov (United States)

    Jeong, Bi O; Kim, Tae Yong; Baek, Jong Hun; Jung, Hyuk; Song, Seung Hyun

    2018-01-18

    This study aimed to assess radiological changes of the ankle joint, subtalar joint and foot following the correction of varus deformity of the knee with total knee arthroplasty (TKA). It was hypothesized that following the correction of varus deformity by TKA, compensatory reactions would occur at the subtalar joint in accordance with the extent of the correction. For this prospective study, 375 knees of patients who underwent TKA between 2011 and 2012 were enrolled. The varus angle of the knee, talar tilt of the ankle joint (TT), ground-talar dome angle of the foot (GD), anterior surface angle of the distal tibia and lateral surface angle of the distal tibia, heel alignment ratio (HR), heel alignment angle (HA), and heel alignment distance (HD) were measured on radiographs obtained pre-operatively and at post-operative 6 months. The mean correction angle in varus deformity of the knee was 10.8 ± 4.1°. TT and GD changed significantly from 0.4 ± 1.9° and 6.5 ± 3.1° pre-operatively to 0.1 ± 1.8° and 0.2 ± 2.1°, respectively (p = 0.007, p varus whereas GD was oriented in valgus. Following the correction of varus deformity of the knee through TKA, significant compensatory changes occurred not only at the ankle and subtalar joints, but also at the foot. The findings of this study are useful in predicting the orientation of changes in the ankle and subtalar joints and the foot following TKA, and in determining the sequence of surgery when both the ankle and knee have a problem. In other words, changes in the parts of the lower extremity below the ankle joint following the correction of varus deformity of the knee must be considered when TKA is planned and performed. Patients who have problems at the ankle, subtalar, and foot joints in addition to varus deformity of the knee are recommended to undergo knee joint correction first. II.

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

    NARCIS (Netherlands)

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

    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.

  1. Instantaneous stiffness and hysteresis of dynamic elastic response prosthetic feet.

    Science.gov (United States)

    Webber, Christina M; Kaufman, Kenton

    2017-10-01

    Dynamic elastic response prosthetic feet are designed to mimic the functional characteristics of the native foot/ankle joint. Numerous designs of dynamic elastic response feet exist which make the prescription process difficult, especially because of the lack of empirical evidence describing the objective performance characteristics of the feet. To quantify the mechanical properties of available dynamic elastic response prosthetic feet, specifically the stiffness and hysteresis. Mechanical testing of dynamic elastic response prosthetic feet. Static Proof Testing in accordance with ISO 10328 was conducted on seven dynamic elastic response prosthetic feet. Load-displacement data were used to calculate the instantaneous stiffness in both the heel and forefoot regions, as well as hysteresis associated with each foot. Heel stiffness was greater than forefoot stiffness for all feet. The heel of the glass composite prosthetic foot was stiffer than the carbon fiber feet and it exhibited less hysteresis. Two different carbon fiber feet had the stiffest forefoot regions. Mechanical testing is a reproducible method that can be used to provide objective evidence about dynamic elastic response prosthetic foot performance and aid in the prescription process. Clinical relevance The quantitative stiffness and hysteresis data from this study can be used by prosthetists to aid the prescription process and make it more objective.

  2. Association between work-related psychological stress and arterial stiffness measured by brachial-ankle pulse-wave velocity in young Japanese males from an information service company.

    Science.gov (United States)

    Nomura, Kyoko; Nakao, Mutsuhiro; Karita, Kanae; Nishikitani, Mariko; Yano, Eiji

    2005-10-01

    This study examined the relationship between work-related psychological stress and arterial stiffness in young Japanese workers. A cross-sectional study was conducted on 396 Japanese male workers, aged 24 to 39 years, employed in a Japanese information service company. Work-related psychological stress was measured by the Job Content Questionnaire based on the job demand-control model. The job-strain index was defined as the ratio of job demand to job-control scores. The outcome of the study was the degree of arteriosclerosis as assessed by brachial pulse-wave velocity (baPWV). The cardiovascular risk factors analyzed were age, heart rate, blood pressure, body mass index, serum lipid, blood sugar levels, catecholamine levels, ethanol consumption, smoking, and overtime. In addition, psychological responses were assessed by tension-anxiety and anger-hostility scales in the Profile of Mood States (POMS). The baPWV was positively (P<0.05) associated with physiological variables including age, heart rate, body mass index, and serum levels of total cholesterol, fasting glucose, and noradrenaline, but negatively (P<0.01) associated with the job-strain index. Significant associations were not found on the POMS tension-anxiety and anger-hostility scale scores. The negative correlation between baPWV and the job-strain index was consistent even after control for the effects of significant physiological variables. The association between job stress and baPWV was found to be inconsistent with the results of previous western studies, and it may require further investigation while taking into account occupation, cardiovascular risk factors, and Japanese culture.

  3. Gynecological Surgery and Low Back Pain in Older Women: Testing the Association With Sacroiliac Joint Stiffness and Pelvic Floor Movements

    OpenAIRE

    Ericksen, Jeffery; Pidcoe, Peter E.; Ketchum-McKinney, Jessica M.; Burnet, Evie N.; Huang, Emily; Wilson, James C.; Hoogstad, Vincent

    2010-01-01

    Objective: To determine sacroiliac joint compliance characteristics and pelvic floor movements in older women relative to gynecological surgery history and back pain complaints. Design: Single-visit laboratory measurement. Setting: University clinical research center. Participants: Twenty-five women aged 65 years or older. Outcome Measures: Sacroiliac joint compliance measured by Doppler imaging of vibrations and ultrasound measures of pelvic floor motion during the active straight leg raise ...

  4. T2 Relaxation Values of the Talar Trochlear Articular Cartilage: Comparison Between Patients With Lateral Instability of the Ankle Joint and Healthy Volunteers.

    Science.gov (United States)

    Park, So Yoon; Yoon, Young Cheol; Cha, Jang Gyu; Sung, Ki Sun

    2016-01-01

    The purpose of this study was to evaluate the difference between the T2 relaxation values of the talar trochlear cartilage in patients with lateral instability of the ankle joint and the values in healthy volunteers. A retrospective assessment was conducted of images from 13 MRI examinations of the ankles of 12 patients who underwent lateral ankle ligament repair with an arthroscopically proven normal talar trochlear cartilage. Thirteen ankle MRI examinations of 12 healthy age- and sex-matched volunteers were prospectively performed. Two radiologists independently measured the T2 relaxation values of the talar trochlear cartilage in two layers (superficial and deep) in the following six compartments: medial anterior (M1), medial middle (M2), medial posterior (M3), lateral anterior (L1), lateral middle (L2), and lateral posterior (L3). The T2 relaxation values of patients were compared with those of healthy volunteers. Both readers found that the mean T2 relaxation values of all six compartments of the superficial layer were significantly higher in patients than in control subjects. For reader 1, the M1 findings were 46.2 for patients and 39.6 for healthy volunteers; M2, 50.4 and 41.1; M3, 52.1 and 46.2; L1, 43.1 and 37.9; L2, 47.8 and 41.8; and L3, 53.8 and 49.8. For reader 2, the M1 findings were 45.0 and 40.2; M2, 48.8 and 41.1; M3, 53.2 and 45.6; L1, 42.8 and 38.5; L2, 48.0 and 42.1; and L3, 55.0 and 49.0 (p L1 deep (0.75). The T2 relaxation values of arthroscopically proven normal talar trochlear cartilage of patients with lateral instability were higher than those of healthy volunteers, especially in the superficial layer and the M2 deep layer.

  5. Ankle arthroscopy

    Science.gov (United States)

    ... Failure of repair to heal Weakness of the ankle Injury to tendon, blood vessel, or nerve Before the ... and the A.D.A.M. Editorial team. Ankle Injuries and Disorders Read more Endoscopy Read more NIH ...

  6. Ankle Pain

    Science.gov (United States)

    ... it follows an injury. Even a relatively benign ankle injury can be quite painful, at least at first. ... improve after several weeks Self-care For many ankle injuries, self-care measures ease the pain. Examples include: ...

  7. Ankle Problems

    Science.gov (United States)

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

  8. Stiffness Analysis of Above Knee Prosthesis

    OpenAIRE

    Ege, Mücahit; Küçük, Serdar

    2016-01-01

    While a healthy human walks, his or her legs mutually perform good repeatabilitywith high accuracy. This provides an esthetical movement and balance. Peoplewith above knee prosthesis want to perform walking as esthetical as a healthyhuman. Therefore, to achieve a healthy walking, the above knee prosthesis mustprovide a good stiffness performance. Especially stiffness values are requiredwhen adding a second axis movement to the ankle for eversion and inversion. Inthis paper, stiffness analysis...

  9. Single-leg drop landing movement strategies 6 months following first-time acute lateral ankle sprain injury.

    Science.gov (United States)

    Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E

    2015-12-01

    No research exists predicating a link between acute ankle sprain injury-affiliated movement patterns and those of chronic ankle instability (CAI) populations. The aim of the current study was to perform a biomechanical analysis of participants, 6 months after they sustained a first-time acute lateral ankle sprain (LAS) injury to establish this link. Fifty-seven participants with a 6-month history of first-time LAS and 20 noninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment of force) data were acquired for the joints of the lower extremity, from 200 ms pre-initial contact (IC) to 200 ms post-IC. Individual joint stiffnesses and the peak magnitude of the vertical component of the ground reaction force (GRF) were also computed. LAS participants displayed increases in hip flexion and ankle inversion on their injured limb (P < 0.05); this coincided with a reduction in the net flexion-extension moment at the hip joint, with an increase in its stiffness (P < 0.05). There was no difference in the magnitude of the peak vertical GRF for either limb compared with controls. These results demonstrate that altered movement strategies persist in participants, 6 months following acute LAS, which may precipitate the onset of CAI. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. A novel tool for measuring ankle dorsiflexion

    DEFF Research Database (Denmark)

    Larsen, Peter; B Nielsen, Henrik; Lund, Christoffer

    2016-01-01

    BACKGROUND: Assessment of ankle joint movement in a weight bearing position has important clinical implications. The Lunge Ankle Dorsiflexion measurement device (LAD) has been developed with the aim of facilitating ease of and standardisation of the measurement of ankle joint movement....... The literature lacks studies evaluating the reliability of weight bearing measurements of the ankle joint in study groups with ankle disabilities. The objective of this study was to examine the intra- and inter-tester reliability of ankle dorsiflexion measured with the novel LAD in patients following a fracture...... of the ankle. METHOD: This study was a randomized intra- and inter-tester reliability study with blinding of testers and participants. All participants were tested twice by each tester, with the order of testers randomized. The intra- and inter-tester reliability was assessed by the calculation of interclass...

  11. Comparison of plantar flexor musculotendinous stiffness, geometry, and architecture in male runners with and without a history of tibial stress fracture.

    Science.gov (United States)

    Pamukoff, Derek N; Blackburn, J Troy

    2015-02-01

    Greater lower extremity joint stiffness may be related to the development of tibial stress fractures in runners. Musculotendinous stiffness is the largest contributor to joint stiffness, but it is unclear what factors contribute to musculotendinous stiffness. The purpose of this study was to compare plantar flexor musculotendinous stiffness, architecture, geometry, and Achilles tendon stiffness between male runners with and without a history of tibial stress fracture. Nineteen healthy runners (age = 21 ± 2.7 years; mass = 68.2 ± 9.3 kg; height = 177.3 ± 6.0 cm) and 19 runners with a history of tibial stress fracture (age = 21 ± 2.9 years; mass = 65.3 ± 6.0 kg; height = 177.2 ± 5.2 cm) were recruited from community running groups and the university's varsity and club cross-country teams. Plantar flexor musculotendinous stiffness was estimated from the damped frequency of oscillatory motion about the ankle follow perturbation. Ultrasound imaging was used to measure architecture and geometry of the medial gastrocnemius. Dependent variables were compared between groups via one-way ANOVAs. Previously injured runners had greater plantar flexor musculotendinous stiffness (P < .001), greater Achilles tendon stiffness (P = .004), and lesser Achilles tendon elongation (P = .003) during maximal isometric contraction compared with healthy runners. No differences were found in muscle thickness, pennation angle, or fascicle length.

  12. The use of hyaluronic acid in the treatment of ankle osteoarthritis: a review of the evidence.

    Science.gov (United States)

    Papalia, R; Albo, E; Russo, F; Tecame, A; Torre, G; Sterzi, S; Bressi, F; Denaro, V

    2017-12-27

    Ankle osteoarthritis (OA) is a progressive degenerative joint disease that causes ankle pain and functional limitation especially during walking. It tends to involve younger people with high functional request and has often a post-traumatic origin. Symptoms control through conservative treatment is essential to procrastinate as long as possible the need for surgery. Although few data are present in literature about the use of local viscosupplementation in ankle OA, their potential use for ankle OA has been suggested. We systematically reviewed literature to evaluate the best evidence about short and long term effectiveness of intra-articular HA injections in the treatment of ankle OA. After having screened titles and abstracts from PubMed, Ovid, Cochrane Reviews, Google Scholar, we identified 14 full text articles and collected the outcome rates of intra-articular cycles of HA injections in patients with symptomatic ankle OA. Only 4 randomized control trials were included. Ankle Osteoarthritis Scales (AOS), American Orthopedic Foot, Ankle Society (AOFAS) clinical rating score, visual analog scales (VAS), Western Ontario and McMaster Universities (WOMAC) OA Index of Pain, Stiffness, and Physical Function Score were most frequently used to evaluate outcomes. Although randomized trials showed scores improvement also in placebo-treated patients, current evidence suggests that viscosupplementation for treatment of ankle OA is a safe and effective method. More randomized controlled trials with a large number of patients that compare not only the different types, dosages and frequency of HA injections, but also the effectiveness of HA versus corticosteroids infiltrations and HA versus other types of conservative treatment are still needed.

  13. Ankle sprain - aftercare

    Science.gov (United States)

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

  14. Analysis of movement axes of the ankle and subtalar joints: relationship with the articular surfaces of the talus.

    Science.gov (United States)

    Cho, Ho-Jung; Kwak, Dai-Soon; Kim, In-Beom

    2014-10-01

    Bone shape varies among human populations, and in the case of articular joints, the shape of the articulating surfaces strongly influences joint movement. In this study, we aimed to analyse the axes of the talocrural and subtalar joints, using the talar articular surface method, and compare these results with those of the previous studies. We used three-dimensional reconstruction models of tali among Korean individuals. The axes of the talocrural and subtalar joints were calculated by using the least-square sphere fitting method, and the principal axis was used for reference coordination. The shape of the talus was classified based on the shape of its anterior, middle, and posterior calcaneal facets, and the talar shape was compared with the movement axes. The movement axes did not differ according to the type of calcaneal facets of the talus. Interestingly, we also noted that the axes of the talocrural and subtalar joints in this study differed significantly from those reported in the previous studies; these differences may be due to variations in the shape of the bones. © IMechE 2014.

  15. Ankle sprain (image)

    Science.gov (United States)

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

  16. Anterior ankle arthrodesis

    Science.gov (United States)

    Slater, Gordon L; Sayres, Stephanie C; O’Malley, Martin J

    2014-01-01

    Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various techniques have been described in the attempt to achieve ankle arthrodesis and there is much debate as to the efficiency of each one. This study aims to evaluate the efficiency of anterior plating in ankle arthrodesis using customised and Synthes TomoFix plates. We present the outcomes of 28 ankle arthrodeses between 2005 and 2012, specifically examining rate of union, patient-reported outcomes scores, and complications. All 28 patients achieved radiographic union at an average of 36 wk; the majority of patients (92.86%) at or before 16 wk, the exceptions being two patients with Charcot joints who were noted to have bony union at a three year review. Patient-reported outcomes scores significantly increased (P plate offers added compression and provides a rigid fixation for arthrodesis stabilization. PMID:24649408

  17. An ADAMTSL2 founder mutation causes Musladin-Lueke Syndrome, a heritable disorder of beagle dogs, featuring stiff skin and joint contractures.

    Directory of Open Access Journals (Sweden)

    Hannah L Bader

    2010-09-01

    Full Text Available Musladin-Lueke Syndrome (MLS is a hereditary disorder affecting Beagle dogs that manifests with extensive fibrosis of the skin and joints. In this respect, it resembles human stiff skin syndrome and the Tight skin mouse, each of which is caused by gene defects affecting fibrillin-1, a major component of tissue microfibrils. The objective of this work was to determine the genetic basis of MLS and the molecular consequence of the identified mutation.We mapped the locus for MLS by genome-wide association to a 3.05 Mb haplotype on canine chromosome 9 (CFA9 (50.11-54.26; p(raw T; p.R221C perfectly associated with MLS (p-value=10(-12. Murine ADAMTSL2 containing the p.R221C mutation formed anomalous disulfide-bonded dimers when transiently expressed in COS-1, HEK293F and CHO cells, and was present in the medium of these cells at lower levels than wild-type ADAMTSL2 expressed in parallel.The genetic basis of MLS is a founder mutation in ADAMTSL2, previously shown to interact with latent TGF-β binding protein, which binds fibrillin-1. The molecular effect of the founder mutation on ADAMTSL2 is formation of disulfide-bonded dimers. Although caused by a distinct mutation, and having a milder phenotype than human GD, MLS nevertheless offers a new animal model for study of GD, and for prospective insights on mechanisms and pathways of skin fibrosis and joint contractures.

  18. The effects of open and closed kinetic chain exercises on the static and dynamic balance of the ankle joints in young healthy women.

    Science.gov (United States)

    Kim, Mi-Kyoung; Yoo, Kyung-Tae

    2017-05-01

    [Purpose] The purpose of the present study was to analyze the effects of open kinetic chain and closed kinetic chain exercises on the static and dynamic balance of ankle joints in young healthy women. [Subjects and Methods] Twenty women in their 20s were randomly assigned to two groups of ten women each: an open kinetic chain exercise group and a closed kinetic chain exercise group. Each group performed five sets of exercises three times per week for four weeks. Exercise intensity was increased once after two weeks. The subjects' Romberg's test results and their limits of stability were measured to evaluate their static and dynamic balance. The data were analyzed using a two-way repeated measures analysis of variance test. [Results] In the results of Romberg's test, the main effect of the time showed a significant difference in the trace length with eyes closed (Effect size: d=0.97). In the result of limits of stability, the interaction effect showed a significant difference in the backward, and the main effect of the group showed a significant difference in the forward. [Conclusion] The open kinetic chain and closed kinetic chain exercises both improved the balance of the subjects. The closed kinetic chain exercise was more effective at improving the dynamic balance of young healthy women than the open kinetic chain exercise.

  19. Sensitivity of a juvenile subject-specific musculoskeletal model of the ankle joint to the variability of operator-dependent input.

    Science.gov (United States)

    Hannah, Iain; Montefiori, Erica; Modenese, Luca; Prinold, Joe; Viceconti, Marco; Mazzà, Claudia

    2017-05-01

    Subject-specific musculoskeletal modelling is especially useful in the study of juvenile and pathological subjects. However, such methodologies typically require a human operator to identify key landmarks from medical imaging data and are thus affected by unavoidable variability in the parameters defined and subsequent model predictions. The aim of this study was to thus quantify the inter- and intra-operator repeatability of a subject-specific modelling methodology developed for the analysis of subjects with juvenile idiopathic arthritis. Three operators each created subject-specific musculoskeletal foot and ankle models via palpation of bony landmarks, adjustment of geometrical muscle points and definition of joint coordinate systems. These models were then fused to a generic Arnold lower limb model for each of three modelled patients. The repeatability of each modelling operation was found to be comparable to those previously reported for the modelling of healthy, adult subjects. However, the inter-operator repeatability of muscle point definition was significantly greater than intra-operator repeatability ( p definition of muscle geometry the most significant source of output uncertainty. The development of automated procedures to prevent the misplacement of crucial muscle points should therefore be considered a particular priority for those developing subject-specific models.

  20. Ankle Fractures: The Operative Outcome

    Directory of Open Access Journals (Sweden)

    Ahmad Hafiz Z

    2011-03-01

    Full Text Available Ankle fractures are commonly seen in orthopaedic practice. This retrospective study of patients with ankle fractures who underwent surgical treatment in our institution from January 2000 to December 2003 was undertaken to analyze the common causes and patterns of ankle fractures; and the functional outcome of operative treatment for these fractures. Eighty patients were identified and reviewed. There were 65 male (81.3% and 15 female patients (18.7% with age ranging from 13 to 71 years old (mean, 32.3y. Common causes of ankle fractures were trauma (especially motor vehicle accidents, sports injuries and the osteoporotic bones in the elderly. Weber C (64.0% was the most common pattern of fracture at presentation. The most common operative treatment for ankle fractures was open reduction and internal fixation (73 patients, 91.2%. Excellent and good outcomes were achieved in 93.8% of cases when measured using the Olerud and Molander scoring system for foot and ankle. In conclusion, operative treatment for ankle fractures restores sufficient stability and allowed mobility of the ankle joint.

  1. Arterial stiffness and cognitive impairment.

    Science.gov (United States)

    Li, Xiaoxuan; Lyu, Peiyuan; Ren, Yanyan; An, Jin; Dong, Yanhong

    2017-09-15

    Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases. To date, a significant number of studies have focused on the relationship between arterial stiffness and cognitive impairment. To investigate the relationships between specific arterial stiffness parameters and cognitive impairment, elucidate the pathophysiological mechanisms underlying the relationship between arterial stiffness and cognitive impairment and determine how to interfere with arterial stiffness to prevent cognitive impairment, we searched PUBMED for studies regarding the relationship between arterial stiffness and cognitive impairment that were published from 2000 to 2017. We used the following key words in our search: "arterial stiffness and cognitive impairment" and "arterial stiffness and cognitive impairment mechanism". Studies involving human subjects older than 30years were included in the review, while irrelevant studies (i.e., studies involving subjects with comorbid kidney disease, diabetes and cardiac disease) were excluded from the review. We determined that arterial stiffness severity was positively correlated with cognitive impairment. Of the markers used to assess arterial stiffness, a higher PWV, CAVI, AI, IMT and index-β and a lower ABI and FMD were related to cognitive impairment. However, the relationship between PP and cognitive impairment remained controversial. The potential mechanisms linking arterial stiffness and cognitive impairment may be associated with arterial pulsatility, as greater arterial pulsatility

  2. Two genetic loci associated with ankle injury

    OpenAIRE

    Kim, Stuart K.; Kleimeyer, John P.; Ahmed, Marwa A.; Avins, Andrew L.; Fredericson, Michael; Dragoo, Jason L.; Ioannidis, John P. A.

    2017-01-01

    Ankle injuries, including sprains, strains and other joint derangements and instability, are common, especially for athletes involved in indoor court or jumping sports. Identifying genetic loci associated with these ankle injuries could shed light on their etiologies. A genome-wide association screen was performed using publicly available data from the Research Program in Genes, Environment and Health (RPGEH) including 1,694 cases of ankle injury and 97,646 controls. An indel (chr21:47156779:...

  3. Effects of Prefabricated Ankle Orthoses on Postural Stability in Basketball Players with Chronic Ankle Instability

    OpenAIRE

    Faraji, Elahe; Daneshmandi, Hassan; Atri, Ahmad Ebrahimi; Onvani, Vahid; Namjoo, Faride Rezaee

    2012-01-01

    Purpose Ankle sprain is one of the most common injuries among athletes and instability and injury to this joint is responsible for long time loss of physical and recreational activity. Also, it can impose high costs to sport teams. Prevention of this injury is an important concern of practice and rehabilitation. One way of reducing the possibility of ankle joint injury is using an ankle orthosis. The present study aimed at inspecting the effects of two ankle orthoses on dynamic and semi-dynam...

  4. Influence of Elastic Bandage and Neoprene Ankle Support on Ankle Position Sense and Pain in Subjects with Ankle Sprain (Grade I & II

    Directory of Open Access Journals (Sweden)

    Basir Majdoleslami

    2004-06-01

    Full Text Available Objective: to investigate whether a neoprene ankle support and elastic bandage around the ankle joint of subjects with ankle sprain (grade I&II would , in short term (a reduce pain (b improve ankle joint position sense and comparison of their effect with each other if they have. Materials & Methods: In a semi-experimental study, 30 subjects (16men, 14 women, age between 16-52 with ankle sprain grade I&II. Subjects had to have at least 2cm from 10cm visual analogue scale (VAS of ankle pain for study entry. All patients were randomly assigned to either an elastic bandage or a neoprene ankle support. One week later they were assigned to the opposite selection. Joint position sense was assessed in the sitting position using an electrogoniometer and pain by VAS where 0cm equals no pain and 10 cm equals worst pain. ankle pain and JPS were assessed for each selection one week apart. During each visit assessment were performed at baseline and after 20 min of bandage/neoprene ankle support application. Results: the mean of scores for ankle variables JPS and VAS was taken and paired-t test and Wilcoxon signed rank test was employed to calculate the different between two trails. Neoprene ankle support had significant effect on ankle JPS (P=0.034. But elastic bandage had no effect (P=0.539. Both of them had significantly reduced ankle pain. (P=0.000  Conclusion: In subjects with both neoprene ankle support and elastic bandage reduced ankle pain with more effect of neoprene ankle support. Only the neoprene ankle support had effect on knee JPS.

  5. Therapeutic ultrasound for acute ankle sprains

    NARCIS (Netherlands)

    van den Bekerom, M. P. J.; van der Windt, D. A. W. M.; ter Riet, G.; van der Heijden, G. J.; Bouter, L. M.

    2012-01-01

    Background. Ultrasound is used in the treatment of a wide variety of musculoskeletal disorders, which include acute ankle sprains. Aim. To evaluate the effects of ultrasound therapy in the treatment of acute ankle sprains. Methods. We searched the Cochrane Bone, Joint and Muscle Trauma Group

  6. Linking the mechanics and energetics of hopping with elastic ankle exoskeletons.

    Science.gov (United States)

    Farris, Dominic James; Sawicki, Gregory S

    2012-12-15

    The springlike mechanics of the human leg during bouncing gaits has inspired the design of passive assistive devices that use springs to aid locomotion. The purpose of this study was to test whether a passive spring-loaded ankle exoskeleton could reduce the mechanical and energetic demands of bilateral hopping on the musculoskeletal system. Joint level kinematics and kinetics were collected with electromyographic and metabolic energy consumption data for seven participants hopping at four frequencies (2.2, 2.5, 2.8, and 3.2 Hz). Hopping was performed without an exoskeleton; with an springless exoskeleton; and with a spring-loaded exoskeleton. Spring-loaded ankle exoskeletons reduced plantar flexor muscle activity and the biological contribution to ankle joint moment (15-25%) and average positive power (20-40%). They also facilitated reductions in metabolic power (15-20%) across frequencies from 2.2 to 2.8 Hz compared with hopping with a springless exoskeleton. Reductions in metabolic power compared with hopping with no exoskeleton were restricted to hopping at 2.5 Hz only (12%). These results highlighted the importance of reducing the rate of muscular force production and work to achieve metabolic reductions. They also highlighted the importance of assisting muscles acting at the knee joint. Exoskeleton designs may need to be tuned to optimize exoskeleton mass, spring stiffness, and spring slack length to achieve greater metabolic reductions.

  7. Arthrography of the ankle sprains

    International Nuclear Information System (INIS)

    Han, Moon Hee

    1985-01-01

    Ankle arthrography, by direct puncture of joint cavity, is considered to be a simple and accurate diagnostic method for a precise evaluation of ligamentous injury. Forty-seven cases of ankle arthrography were successively performed in the patients of acute ankle sprains. The purpose of this study is to demonstrate how ankle arthrography can delineate the pathologic anatomy in such cases. The results are as follows: 1. Thirty cases among forty seven revealed the findings of ligament tears. 2. For better diagnostic accuracy, the arthrography should be performed within 72 hrs. after injury. 3. The anterior talofibular ligament tears were the most common (twenty-nine cases) of all and seventeen of them revealed tears without association of any other ligament tears. 4. There were ten cases of calcaneofibular ligament tears and nine of them were associated with anterior talofibular ligament tears. 5. Three cases of anterior tibiofibular and one deltoid ligament tears were demonstrated

  8. Compression therapy after ankle fracture surgery

    DEFF Research Database (Denmark)

    Winge, R; Bayer, L; Gottlieb, H

    2017-01-01

    PURPOSE: The main purpose of this systematic review was to investigate the effect of compression treatment on the perioperative course of ankle fractures and describe its effect on edema, pain, ankle joint mobility, wound healing complication, length of stay (LOS) and time to surgery (TTS). The aim...... was to suggest a recommendation to clinicians considering implementing compression therapy in the standard care of the ankle fracture patient, based on the existing literature. METHODS: We conducted a systematic search of literature including studies concerning adult patients with unstable ankle fractures...... undergoing surgery, testing either intermittent pneumatic compression, compression bandage and/or compression stocking and reporting its effect on edema, pain, ankle joint mobility, wound healing complication, LOS and TTS. To conclude on data a narrative synthesis was performed. RESULTS: The review included...

  9. Relação entre rigidez articular passiva e torque concêntrico dos rotadores laterais do quadril Relationship between joint passive stiffness and hip lateral rotator concentric torque

    Directory of Open Access Journals (Sweden)

    Diego X. Leite

    2012-10-01

    Full Text Available CONTEXTUALIZAÇÃO: Rigidez passiva adequada do quadril pode impedir movimentos excessivos dos membros inferiores no plano transverso durante a realização de atividades funcionais. O fortalecimento muscular dos rotadores laterais do quadril poderia ser utilizado na tentativa de aumentar a rigidez dessa articulação. No entanto, a relação entre rigidez passiva e força dos músculos do quadril não está documentada na literatura. OBJETIVO: Investigar a associação entre rigidez passiva do quadril durante o movimento de rotação medial e torque concêntrico dos rotadores laterais dessa articulação em indivíduos saudáveis. MÉTODO: Foram avaliados 26 indivíduos com média de idade de 24,42±2,77 anos. Para quantificação da rigidez passiva do quadril, o torque passivo de resistência durante a rotação medial dessa articulação foi mensurado por um dinamômetro isocinético. A rigidez foi determinada como a inclinação média da curva de torque passivo obtida nos primeiros 20° do movimento. Eletromiografia foi utilizada para verificar o repouso dos músculos do quadril durante esse procedimento. O dinamômetro isocinético também foi utilizado para avaliação do pico de torque e trabalho máximo dos rotadores laterais do quadril em uma amplitude de 55° de rotação. RESULTADOS: Regressões lineares demonstraram coeficientes de correlação r=0,70 (R²=0,50/pBACKGROUND: Adequate passive stiffness of the hip joint can prevent the occurrence of excessive transverse plane lower limb movement during functional activities. Strength training of the hip lateral rotator muscles can be used to increase the stiffness of this joint. However, the relationship between hip joint passive stiffness and muscle strength remains undocumented in the literature. OBJECTIVE: To investigate the association between hip passive stiffness measured during medial rotation and hip lateral rotator concentric torque in healthy young adults. METHOD: Twenty

  10. 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

  11. MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

    Energy Technology Data Exchange (ETDEWEB)

    Peace, K.A.L. E-mail: kalpeace@hotmail.com; Hillier, J.C.; Hulme, A.; Healy, J.C

    2004-11-01

    AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS.

  12. MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

    International Nuclear Information System (INIS)

    Peace, K.A.L.; Hillier, J.C.; Hulme, A.; Healy, J.C.

    2004-01-01

    AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS

  13. Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.

    Science.gov (United States)

    Toyota, Yukihiro; Tamura, Maasa; Kirino, Yohei; Sugiyama, Yumiko; Tsuchida, Naomi; Kunishita, Yosuke; Kishimoto, Daiga; Kamiyama, Reikou; Miura, Yasushi; Minegishi, Kaoru; Yoshimi, Ryusuke; Ueda, Atsuhisa; Nakajima, Hideaki

    2017-05-01

    To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA). Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients' visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0-3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable. Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS. US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.

  14. Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Chamorro Claudio

    2017-10-01

    Full Text Available The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs and isokinetic dynamometers (IDs in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (% or limit of agreement LOA (% expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (% was 33.59%, 95% confidence interval (CI 23.91 to 43.26 and ankle plantar flexion LOA (% was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (% under 15%. Lower hip, knee, and ankle LOA (% were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87 for ankle dorsiflexion to 0.94, IC (0.91to 0.98 for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors.

  15. Absolute Reliability and Concurrent Validity of Hand Held Dynamometry and Isokinetic Dynamometry in the Hip, Knee and Ankle Joint: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Chamorro, Claudio; Armijo-Olivo, Susan; De la Fuente, Carlos; Fuentes, Javiera; Javier Chirosa, Luis

    2017-01-01

    The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors.

  16. Adaptive Admittance Control for an Ankle Exoskeleton Using an EMG-Driven Musculoskeletal Model

    Directory of Open Access Journals (Sweden)

    Shaowei Yao

    2018-04-01

    Full Text Available Various rehabilitation robots have been employed to recover the motor function of stroke patients. To improve the effect of rehabilitation, robots should promote patient participation and provide compliant assistance. This paper proposes an adaptive admittance control scheme (AACS consisting of an admittance filter, inner position controller, and electromyography (EMG-driven musculoskeletal model (EDMM. The admittance filter generates the subject's intended motion according to the joint torque estimated by the EDMM. The inner position controller tracks the intended motion, and its parameters are adjusted according to the estimated joint stiffness. Eight healthy subjects were instructed to wear the ankle exoskeleton robot, and they completed a series of sinusoidal tracking tasks involving ankle dorsiflexion and plantarflexion. The robot was controlled by the AACS and a non-adaptive admittance control scheme (NAACS at four fixed parameter levels. The tracking performance was evaluated using the jerk value, position error, interaction torque, and EMG levels of the tibialis anterior (TA and gastrocnemius (GAS. For the NAACS, the jerk value and position error increased with the parameter levels, and the interaction torque and EMG levels of the TA tended to decrease. In contrast, the AACS could maintain a moderate jerk value, position error, interaction torque, and TA EMG level. These results demonstrate that the AACS achieves a good tradeoff between accurate tracking and compliant assistance because it can produce a real-time response to stiffness changes in the ankle joint. The AACS can alleviate the conflict between accurate tracking and compliant assistance and has potential for application in robot-assisted rehabilitation.

  17. Boi-ogi-to (TJ-20, a Kampo Formula, Suppresses the Inflammatory Bone Destruction and the Expression of Cytokines in the Synovia of Ankle Joints of Adjuvant Arthritic Rats

    Directory of Open Access Journals (Sweden)

    Xinwen Zhang

    2017-01-01

    Full Text Available TJ-20 is a formula consisting of 6 herbs that has been used in the clinical treatment of rheumatoid arthritis (RA in China and Japan for centuries. However, scientific evidence of the effects of TJ-20 has not been established. In the present study, we focused on the therapeutic effects and investigated the main function of TJ-20 on adjuvant arthritis (AA, an animal model of RA, which was induced with complete Freund’s adjuvant (CFA. TJ-20 was administered orally at 600 mg/kg once a day from 0, 7, and 10 days to 8 weeks after the CFA treatment. TJ-20 significantly ameliorated inflammatory progression and bone destruction in AA in a time-dependent manner. Furthermore, TJ-20 significantly reduced the increased changes in a number of macrophages and helper T cells. Moreover, TJ-20 suppressed the expression of TNF-α whereas it augmented the expression of IL-10 and attenuated Th1 cells responses in the synovia of the ankle joint. Therefore, TJ-20 regulated the expression of proinflammatory and anti-inflammatory cytokines in macrophages and Th1/Th2 balance in the synovia of ankle joints in AA rats. These results suggest the positive anti-inflammatory effect of TJ-20 and provide a scientific basis for the clinical use of TJ-20 for RA.

  18. 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

  19. 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.

  20. Acute decrease in the stiffness of resting muscle belly due to static stretching.

    Science.gov (United States)

    Taniguchi, K; Shinohara, M; Nozaki, S; Katayose, M

    2015-02-01

    The purpose of the study was to examine the acute effect of static stretching exercise on the resting stiffness of gastrocnemius muscle belly. Ten healthy young adults performed standing wall stretching in dorsiflexion for 1 min at a time and repeated five times. Before and after stretching, the shear modulus was measured in medial and lateral heads of the resting gastrocnemius muscle with ultrasound shear-wave elastography. After the stretching, dorsiflexion range of motion (ROM) of the ankle joint increased (P stretching, shear modulus decreased (P stretching across muscle heads. The decrease in shear modulus returned in 20 min after stretching. In the comparison group of 10 additional subjects, the standing intervention without stretching had no influence on these measures. There was a negative correlation between dorsiflexion ROM and shear modulus in either head before and after stretching. The results demonstrate the transient decreases in the stiffness of the resting gastrocnemius muscle belly and indicate that joint flexibility is greater in individuals with lower resting stiffness of the muscle belly. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: A randomized control study.

    Science.gov (United States)

    Ebnezar, John; Nagarathna, Raghuram; Yogitha, Bali; Nagendra, Hongasandra Ramarao

    2012-01-01

    To study the effect of integrated yoga on pain, morning stiffness and anxiety in osteoarthritis of knees. Two hundred and fifty participants with OA knees (35-80 years) were randomly assigned to yoga or control group. Both groups had transcutaneous electrical stimulation and ultrasound treatment followed by intervention (40 min) for two weeks with follow up for three months. The integrated yoga consisted of yogic loosening and strengthening practices, asanas, relaxation, pranayama and meditation. The control group had physiotherapy exercises. Assessments were done on 15(th) (post 1) and 90(th) day (post 2). Resting pain (numerical rating scale) reduced better (Panxiety (STAI-1) reduced (Panxiety (STAI 2) reduced (Preduced (Preduced (Preduced (Preducing pain, morning stiffness, state and trait anxiety, blood pressure and pulse rate in patients with OA knees.

  2. Arterial stiffness

    Directory of Open Access Journals (Sweden)

    Ursula Quinn

    2012-09-01

    Full Text Available Measurements of biomechanical properties of arteries have become an important surrogate outcome used in epidemiological and interventional cardiovascular research. Structural and functional differences of vessels in the arterial tree result in a dampening of pulsatility and smoothing of blood flow as it progresses to capillary level. A loss of arterial elastic properties results a range of linked pathophysiological changes within the circulation including increased pulse pressure, left ventricular hypertrophy, subendocardial ischaemia, vessel endothelial dysfunction and cardiac fibrosis. With increased arterial stiffness, the microvasculature of brain and kidneys are exposed to wider pressure fluctuations and may lead to increased risk of stroke and renal failure. Stiffening of the aorta, as measured by the gold-standard technique of aortic Pulse Wave Velocity (aPWV, is independently associated with adverse cardiovascular outcomes across many different patient groups and in the general population. Therefore, use of aPWV has been proposed for early detection of vascular damage and individual cardiovascular risk evaluation and it seems certain that measurement of arterial stiffness will become increasingly important in future clinical care. In this review we will consider some of the pathophysiological processes that result from arterial stiffening, how it is measured and factors that may drive it as well as potential avenues for therapy. In the face of an ageing population where mortality from atheromatous cardiovascular disease is falling, pathology associated with arterial stiffening will assume ever greater importance. Therefore, understanding these concepts for all clinicians involved in care of patients with cardiovascular disease will become vital.

  3. Long-Term Effects of Orthoses Use on the Changes of Foot and Ankle Joint Motions of Children With Spastic Cerebral Palsy.

    Science.gov (United States)

    Liu, Xue-Cheng; Embrey, David; Tassone, Channing; Zvara, Kim; Brandsma, Brenna; Lyon, Roger; Goodfriend, Karin; Tarima, Sergey; Thometz, John

    2017-09-01

    Orthoses commonly are prescribed to children with cerebral palsy (CP) to provide foot correction and to improve ambulatory function. Immediate effects of ankle foot orthosis (AFOs) have been investigated, but long-term kinematic effects are lacking clinical evidence. To determine changes in 3-dimensional ankle and foot segment motion in pediatric patients with CP between initial and follow-up visits (18-month average time differences) in both barefoot gait and gait with their AFO. We also investigated intravisit changes between barefoot and AFO gait. A prospective cohort study. Children's Hospital of Wisconsin, Department of Orthopaedic Surgery, Medical College of Wisconsin. A total of 23 children with CP, mean age 10.5 years (6.2-18.1 years) were clinically prescribed either a solid ankle foot orthotic (SAFO), hinged ankle foot orthotic (HAFO), or supramalleolar orthotic. Holes were cut in the study orthoses so that electromagnetic markers could be directly placed on the skin. A 6-foot segment model was used. Kinematic and kinetic data was recorded for each patient's initial and follow-up visit (18-month follow-up average, 15-20 months range). For the SAFO group (gait with AFO), a significant decrease in dorsiflexion was found between the initial and third visit (P = .008). Furthermore, the SAFO group (barefoot gait) had an increased eversion at the midfoot for most of the gait cycle (P AFO groups. The use of AFOs long term either maintained or improved foot deformities or dysfunction. Level II. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  4. Diagnostic value of magnetic resonance imaging of the ankle joint - visualization of ligaments and tendons by standard slice orientations; Die diagnostische Wertigkeit der Magnetresonanztomographie des oberen Sprunggelenks - Darstellung von Baendern und Sehnen in den Standardschichtorientierungen

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, R.J. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Siewert, C. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Maeurer, J. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Vogl, T.J. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Suedkamp, N. [Klinik fuer Unfall- und Wiederherstellungschirurgie, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany); Felix, R. [Strahlenklinik und Poliklinik, Virchow-Klinikum, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin (Germany)

    1996-01-01

    We sought to evaluate the capability of high field strength MRI in depicting clinically important tendons and ligaments of the ankle joint using slice orientations parallel to the standard space directions without angulation. Patients (65) whose ankle joint complaints were not sufficiently clarified by conventional radiology sphere underwent MRI using plain T{sub 1}-weighted spin echo sequences. Tendons and ligaments were classified by three independent radiologists with regard to their perceptibility on images of the different slice orientations. Good perceptibility of at least two-thirds of each structure was observed with the possibility for a decision regarding continuity or rupture of the remaining part was given most frequently in the following slice orientations: Axially for the tendons of peroneus longus, peroneus brevis, tibialis posterior, flexor digitorum longus, flexor hallucis longus, tibialis anterior, extensor digitorum longus, and extensor hallucis longus muscles, and for the calcanear tendor (each over 94% of cases), anterior (68%) talofibular ligament, deltoid (77%), anterior (63%), and posterior (72%) tibiofibular ligaments and coronally for the calcaneofibular (39%) and posterior talofibular ligaments (70%). The sagittal orientation was never the favored one. Thus in most cases tendons and ligaments of the ankle joint can be sufficiently visualized by non-angulated spin echo sequences in standard slice orientations if the examination is performed in at least two slice directions. [Deutsch] Studienziel: Bewertung der Darstellungsqualitaet von klinisch bedeutsamen Sehnen- und Bandstrukturen im Bereich des oberen Sprunggelenks in Hochfeld-MRT-Aufnahmen bei Schichtorientierung parallel zu den Standardraumebenen ohne Angulierung. Material und Methodik: Bei Verwendung nativer T{sub 1}-gewichteter Spinechosequenzen wurden 65 Patienten mit konventionell-radiologisch nicht ausreichend abgeklaerten Beschwerden im oberen Sprunggelenkbereich untersucht und

  5. Postoperative MR study of the ankle

    International Nuclear Information System (INIS)

    Tosch, U.; Sander, B.; Schubeus, P.; Tepe, H.; Goudarzi, Y.M.

    1991-01-01

    20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress X-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress X-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exsudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR. (orig.) [de

  6. Defining the mechanical properties of a spring-hinged ankle foot orthosis to assess its potential use in children with spastic cerebral palsy.

    Science.gov (United States)

    Kerkum, Yvette L; Brehm, Merel-Anne; Buizer, Annemieke I; van den Noort, Josien C; Becher, Jules G; Harlaar, Jaap

    2014-12-01

    A rigid ventral shelf ankle foot orthosis (AFO) may improve gait in children with spastic cerebral palsy (SCP) whose gait is characterized by excessive knee flexion in stance. However, these AFOs can also impede ankle range of motion (ROM) and thereby inhibit push-off power. A more spring-like AFO can enhance push-off and may potentially reduce walking energy cost. The recent development of an adjustable spring-hinged AFO now allows adjustment of AFO stiffness, enabling tuning toward optimal gait performance. This study aims to quantify the mechanical properties of this spring-hinged AFO for each of its springs and settings. Using an AFO stiffness tester, two AFO hinges and their accompanying springs were measured. The springs showed a stiffness range of 0.01-1.82 N · m · deg(-1). The moment-threshold increased with increasing stiffness (1.13-12.1 N · m), while ROM decreased (4.91-16.5°). Energy was returned by all springs (11.5-116.3 J). These results suggest that the two stiffest available springs should improve joint kinematics and enhance push-off in children with SCP walking with excessive knee flexion.

  7. Clinical application of a modular ankle robot for stroke rehabilitation

    Science.gov (United States)

    Forrester, Larry W.; Roy, Anindo; Goodman, Ronald N.; Rietschel, Jeremy; Barton, Joseph E.; Krebs, Hermano Igo; Macko, Richard F.

    2015-01-01

    Background Advances in our understanding of neuroplasticity and motor learning post-stroke are now being leveraged with the use of robotics technology to enhance physical rehabilitation strategies. Major advances have been made with upper extremity robotics, which have been tested for efficacy in multi-site trials across the subacute and chronic phases of stroke. In contrast, use of lower extremity robotics to promote locomotor re-learning has been more recent and presents unique challenges by virtue of the complex multi-segmental mechanics of gait. Objectives Here we review a programmatic effort to develop and apply the concept of joint-specific modular robotics to the paretic ankle as a means to improve underlying impairments in distal motor control that may have a significant impact on gait biomechanics and balance. Methods An impedance controlled ankle robot module (anklebot) is described as a platform to test the idea that a modular approach can be used to modify training and measure the time profile of treatment response. Results Pilot studies using seated visuomotor anklebot training with chronic patients are reviewed, along with results from initial efforts to evaluate the anklebot's utility as a clinical tool for assessing intrinsic ankle stiffness. The review includes a brief discussion of future directions for using the seated anklebot training in the earliest phases of sub-acute therapy, and to incorporate neurophysiological measures of cerebro-cortical activity as a means to reveal underlying mechanistic processes of motor learning and brain plasticity associated with robotic training. Conclusions Finally we conclude with an initial control systems strategy for utilizing the anklebot as a gait training tool that includes integrating an Internal Model-based adaptive controller to both accommodate individual deficit severities and adapt to changes in patient performance. PMID:23949045

  8. Estudo da confiabilidade da força aplicada durante a mobilização articular ântero-posterior do tornozelo Reliability study on the force applied during anteroposterior mobilization of the ankle joint

    Directory of Open Access Journals (Sweden)

    MA Resende

    2006-01-01

    Full Text Available INTRODUÇÃO: Os fatores que contribuem para a eficiência da manobra de mobilização articular são a intensidade e a reprodutibilidade da força aplicada durante a mobilização, por um ou por diferentes examinadores. OBJETIVO: Avaliar a confiabilidade intra e interexaminador da força de mobilização ântero-posterior da articulação do tornozelo, grau III e IV de Maitland. MÉTODO: Os dois tornozelos de 35 voluntários assintomáticos foram mobilizados por dois examinadores experientes com o procedimento. Uma miniplataforma de força foi posicionada sob a perna do voluntário a fim de captar as forças obtidas durante as manobras de mobilização e seu sinal foi convertido e armazenado em um software DasyLab4.0, o que permitiu o registro dos picos mínimo e máximo das curvas da força aplicada. A análise da confiabilidade foi realizada através do coeficiente de correlação intraclasse (CCI. Para avaliar o erro sistemático das medidas foi utilizado o teste t pareado e o teste t independente, para as condições intra e interexaminadores, respectivamente. O método de Bland e Altman avaliou os limites de concordância das medidas entre os examinadores. RESULTADOS: Os dados demonstraram alta confiabilidade intra-examinador. A confiabilidade inter-examinador foi baixa e moderada para a força máxima e mínima respectivamente, durante a mobilização ântero-posterior da articulação do tornozelo. CONCLUSÃO: Esses dados sugerem que a força aplicada durante a mobilização articular grau III e IV de Maitland no tornozelo, apresenta alta confiabilidade intra-examinador e baixa para interexaminador.BACKGROUND: Factors that contribute towards the efficiency of joint mobilization maneuvers is the intensity and reproducibility of the force applied during mobilization, by one or more examiners. OBJECTIVE: To evaluate the intra and inter-examiner reliability of Maitland grade III and IV anteroposterior mobilization force on the ankle joint

  9. Two genetic loci associated with ankle injury.

    Science.gov (United States)

    Kim, Stuart K; Kleimeyer, John P; Ahmed, Marwa A; Avins, Andrew L; Fredericson, Michael; Dragoo, Jason L; Ioannidis, John P A

    2017-01-01

    Ankle injuries, including sprains, strains and other joint derangements and instability, are common, especially for athletes involved in indoor court or jumping sports. Identifying genetic loci associated with these ankle injuries could shed light on their etiologies. A genome-wide association screen was performed using publicly available data from the Research Program in Genes, Environment and Health (RPGEH) including 1,694 cases of ankle injury and 97,646 controls. An indel (chr21:47156779:D) that lies close to a collagen gene, COL18A1, showed an association with ankle injury at genome-wide significance (p = 3.8x10-8; OR = 1.99; 95% CI = 1.75-2.23). A second DNA variant (rs13286037 on chromosome 9) that lies within an intron of the transcription factor gene NFIB showed an association that was nearly genome-wide significant (p = 5.1x10-8; OR = 1.63; 95% CI = 1.46-1.80). The ACTN3 R577X mutation was previously reported to show an association with acute ankle sprains, but did not show an association in this cohort. This study is the first genome-wide screen for ankle injury that yields insights regarding the genetic etiology of ankle injuries and provides DNA markers with the potential to inform athletes about their genetic risk for ankle injury.

  10. Two genetic loci associated with ankle injury.

    Directory of Open Access Journals (Sweden)

    Stuart K Kim

    Full Text Available Ankle injuries, including sprains, strains and other joint derangements and instability, are common, especially for athletes involved in indoor court or jumping sports. Identifying genetic loci associated with these ankle injuries could shed light on their etiologies. A genome-wide association screen was performed using publicly available data from the Research Program in Genes, Environment and Health (RPGEH including 1,694 cases of ankle injury and 97,646 controls. An indel (chr21:47156779:D that lies close to a collagen gene, COL18A1, showed an association with ankle injury at genome-wide significance (p = 3.8x10-8; OR = 1.99; 95% CI = 1.75-2.23. A second DNA variant (rs13286037 on chromosome 9 that lies within an intron of the transcription factor gene NFIB showed an association that was nearly genome-wide significant (p = 5.1x10-8; OR = 1.63; 95% CI = 1.46-1.80. The ACTN3 R577X mutation was previously reported to show an association with acute ankle sprains, but did not show an association in this cohort. This study is the first genome-wide screen for ankle injury that yields insights regarding the genetic etiology of ankle injuries and provides DNA markers with the potential to inform athletes about their genetic risk for ankle injury.

  11. Static stiffness modeling of a novel hybrid redundant robot machine

    Energy Technology Data Exchange (ETDEWEB)

    Li Ming, E-mail: hackingming@gmail.com [Laboratory of Intelligent Machines, Lappeenranta University of Technology (Finland); Wu Huapeng; Handroos, Heikki [Laboratory of Intelligent Machines, Lappeenranta University of Technology (Finland)

    2011-10-15

    This paper presents a modeling method to study the stiffness of a hybrid serial-parallel robot IWR (Intersector Welding Robot) for the assembly of ITER vacuum vessel. The stiffness matrix of the basic element in the robot is evaluated using matrix structural analysis (MSA); the stiffness of the parallel mechanism is investigated by taking account of the deformations of both hydraulic limbs and joints; the stiffness of the whole integrated robot is evaluated by employing the virtual joint method and the principle of virtual work. The obtained stiffness model of the hybrid robot is analytical and the deformation results of the robot workspace under certain external load are presented.

  12. Static stiffness modeling of a novel hybrid redundant robot machine

    International Nuclear Information System (INIS)

    Li Ming; Wu Huapeng; Handroos, Heikki

    2011-01-01

    This paper presents a modeling method to study the stiffness of a hybrid serial-parallel robot IWR (Intersector Welding Robot) for the assembly of ITER vacuum vessel. The stiffness matrix of the basic element in the robot is evaluated using matrix structural analysis (MSA); the stiffness of the parallel mechanism is investigated by taking account of the deformations of both hydraulic limbs and joints; the stiffness of the whole integrated robot is evaluated by employing the virtual joint method and the principle of virtual work. The obtained stiffness model of the hybrid robot is analytical and the deformation results of the robot workspace under certain external load are presented.

  13. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A Three-Month Study with Proprioceptive Neuromuscular Facilitation

    Directory of Open Access Journals (Sweden)

    Zhihao Zhou

    2016-11-01

    Full Text Available In this paper, we aim to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS. A modified robot-assisted system was proposed and seven post-stroke patients with hemiplegic spastic ankles participated a three-month of robotic PNF training. Their impaired sides were used as the experimental group while their unimpaired sides as the control group. A robotic intervention for the experimental group generally started from a two minutes passive stretching to warm-up or relax the soleus and gastrocnemius muscle and also ended with the same one. Then a PNF training session included 30 trails was activated between them. The rehabilitation trainings were carried out three times a week as an addition of their regular rehabilitation exercise. Passive ankle joint range of motion, resistance torque and stiffness were measured in both ankles before and after the intervention. The changes in Achilles' tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the three months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased ( p0.05 . The robotic rehabilitation also improved the muscle strength ( p0.05 and fast walking speed ( p<0.05 . These results indicated that PNF based robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in post-stroke rehabilitation training.

  14. Low-field MRI of the ankle joint-first experience in the pediatric age group; Niederfeld-MRT des Springgelenkes - Erste Erfahrungen bei Kindern und Jugendlichen an einem offenen 0,2 T MR-System

    Energy Technology Data Exchange (ETDEWEB)

    Herber, S.; Kreitner, K.F.; Kalden, P.; Loew, R.; Thelen, M. (Klinik und Poliklinik fuer Radiologie); Berger, S. (Klinik und Poliklinik fuer Kinderchirurgie)

    2000-03-01

    Purpose: To evaluate the feasibility and diagnostic confidence of MRI with an open low field System (Magnetom open {sup trademark}, Siemens, Germany) in children with predominantly traumatic disorders. Material and methods: Conventional X-rays and MRI examinations have been evaluated in 55 children. MRI was performed at an open 0.2 T MR-unit. The study protocol comprised coronal STIR-sequence, an angulated T{sub 2} weighted TSE-sequence and T{sub 1} weighted SE-sequence. Results: MRI showed ligamental ruptur in 33/50 (60%) cases. Injuries of the ATFL were most frequent (27/33); osseous ligamental tears occurred in approx. 50% of all cases. Fractures of the distal tibia and fibula were diagnosed in 28/55 children. 15/28 cases showed an involvement of the epiphysis. We found occult fractures in 11/28 children. Fractures, diagnosed by conventional X-rays, were excluded in 6 cases. Therapy changed in 35/55 patients on the basis of MRI-findings. Conclusion: Low-field MRI of the ankle joint in children and adolescents is able to show numerous pathological conditions. We recommend low-field MRI of the ankle in children with persistent or unclear pain of the ankle joint and inconspicuous conventional X-ray. (orig.) [German] Zielsetzung: Bestimmung der Durchfuehrbarkeit und diagnostischen Aussagekraft (Magnetom Open, Siemens {sup trademark}) an Kindern und Jugendlichen mit vorwiegend traumatischen Laesionen des oberen Sprunggelenkes. Material und Methoden: 55 Patienten unterzogen sich zusaetzlich zur konventionellen Roentgendiagnostik einer MRT des oberen Sprunggelenkes. Das Untersuchungsprotokoll beinhaltete eine coronare STIR-Sequenz, T{sub 2}-gewichtete TSE-Sequenzen in anguliert-axialer sowie eine T{sub 1}-gewichtete SE-Sequenz in sagittaler Schnittfuehrung. Das Bildmaterial wurde von zwei Radiologen in Unkenntnis klinischer und/oder operativer Befunde im Konsens ausgewertet. Ergebnisse: Bandrupturen liessen sich in 33/55 (60%) Faellen nachweisen; knoecherne

  15. Understanding acute ankle ligamentous sprain injury in sports

    OpenAIRE

    Fong, Daniel TP; Chan, Yue-Yan; Mok, Kam-Ming; Yung, Patrick SH; Chan, Kai-Ming

    2009-01-01

    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 sprai...

  16. Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: A randomized control study

    Directory of Open Access Journals (Sweden)

    John Ebnezar

    2012-01-01

    Full Text Available Aim: To study the effect of integrated yoga on pain, morning stiffness and anxiety in osteoarthritis of knees. Materials and Methods: Two hundred and fifty participants with OA knees (35-80 years were randomly assigned to yoga or control group. Both groups had transcutaneous electrical stimulation and ultrasound treatment followed by intervention (40 min for two weeks with follow up for three months. The integrated yoga consisted of yogic loosening and strengthening practices, asanas, relaxation, pranayama and meditation. The control group had physiotherapy exercises. Assessments were done on 15 th (post 1 and 90 th day (post 2. Results: Resting pain (numerical rating scale reduced better (P<0.001, Mann-Whitney U test in yoga group (post 1=33.6% and post 2=71.8% than control group (post 1=13.4% and post 2=37.5%. Morning stiffness decreased more (P<0.001 in yoga (post 1=68.6% and post 2=98.1% than control group (post 1=38.6% and post 2=71.6%. State anxiety (STAI-1 reduced (P<0.001 by 35.5% (post 1 and 58.4% (post 2 in the yoga group and 15.6% (post 1 and 38.8% (post 2 in the control group; trait anxiety (STAI 2 reduced (P<0.001 better (post 1=34.6% and post 2=57.10% in yoga than control group (post 1=14.12% and post 2=34.73%. Systolic blood pressure reduced (P<0.001 better in yoga group (post 1=−7.93% and post 2=−15.7% than the control group (post 1=−1.8% and post 2=−3.8%. Diastolic blood pressure reduced (P<0.001 better in yoga group (post 1=−7.6% and post 2=−16.4% than the control group (post 1=−2.1% and post 2=−5.0%. Pulse rate reduced (P<0.001 better in yoga group (post 1=−8.41% and post 2=−12.4% than the control group (post 1=−5.1% and post 2=−7.1%. Conclusion: Integrated approach of yoga therapy is better than physiotherapy exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in reducing pain, morning stiffness, state and trait anxiety, blood pressure and pulse rate in patients

  17. Comparison of Multisegmental Foot and Ankle Motion Between Total Ankle Replacement and Ankle Arthrodesis in Adults.

    Science.gov (United States)

    Seo, Sang Gyo; Kim, Eo Jin; Lee, Doo Jae; Bae, Kee Jeong; Lee, Kyoung Min; Lee, Dong Yeon

    2017-09-01

    Total ankle replacement (TAR) and ankle arthrodesis (AA) are usually performed for severe ankle arthritis. We compared postoperative foot segmental motion during gait in patients treated with TAR and AA. Gait analysis was performed in 17 and 7 patients undergoing TAR and AA, respectively. Subjects were evaluated using a 3-dimensional multisegmental foot model with 15 markers. Temporal gait parameters were calculated. The maximum and minimum values and the differences in hallux, forefoot, hindfoot, and arch in 3 planes (sagittal, coronal, transverse) were compared between the 2 groups. One hundred healthy adults were evaluated as a control. Gait speed was faster in the TAR ( P = .028). On analysis of foot and ankle segmental motion, the range of hindfoot sagittal motion was significantly greater in the TAR (15.1 vs 10.2 degrees in AA; P = .004). The main component of motion increase was hindfoot dorsiflexion (12.3 and 8.6 degrees). The range of forefoot sagittal motion was greater in the TAR (9.3 vs 5.8 degrees in AA; P = .004). Maximum ankle power in the TAR (1.16) was significantly higher than 0.32 in AA; P = .008). However, the range of hindfoot and forefoot sagittal motion was decreased in both TAR and AA compared with the control group ( P = .000). Although biomechanical results of TAR and AA were not similar to those in the normal controls, joint motions in the TAR more closely matched normal values. Treatment decision making should involve considerations of the effect of surgery on the adjacent joints. Level III, case-control study.

  18. Ultrasonography in the Assessment of Lateral Ankle Ligament Injury, Instability, and Anterior Ankle Impingement: A Diagnostic Case Report.

    Science.gov (United States)

    Battaglia, Patrick J; Craig, Kate; Kettner, Norman W

    2015-12-01

    The purpose of this case report is to describe the diagnostic value of ultrasonography (US) in a patient with injury to the lateral ligaments of the ankle with concomitant ankle joint osteoarthritis and anterior impingement. A 28-year-old male had a history of an inversion injury of the left ankle. Diagnostic US of the left ankle using an 8- to 15-MHz linear array transducer demonstrated a full thickness tear of the anterior talofibular ligament, partial thickness tearing of the calcaneofibular ligament, and laxity of the ankle with varus stress testing. In addition, US was able to demonstrate degeneration of the ankle and talonavicular joints and anterior impingement with dorsiflexion. Osteoarthritic changes were confirmed with radiography. Other US findings included remote deltoid ligamentous complex injury, multiple sites of tenosynovitis, and a large ankle joint effusion with synovial hypertrophy and synovitis. Using US, an accurate diagnosis was established with respect to the pathology and functional impairments of the patient's ankle. This case report exemplifies the value and utility of US in diagnosing derangement in ligamentous, tendinous, articular, and osseous injuries of the ankle.

  19. Gait analysis after successful mobile bearing total ankle replacement.

    NARCIS (Netherlands)

    Doets, H.C.; van Middelkoop, M.; Houdijk, J.H.P.; Nelissen, R.G.; Veeger, H.E.J.

    2007-01-01

    Background: The effect of total ankle replacement on gait is not fully known in terms of joint kinematics, ground reaction force, and activity of the muscles of the lower leg. Methods: A comparative gait study was done in 10 patients after uneventful unilateral mobile-bearing total ankle replacement

  20. Safety and efficiency of posterior arthroscopic ankle arthrodesis

    NARCIS (Netherlands)

    Hendrickx, Roel P. M.; de Leeuw, Peter A. J.; Golano, Pau; van Dijk, C. Niek; Kerkhoffs, Gino M. M. J.

    2015-01-01

    To study the safety and efficiency of posterior arthroscopic ankle arthrodesis. Ten fresh-frozen human lower leg specimens without evidence of previous surgery to the foot and ankle were selected. Arthroscopic debridement of the tibiotalar joint was performed in all specimens using a standardized

  1. Ankle Fractures Often Not Diagnosed

    Science.gov (United States)

    ... especially in the cold-weather months when most ankle injuries occur. An ankle fracture involves a crack or ... Weak ankles may be a result of previous ankle injuries, but in some cases, they are a congenital ( ...

  2. Post-Traumatic Osteoarthritis of the Ankle: A Distinct Clinical Entity Requiring New Research Approaches

    Science.gov (United States)

    Delco, Michelle L.; Kennedy, John G.; Bonassar, Lawrence J.; Fortier, Lisa A.

    2017-01-01

    The diagnosis of ankle osteoarthritis (OA) is increasing as a result of advancements in non-invasive imaging modalities such as magnetic resonance imaging, improved arthroscopic surgical technology and heightened awareness among clinicians. Unlike OA of the knee, primary or age-related ankle OA is rare, with the majority of ankle OA classified as post-traumatic (PTOA). Ankle trauma, more specifically ankle sprain, is the single most common athletic injury, and no effective therapies are available to prevent or slow progression of PTOA. Despite the high incidence of ankle trauma and OA, ankle-related OA research is sparse, with the majority of clinical and basic studies pertaining to the knee joint. Fundamental differences exist between joints including their structure and molecular composition, response to trauma, susceptibility to OA, clinical manifestations of disease, and response to treatment. Considerable evidence suggests that research findings from knee should not be extrapolated to the ankle, however few ankle-specific preclinical models of PTOA are currently available. The objective of this article is to review the current state of ankle OA investigation, highlighting important differences between the ankle and knee that may limit the extent to which research findings from knee models are applicable to the ankle joint. Considerations for the development of new ankle-specific, clinically relevant animal models are discussed. PMID:27764893

  3. Acute lateral ankle ligament ruptures in the athlete: the role of surgery

    NARCIS (Netherlands)

    Kerkhoffs, Gino M. M. J.; van Dijk, C. Niek

    2013-01-01

    High-level athletes have significantly greater load and demand on their ankle joints than the average population. Therefore, treatment of acute lateral ankle ligament ruptures in the high-demanding athlete is a challenge. This article reviews the treatment of acute lateral ankle ruptures in

  4. Primary subtalar joint arthrodesis for comminuted fractures of the calcaneus.

    Science.gov (United States)

    Holm, Janson L; Laxson, Steven E; Schuberth, John M

    2015-01-01

    Severely comminuted intra-articular calcaneal fractures often culminate in subtalar arthrosis and stiffness even after operative reduction. In some instances, subtalar arthrodesis is necessary to reduce the symptoms. Primary subtalar arthrodesis for these fractures has gained acceptance in recent years. However, few definite predictors of functional outcome after primary fusion have been found. A series of 17 patients with highly comminuted fractures were studied to determine which radiographic parameters were predictive of functional outcome. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score was obtained at an average of 34 (range 12 to 157) months after arthrodesis. Radiographic measurements included the talocalcaneal, calcaneal inclination, talo-first metatarsal, and Böhler's angles, and the height of the tibial plafond, width of the calcaneus, and the presence of a medial step-off on the injured and uninjured foot. The mean Ankle-Hindfoot scale score was 78 (range 56 to 92), and the mean visual analog score was 1.9 (0 to 4). Statistically significant associations were noted between greater postoperative function and increasing age (p = .028), the quality of restoration of Böhler's angle (p = .038), and the talocalcaneal angle (p = .049). No patient had nonunion. The results of the present study suggest that the outcomes after primary arthrodesis of the subtalar joint are favorable, in particular, when the radiographic relationships of the hindfoot have been restored. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Short-term effect of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in patients with rheumatoid arthritis of the ankle and foot joints. A randomized controlled pilot trial.

    Science.gov (United States)

    Wang, Chien-Chih; Lee, Si-Huei; Lin, Hsiao-Yi; Liu, Fu-Wei; Chiou, Hong-Jen; Chan, Rai-Chi; Chou, Chen-Liang

    2017-11-01

    To determine whether hyaluronic acid (HA) injection into rheumatoid arthritis ankles and feet can achieve improvement in foot function and reduce synovial hyper-vascularization. Forty-four patients with RA having unilateral or bilateral painful ankle and foot involvement (N = 75) were studied. All the patients were randomized to receive HA (N = 40) or lidocaine (LI) (N = 35) injection at 2-week intervals; Clinical assessments were performed using a visual analog scale (VAS) and foot function index (FFI total ) including subscales of pain (FFI pain) before injection at baseline, 4 weeks (first evaluation) and 12 weeks (secondary evaluation). Imaging evaluation based on color Doppler ultrasound (CDUS) and synovitis scores was performed simultaneously. HA injection improved the VAS score (p = .009), FFI pain (p = .041), and FFI total (p = .032) considerably more than LI injections did at the first evaluation. The CDUS values at first evaluation (p = .005) and secondary evaluation (p injections reduced the CDUS values of more than half of the joints (54%, p = .042) while the control group exhibited no change (20%, p = .56). However, HA injection did not reduce the CDUS values more than LI injection did. Regarding the evaluation of synovial hypertrophy, no significant difference was observed between or within the groups in the synovitis scores. HA injection improved short-term foot function and pain reduction. HA injection may have a modest effect in reducing synovial hyper-vascularization. Further large-scale study is warranted to confirm this result.

  6. Kinematics of a Novel Ankle Rehabilitation Device with Two Degrees of Freedom

    Directory of Open Access Journals (Sweden)

    Ioan Doroftei

    2015-06-01

    Full Text Available The human ankle joint is the most common injured in sports and daily life in general. Traditionally, ankle injuries are rehabilitated via physiotherapy. However, the experiences suggest that without sufficient rehabilitation many people will have future problems. Furthermore, during a rehabilitation treatment, cooperative and intensive efforts of therapists and patients are required over prolonged sessions. Thus, robotic devices have been developed for human ankle rehabilitation. This paper discusses kinematic aspects of a novel ankle rehabilitation device, which can facilitate the recovery of the ankle joint

  7. Ankle fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this page, please enable JavaScript. An ankle fracture is a break in 1 or more ...

  8. Ankle Sprain Treatment

    Science.gov (United States)

    ... Ankle Sprain Treatment Page Content Article Body Acute ankle and foot injuries are common in athletes and other active young ... Phase I treatment involves resting and protecting the ankle to permit healing, to prevent further injury, and to control pain and swelling. Rest, protection ( ...

  9. Assessment of Ankle Injuries

    Science.gov (United States)

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  10. Advancements in ankle arthroscopy

    NARCIS (Netherlands)

    van Dijk, C. Niek; van Bergen, Christiaan J. A.

    2008-01-01

    Important progress has been made during the past 30 years in arthroscopic ankle surgery. Ankle arthroscopy has gradually changed from a diagnostic to a therapeutic tool. Most arthroscopic procedures can be performed by using the anterior working area with the ankle in dorsiflexion or plantar

  11. The effect of ankle joint mobility when using an isocentric reciprocating gait orthosis (IRGO) on energy consumption in people with spinal cord injury: preliminary results.

    Science.gov (United States)

    Arazpour, M; Hojjati, M J; Samadian, M; Bahramizadeh, M; Bani, M Ahmadi; Hutchins, S W

    2015-01-01

    The aim of this study was to evaluate the effect of walking with isocentric reciprocating gait orthoses (IRGOs) utilizing two designs of ankle foot orthoses (AFOs) on specific outcome measures in people with spinal cord injury (SCI). Four volunteer SCI subjects participated in this study, and were fitted with an IRGO equipped with either solid or dorsiflexion-assisted AFOs in a randomized order. Subjects walked at their self-selected speed along a flat walkway to enable a comparison of walking speed, endurance and the resulting physiological cost index (PCI) to be performed. Increased walking speed, increased distance walked and less PCI were demonstrated in walking with the IRGO incorporating dorsiflexion-assisted AFOs as compared to walking with an IRGO plus solid AFO as a control condition. This study demonstrated that people with SCI could walk at relatively higher speeds and with greater endurance and a reduced PCI when utilizing an IRGO with dorsiflexion-assisted AFO components compared to solid ones. It is therefore concluded that the IRGO incorporating dorsiflexion-assisted AFOs may be an effective alternative in helping to reduce the energy consumption experienced by people with SCI.

  12. Single-leg drop landing movement strategies in participants with chronic ankle instability compared with lateral ankle sprain 'copers'

    OpenAIRE

    Doherty, Cailbhe; Bleakley, Chris J.; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2016-01-01

    Individuals with CAI display alterations in hip joint kinematics and energetics during a unipodal landing task compared to LAS 'copers'. These alterations may be responsible for the increased risk of injury experienced by individuals with CAI during landing manoeuvres. Thus, clinicians must recognise the potential for joints proximal to the affected ankle to contribute to impaired function following an acute lateral ankle sprain injury and to develop rehabilitation protocols accordingly.

  13. Medial ankle pain after lateral ligament rupture

    NARCIS (Netherlands)

    van Dijk, C. N.; Bossuyt, P. M.; Marti, R. K.

    1996-01-01

    After a severe ankle sprain the incidence of residual complaints, particularly on the medial side of the joint, is high. We studied a consecutive series of 30 patients who had operative repair of acute ruptures of lateral ligaments. During operation, arthroscopy revealed a fresh injury to the

  14. Ankle-Dorsiflexion Range of Motion After Ankle Self-Stretching Using a Strap

    Science.gov (United States)

    Jeon, In-cheol; Kwon, Oh-yun; Yi, Chung-Hwi; Cynn, Heon-Seock; Hwang, Ui-jae

    2015-01-01

    Context  A variety of ankle self-stretching exercises have been recommended to improve ankle-dorsiflexion range of motion (DFROM) in individuals with limited ankle dorsiflexion. A strap can be applied to stabilize the talus and facilitate anterior glide of the distal tibia at the talocrural joint during ankle self-stretching exercises. Novel ankle self-stretching using a strap (SSS) may be a useful method of improving ankle DFROM. Objective  To compare the effects of 2 ankle-stretching techniques (static stretching versus SSS) on ankle DFROM. Design  Randomized controlled clinical trial. Setting  University research laboratory. Patients or Other Participants  Thirty-two participants with limited active dorsiflexion (<20°) while sitting (14 women and 18 men) were recruited. Main Outcome Measure(s)  The participants performed 2 ankle self-stretching techniques (static stretching and SSS) for 3 weeks. Active DFROM (ADFROM), passive DFROM (PDFROM), and the lunge angle were measured. An independent t test was used to compare the improvements in these values before and after the 2 stretching interventions. The level of statistical significance was set at α = .05. Results  Active DFROM and PDFROM were greater in both stretching groups after the 3-week interventions. However, ADFROM, PDFROM, and the lunge angle were greater in the SSS group than in the static-stretching group (P < .05). Conclusions  Ankle SSS is recommended to improve ADFROM, PDFROM, and the lunge angle in individuals with limited DFROM. PMID:26633750

  15. Development and evaluation of a new measure for muscle tone of ankle plantar flexors: the ankle plantar flexors tone scale.

    Science.gov (United States)

    Takeuchi, Nobuyuki; Kuwabara, Takeya; Usuda, Shigeru

    2009-12-01

    Takeuchi N, Kuwabara T, Usuda S. Development and evaluation of a new measure for muscle tone of ankle plantar flexors: the Ankle Plantar Flexors Tone Scale. To develop and evaluate the reliability and concurrent validity of a clinically feasible measure for muscle tone of the ankle plantar flexors. Cross-sectional reliability and validity study of the Ankle Plantar Flexors Tone Scale. Department of rehabilitation in a general hospital. Patients (N=74) with cerebrovascular disease. Not applicable. Muscle tone of the ankle plantar flexors was measured using the Ankle Plantar Flexors Tone Scale, the Modified Ashworth Scale (MAS), quality of muscle reaction with the Modified Tardieu Scale, and passive resistive joint torque with a handheld dynamometer. Intrarater and interrater reliabilities were assessed using the Cohen kappa coefficient (kappa). Internal consistency was assessed using the Cronbach alpha (alpha). Concurrent validity was assessed with the Spearman rank correlation coefficient (rho). The Ankle Plantar Flexors Tone Scale included 3 items: stretch reflex, middle range resistance, and final range resistance. Intrarater and interrater reliabilities and internal consistency of the Ankle Plantar Flexors Tone Scale showed moderate to excellent agreement (kappa=.63-.94; alpha=.81). Concurrent validity of the Ankle Plantar Flexors Tone Scale was low to very high among the 3 items of the Ankle Plantar Flexors Tone Scale and existing measures. The Spearman rank correlation coefficient showed high to very high correlation between stretch reflex and quality of muscle reaction as indices of the central component (rho=.85-.94). Middle range resistance and final range resistance as indices of the peripheral component had low to moderate correlation with passive resistive joint torque using a handheld dynamometer and MAS (rho=.44-.68). The Ankle Plantar Flexors Tone Scale allows measurement of ankle plantar flexor tone in greater detail than existing subjective measures

  16. Synovial and tenosynovial lipoma arborescens of the ankle in an adult: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Babar, S.A.; Mitchell, A.W. [Hammersmith Hospital Trust, Imaging Department, London (United Kingdom); Sandison, A. [Charing Cross Hospital, Hammersmith Hospitals NHS Trust, Department of Histopathology, London (United Kingdom)

    2008-01-15

    Lipoma arborescens is a rare benign fat-containing synovial proliferative lesion that is typically known to affect the knee joint in adults. We present the first case of lipoma arborescens of the ankle joint in an adult patient with involvement of the intra-articluar synovium as well as the synovial sheath of the tendons around the ankle. The MRI features of this lesion in the adult ankle are described. (orig.)

  17. Effects of prefabricated ankle orthoses on postural stability in basketball players with chronic ankle instability.

    Science.gov (United States)

    Faraji, Elahe; Daneshmandi, Hassan; Atri, Ahmad Ebrahimi; Onvani, Vahid; Namjoo, Faride Rezaee

    2012-12-01

    Ankle sprain is one of the most common injuries among athletes and instability and injury to this joint is responsible for long time loss of physical and recreational activity. Also, it can impose high costs to sport teams. Prevention of this injury is an important concern of practice and rehabilitation. One way of reducing the possibility of ankle joint injury is using an ankle orthosis. The present study aimed at inspecting the effects of two ankle orthoses on dynamic and semi-dynamic postural stability in athletes with chronic ankle instability (CAI). Twenty basketball players with CAI and fifteen non-injured athletes volunteered to participate in this study. Biodex Balance System was used to assess the participants' postural stability in bilateral position at level 8 and level 2. Repeated measures analysis of variance (ANOVA) was performed in order to examine the effects of ankle orthoses. Statistical significance level was determined at Pankle supports on dynamic and semi-dynamic postural stability in the two groups and results indicated there wasn't significant difference between groups. According to our results the orthoses improved both dynamic and semi-dynamic postural stability. Therefore, orthoses can prevent injury and its reoccurrence.

  18. A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology

    NARCIS (Netherlands)

    van Dijk, C. N.; Scholten, P. E.; Krips, R.

    2000-01-01

    We describe a 2-portal endoscopic approach of the hindfoot with the patient in the prone position. By means of this approach, it is possible to visualize and treat a variety of posterior ankle problems. Not only can pathology of the posterior ankle joint and subtalar joint be visualized and treated,

  19. Chronic instability of the anterior syndesmosis of the ankle: Biomechanical, kinematical, radiological and clinical aspects

    NARCIS (Netherlands)

    A. Beumer (Annechien)

    2007-01-01

    textabstractThis thesis is concerned with chronic anterior instability of the tibiofibular syndesmosis of the ankle. The ankle plays a fundamental role in locomotion. It consists of the talocrural and distal tibiofibular joint. The latter is a syndesmosis, a fibrous joint with ample intervening

  20. Indications for intra-articular steroid in osteoarthritis of the ankle and ...

    African Journals Online (AJOL)

    The results of treatment with intra-articular steroid in an unselected group of patients with osteo-arthritis of the ankle and metatarsophalangeal joint of the big toe are described. From the results of this trial it is possible to lay down indications for the use of intra-articular steroid in these conditions. In the ankle joint it is ...

  1. Analysis of the Ankle Moment-Angle Curve in Different Gait Speeds and Phases for Designing Ankle-Foot Prosthesis

    Directory of Open Access Journals (Sweden)

    Zahra Safaei-Pour

    2014-01-01

    Full Text Available Objective: Aim of this study was to analysis the ankle moment-angle relation and its characteristics at different gait speeds and phases for using in prosthetic ankle-foot design. Materials & Methods: This was a cross-sectional analytic study in which 20 participants were chosen with assessable sampling method. Gait analysis at different speeds was performed with two force-plates and five high speed cameras. Ankle characteristics including quasi-stiffness and work were estimated at three periods of stance phase based on moment-angle loop. Mean differences were analyzed with repeated measure ANOVA and regression analysis was performed to fit the linear model to the data. Results: Moment-angle curve was clockwise at slower speeds and turned counter-clockwise while speed increased. The best fitted line to the work-walking speed curve had R2=0.81. There were significant differences in quasi-stiffness between fast and normal speed and slower speeds (P<0.001. Conclusion: Moment-angle curve displayed ankle passive function in slower speeds and active function in faster speeds. Results showed ankle characteristics varied at different gait phases and speeds. Thus, at slower speeds a spring-damper model with regulable damping would simulate the ankle function. However, at higher speeds the active elements also should be considered.

  2. Recalcitrant Lateral Premalleolar Bursitis of the Ankle Associated with Lateral Ankle Instability

    Directory of Open Access Journals (Sweden)

    Masashi Naito

    2017-01-01

    Full Text Available Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between the bursa and articular cavity of the ankle joint via the sheath of the extensor digitorum longus tendon, which was considered to act as a check valve leading to a large and recalcitrant bursitis. This report provides a novel concept about the etiology of recalcitrant lateral premalleolar bursitis of the ankle.

  3. The sprained ankle.

    Science.gov (United States)

    Puffer, J C

    2001-01-01

    The sprained ankle is the most common musculoskeletal injury seen by physicians caring for active youngsters and adults. It accounts for approximately one fourth of all sports-related injuries and is commonly seen in athletes participating in basketball, soccer, or football. It has been shown that one third of West Point cadets suffer an ankle sprain during their 4 years at the military academy. While diagnosis and management of the sprained ankle is usually straightforward, several serious injuries can masquerade as an ankle sprain, and it is important for the clinician to recognize these to prevent long-term morbidity. In this article the basic anatomy of the ankle, mechanisms by which the ankle is injured, and the differential diagnosis of the acutely injured ankle are reviewed. Appropriate evaluation of the injured ankle and the criteria that should be utilized for determining the necessity of radiographs are discussed as well as management of the acutely sprained ankle and the role of prevention in reducing the risk of ankle injury.

  4. The Influence of Mulligan Ankle Taping on Dynamic Balance in the Athletes with and without Chronic Ankle Instability

    Directory of Open Access Journals (Sweden)

    Tahereh Pourkhani

    2014-04-01

    Full Text Available Objective: The ankle joint is the most frequently injured anatomical site in athletes. Ankle instability is responsible for 25% of all time lost from sport. Clinical efficacy of the effect of taping in athletes with chronic ankle instability is unknown. So the purpose of this investigation is the study of the influence of Mulligan ankle taping on dynamic balance in the athletes with and without chronic ankle instability. Materials & Methods: 32 athletes participated in this investigation: 16 subjects with chronic ankle instability, 6 women and 10 men (age 23.5±0.3 years, height 175.4±10.3 cm, weight 73.6±14.5 kg, Foot Ankle Disability Index 74.5±8.62% and Foot Ankle Disability Index Sport 63.5±7.86% and 16 healthy subjects, 6 women and 10 men (age 22.81±7.1 years, height 173.6±12.26 cm, weight 66.4±11.4 kg, Foot Ankle Disability Index and Foot Ankle Disability Index Sport 100%. Dynamic balance was assessed with Star Excursion Balance Test in 3 reaching directions (medial, antero-medial and postero-medial before and after Mulligan ankle taping. Independent and paired t-test were used for statistical analysis. Results: Dynamic balance in healthy group significantly was better than injured group (P&le0.05. Application of taping caused significantly improvement in dynamic balance in both groups (reaching in media, antero-medial and postero-medial directions (P&le0.05 (except reaching in antero-medial direction in healthy group (P>0.05. Conclusion: So it seems that Mulligan ankle taping can improve dynamic balance in the athletes with and without chronic ankle instability.

  5. WITHDRAWN: Interventions for preventing ankle ligament injuries.

    Science.gov (United States)

    Handoll, Helen Hg; Rowe, Brian H; Quinn, Kathryn M; de Bie, Rob

    2011-05-11

    Some sports, for example basketball and soccer, have a very high incidence of ankle injuries, mainly sprains. Consequently, ankle sprains are one of the most commonly treated injuries in acute care. To assess the effects of interventions used for the prevention of ankle ligament injuries or sprains in physically active individuals from adolescence to middle age. We searched the Cochrane Bone, Joint and Muscle Trauam Group's specialised register, MEDLINE, PubMed, EMBASE, CINAHL, the National Research Register and bibliographies of study reports. We also contacted colleagues and some trialists. The most recent search was conducted in July 2000. Randomised or quasi-randomised trials of interventions for the prevention of ankle sprains in physically active individuals from adolescence to middle age were included provided that ankle sprains were recorded. Interventions included use of modified footwear, external ankle supports, co-ordination training and health education. These could be applied as a supplement to treatment provided that prevention of re-injury was the primary objective. At least two reviewers independently assessed methodological quality and extracted data. Wherever possible, results of outcome measures were pooled and sub-grouped by history of previous sprain. Relative risks (RR) and 95% confidence intervals (95% CI) are reported for individual and pooled data. In this review update, a further nine new trials were included. Overall, 14 randomised trials with data for 8279 participants were included. Twelve trials involved active, predominantly young, adults participating in organised, generally high-risk, activities. The other two trials involved injured patients who had been active in sports before their injury. The prophylactic interventions under test included the application of an external ankle support in the form of a semi-rigid orthosis (three trials), air-cast brace (one trial) or high top shoes (one trial); ankle disk training; taping; muscle

  6. Relationship between stress ankle radiographs and injured ligaments on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Kyungki (Korea, Republic of); Kwon, Soon-Sun [Seoul National University Bundang Hospital, Biomedical Research Institute, Kyungki (Korea, Republic of)

    2013-11-15

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  7. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    International Nuclear Information System (INIS)

    Jordan, L.K. III.; Cooperman, A.E.; Helms, C.A.; Speer, K.P.

    2000-01-01

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  8. Relationship between stress ankle radiographs and injured ligaments on MRI

    International Nuclear Information System (INIS)

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok; Kwon, Soon-Sun

    2013-01-01

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  9. Simulations Results of an Ankle Rehabilitation Device

    Directory of Open Access Journals (Sweden)

    Ioan Doroftei

    2015-12-01

    Full Text Available The ankle structure is one of the most important structures of the human body. Due to its important role in human’s activities, this joint is the most injured part of the lower limb. For a complete recovery of the range of motion, recovery exercises are mandatory. The introduction of robotic physical recovery systems represents a modern alternative to traditional recovery. In this paper we present the development of a new ankle rehabilitation device, that aims to fully recover the range of motion required for daily activities.

  10. Joint Instability and Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Darryl Blalock

    2015-01-01

    Full Text Available Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA. Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA.

  11. Effects of visual feedback balance training on the balance and ankle instability in adult men with functional ankle instability.

    Science.gov (United States)

    Nam, Seung-Min; Kim, Kyoung; Lee, Do Youn

    2018-01-01

    [Purpose] This study examined the effects of visual feedback balance training on the balance and ankle instability in adult men with functional ankle instability. [Subjects and Methods] Twenty eight adults with functional ankle instability, divided randomly into an experimental group, which performed visual feedback balance training for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Bio rescue was used for balance ability. It measured limit of stability at one minute. For ankle instability was measured using Cumberland ankle instability tool (CAIT). This measure was performed before and after the experiments in each group. [Results] The experimental group had significant increase in the Limit of Stability and CAIT score. The control group had significant increase in CAIT score. While the Limit of Stability increased without significance. [Conclusion] In conclusion, visual feedback balance training can be recommended as a treatment method for patients with functional ankle instability.

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

    Science.gov (United States)

    Wang, Yan; Li, Zengyong; Wong, Duo Wai-Chi; Zhang, Ming

    2015-01-01

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

  13. Ankle Sprains. A Round Table.

    Science.gov (United States)

    Physician and Sportsmedicine, 1986

    1986-01-01

    Types of ankle sprains, surgical versus nonsurgical treatment, tape versus brace for support, rehabilitation, exercise, and prevention of ankle sprains are discussed by a panel of experts. An acute ankle taping technique is illustrated. (MT)

  14. Foot, leg, and ankle swelling

    Science.gov (United States)

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...

  15. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic 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...

  16. Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury.

    Science.gov (United States)

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

    2016-04-01

    To quantify the dynamic balance deficits that characterise a group with chronic ankle instability compared to lateral ankle sprain copers and non-injured controls using kinematic and kinetic outcomes. Forty-two participants with chronic ankle instability and twenty-eight lateral ankle sprain copers were initially recruited within 2 weeks of sustaining a first-time, acute lateral ankle sprain and required to attend our laboratory 1 year later to complete the current study protocol. An additional group of non-injured individuals were also recruited to act as a control group. All participants completed the anterior, posterior-lateral and posterior-medial reach directions of the star excursion balance test. Sagittal plane kinematics of the lower extremity and associated fractal dimension of the centre of pressure path were also acquired. Participants with chronic ankle instability displayed poorer performance in the anterior, posterior-medial and posterior-lateral reach directions compared with controls bilaterally, and in the posterior-lateral direction compared with lateral ankle sprain copers on their 'involved' limb only. These performance deficits in the posterior-lateral and posterior-medial directions were associated with reduced flexion and dorsiflexion displacements at the hip, knee and ankle at the point of maximum reach, and coincided with reduced complexity of the centre of pressure path. In comparison with lateral ankle sprain copers and controls, participants with chronic ankle instability were characterised by dynamic balance deficits as measured using the SEBT. This was attested to reduced sagittal plane motions at the hip, knee and ankle joints, and reduced capacity of the stance limb to avail of its supporting base. III.

  17. Posterior ankle labral changes at MRI: A preliminary study.

    Science.gov (United States)

    Khan, Nasir; Sahota, Navdeep; Shepel, Michael L; Obaid, Haron

    2017-10-01

    The transverse ligament in the ankle joint has been described as a labrum-like structure in a previous cadaveric study. The purpose of this study is to assess the spectrum of abnormal changes related to this structure on imaging/MRI, and correlate these findings with other ankle joint findings and patient symptoms. A retrospective observational review of 172 ankle MRI scans was carried out independently by two fellowship trained musculoskeletal Radiologists. Correlation between abnormal labral changes, other ankle joint findings and patient symptomatology was performed. Abnormal labral changes were seen in 26% of the MRI scans (n = 44/172) and included signal change, contour abnormality with heterogeneous signal change, linear fluid filled clefts, multidirectional fluid filled clefts, and a macerated labrum. There was a statistically significant association between abnormal labral changes and the presence of Stieda process/os trigonum (P = 0.001), talocrural joint osteoarthritis (P = 0.0003), paralabral cysts (P = 0.0001), imaging features of posterior impingement (P = 0.01), and both medial (P = 0.005) and lateral (P = 0.01) ankle ligament injuries. However, there was no statistically significant association between abnormal labral changes and patient symptoms. The posterior ankle labrum can develop a spectrum of abnormal MRI appearances in patients with other ankle joint abnormalities. Although this study showed no correlation between patients' symptoms and posterior ankle labral changes, larger studies are needed to examine the biomechanical alterations that may arise from these labral changes. © 2017 The Royal Australian and New Zealand College of Radiologists.

  18. History-dependent changes in the recovery process of the middle latency cutaneous reflex gain after ankle sprain injury.

    Science.gov (United States)

    Futatsubashi, Genki; Sasada, Syusaku; Ohtsuka, Hiroyuki; Suzuki, Shinya; Komiyama, Tomoyoshi

    2016-03-01

    We previously reported that suppressive middle latency cutaneous reflexes (MLRs) in the peroneus longus (PL) are exaggerated in subjects with chronic ankle instability, and the changes are related to functional instability. However, the time-varying history of these neurophysiological changes after an ankle sprain is yet to be elucidated. Therefore, in the present study, we investigated the time course of the changes in the PL MLR after an ankle sprain in relation to the number of sprain recurrences. Twenty-three subjects with ankle sprain were classified into 3 groups according to their history of ankle sprain: first ankle sprain, 2-3 ankle sprains, and ≥4 ankle sprains. Twenty-three age-matched control subjects also participated. The PL MLRs were elicited by stimulating the sural nerve while the subjects performed different levels of isometric ankle eversion. Gain of MLR was estimated using linear regression analysis (slope value) of the amplitude modulation of MLRs obtained from graded isometric contractions. The gain of MLRs first increased 4 weeks after the injury. In subjects with their first ankle sprain, the MLRs returned to almost baseline levels after 3 months. In contrast, the increase in MLR gain persisted even after 3 months in subjects with recurrent ankle sprains. In addition, the MLR gains were closely related to functional recovery of the ankle joint. Our findings suggest that the recovery process of MLR gains were strongly affected by the history of ankle sprains as well as the functional recovery of the ankle joint.

  19. Talofibular interval changes after acute ankle sprain: a stress ultrasonography study of ankle laxity.

    Science.gov (United States)

    Croy, Theodore; Saliba, Susan; Saliba, Ethan; Anderson, Mark W; Hertel, Jay

    2013-11-01

    Quantifying talocrural joint laxity after ankle sprain is problematic. Stress ultrasonography (US) can image the lateral talocrural joint and allow the measurement of the talofibular interval, which may suggest injury to the anterior talofibular ligament (ATFL). The acute talofibular interval changes after lateral ankle sprain are unknown. Twenty-five participants (9 male, 16 female; age 21.8 ± 3.2 y, height 167.8 ± 34.1 cm, mass 72.7 ± 13.8 kg) with 27 acute, lateral ankle injuries underwent bilateral stress US imaging at baseline (ankle at 3 wk and 6 wk from injury in 3 ankle conditions: neutral, anterior drawer, and inversion. Talofibular interval (mm) was measured using imaging software and self-reported function (activities of daily living [ADL] and sports) by the Foot and Ankle Ability Measure (FAAM). The talofibular interval increased with anterior-drawer stress in the involved ankle (22.65 ± 3.75 mm; P = .017) over the uninvolved ankle (19.45 ± 2.35 mm; limb × position F1,26 = 4.9, P = .035) at baseline. Inversion stress also resulted in greater interval changes (23.41 ± 2.81 mm) than in the uninvolved ankles (21.13 ± 2.08 mm). A main effect for time was observed for inversion (F2,52 = 4.3, P = .019, 21.93 ± 2.24 mm) but not for anterior drawer (F2,52 = 3.1, P = .055, 21.18 ± 2.34 mm). A significant reduction in the talofibular interval took place between baseline and week 3 inversion measurements only (F1,26 = 5.6, P = .026). FAAM-ADL and sports results increased significantly from baseline to wk 3 (21.9 ± 16.2, P ankle sprain. Stress US provides a safe, repeatable, and quantifiable method of measuring the talofibular interval and may augment manual stress examinations in acute ankle injuries.

  20. How to Care for a Sprained Ankle

    Science.gov (United States)

    ... Sprained Ankle How to Care for a Sprained Ankle Page Content Ankle sprains are very common injuries. ... Grade I, II or III. Treating your Sprained Ankle Treating your sprained ankle properly may prevent chronic ...

  1. [Case-control study on treatment of ankle fractures of supination-extorsion with different fixed position].

    Science.gov (United States)

    Lin, Qiao-Ling; Li, Min; Wei, Shuang-Sheng

    2012-01-01

    To explore the best external fixation posture of ankle fracture of Lauge-Hanson III degree and IV degree supintion-eversion after manipulation. From January 2007 to June 2010, 46 patients with ankle fracture of Lauge-Hanson III degree and IV degree supintion-eversion were selected for this study and were randomly divided into two groups (group A and group B). There were 14 males and 9 females in group A; and the Lauge-Hanson III degree was in 13 cases and IV degree was in 10 cases; fractures were reduced and fixed with plaster splint of U-shape to the posture with inversion, internal rotation and plantar flexion. There was 15 males and 8 females in group B, and the Lauge-Hanson III degree was in 14 case and IV degree was in 9 cases; fractures were reduced and fixed with plaster splint of U-shape to the posture with inversion, internal rotation and dorsiflexion. The clinical effects were evaluated according to AOFAS scoring system. All the patient were followed up from 6 to 18 months with an average of 12 months. In group A, AOFAS scoring was from 73 to 100 scores with an average of (92.58 +/- 5.73) scores, 16 cases obtained excellent results, 6 good, 1 fair; in group B, AOFAS scoring was from 66 to 100 scores with an average of (85.74 +/- 7.56) scores, 9 cases obtained excellent results, 7 good, 6 fair and 1 poor. The result of group A was better than that of group B. In group A, 1 case occurred with ankle joint ache after long walk and swelling in night. In group B, 6 cases also occurred with ankle joint ache after long walk and swelling in night and 1 case with stiffness of joint. So there was obvious difference (P < 0.05). For treatment of ankle fracture of Lauge-Hanson III degree and IV degree supintion-eversion, the posture with inversion, internal rotation and plantar flexion exceeds another one with inversion, internal rotation and dorsiflexion with plaster after manipulative reduction.

  2. Chronic Ankle Instability

    Science.gov (United States)

    ... treatments and exercises to strengthen the ankle, improve balance and range of motion and retrain your muscles. As you progress through rehabilitation, you may also receive training that relates specifically to your activities or sport. Bracing. Some patients wear an ankle brace to ...

  3. Ankle-Brachial Index

    Science.gov (United States)

    ... measured at your arm. A low ankle-brachial index number can indicate narrowing or blockage of the arteries in ... tell your doctor so that he or she can continue to monitor your risk. Blockage (0.9 or less). An ankle-brachial index number less than 1.0 indicates narrowing of ...

  4. The foot and ankle

    International Nuclear Information System (INIS)

    Berquist, T.H.

    1985-01-01

    Imaging of the foot and ankle can be difficult because of the complex anatomy. Familiarity with the bony and ligamentous anatomy is essential for proper evaluation of radiographic findings. Therefore, pertinent anatomy is discussed as it applies to specific injuries. Special views, tomography, arthrography, and other techniques may be indicated for complete evaluation of foot and ankle trauma

  5. Anterior ankle impingement

    NARCIS (Netherlands)

    Tol, Johannes L.; van Dijk, C. Niek

    2006-01-01

    The anterior ankle impingement syndrome is a clinical pain syndrome that is characterized by anterior ankle pain on (hyper) dorsiflexion. The plain radiographs often are negative in patients who have anteromedial impingement. An oblique view is recommended in these patients. Arthroscopic excision of

  6. Prolonged stretching of the ankle plantarflexors elicits muscle-tendon adaptations relevant to ankle gait kinetics in children with spastic cerebral palsy.

    Science.gov (United States)

    Martín Lorenzo, Teresa; Rocon, Eduardo; Martínez Caballero, Ignacio; Ramírez Barragán, Ana; Lerma Lara, Sergio

    2017-11-01

    Tissue related ankle hyper-resistance has been reported to contribute to equinus gait in children with spastic cerebral palsy. Hence, ankle plantarflexor stretching programs have been developed in order to restore passive ankle dorsiflexion. Despite high quality evidence on the limited effects of stretching on passive joint mobility, further muscle-tendon adaptations have been reported which may impact gait performance. As such, children with spastic cerebral palsy subject to long-term manual static stretching achieved dorsiflexion gains through the reduction of muscle and fascicle strain whilst preserving tendon strain, and prolonged use of ankle-foot orthoses achieved similar dorsiflexion gains through increased tendon strain whilst preserving muscle and fascicle strain. The latter concurred with normalization of early stance plantarflexor moment yet reductions in push-off plantarflexor moment given the increase in tendon compliance. Therefore, similar limited gains in passive ankle joint mobility in response to stretching may be achieved either by preserving/restoring optimal muscle-tendon function, or at the expense of muscle-tendon function and thus contributing gait impairments. The largest increase in ankle passive joint mobility in children with SCP has been obtained through prolonged plantarflexor stretching through ankle casting combined with botulinum neurotoxin type A. However, to our knowledge, there are no published studies on muscle-tendinous adaptations to ankle casting combined with botulinum toxin type A and its effect on ankle joint gait kinetics. Therefore, we hypothesized that ankle casting elicits muscle-tendon adaptations which concur with altered ankle joint kinetics during the stance phase of gait in children with SCP. More information is needed about the relationships between muscle structure and function, and the effect of specific interventions designed to alter muscle properties and associated functional outcomes in children with

  7. Ankle sprains and instability.

    Science.gov (United States)

    Czajka, Cory M; Tran, Elaine; Cai, Andrew N; DiPreta, John A

    2014-03-01

    Ankle injuries are among the most common injuries presenting to primary care providers and emergency departments and may cause considerable time lost to injury and long-term disability. Inversion injuries about the ankle involve about 25% of all injuries of the musculoskeletal system and 50% of all sports-related injuries. Medial-sided ankle sprains occur less frequently than those on the lateral side. High ankle sprains occur less frequently in the general population, but do occur commonly in collision sports. Providers should apply the Ottawa ankle rules when radiography is indicated and refer fractures and more severe injuries to orthopedic surgery as needed. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain.

    Science.gov (United States)

    Vega, Jordi; Peña, Fernando; Golanó, Pau

    2016-04-01

    The aim of this study was to determine which intra-articular injuries are associated with chronic anterolateral pain and functional instability after an ankle sprain. From 2008 to 2010, records of all patients who underwent ankle joint arthroscopy with anterolateral pain and functional instability after an ankle sprain were reviewed. A systematic arthroscopic examination of the intra-articular structures of the ankle joint was performed. Location and characteristics of the injuries were identified and recorded. A total of 36 ankle arthroscopic procedures were reviewed. A soft-tissue occupying mass over the lateral recess was present in 18 patients (50%). A partial injury of the anterior talofibular ligament (ATFL) was observed in 24 patients (66.6%). Cartilage abrasion due to the distal fascicle of the anteroinferior tibiofibular ligament coming into contact with the talus was seen in 21 patients (58.3%), but no thickening of the ligament was observed. Injury to the intra-articular posterior structures, including the transverse ligament in 19 patients (52.7%) and the posterior surface of the distal tibia in 21 patients (58.3%), was observed. Intra-articular pathological findings have been observed in patients affected by anterolateral pain after an ankle sprain. Despite no demonstrable abnormal lateral laxity, morphologic ATFL abnormality has been observed on arthroscopic evaluation. An injury of the ATFL is present in patients with chronic anterolateral pain and functional instability after an ankle sprain. A degree of microinstability due to a deficiency of the ATFL could explain the intra-articular pathological findings and the patients' complaints. IV.

  9. Running with a load increases leg stiffness.

    Science.gov (United States)

    Silder, Amy; Besier, Thor; Delp, Scott L

    2015-04-13

    Spring-mass models have been used to characterize running mechanics and leg stiffness in a variety of conditions, yet it remains unknown how running while carrying a load affects running mechanics and leg stiffness. The purpose of this study was to test the hypothesis that running with a load increases leg stiffness. Twenty-seven subjects ran at a constant speed on a force-measuring treadmill while carrying no load, and while wearing weight vests loaded with 10%, 20%, and 30% of body weight. We measured lower extremity motion and created a scaled musculoskeletal model of each subject, which we used to estimate lower extremity joint angles and leg length. We estimated dimensionless leg stiffness as the ratio of the peak vertical ground reaction force (normalized to body weight) and the change in stance phase leg length (normalized to leg length at initial foot contact). Leg length was calculated as the distance from the center of the pelvis to the center-of-pressure under the foot. We found that dimensionless leg stiffness increased when running with load (p=0.001); this resulted from an increase in the peak vertical ground reaction force (pleg length (p=0.025). When running with load, subjects had longer ground contact times (pleg stiffness to accommodate an added load. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Posttraumatic ankle osteoarthritis: How initial cartilage lesions, the deltoid ligament and hindfoot alignment affect the outcome of operatively treated ankle fractures

    NARCIS (Netherlands)

    Stufkens, S.A.S.

    2014-01-01

    The vast majority (70-78%) of ankle osteoarthritis is of posttraumatic origin. The quality of the reduction of intra-articular fractures is of paramount importance for a satisfactory outcome in all joints. Accordingly, the most important aspect of conservative or surgical treatment of ankle

  11. 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.

  12. Adaptive sports ankle prosthetics. Interview by Sarah A. Curran.

    Science.gov (United States)

    Lyle, David K

    2012-09-01

    Participating in sport at all levels is gaining a dedicated following and this is also apparent in individuals with an amputation. Currently, there is a wide variety of ankle prostheses available which attempt to provide function, control, and comfort, as well as good aesthetic appeal. Participation in sport, however, increases the demands placed upon ankle prostheses. This can compromise function and performance, and constrain the opportunities of participation in various outdoor and water sports. In acknowledging this limitation and the need to develop more versatile ankle prostheses, this article introduces the evolution of a prototype ankle prosthesis referred to as "Adaptive Sports Ankle." The ankle prosthesis, which is compatible with any foot pyramid adapter, offers the same range of motion as the normal human ankle joint and is made up of components that are chemical and corrosion resistant. These design features that are specifically created to accommodate below-the-knee amputees provide an ideal prosthesis for those wishing to lead an active lifestyle and participate in aquatic (i.e. swimming, surfing, and scuba diving), snowboarding, and equestrian activities. Although it is acknowledged that there is a need to establish research on the Adaptive Sports Ankle, its introduction to the market will enhance and expand opportunities of those individuals with a lower limb amputation to lead an active and healthy lifestyle.

  13. Review on design and control aspects of ankle rehabilitation robots.

    Science.gov (United States)

    Jamwal, Prashant K; Hussain, Shahid; Xie, Sheng Q

    2015-03-01

    Ankle rehabilitation robots can play an important role in improving outcomes of the rehabilitation treatment by assisting therapists and patients in number of ways. Consequently, few robot designs have been proposed by researchers which fall under either of the two categories, namely, wearable robots or platform-based robots. This paper presents a review of both kinds of ankle robots along with a brief analysis of their design, actuation and control approaches. While reviewing these designs it was observed that most of them are undesirably inspired by industrial robot designs. Taking note of the design concerns of current ankle robots, few improvements in the ankle robot designs have also been suggested. Conventional position control or force control approaches, being used in the existing ankle robots, have been reviewed. Apparently, opportunities of improvement also exist in the actuation as well as control of ankle robots. Subsequently, a discussion on most recent research in the development of novel actuators and advanced controllers based on appropriate physical and cognitive human-robot interaction has also been included in this review. Implications for Rehabilitation Ankle joint functions are restricted/impaired as a consequence of stroke or injury during sports or otherwise. Robots can help in reinstating functions faster and can also work as tool for recording rehabilitation data useful for further analysis. Evolution of ankle robots with respect to their design and control aspects has been discussed in the present paper and a novel design with futuristic control approach has been proposed.

  14. Antioxidant-related gene polymorphisms associated with the cardio-ankle vascular index in young Russians.

    Science.gov (United States)

    Sorokin, Alexander V; Kotani, Kazuhiko; Bushueva, Olga Y; Polonikov, Alexey V

    2016-04-01

    The cardio-ankle vascular index is a measure of arterial stiffness, whereas oxidative stress underlies arterial pathology. This study aimed to investigate the association between the cardio-ankle vascular index and antioxidant-related gene polymorphisms in young Russians. A total of 89 patients (mean age, 21.6 years) were examined by the cardio-ankle vascular index and for 15 gene polymorphisms related to antioxidant enzymes including FMO3 (flavin-containing monooxygenase 3), GPX1 (glutathione peroxidase 1), and GPX4 (glutathione peroxidase 4). A higher cardio-ankle vascular index level was detected in carriers with the KK-genotype of FMO3 polymorphism rs2266782 than in those without (mean levels: 6.2 versus 5.6, respectively, pcardio-ankle vascular index level was seen in carriers with the CC-genotype of GPX4 polymorphism rs713041 than in those without (6.0 versus 5.5, respectively, pcardio-ankle vascular index levels and the other gene polymorphisms. Although carriers with the LL-genotype of GPX1 polymorphism rs1050450 showed a higher diastolic blood pressure level than those without, the polymorphism did not affect the cardio-ankle vascular index level. This study showed a significant association between rs2266782 and rs713041 polymorphisms and arterial stiffness, as measured by the cardio-ankle vascular index, in young Russians. The pathways utilised by antioxidant enzymes may be responsible for early arterial stiffening in the Russian population.

  15. The Effect of Ankle Kinesio Tape on Ankle Muscle Activity During a Drop Landing.

    Science.gov (United States)

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

    2015-11-01

    The use of Kinesio Tape among health care professional has grown recently in efforts to efficiently prevent and treat joint injuries. However, limited evidence exists regarding the efficacy of this technique in enhancing joint stability and neuromuscular control. To determine how Kinesio Tape application to the ankle joint alters forces and muscle activity during a drop-jump maneuver. Single-group pretest- posttest. University laboratory. 22 healthy adults with no previous history of ankle injury. Participants were instrumented with electromyography on the lower-leg muscles as they jumped from a 35-cm platform onto force plates. Test trials were performed without tap