Ankle Kinetics Research Articles

Recovery of the medial gastrocnemius muscle after calcaneus fracture differs between contractile and elastic components.

BackgroundCalcaneal fractures result in severe functional impairments and walking restrictions. Postoperative evaluation mainly focusses on the restoration of calcaneal anatomy while ankle plantar flexor insufficiency remains largely neglected. This study aims to investigate biomechanical and morphologic adaptions of elastic and contractile components of the gastrocnemius medialis after unilateral calcaneal fracture. Methods20 Patients (BMI: 27.6 ± 3.1 kgm−2, Age: 50 ± 12 years) were measured using gait analysis and portable ultrasound over a follow-up of three, six and twelve months after surgery. Data comparison was performed using 20 matched healthy controls (BMI: 26.2 ± 2.9 kgm−2, Age: 48 ± 11 years). Static and dynamic behavior of the gastrocnemius muscle tendon unit, muscle fascicle and the serial-elastic element as well ankle joint kinematics and kinetics were analyzed. FindingsWithin patients, a significant (p < 0.05) increase in fascicle length (by 67%) during single support and a decrease of serial elastic element shortening (by 20%) during push off was found between three and twelve months follow-up comparisons. Patients showed differences for fascicle lengthening and pennation angle increase during single support after three and six months compared to healthy controls. A smaller shortening of the serial-elastic element (by 29%) and muscle-tendon unit (by 16%) persisted even for the twelve month comparisons. InterpretationPatients with calcaneal fracture showed an incomplete restoration of the medial gastrocnemius dynamic morphological behavior. While muscle fascicle contraction almost recovered, the serial elastic component still showed restrictions regarding its shortening behavior. Limited foot mobility and plantarflexor strength as well as lowered responsiveness of elastic tissues to mechanical loading are regarded as key mechanisms.

Radiographic analysis using the hip-to-calcaneus line and its association with lower limb joint kinetics in varus knee osteoarthritis

BackgroundThis study aimed to (1) determine whether the hip to ankle (HA) line or hip to calcaneus (HC) line better reflects knee coronal plane kinetics, (2) to examine whether the HC line reflects ankle coronal plane kinetics, and (3) to evaluate the radiological and biomechanical aspects of ankle in varus knee osteoarthritis (OA). MethodsFull-length, postero-anterior radiographs (hip-to-calcaneus radiographs) were taken and gait analysis was performed in 21 varus knee OA patients. The %HA where the HA lines pass through the tibial plateau, and the %HC and the mechanical ankle joint axis point (MAJAP), where the HC line passes through the tibial plateau and tibial plafond, respectively, were calculated. Knee adduction angular impulse (KAAI) and ankle inversion angular impulse (AIAI) were collected as kinetic data. Finally, we divided the patients into two groups with and without ankle OA, and compared each parameter between both groups. ResultsThe %HA and %HC were correlated with KAAI (%HA; r = -0.68, P = 0.001, %HC; r = -0.81, P < 0.001, respectively) and MAJAP was correlated with AIAI (r = -0.55, P = 0.009). MAJAP was significantly smaller, and KAAI and AIAI were significantly larger in the ankle OA group. ConclusionsRadiographic analysis using the HC line was more strongly correlated to knee joint kinetics than the HA line and was also correlated to ankle joint kinetics. Assessing lower limb alignment using the HC line could be useful to evaluate the knee and ankle joints for varus knee OA.

Modeling toes contributes to realistic stance knee mechanics in three-dimensional predictive simulations of walking.

Physics-based predictive simulations have been shown to capture many salient features of human walking. Yet they often fail to produce realistic stance knee and ankle mechanics. While the influence of the performance criterion on the predicted walking pattern has been previously studied, the influence of musculoskeletal mechanics has been less explored. Here, we investigated the influence of two mechanical assumptions on the predicted walking pattern: the complexity of the foot model and the stiffness of the Achilles tendon. We found, through three-dimensional muscle-driven predictive simulations of walking, that modeling the toes, and thus using two-segment instead of single-segment foot models, contributed to robustly eliciting physiological stance knee flexion angles, knee extension torques, and knee extensor activity. Modeling toes also slightly decreased the first vertical ground reaction force peak, increasing its agreement with experimental data, and improved stance ankle kinetics. It nevertheless slightly worsened predictions of ankle kinematics. Decreasing Achilles tendon stiffness improved the realism of ankle kinematics, but there remain large discrepancies with experimental data. Overall, this simulation study shows that not only the performance criterion but also mechanical assumptions affect predictive simulations of walking. Improving the realism of predictive simulations is required for their application in clinical contexts. Here, we suggest that using more complex foot models might contribute to such realism.

A randomized crossover study of functional electrical stimulation during walking in spastic cerebral palsy: the FES on participation (FESPa) trial

BackgroundSpastic cerebral palsy is the most common cause of motor disability in children. It often leads to foot drop or equinus, interfering with walking. Ankle-foot orthoses (AFOs) are commonly used in these cases. However, AFOs can be too restrictive for mildly impaired patients. Functional electrical stimulation (FES) of the ankle-dorsiflexors is an alternative treatment as it could function as a dynamic functional orthosis. Despite previous research, high level evidence on the effects of FES on activities and participation in daily life is missing. The primary aim of this study is to evaluate whether FES improves the activity and participation level in daily life according to patients, and the secondary aim is to provide evidence of the effect of FES at the level of body functions and activities. Furthermore, we aim to collect relevant information for decisions on its clinical implementation.MethodsA randomized crossover trial will be performed on 25 children with unilateral spastic cerebral palsy. Patients aged between 4 and 18 years, with Gross Motor Functioning Classification System level I or II and unilateral foot drop of central origin, currently treated with AFO or adapted shoes, will be included. All participants will undergo twelve weeks of conventional treatment (AFO/adapted shoes) and 12 weeks of FES treatment, separated by a six-week washout-phase. FES treatment consists of wearing the WalkAide® device, with surface electrodes stimulating the peroneal nerve during swing phase of gait. For the primary objective, the Goal Attainment Scale is used to test whether FES improves activities and participation in daily life. The secondary objective is to prove whether FES is effective at the level of body functions and structures, and activities, including ankle kinematics and kinetics measured during 3D-gait analysis and questionnaire-based frequency of falling. The tertiary objective is to collect relevant information for clinical implementation, including acceptability using the device log file and side effect registration, cost-effectiveness based on quality adjusted life years (QALYs) and clinical characteristics for patient selection.DiscussionWe anticipate that the results of this study will allow evidence-based use of FES during walking in children with unilateral spastic cerebral palsy.Trial registrationClinicalTrials.gov: NCT03440632.

Isolated Joint Block Progression Training Improves Leaping Performance in Dancers.

The purpose of this study was to investigate the effect of a 12-week ankle-specific block progression training program on saut de chat leaping performance [leap height, peak power (PP), joint kinetics and kinematics], maximal voluntary isometric plantar flexion (MVIP) strength, and Achilles tendon (AT) stiffness. Dancers (training group n = 7, control group n = 7) performed MVIP at plantarflexed (10◦) and neutral ankle positions (0◦) followed by ramping isometric contractions equipped with ultrasound to assess strength and AT stiffness, respectively. Dancers also performed saut de chat leaps surrounded by 3-D motion capture atop force platforms to determine center of mass and joint kinematics and kinetics. The training group then followed a 12-week ankle-focused program including isometric, dynamic constant external resistance, accentuated eccentric loading, and plyometric training modalities, while the control group continued dancing normally. We found that the training group's saut de chat ankle PP (59.8%), braking ankle stiffness (69.6%), center of mass PP (11.4%), and leap height (12.1%) significantly increased following training. We further found that the training group's MVIP significantly increased at 10◦ (17.0%) and 0◦ (12.2%) along with AT stiffness (29.6%), while aesthetic leaping measures were unchanged (peak split angle, mean trunk angle, trunk angle range). Ankle-specific block progression training appears to benefit saut de chat leaping performance, PP output, ankle-joint kinetics, maximal strength, and AT stiffness, while not affecting kinematic aesthetic measures. We speculate that the combined training blocks elicited physiological changes and enhanced neuromuscular synchronization for increased saut de chat leaping performance in this cohort of dancers.

Prediction of EMG Activation Profiles from Gait Kinematics and Kinetics during Multiple Terrains.

Continuous myoelectric prediction of intended limb dynamics has the ability to provide transparent control of a prosthesis by the user. However, the impact on these models of adding a human user into the control loop is less clear. Here, the ability of a User Response Model (URM) to continuously predict EMG activity from gait kinematics and kinetics collected during three mobility tasks (level-ground walking, stair ascent, and stair descent) was examined. Multiple-input, multiple-output NARX-based URMs were developed with two outputs (ankle plantarflexor and dorsiflexor) and variable inputs (ankle kinetics, and shank and/or ankle kinematics). Accuracy in predicting the tibialis anterior and medial gastrocnemius EMG was comparable across URMs regardless of the number of inputs. Stair descent had the lowest accuracy among the mobility tasks. No significant differences in normalized root-mean-square error and cross-correlation were found between URMs with five and nine inputs. A URM that continuously predicts EMG activity from gait kinetics and kinematics could be used to simulate human-in-the-loop myoelectric control of a transtibial prosthesis and examine the stability of the system to changes in the environment or due to control errors.

Effect of Obesity on Knee and Ankle Biomechanics during Walking.

The purpose of this retrospective study was to quantify the three-dimensional knee and ankle joint kinematics and kinetics during walking in young participants with different degrees of obesity and to identify the associated effects by stratifying the obese participants according to their BMI. Thirty-two young obese individuals (mean age 30.32 years) and 16 normal-weight age-matched individuals were tested using 3D gait analysis. Analysis of kinematic and kinetic data revealed significant differences in mechanics at knee and ankle joints in all the evaluated planes of movement. Compared to the healthy-weight participants, obese adults demonstrated less knee flexion, greater knee ab-adduction angle during the entire gait cycle and abnormalities at the knee flex-extension moment. At the ankle joint, reduced range of motion was observed together with a lower peak of ankle plantarflexor moment and power during terminal stance. These results provide insight into a potential pathway by which obesity predisposes a healthy adult for increased risk of osteoarthritis.

Design of 3D printable prosthetic foot to implement nonlinear stiffness behavior of human toe joint based on finite element analysis

Toe joint is known as one of the critical factors in designing a prosthetic foot due to its nonlinear stiffness characteristic. This stiffness characteristic provides a general feeling of springiness in the toe-off and it also affects the ankle kinetics. In this study, the toe part of the prosthetic foot was designed to improve walking performance. The toe joint was implemented as a single part suitable for 3D printing. The various shape factors such as curved shape, bending space, auxetic structure, and bending zone were applied to mimic human foot characteristics. The finite element analysis (FEA) was conducted to simulate terminal stance (from heel-off to toe-off) using the designed prosthetic foot. To find the structure with characteristics similar to the human foot, the optimization was performed based on the toe joint geometries. As a result, the optimized foot showed good agreement with human foot behavior in the toe torque-angle curve. Finally, the simulation conditions were validated by comparing with human walking data and it was confirmed that the designed prosthetic foot structure can implement the human foot function.

Leaning the Trunk Forward Decreases Patellofemoral Joint Loading During Uneven Running.

AminiAghdam, S, Epro, G, James, D, and Karamanidis, K. Leaning the trunk forward decreases patellofemoral joint loading during uneven running. J Strength Cond Res 36(12): 3345-3351, 2022-Although decline surfaces or a more upright trunk posture during running increase the patellofemoral joint (PFJ) contact force and stress, less is known about these kinetic parameters under simultaneous changes to the running posture and surface height. This study aimed to investigate the interaction between Step (10-cm drop-step and level step) and Posture (trunk angle from the vertical: self-selected, ∼15°; backward, ∼0°; forward, ∼25°) on PFJ kinetics (primary outcomes) and knee kinematics and kinetics as well as hip and ankle kinetics (secondary outcomes) in 12 runners at 3.5 ms -1 . Two-way repeated measures analyses of variance ( α = 0.05) revealed no step-related changes in peak PFJ kinetics across running postures; however, a decreased peak knee flexion angle and increased joint stiffness in the drop-step only during backward trunk-leaning. The Step main effect revealed significantly increased peak hip and ankle extension moments in the drop-step, signifying pronounced mechanical demands on these joints. The Posture main effect revealed significantly higher and lower PFJ kinetics during backward and forward trunk-leaning, respectively, when compared with the self-selected condition. Forward trunk-leaning yielded significantly lower peak knee extension moments and higher hip extension moments, whereas the opposite effects occurred with backward trunk-leaning. Overall, changes to the running posture, but not to the running surface height, influenced the PFJ kinetics. In line with the previously reported efficacy of forward trunk-leaning in mitigating PFJ stress while even or decline running, this technique, through a distal-to-proximal joint load redistribution, also seems effective during running on surfaces with height perturbations.

Biomechanics Differ for Individuals With Similar Self-Reported Characteristics of Patellofemoral Pain During a High-Demand Multiplanar Movement Task.

Patellofemoral pain (PFP) is often categorized by researchers and clinicians using subjective self-reported PFP characteristics; however, this practice might mask important differences in movement biomechanics between PFP patients. To determine whether biomechanical differences exist during a high-demand multiplanar movement task for PFP patients with similar self-reported PFP characteristics but different quadriceps activation levels. Cross-sectional design. Biomechanics laboratory. A total of 15 quadriceps deficient and 15 quadriceps functional (QF) PFP patients with similar self-reported PFP characteristics. In total, 5 trials of a high-demand multiplanar land, cut, and jump movement task were performed. Biomechanics were compared at each percentile of the ground contact phase of the movement task (α = .05) between the quadriceps deficient and QF groups. Biomechanical variables included (1)whole-body center of mass, trunk, hip, knee, and ankle kinematics; (2)hip, knee, and ankle kinetics; and (3)ground reaction forces. The QF patients exhibited increased ground reaction force, joint torque, and movement, relative to the quadriceps deficient patients. The QF patients exhibited: (1)up to 90, 60, and 35N more vertical, posterior, and medial ground reaction force at various times of the ground contact phase; (2)up to 4° more knee flexion during ground contact and up to 4° more plantarflexion and hip extension during the latter parts of ground contact; and (3)up to 26, 21, and 48 N·m more plantarflexion, knee extension, and hip extension torque, respectively, at various times of ground contact. PFP patients with similar self-reported PFP characteristics exhibit different movement biomechanics, and these differences depend upon quadriceps activation levels. These differences are important because movement biomechanics affect injury risk and athletic performance. In addition, these biomechanical differences indicate that different therapeutic interventions may be needed for PFP patients with similar self-reported PFP characteristics.

The effects of shoe upper construction on mechanical ankle joint work during lateral shuffle movements

ABSTRACT Lateral shuffles are common movements in sports and are facilitated by the hip, knee, and ankle joints. Shoe uppers can change ankle kinetics during walking and running. However, it is not known how shoe upper modifications affect ankle kinetics during shuffling. The purpose of this study was to investigate the effects of shoe upper construction on mechanical ankle joint work during shuffling. It was hypothesized that a shoe with a reinforced upper will result in decreased negative ankle joint work. Twenty participants performed Maximal (MLST) and Submaximal Lateral Shuffle Tests (90% of MLST) in footwear with a minimal (MU) and reinforced upper (RU). Ground reaction forces and ankle kinematics were collected to compute ankle joint work. Performing lateral shuffles in the RU condition resulted in significantly reduced positive (MU: 0.62 ± 0.16 J/kg, RU: 0.55 ± 0.16 J/kg; p = 0.001, d = 0.44) and negative (MU: −0.60 ± 0.20 J/kg, RU: −0.53 ± 0.19 J/kg; p = 0.004, d = 0.41) ankle work. A decrease in positive and negative work could be a performance benefit, enabling the athlete to perform the same movement with a lower energy cost. More extreme upper interventions may yield even larger performance benefits.

A four-experiment examination of ankle kinetics, kinematics and lateral ligament strains during different conditions: an examination using musculoskeletal simulation

PurposeFirst, to provide insight into the differences in ankle kinetics, kinematics and lateral ligament strain between males and females during functional sports movements. In addition this study explores the prophylactic efficacy of different footwear and bracing modalities.MethodsExperiment 1 examined male and female athletes performing run, 45° cut and one-legged hop movements, experiment 2 observed court, energy return and trainer footwear conditions during a change of direction task, experiment 3 examined high-cut, low-cut and trainer footwear conditions in a change of direction, run, 45° cut and vertical jump movements and experiment 4 explored an ankle sleeve and an ankle brace during a change of direction movement. In each experiment ankle kinetics and ligament strain were measured using a musculoskeletal simulation approach.ResultsExperiment 1 indicates that males exhibited increased inversion velocity (male = 260.39 and female = 219.18°/s) in the cut movement as well as enhanced peak posterior force (male = 2.24 and female = 1.35BW), anterior talofibular ligament (ATFL) strain rate (male = 266.77 and female = 133.16%/s). Experiment 2 showed that both calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL) strain velocities were greater in the court footwear (CFL = 90.86 and PTFL = 151.45%/s) compared to the trainer (CFL = 69.07 and PTFL = 119.57%/s). Experiment 3 showed in the run movement anterior talofibular ligament (ATFL) strain was enhanced in the trainer (7.86%) compared to the high (3.61%) and low (5.87%) conditions and the trainer (8.14%) compared to the low footwear (5.39%) for the cut movement. PTFL strain velocity was greater in the high footwear (188.01%/s) compared to the trainer (175.60%/s) during the run movement and in both high (221.55%/s) and low (220.29%/s) footwear compared to the trainer (202.05%/s) during the cut. Experiment 4 revealed that PTFL strain was greater in the sleeve condition (17.05%) compared to the ankle brace (15.42%).ConclusionThis study provides insight into the potentially increased incidence of lateral ankle ligament sprain injuries in males, whilst also highlighting the prophylactic efficacy of ankle braces in attenuating the ankle strain mechanisms linked to the aetiology of lateral ankle ligament injuries.

Rounding the base: A lower extremity biomechanical analysis in softball players

Contacting the base is a common injury mechanism for base runners in softball, with ankle sprains being the most common type of injury, but it is not known how the base affects lower extremity mechanics. The purpose of this study was to analyze lower extremity biomechanics while rounding a base. Sixteen recreationally active females with previous softball experience completed two base rounding conditions. A base was securely placed on the force place for the with base (WB) condition, and an outline of the base was taped on the force plate for the no base (NB) condition. Three-dimensional right-leg hip, knee, and ankle kinematics and kinetics were measured during the stance phase of the base rounding and analyzed using statistical parametric mapping (SPM). The WB condition resulted in decreased hip abduction ( p = 0.034), increased dorsiflexion ( p = 0.012), and decreased inversion ( p &lt; 0.001) angles. Increased hip extension ( p &lt; 0.001) and hip abduction ( p = 0.016) moments were exhibited during the WB condition. Decreased hip abduction ( p = 0.026), ankle plantarflexor ( p &lt; 0.001), and ankle eversion ( p &lt; 0.001) moments were also exhibited in the WB condition. The base acts as a lateral banking surface, reducing variables associated with ankle sprains, and likely assists in propelling base runners to the next base without injury.

A comprehensive biomechanical analysis of the barbell hip thrust.

Barbell hip thrust exercises have risen in popularity within the biomechanics and strength and conditioning literature over recent years, as a method of developing the hip extensor musculature. Biomechanical analysis of the hip thrust beyond electromyography is yet to be conducted. The aim of this study was therefore to perform the first comprehensive biomechanical analysis the barbell hip thrust. Nineteen resistance trained males performed three repetitions of the barbell hip thrust at 70% one-repetition maximum. Kinematic (250 Hz) and kinetic (1000 Hz) data were used to calculate angle, angular velocity, moment and power data at the ankle, knee, hip and pelvic-trunk joint during the lifting phase. Results highlighted that the hip thrust elicits significantly (p < 0.05) greater bilateral extensor demand at the hip joint in comparison with the knee and pelvic-trunk joints, whilst ankle joint kinetics were found to be negligible. Against contemporary belief, hip extensor moments were not found to be consistent throughout the repetition and instead diminished throughout the lifting phase. The current study provides unique insight to joint kinematics and kinetics of the barbell hip thrust, based on a novel approach, that offers a robust evidence base for practitioners to guide exercise selection.

Effects of Nonelastic Taping and Dual Task on Kinematics and Kinetics of the Ankle Joint.

Objectives The purpose of this experimental study was to investigate the effects of nonelastic taping and dual task on ankle kinematics and kinetics in gait analysis of healthy adults. Methods A total of 21 healthy adults completed trials of gait analysis using a Vicon system combining ground walking with different cognitive task conditions (none, modified Stroop color/character naming, and serial-7 subtraction), with or without nonelastic taping. Ankle kinematics and kinetics including speed, ankle plantarflexion and inversion angle, ground reaction force (GRF), and stride time variability (STV) under all conditions of taping (YES or NO) and cognitive task (none, naming, and subtraction) were characterized and analyzed with repeated-measures ANOVA. Results As regards cognitive performance, the serial-7 subtraction performance under walking conditions with and without taping was significantly poorer than simple sitting condition (P < 0.001). For kinematics and kinetics, STV showed statistically significant decrease (P=0.02) when subjects underwent taping application. Vertical GRF was significantly greater under taping than barefoot (P=0.001). Ankle plantarflexion at initial contact (IC) under the dual-task walking was significantly more than under simple walking (P=0.008). Conclusions Applications of nonelastic taping and dual task may lead to the STV, vertical GRF, ankle plantarflexion, and speed alterations because of restricted joint range of motion and changed sensorimotor neural circuit. When healthy adults performed dual-task walking, central neural resources allocation was disturbed, leading to weakened performance in both motor and cognitive tasks.

Habitual endurance running does not mitigate age-related differences in gait kinetics.

Older adults often walk with smaller ankle joint kinetics and larger hip joint kinetics compared to young adults. These age-related differences have been attributed, in part, to weaker plantarflexor muscles. While it is thought that regular physical activity helps to maintain muscle strength and mobility in older adults, physical activity levels on average decline with age. Therefore, understanding the effect of physical activity level on gait kinetics is an important objective for the management of mobility impairment in older adults. The purpose of this study was determine the effect of habitual endurance running on lower-extremity joint kinetics. 12 male older long-term runners (67±5yrs., 1.79±0.07m, 77.3±13.7kg) and 12 male older non-runners (70±3yrs., 1.78±0.06m, 79.68±10.6kg), performed overground walking trials at 1.3m/s while kinematic and kinetic data were collected. Participants also performed maximal voluntary contractions at the hip, knee, and ankle joints on an isokinetic dynamometer. Older runners displayed similar ankle plantarflexor strength, similar hip extensor strength, and greater knee extensor strength compared to older non-runners, and walked with similar ankle joint kinetics (p>0.05), and larger hip joint kinetics compared to older non-runners (p<0.05). Thus, physical activity, in the form of running at least 20miles/wk. and training for at least one race per year, did not mitigate the characteristic age-related differences in gait kinetics. Our findings may indicate that age-related differences in lower-extremity gait kinetics are a normal consequence of natural aging.

Do Novice Runners Show Greater Changes in Biomechanical Parameters?

Purpose Examining and understanding the biomechanics of novice runners and experienced runners can further improve our knowledge within the field of running mechanics and running injuries. The purpose of this study was to classify the differences in lower limb biomechanics during a 3.3 m/s running task among both experienced runners and novice runners. Method Twenty-four participants (12 experienced runners and 12 novice runners) ran at 3.3 m/s across a force plate; kinematics and kinetics data were collected by the Vicon motion system and Kistler force plate. Group comparisons were made using an independent samples t-test to identify differences in the impact peak, loading rate, contact time, ankle, knee, and hip joint kinematics and kinetics during the stance phase. Results No significant differences were observed between novice and experienced runners for both ankle and knee joint kinetics except that the ankle joint plantar flexion torque was significantly greater in the novice runners. However, the plantar flexion, dorsiflexion, range of motion (ROM), plantar flexion torque, and max angular velocity of ankle joint significantly increased in novice runners than inexperienced runners. Additionally, the flexion angle and range of motion of the hip joint were observed to be larger in the novice runners. Moreover, the maximum extension torque and the maximum extension power in the hip joint were significantly increased in the experienced runners. There were no significant differences in the first peak, contact time, and average vertical loading rate. Novice runners showed a larger vertical instantaneous loading rate than experienced runners. Conclusion These preliminary findings indicate that novice runners are prone to running injuries in comparison to experienced runners. Novice runners showed larger kinematics and kinetic parameters in the joint of the ankle and hip. Novice runners should enhance muscle strength in the hip and choose scientific training methods.

People with chronic ankle instability benefit from brace application in highly dynamic change of direction movements

BackgroundThe application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability.MethodsFifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated.ResultsMaximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found.ConclusionsBased on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.

Differences in Gait and Stair Ascent After Total Ankle Arthroplasty and Ankle Arthrodesis.

Ankle arthrodesis has historically been the standard of care for end-stage ankle arthritis; however, total ankle arthroplasty (TAA) is considered a reliable alternative. Our objective was to compare 3-dimensional foot and ankle kinetics and kinematics and determine the ankle power that is generated during level walking and stair ascent between TAA and ankle arthrodesis patients. Ten patients who underwent TAA with a modern fixed-bearing ankle prosthesis and 10 patients who previously underwent ankle arthrodesis were recruited. Patients were matched for age, sex, body mass index, time from surgery, and preoperative diagnosis. A minimum of 2-year follow-up was required. Patients completed instrumented 3D motion analysis while walking over level ground and during stair ascent. Between-group differences were assessed with a 2-tailed Mann-Whitney exact test for 2 independent samples. Sagittal ankle range of motion (ROM) was significantly higher in the TAA group (21.1 vs 14.7 degrees, P = .003) during level walking. In addition, forefoot-tibia motion (25.3±5.9 degrees vs 18.6±5.1 degrees, P = .015) and hindfoot-tibia motion (15.4±3.2 degrees vs 12.2±2.5 degrees, P = .022) were significantly greater in the TAA group. During stair ascent, sagittal ankle ROM (25 vs 17.1 degrees, P = .026), forefoot-tibia motion (27.6 vs 19.6 degrees, P = .017), and hindfoot-tibia motion (16.8 vs 12 degrees, P = .012) was greater. There were significant differences during level walking and stair ascent between patients with TAA and ankle arthrodesis. TAA patients generated greater peak plantarflexion power and sagittal motion within the foot and ankle compared to patients with an ankle arthrodesis. Further investigation should continue to assess biomechanical differences in the foot and ankle during additional activities of daily living. Level III, comparative study.

Type of unanticipated stimulus affects lower extremity kinematics and kinetics during sidestepping

ABSTRACT Including an unanticipated stimulus has significant impacts on lower extremity biomechanics during dynamic movements. It is unknown how a live, human defender affects lower extremity biomechanics. The purpose of this study was thus to determine the effects of two types of unanticipated stimuli (visual stimulus; defensive opponent) on lower extremity kinematics and kinetics in males and females during 45° sidestepping trials. Eight males and eight females completed two unanticipated stimuli sidestepping conditions. Numeric visual analog scales for reaction difficulty and movement realism were collected and analysed using a 2 × 2 mixed-model ANOVA. Three-dimensional hip, knee, and ankle kinematics and kinetics were measured during the stance phase of the sidestep and analysed using statistical parametric mapping. Participants reported greater difficulty and less realistic movements with the visual stimulus. Unanticipated stimulus main effects were observed for knee abduction angle, and hip extension and adduction, and knee extension and adduction moments. Sex main effects were observed for hip flexion, hip abduction, and ankle dorsiflexion angles, as well as hip abduction, ankle plantarflexion and ankle eversion moments and vertical ground reaction forces. Participants responded differently to two unanticipated stimuli. Careful consideration should be used when determining the type of unanticipated stimulus used.