Ankle Motion Research Articles

The NewGait Rehabilitative Device Corrects Gait Deviations in Individuals With Foot Drop.

The purpose of this quasiexperimental study was to test the effects of wearing the NewGait rehabilitative device on walking abilities in individuals with foot drop. The study involved 16 participants with foot drops caused by stroke (11 participants), multiple sclerosis (one participant), and peripheral neuropathies (four individuals). During a single testing session, participants walked 12 m at their self-selected speed in four experimental conditions: walking without any orthotic device; walking while wearing a regular plastic posterior leaf ankle foot orthosis (AFO); walking with the NewGait device assisting ankle dorsiflexion only; and walking with the NewGait device assisting the hip, knee, and ankle joint motions. Body motions during walking were recorded using a 3D system for motion analysis and analyzed with a set of spatiotemporal and kinematic parameters and a gait decomposition index. The gait decomposition index indicated sagittal interjoint coordination in the three joint pairs (hip-knee, knee-ankle, and hip-ankle) of the paretic (foot drop) leg during walking and was validated in a previous study. Overall, wearing all three orthotic devices improved the gait velocity, ankle dorsiflexion, and foot clearance compared to gait trials in which no assistive devices were used. However, wearing the AFO significantly restricted the plantarflexion range of motion and decreased interjoint coordination as measured by joint decomposition. In contrast, the NewGait device altered the ankle plantarflexion motions but also increased coordinated movement (reduced the decomposition) in most lower-extremity joint pairs and conditions. Therefore, the NewGait rehabilitative device can be considered superior to a regular AFO in correcting gait deviations caused by foot drop.

Inertial Measurement Unit-Based Romberg Test for Assessing Adults With Vestibular Hypofunction.

This work aims to explore the utility of wearable inertial measurement units (IMUs) for quantifying movement in Romberg tests and investigate the extent of movement in adults with vestibular hypofunction (VH). A cross-sectional study was conducted at an academic tertiary medical center between March 2021 and April 2022. Adults diagnosed with unilateral vestibular hypofunction (UVH) or bilateral vestibular hypofunction (BVH) were enrolled in the VH group. Healthy controls (HCs) were recruited from community or outpatient clinics. The IMU-based instrumented Romberg and tandem Romberg tests on the floor were applied to both groups. The primary outcomes were kinematic body metrics (maximum acceleration [ACC], mean ACC, root mean square [RMS] of ACC, and mean sway velocity [MV]) along the medio-lateral (ML), cranio-caudal (CC), and antero-posterior (AP) axes. A total of 31 VH participants (mean age, 33.48 [SD 7.68] years; 19 [61%] female) and 31 HCs (mean age, 30.65 [SD 5.89] years; 18 [58%] female) were recruited. During the eyes-closed portion of the Romberg test, VH participants demonstrated significantly higher maximum ACC and increased RMS of ACC in head movement, as well as higher maximum ACC in pelvic movement along the ML axis. In the same test condition, individuals with BVH exhibited notably higher maximum ACC and RMS of ACC along the ML axis in head and pelvic movements compared with HCs. Additionally, BVH participants exhibited markedly increased maximum ACC along the ML axis in head movement during the eyes-open portion of the tandem Romberg test. Conversely, no significant differences were found between UVH participants and HCs in the assessed parameters. The instrumented Romberg and tandem Romberg tests characterized the kinematic differences in head, pelvis, and ankle movement between VH and healthy adults. The findings suggest that these kinematic body metrics can be useful for screening BVH and can provide goals for vestibular rehabilitation.

Impact of lower limb movements on iliac vein stenting in iliac vein compression syndrome patients: insights from computational modeling.

Purpose: Iliac vein stenting is the primary treatment for patients with iliac vein compression syndrome (IVCS). However, post-stent placement, patients often experience in-stent restenosis and thrombosis. Despite this, the role of lower limb movements in the functioning of stents and veins in IVCS patients remains unclear. This study aimed to address this knowledge gap by developing a computational model using medical imaging techniques to simulate IVCS after stent placement. Methods: This research used a patient-specific model to analyze the effects of lower extremity exercises on hemodynamics post-stent placement. We conducted a comprehensive analysis to evaluate the impact of specific lower limb movements, including hip flexion, ankle movement and pneumatic compression on the hemo-dynamic characteristics within the treated vein. The analysis assessed parameters such as wall shear stress (WSS), oscillatory shear index (OSI), and residence time (RRT). Results: The results demonstrated that hip flexion significantly disrupts blood flow dynamics at the iliac vein bifurcation after stenting. Bilateral and left hip flexion were associated with pronounced regions of low WSS and high OSI at the iliac-vena junction and the stent segment. Additionally, active ankle exercise (AAE) and intermittent pump compression (IPC) therapy were found to enhance the occurrence of low WSS regions along the venous wall, potentially reducing the risk of thrombosis post-stent placement. Consequently, both active joint movements (hip and ankle) and passive movements have the potential to influence the local blood flow environment within the iliac vein after stenting. Conclusions: The exploration of the impact of lower limb movements on hemodynamics provides valuable insights for mitigating adverse effects associated with lower limb movements post iliac-stenting. Bilateral and left hip flexions negatively impacted blood flow, increasing thrombosis risk. However, active ankle exercise and intermittent pump compression therapies effectively improve the patency.

The Neuromuscular Parameters Affecting Static and Dynamic Balance in Adolescent Male Soccer Players with Dynamic Knee Valgus

Background and Aims The anterior cruciate ligament injury in athletes is associated with disorders related to balance and postural control. Poor balance is a predictor of lower limb injury in athletes. This study aims to investigate the different neuromuscular parameters that affect the static and dynamic balance in adolescent male football players with Dynamic Knee Valgus (DKV). Methods This is a correlational study. Participants were 83 adolescent male football players with DKV (age: 12.63±0.72 years, height: 1.69±0.07 meters, weight: 23.23±7.74 58 kg, BMI: 20.32±2.38 kg /m2), who were selected using a purposive sampling method. The presence of DKV was assessed by the squat test. The strength of the trunk and hip muscles was assessed by manual muscle testing (MMT), trunk endurance by the McGill test, and range of motion (ROM) of hip and ankle joints by a goniometer. Moreover, the static and dynamic balances were evaluated by the Bass Stick test and Y balance test, respectively. The Pearson correlation test was used to examine the relationships at a significance level of 0.05. All statistical operations were performed by SPSS software, version 24. Results The results of the present study showed a significant relationship between static balance and the study parameters (P≤0.05) except for trunk flexion strength (P=0.16) and ROM (P<0.05), hip flexion ROM (P=0.83), hip extension ROM (P=0.96), hip abduction ROM (P=0.77) and ankle dorsiflexion ROM (P=0.94). The dynamic balance at anterior-posterior direction had a significant relationship with trunk endurance and left-side plank (P=0.07) and strength (P=0.05), but not with plank test score (P=0.45). The dynamic Y balance at posteromedial direction had a significant relationship with all variables except for 60° flexion (P=0.40), plank (P=0.53), left-side plank (P=0.09), and trunk extension strength (P=0.23). The results of the study also showed the significant relationship of dynamic balance at posterolateral direction and the total score of Y balance test with total trunk endurance test score (P=0.03, P=0.003) and right-side plank (P=0.005, P=0.001). Moreover, trunk extension strength and hip strength variables had a significant relationship with posterolateral dynamic balance and total Y balance test score (P≤0.05). Furthermore, the ROM of ankle dorsiflexion had a significant relationship with balance at the posteromedial (P=0.03), posterolateral (P=0.02) directions and the total Y balance score (P=0.02). Conclusion Static balance of adolescent male soccer players with DKV has a significant relationship with trunk endurance, trunk strength and thigh strength. There is a significant relationship between dynamic balance and trunk endurance, trunk strength, hip strength, and ankle dorsiflexion ROM.

Effect of Countermovement Depth on the Neuromechanics of a Vertical Jump.

The purpose of this study was to examine kinematic, kinetic, and muscle activation metrics during countermovement jumps (CMJs) with varying countermovement depths. The hypothesis was that a shallow countermovement depth would compromise jump height by disrupting neuromechanical control. Ten healthy men (age 26 ± 8 yr, height 1.81 ± 0.08 m, mass 83.5 ± 9.0 kg) performed maximal CMJs at self-selected countermovement depth (self-selected CMJ), at reduced countermovement depth (shallow CMJ), and at increased countermovement depth (deep CMJ). Three jumps were performed in each condition on force plates with ankle, knee, and hip motion recorded and electromyograms (EMG) recorded from the gluteus maximus (GM), vastus lateralis (VL), and medial gastrocnemius (MG) muscles. During CMJs, the knee flexion angle was recorded with an electrogoniometer. Jumpers were instructed to flex at least 15% less (shallow CMJ) and at least 15% more (deep CMJ) than the self-selected CMJs. Kinematic, kinetic, and EMG metrics were compared between the different CMJ depths using repeated measures ANOVA. Compared with self-selected CMJs, shallow CMJs had 26% less countermovement depth (P < 0.001, effect size 1.74) and the deep CMJs had 28% greater countermovement depth (P < 0.001, effect size 1.56). Jump height was 8% less for the shallow vs. self-selected CMJs (P = 0.007, effect size 1.09) but not different between self-selected and deep CMJs (P = 0.254). Shallow CMJs differed from self-selected CMJs at the initiation of the countermovement (unweighting). For self-selected CMJs, force dropped to 43% of body weight during unweighting but only to 58% for shallow CMJs (P = 0.015, effect size 0.95). During unweighting, VL EMG averaged 5.5% of MVC during self-selected CMJs versus 8.1% for shallow CMJs (P = 0.014, effect size 0.97). Percent decline in jump height with shallow versus self-selected CMJs was correlated with the difference in VL EMG during unweighting between shallow and self-selected CMJs (r = 0.651, P = 0.041). A deep countermovement prolonged the time to execute the jump by 38% (P < 0.010, effect size 1.04) but did not impair CMJ force metrics. In conclusion, self-selected countermovement depth represents a tradeoff between dropping the center of mass sufficiently far and executing the jump quickly. Unweighting at the initiation of a CMJ appears to be a critical element in the neuromechanics of the CMJ.

New Insights Optimize Landing Strategies to Reduce Lower Limb Injury Risk.

Single-leg landing (SL) is often associated with a high injury risk, especially anterior cruciate ligament (ACL) injuries and lateral ankle sprain. This work investigates the relationship between ankle motion patterns (ankle initial contact angle [AICA] and ankle range of motion [AROM]) and the lower limb injury risk during SL, and proposes an optimized landing strategy that can reduce the injury risk. To more realistically revert and simulate the ACL injury mechanics, we developed a knee musculoskeletal model that reverts the ACL ligament to a nonlinear short-term viscoelastic mechanical mechanism (strain rate-dependent) generated by the dense connective tissue as a function of strain. Sixty healthy male subjects were recruited to collect biomechanics data during SL. The correlation analysis was conducted to explore the relationship between AICA, AROM, and peak vertical ground reaction force (PVGRF), joint total energy dissipation (TED), peak ankle knee hip sagittal moment, peak ankle inversion angle (PAIA), and peak ACL force (PAF). AICA exhibits a negative correlation with PVGRF (r = -0.591) and PAF (r = -0.554), and a positive correlation with TED (r = 0.490) and PAIA (r = 0.502). AROM exhibits a positive correlation with TED (r = 0.687) and PAIA (r = 0.600). The results suggested that the appropriate increases in AICA (30° to 40°) and AROM (50° to 70°) may reduce the lower limb injury risk. This study has the potential to offer novel perspectives on the optimized application of landing strategies, thus giving the crucial theoretical basis for decreasing injury risk.

Brodie's Abscess of the Ankle Presenting as a Tumor: A Summary of Five Cases.

A Brodie's abscess is a form of subacute osteomyelitis that is often considered in the differential diagnosis of other benign and malignant bone lesions. The authors summarize the findings of five cases of Brodie's abscesses in the distal tibia initially thought to be tumors by the referring physicians. All five cases were presented to the referring physicians with a chief complaint of ankle pain. All patients complained of chronic ankle pain and swelling that was aggravated by activity without constitutional symptoms. On physical examination, all patients presented with point tenderness over the distal tibia/malleolar regions. Three out of the five cases had a full range of ankle motion; the other two had limited dorsiflexion secondary to pain. All inflammatory laboratory values were within normal limits or only slightly elevated. All initial radiographs of the cases described demonstrated a well-defined radiolucent lesion within the distal tibia. In all cases, patients were treated with curetting, with or without bone graft. Bacterial and fungal cultures were negative in all five patients and no long-term post-operative antibiotics were administered. In this report, we discuss the clinical, radiographic, and pathologic features of this relatively rare condition in the distal tibia. The distinct clinicopathologic features of the disease process are presented to distinguish Brodie's abscess from a bone tumor.

Selective orthotic constraint of lower limb movement during walking reveals new insights into neuromuscular adaptation.

A concern expressed by the clinical community is that the constraint of motion provided by an ankle foot orthosis (AFO) may lead the user to become dependent on its stiffness, leading to learned non-use. To examine this, we hypothesized that using an experimental AFO-footwear combination (exAFO-FC) that constrains ankle motion during walking would result in reduced soleus and tibialis anterior EMG compared to free (exAFO-FC) and control (no AFO, footwear only) conditions. A total of 14 healthy subjects walked at their preferred speed (1.34 ± 0.09 m·s-1) for 15 min, in three conditions, namely, control, free, and stop. During the stance phase of walking in the stop condition, ipsilateral soleus integrated EMG (iEMG) declined linearly, culminating in a 32.1% reduction compared to the control condition in the final 5 min interval of the protocol. In contrast, ipsilateral tibialis anterior iEMG declined in a variable fashion culminating in an 11.2% reduction compared to control in the final 5 min interval. During the swing phase, the tibialis anterior iEMG increased by 6.6% compared to the control condition during the final 5 min interval. The contralateral soleus and tibialis anterior exhibited increased iEMG in the stop condition. An AFO-FC functions as a biomechanical motion control device that influences the neural control system and alters the output of muscles experiencing constraints of motion.

Closed-Loop Control of Functional Electrical Stimulation Using a Selectively Recording and Bidirectional Nerve Cuff Interface.

Discriminating recorded afferent neural information can provide sensory feedback for closed-loop control of functional electrical stimulation, which restores movement to paralyzed limbs. Previous work achieved state-of-the-art off-line classification of electrical activity in different neural pathways recorded by a multi-contact nerve cuff electrode, by applying deep learning to spatiotemporal neural patterns. The objective of this study was to demonstrate the feasibility of this approach in the context of closed-loop stimulation. Acute in vivo experiments were conducted on 11 Long Evans rats to demonstrate closed-loop stimulation. A 64-channel ( 8×8 ) nerve cuff electrode was implanted on each rat's sciatic nerve for recording and stimulation. A convolutional neural network (CNN) was trained with spatiotemporal signal recordings associated with 3 different states of the hindpaw (dorsiflexion, plantarflexion, and pricking of the heel). After training, firing rates were reconstructed from the classifier outputs for each of the three target classes. A rule-based closed-loop controller was implemented to produce ankle movement trajectories using neural stimulation, based on the classified nerve recordings. Closed-loop stimulation was successfully demonstrated in 6 subjects. The number of successful movement sequence trials per subject ranged from 1-17 and number of correct state transitions per trial ranged from 3-53. This work demonstrates that a CNN applied to multi-contact nerve cuff recordings can be used for closed-loop control of functional electrical stimulation.

Ankle Plica, is it a Myth? Report of Two Cases and Review of Literature

Introduction: Chronic ankle pain in active adults is associated with disability, pain, and giving way, undermining sports and leisure activities. The aetiology is multi factorial. Material and methods: Two adult active and fit patients presented with chronic ankle global pain, stiffness and occasional giving way. History of ankle sprain was present in both patients. Ankle arthroscopy revealed ankle plica across the gutters, with no other anomaly. Excision of the plica arthroscopically cured the problem with no recurrence after a year of follow-up. Conclusion: Ankle plica, does seem to exist and cause disability; it should be put in the differential diagnosis in patients otherwise having good ankle movement and relatively normal investigations. Arthroscopy, will identify the problems and cure it by excision. The plica finding on ankle arthroscopy should be considered as a pathological lesion needing excision in symptomatic patients

Adaptive Active Disturbance Rejection Control of an Actuated Ankle Foot Orthosis for Ankle Movement Assistance

Adaptive Active Disturbance Rejection Control of an Actuated Ankle Foot Orthosis for Ankle Movement Assistance

Arthroscopic Reconstruction of Injured Anterior Cruciate Ligament Using Peroneus Longus Graft With Fixed Loop Endobutton - A Prospective Study.

ACL injuries are more common amongst active young people where RTA and sports injuries predominate as the most common methods of injury ACL reconstruction with peroneus longus graft method have been used more frequently nowadays. The advantages of peroneus longus graft are, Adequate graft length of minimum of 25 to 30 cm. Adequate thickness of minimum 8.5 to 9mm,Less incidence of graft thinning, Lesser hamstring and quadriceps weakness, Minimal donor site morbidity. Minimal restriction of ankle movements. A prospective study of 25 patients with injured anterior cruciate ligament without meniscal injury within the age group of 18-55 years managed with arthroscopic reconstruction of anterior cruciate ligament with peroneus longus graft and fixed loop endobutton at femoral side and interference screw at tibial side. Functional outcome was assessed using clinical examination, International Knee Documentation committee and Lysholm knee scoring scale, FADI score (foot and ankle disability index score). Patients were followed up at 2, 4, 8, 12weeks and 6, 8 months post-operatively. This study consists of 25 cases of Anterior Cruciate Ligament injury. ACL rupture was common in second and third decade of life. In our study, 18(63.34%) were sports related injuries, 5(26.66%) were due to road traffic accidents and 2(10%) were atraumatic degenerations. 22(80%) showed excellent results and 3(20%) showed good results. Arthroscopic ACL reconstruction using peroneus longus graft and Fixed-loop Endobutton and interference screws provided excellent post-operative clinical outcome in terms of knee stability, subjective knee and ankle function and range of movements of the knee and ankle in our study.

Effects of Body Mass Index on Ankle Joint Muscle Function and Dynamic Proprioceptive Control

PURPOSE Increased body mass index (BMI) increases ankle instability and adversely affects human movement. This study aims to compare and analyze the muscle function and proprioception of the ankle joint based on Body Mass Index (BMI) to determine potential differences.METHODS Twenty-eight healthy male and female college students were categorized into overweight (≥ BMI 23) and normal (&lt; BMI 23) groups. Measurements included BMI, isokinetic strength of dorsiflexion, plantarflexion, eversion, inversion, ankle joint range of motion, and ankle joint proprioception.RESULTS In dorsiflexion, right 30°/sec (p=.035), left 30°/sec (p=.009) and right 120°/sec (p=.011); in plantarflexion, left 30°/sec (p&lt;.001), right 120°/sec (p=.007) and left 120°/sec (p=.006) in ankle inversion, left 30°/sec (p=.001), right 120°/sec (p=.021) and left 120°/sec (p=.007), left 30°/sec (p=.014), 120°/sec (p=.001) in ankle inversion-eversion ratio, right (p=.003) and left (p=.003) in ankle joint range of motion, right (p&lt;.001) and left (p=.022) in total proprioception, and left (p&lt;.001) in left-right proprioception were significantly different between the normal and overweight groups.CONCLUSIONS It was found that the overweight group had lower muscle strength, joint range of motion, and proprioceptive control function of the ankle joint than the normal group according to BMI. Therefore, exercise programs should be provided to strengthen the periarticular muscles involved in ankle movement, such as the tibialis anterior, soleus, and peroneus longus, and to control dynamic proprioception to prevent ankle injuries and function of the ankle joint according to BMI.

Comparative Effects of Active Release Technique and Positional Release Therapy in Female Students with Tightened Calf Muscles

Background: Prior research has established that regular use of high-heeled shoes significantly alters the gait pattern, impacts ankle joint motion, increases joint forces and moments in the lower extremities, modifies foot pressure distribution, and affects posture and balance. These biomechanical changes can lead to tightened calf muscles and associated discomfort in frequent high heel wearers. Objective: The main objective of this study is to compare the effect of Active Release Technique and Positional Release Therapy in female students with tightened calf muscles. Methods: A randomized clinical trial including 26 subjects by using convenient sampling technique, with subject age ranging from 20-30 years wearing high heels with minimum duration (5 hours a day, 5 times a week and for more than 1 year) with heel height minimum of 2''. The outcome measures were ankle dorsiflexion plantar flexion range of motion measured by goniometer, and pain measured by Numerical Pain Rating Scale. Data was collected for 4 months (Feb-May 2023) from The University of Faisalabad and Government College University Faisalabad. Over four weeks &amp; 3 times per week both groups received ultrasound and traditional Physiotherapy of conventional calf muscle stretching as baseline treatment. Group 1 received Positional Release Therapy, while Group 2 received Active Release Technique. Results: Friedman test showed within-group improvements in NPRS, Dorsiflexion, Plantar flexion, and Cadence (p&lt;0.05) for both groups. Mann Whitney U test revealed significant improvements in NPRS, Dorsiflexion, Plantar flexion, and Cadence at post-treatment (p&lt;0.05) for Positional Release Therapy group more than Active Release Therapy.. Conclusion: Positional Release Therapy (PRT) has more significant effects for calf muscle tightness, exhibiting increased cadence, ankle dorsiflexion, and plantar flexion range of motion, along with significant pain reduction than Active Release Therapy (ART)

Peroneal tendon injuries

The peroneal tendons work to both evert the foot and stabilize the hindfoot on plantarflexion and push off. The tendons are frequently injured as part of sprains and soft tissue injuries to the ankle joint, but diagnosis and treatment are often delayed. Athletes participating in activities with repetitive ankle motion, particularly those involving cutting and twisting movements, as well as those with certain anatomical features, are prone to peroneal tendon injury. Often synovitis and low-grade tendinopathy of the peroneal tendons can be managed with physiotherapy and bracing. Large longitudinal tears, rupture, and subluxation or dislocation of the tendons from the retromalleolar groove are more likely to be treated operatively, although pre-surgical rehabilitation will still be useful in chronic cases. Other surgical procedures can be combined as part of an effective treatment plan such as ankle arthroscopy, ligament stabilization and realignment procedures such as a lateralizing calcaneal osteotomy and Barouk–Rippstein–Toullec first metatarsal elevation osteotomy for non-neurogenic cavus. Persistent weakness in the peroneal tendons post injury may contribute to worsening hindfoot varus deformity: in turn, this leads to further stress on peroneus brevis which can lead to its rupture and consequently further deformity if untreated.

DEALING WITH INJURED OR REPAIRED ANKLES IN OLDER ADULTS: ASSESSING ANKLE IMMOBILIZATION METHODS DURING LOCOMOTION

Abstract Orthopedic walking boots (OWB) are an alternative to casting and immobilizing an injured ankle. Unfortunately, OWB causes a change in leg-length and pelvis angle which alters gait and postural stability and can lead to chronic back pain. Immobilizing the ankle without changing leg-length would be beneficial, especially for individuals with impaired gait and postural stability. The purpose of this study was to assess level-ground walking and stair negotiation in healthy older adults across three ankle support conditions (1) OWB, (2) TayCo ankle brace (TAB) and (3) athletic footwear (SHOD). Sixteen older adults (69+/-7.0 years) performed 2-3 trials of walking, stair ascent, and stair descent using each of the three ankle support conditions. Ankle motion in all three planes was monitored using 3D motion capture cameras to assess differences during walking and stair negotiation. For all tasks, significant differences were revealed between the SHOD and both ankle support methods for all three planes (p &amp;lt; .001). Significant differences were also revealed between OWB and TAB during walking in the transverse plane (abd/adduction) (p = .036 OWB&amp;gt;TAB) and for stair descent in the sagittal plane (dorsi/plantarflexion) (p = .001 TAB&amp;gt;OWB). No other differences were observed between the OWB and TAB for walking or stair negotiation. Ankle motion was similarly controlled with both the OWB and TAB indicating that either method would be appropriate to immobilize an injured ankle, however the TAB does not alter leg length or pelvic tilt since it fits over the individual’s footwear.

Biomechanical analysis of lower limbs during stand-to-sit tasks in patients with early-stage knee osteoarthritis.

Background: Knee osteoarthritis (KOA) is a common degenerative disease among the older people that severely affects their daily life. Previous studies have confirmed that movement biomechanics are altered in patients with KOA during task performance. However, changes that occur in lower limb joints and muscles in the three planes during stand-to-sit (STS) tasks in patients with early-stage KOA are unclear. Method: Of the 36 participants recruited in this study, 24 (8 males and 16 females) and 12 (4 males and 8 females) were added to the KOA and control groups, respectively. The Nexus Vicon motion capture system along with Delsys wireless surface electromyography devices and plantar pressure measurement mat was used to record test data. A Visual 3D software was used to process the data and calculate the biomechanical and electromyographic parameters during STS tasks. Results: There was no significant difference in task duration between the two groups. Patients with KOA could perform a greater range of pelvic motion and smaller range of hip and knee joint motion with a lower maximum hip joint angular acceleration in the sagittal plane and greater knee and ankle joint motion in the coronal plane. There was no significant difference in the motion range in the horizontal plane. During the STS task, patients in the KOA group had a lower vertical ground reaction force (GRF) amplitude on the injured side but a higher integrated GRF on both sides than those in the control group. Moreover, patients with KOA demonstrated higher PERM and PABM of the lower limb joints and smaller knee PADM and ankle PEM. Additionally, maximum activation levels of GMed muscle, affected-side gluteus medius (GM), ST, rectus femoris (RF), and tibialis anterior (TA) muscles were lower in patients with KOA than in controls. Conversely, the activation level of biceps femoris (BF) was higher. Furthermore, the integral EMG values of GMed, GM, ST, VL, RF, vastus medialis VM, and TA muscles on the affected side were lower, except for the BF muscle, in patients with KOA. Conclusion: Compared with the participants in the control group, patients with early-stage KOA exhibited consistent changes in sEMG parameters and biomechanical alterations in the sagittal plane, as observed in previous studies. However, differences in parameters were observed in the coronal and transverse planes of these patients. The noninvasive analysis of the 3D parameters of the involved motion patterns may lead to the early detection of KOA.

Configuration Design and Kinematic Performance Analysis of a Novel 4-DOF Parallel Ankle Rehabilitation Mechanism with Two Virtual Motion Centers

Aiming at the problem that the existing ankle rehabilitation robot is difficult to fully fit the complex motion of human ankle joint and has poor human-machine motion compatibility, an equivalent series mechanism model that is highly matched with the actual bone structure of the human ankle joint is proposed and mapped into a parallel rehabilitation mechanism. The parallel rehabilitation mechanism has two virtual motion centers (VMCs), which can simulate the complex motion of the ankle joint, adapt to the individual differences of various patients, and can meet the rehabilitation needs of both left and right feet of patients. Firstly, based on the motion properties and physiological structure of the human ankle joint, the mapping relationship between the rehabilitation mechanism and ankle joint is determined, and the series equivalent model of the ankle joint is established. According to the kinematic and constraint properties of the ankle equivalent model, the configuration design of the parallel ankle rehabilitation robot is carried out. Secondly, according to the intersecting motion planes theory, the full-cycle mobility of the mechanism is proved, and the continuous axis of the mechanism is judged based on the constraint power and its derivative. Then, the kinematics of the parallel ankle rehabilitation robot is analyzed. Finally, based on the OpenSim biomechanical software, a human-machine coupling rehabilitation simulation model is established to evaluate the rehabilitation effect, which lays the foundation for the formulation of a rehabilitation strategy for the later prototype.

Acute biomechanical responses to wearing a controlled ankle motion (CAM) Walker boot during walking

BackgroundControlled ankle motion (CAM) boots are often prescribed during the rehabilitation of lower limb injuries and pathologies to reduce foot and ankle movement and loading whilst allowing the patient to maintain normal daily function. Research questionThe aim of this study was to quantify the compensatory biomechanical mechanisms undergone by the ipsilateral hip and knee joints during walking. In addition, the compensatory mechanisms displayed by the contralateral limb were also considered. MethodsTwelve healthy participants walked on an instrumented treadmill at their preferred walking speed. They underwent kinematic and kinetic analysis during four footwear conditions: normal shoes (NORM), a Malleo Immobil Air Walker on the right leg (OTTO), a Rebound® Air Walker on the right leg with (EVEN) and without (OSS) an Evenup Shoelift™ on the contralateral leg. ResultsCAM boot wear increased the relative joint contribution to total mechanical work from the ipsilateral hip and knee joints (p < 0.05), which was characterised by increased hip and knee abduction during the swing phase of the gait cycle. EVEN increased the absolute work done and relative contribution of the contralateral limb. CAM boot wear reduced walking speed (p < 0.05), which was partially compensated for during EVEN. SignificanceThe increased hip abduction in the ipsilateral leg was likely caused by the increase in effective leg length and limb mass, which could lead to secondary site complications following prolonged CAM boot wear. Although prescribing an even-up walker partially mitigates these compensatory mechanisms, adverse effects to contralateral limb kinematics and kinetics (e.g., elevated knee joint work) should be considered.

Redefining Maternal Wellness: The Role of Antenatal Exercises in Musculoskeletal Issues Among Primigravida Mothers.

During pregnancy, there are notable alterations in biomechanics, hormones, and vascular functioning, which frequently result in a range of musculoskeletal ailments, including back pain, leg cramps, and pelvic girdle discomfort. The significance of pregnancy-related musculoskeletal problems on women's daily functioning and general well-being is highlighted by their widespread occurrence worldwide, necessitating heightened focus and implementation of effective therapeutic approaches. The main aims of this study were to assess the effectiveness of prenatal exercises in musculoskeletal discomfort and investigate the association between post-intervention levels of discomfort and certain demographic factors. A quantitative technique was used in this study, utilizing a pre-experimental design conducted for three months. A total of 60 primigravida mothers were selected as participants through purposive sampling. The study was conducted in a Maternity Tertiary Care Center located in Tamil Nadu. The intervention encompassed the provision of antenatal exercises, specifically focusing on abdominal tightness, pelvic tilting, and foot and ankle movements. The researcher demonstrated the exercises for 20 minutes, and afterward, mothers were asked to perform the activities themselves. The process was monitored and observed for two weeks. The findings were statistically significant, suggesting a noteworthy decrease in musculoskeletal disorders following the implementation of the intervention. The statistical analysis revealed a significant degree of significance (P = 0.001), confirming the efficacy of the exercises. Before the implementation of the intervention, a significant proportion of mothers, namely, 45 (75%) reported experiencing moderate back pain. However, following the intervention, this percentage notably fell to 33.34% (20). The incidence of moderate pelvic pain decreased from 80% (48) to 30% (18), and a comparable pattern was observed in the reduction of leg cramps. Additionally, the research identified significant associations between the improvements and a range of demographic and obstetricfactors, including the level of education, occupation, family structure, age at marriage, and weight of the mother. The results highlight the significance of incorporating antenatal exercises as a regular component of prenatal care to minimize musculoskeletal discomfort, hence promoting the overall health and well-being of expectant mothers.