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1.
William Fredericks Seth Swank Madeline Teisberg Bethany Hampton Lance Ridpath Jandy B. Hanna 《Journal of Sports Science and Medicine》2015,14(2):276-283
Minimalist running footwear has grown increasingly popular. Prior studies that have compared lower extremity biomechanics in minimalist running to traditional running conditions are largely limited to a single running velocity. This study compares the effects of running at various speeds on foot strike pattern, stride length, knee angles and ankle angles in traditional, barefoot, and minimalist running conditions. Twenty-six recreational runners (19-46 years of age) ran on a treadmill at a range of speeds (2.5-4.0 m·sec-1). Subjects ran with four different footwear conditions: personal, standard, and minimalist shoes and barefoot. 3D coordinates from video data were collected. The relationships between speed, knee and ankle angles at foot strike and toe-off, relative step length, and footwear conditions were evaluated by ANCOVA, with speed as the co-variate. Distribution of non-rearfoot strike was compared across shod conditions with paired t-tests. Non-rearfoot strike distribution was not significantly affected by speed, but was different between shod conditions (p < 0.05). Footwear condition and speed significantly affected ankle angle at touchdown, independent of one another (F [3,71] = 10.28, p < 0.001), with barefoot and minimalist running exhibiting greater plantarflexion at foot strike. When controlling for foot strike style, barefoot and minimalist runners exhibited greater plantarflexion than other conditions (p < 0.05). Ankle angle at lift-off and relative step length exhibited a significant interaction between speed and shod condition. Knee angles had a significant relationship with speed, but not with footwear. There is a clear influence of footwear, but not speed, on foot strike pattern. Additionally, speed and footwear predict ankle angles (greater plantarflexion at foot strike) and may have implications for minimalist runners and their risk of injury. Long-term studies utilizing various speeds and habituation times are needed.
Key points
- Foot strike style does not change with speed, but does change with shod condition, with minimalist shoes exhibiting an intermediate distribution of forefoot strikes between barefoot and traditional shoes.
- Plantarflexion at touchdown does change with speed and with shoe type, with barefoot and minimalist shoes exhibiting a greater plantarflexion angle than traditional running shoes.
- Knee angles change with speed in all shod conditions, but knee flexion at touchdown is not different between shod conditions.
- Relative step length changes with speed and shod condition, but there is an interaction between these variables such that step length increases more quickly in traditional shoes as speed increases.
2.
Background
There is limited information on the relationship between plantar foot pressure and patellofemoral pain syndrome (PFPS). In addition, there is not enough research on the effects of an infrapatellar strap on PFPS.Objective
The aim of this study was to evaluate the immediate effects of an infrapatellar strap on dynamic pedabarography in patients with unilateral PFPS.Methods
Clinical case control study design. 18 females subjects with unilateral PFPS were included in the study. Gait parameters were tested using pedabarography during barefoot walking with and without an infrapatellar strap.Results
There were no statistically significant differences in gait trials comparing infrapatellar strap to no strap (P > 0.05). In addition, a significant difference (P = 0.043) in the % forefoot surface on the involved side demonstrated that body weight is transferred to medial aspect of the foot.Discussion
Although our results show a difference between the forefoot surface % of the affected and unaffected sides of subjects with PFPS there was no indication that an infrapatellar strap had any immediate effect on this parameter.Conclusion
It is not clear whether PFPS is a cause or effect of abnormal gait. Further research is warranted to investigate the long-term effects of wearing an infrapatellar strap and associated altered foot biomechanics due to PFPS. 相似文献3.
《Journal of vascular surgery》2020,71(2):575-583
ObjectiveIn patients with peripheral artery disease (PAD), supervised exercise therapy is a first line of treatment because it increases maximum walking distances comparable with surgical revascularization therapy. Little is known regarding gait biomechanics after supervised exercise therapy. This study characterized the effects of supervised exercise therapy on gait biomechanics and walking distances in claudicating patients with PAD.MethodsForty-seven claudicating patients with PAD underwent gait analysis before and immediately after 6 months of supervised exercise therapy. Exercise sessions consisted of a 5-minute warmup of mild walking and stretching of upper and lower leg muscles, 50 minutes of intermittent treadmill walking, and 5 minutes of cooldown (similar to warmup) three times per week. Measurements included self-perceived ambulatory limitations measured by questionnaire, the ankle-brachial index (ABI), walking distance measures, maximal plantar flexor strength measured by isometric dynamometry, and overground gait biomechanics trials performed before and after the onset of claudication pain. Paired t-tests were used to test for differences in quality of life, walking distances, ABI, and maximal strength. A two-factor repeated measures analysis of variance determined differences for intervention and condition for gait biomechanics dependent variables.ResultsAfter supervised exercise therapy, quality of life, walking distances, and maximal plantar flexor strength improved, although the ABI did not significantly change. Several gait biomechanics parameters improved after the intervention, including torque and power generation at the ankle and hip. Similar to previous studies, the onset of claudication pain led to a worsening gait or a gait that was less like healthy individuals with a pain-free gait.ConclusionsSix months of supervised exercise therapy produced increases in walking distances and quality of life that are consistent with concurrent improvements in muscle strength and gait biomechanics. These improvements occurred even though the ABI did not improve. Future work should examine the benefits of supervised exercise therapy used in combination with other available treatments for PAD. 相似文献
4.
Peter A. Smith MD Ken N. Kuo MD Adam N. Graf MS Joseph Krzak PT PhD Ann Flanagan PT Sahar Hassani MS Angela K. Caudill PT Fredrick R. Dietz MD Jose Morcuende MD Gerald F. Harris PE PhD 《Clinical orthopaedics and related research》2014,472(4):1281-1290
Background
Clubfoot can be treated nonoperatively, most commonly using a Ponseti approach, or surgically, most often with a comprehensive clubfoot release. Little is known about how these approaches compare with one another at longer term, or how patients treated with these approaches differ in terms of foot function, foot biomechanics, or quality-of-life from individuals who did not have clubfoot as a child.Questions/purposes
We compared (1) focused physical and radiographic examinations, (2) gait analysis, and (3) quality-of-life measures at long-term followup between groups of adult patients with clubfoot treated either with the Ponseti method of nonsurgical management or a comprehensive surgical release through a Cincinnati incision, and compared these two groups with a control group without clubfoot.Methods
This was a case control study of individuals treated for clubfoot at two separate institutions with different methods of treatment between 1983 to 1987. One hospital used only the Ponseti method and the other mainly used a comprehensive clubfoot release. There were 42 adults (24 treated surgically, 18 treated with Ponseti method) with isolated clubfoot along with 48 healthy control subjects who agreed to participate in a detailed analysis of physical function, foot biomechanics, and quality-of-life metrics.Results
Both treatment groups had diminished strength and motion compared with the control subjects on physical examination measures; however, the Ponseti group had significantly greater ankle plantar flexion ROM (p < 0.001), greater ankle plantar flexor (p = 0.031) and evertor (p = 0.012) strength, and a decreased incidence of osteoarthritis in the ankle and foot compared with the surgical group. During gait the surgical group had reduced peak ankle plantar flexion (p = 0.002), and reduced sagittal plane hindfoot (p = 0.009) and forefoot (p = 0.008) ROM during the preswing phase compared with the Ponseti group. The surgical group had the lowest overall ankle power generation during push off compared with the control subjects (p = 0.002). Outcome tools revealed elevated pain levels in the surgical group compared with the Ponseti group (p = 0.008) and lower scores for physical function and quality-of-life for both clubfoot groups compared with age-range matched control subjects (p = 0.01).Conclusions
Although individuals in each treatment group experienced pain, weakness, and reduced ROM, they were highly functional into early adulthood. As adults the Ponseti group fared better than the surgically treated group because of advantages including increased ROM observed at the physical examination and during gait, greater strength, and less arthritis. This study supports efforts to correct clubfoot with Ponseti casting and minimizing surgery to the joints, and highlights the need to improve methods that promote ROM and strength which are important for adult function.Level of Evidence
Level III, prognostic study. 相似文献5.
Background
In clinical practice, visual gait observation is often used to determine gait disorders and to evaluate treatment. Several reliability studies on observational gait analysis have been described in the literature and generally showed moderate reliability. However, patients with orthopedic disorders have received little attention. The objective of this study is to determine the reliability levels of visual observation of gait in patients with orthopedic disorders. 相似文献6.
Claudia Giacomozzi Emanuela D'Ambrogi Stefano Cesinaro Velio Macellari Luigi Uccioli 《BMC musculoskeletal disorders》2008,9(1):99
Background
Long-term patients with diabetes and peripheral neuropathy show altered foot biomechanics and abnormal foot loading. This study aimed at assessing muscle performance and ankle mobility in such patients under controlled conditions. 相似文献7.
Hyun-Joon Park Taeyong Sim Seung-Woo Suh Jae Hyuk Yang Hyeran Koo Joung Hwan Mun 《European spine journal》2016,25(2):385-393
Purpose
In this research, we investigated the coordination pattern and consistency of coordination between the thorax and pelvis during gait in patients with idiopathic scoliosis.Methods
Across the study, 69 adolescent girls (controls: 30, patients: 39) participated. All participants were asked to walk 10 m barefoot at a self-selected speed. The walking speed, stride length, and range of motion of the pelvic and thoracic angles were collected using a three-dimensional optical motion analysis system, and the thorax–pelvis coordination was quantified using a vector coding technique. The frequency of four different patterns of coordination (in-phase, anti-phase, pelvis only, and thorax only) and the consistency of coordination including direction and magnitude during the gait cycle of the two groups were investigated. Independent-sample t tests were performed to examine differences between the two groups with regard to coordination patterns and consistency.Results
The patients with idiopathic scoliosis showed significantly higher in-phase and relatively lower anti-phase in the transverse plane compared to controls. Additionally, the pelvis only in the transverse, frontal, and sagittal planes was significantly lower in patients. The consistency of coordination in patients was significantly lower than in controls in direction and magnitude on the transverse and frontal planes.Conclusion
From viewpoint of the thorax–pelvis coordination, patients with IS had less gait stability in the trunk than controls.8.
Jae Hyuk Yang Seung-Woo Suh Paul S. Sung Woo-Hyung Park 《European spine journal》2013,22(11):2407-2413
Purpose
This study investigated side-to-side gait asymmetry in subjects with adolescent idiopathic scoliosis.Methods
There were 20 adolescents with idiopathic scoliosis and 20 age-matched control subjects, who participated in the study. To minimize confounding effects, we recruited patients with similar spinal curvature for the scoliosis group, and all participants are right hand dominant. The participants were instructed to ambulate on a 10 m walkway while barefoot. There were two force plates in the middle of the walkway. The ground reaction force (GRF) and angular displacements of six segments (foot, shank, thigh, pelvis, trunk, and head) were measured during one gait cycle based on the right and left lower extremities. To remove the positional information in the kinematic data, the derivative of angular displacement in each segment was calculated. To evaluate the side-to-side gait symmetry, we calculated the cross-correlation of each bilateral gait parameter.Results
In the kinematics, the scoliosis group demonstrated asymmetrical gait in the frontal and transverse planes compared to the control group. In the GRF data, the scoliosis group demonstrated asymmetrical gait in the medial–lateral (M/L) direction compared to the control group.Conclusions
These results indicated that the scoliosis group produced an asymmetrical rotation pattern of the segments bilaterally in the frontal and transverse planes, resulting in asymmetrical GRF patterns in the M/L direction. This asymmetrical gait may be produced by changes in global postural control during gait and not simply by changes in control of only one or two specific segments. 相似文献9.
Background
Barefoot locomotion has evoked an increasing scientific interest with a controversial debate about benefits and limitations of barefoot and simulated barefoot walking and running. While most current knowledge comes from cross sectional laboratory studies, the evolutionary perspective suggests the importance of investigating the long-term effects. Observing habitually barefoot populations could fill the current gap of missing high quality longitudinal studies. Therefore, the study described in this design paper aims to investigate the effects of being habitually barefoot on foot mechanics and motor performance of children and adolescents.Methods
This study has a cross-sectional, binational design and is part of the “Barefoot Locomotion for Individual Foot- and health Enhancement (Barefoot LIFE)” project. Two large cohorts (n(total)?=?520) of healthy children and adolescents between 6 and 18 years of age will be included respectively in Germany and South Africa. A barefoot questionnaire will be used to determine habitually barefoot individuals. The testing will be school-based and include foot mechanical (static arch height index, dynamic arch index, foot pliability) and motor performance (coordination, speed, leg power) outcomes. Gender, BMI and level of physical activity will be considered for confounding.Discussion
The strength of this study is the comparison of two large cohorts with different footwear habits to determine long-term effects of being habitually barefoot on foot mechanics and motor performance.10.
Yair Barzilay Ganit Segal Raphael Lotan Gilad Regev Yiftah Beer Baron S. Lonner Amit Mor Avi Elbaz 《European spine journal》2016,25(9):2761-2766
Purpose
To assess the changes in gait pattern and clinical symptoms of patients with chronic non-specific low back pain (CNSLBP) following a home-based biomechanical treatment (HBBT).Methods
This was a retrospective analysis of 60 CNSLBP patients. All patients underwent a gait evaluation and completed self-assessment questionnaires at pre-treatment and after 3 and 6 months of a HBBT (AposTherapy). Twenty-four healthy, aged-matched individuals served as a reference group.Results
Significant differences were found in all gait parameters and clinical symptoms between patients with CNSLBP and healthy people before treatment. Significant improvements were found in all gait parameters and clinical measures following 6 months of therapy including an increase in gait velocity (10.6 %), step length (5.6 %), cadence (5 %), and quality of life and a decrease in pain (13.3 %). There were no significant differences between groups in the gait parameters following 6 months of treatment.Conclusions
Significant differences exist between patients with CNSLBP and healthy controls in terms of gait pattern and self-assessed health status. The examined HBBT led to significant improvements in gait pattern, reduction in pain, improved function and increased quality of life. However, future studies should validate these results while comparing this treatment to other treatment modalities.11.
Hans HCM Savelberg Nicolaas C Schaper Paul JB Willems Ton LH de Lange Kenneth Meijer 《BMC musculoskeletal disorders》2009,10(1):16
Background
Patients with diabetic polyneuropathy (DPN) are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. 相似文献12.
Ruth Prieto Jose M. Pascual Raquel Gutiérrez Enrique Santos 《Acta neurochirurgica》2009,151(11):1385-1397
Background
Spinal dural arteriovenous fistula (SDAVF) is a rare and enigmatic disease. Functional outcome is particularly uncertain for the small group of patients that are unable to stand at the time of diagnosis (grade 5 gait disturbance on the Aminoff-Logue scale, ALS). The objective of this study is to examine the final functional outcome of patients with SDAVF in grade 5 gait ALS before treatment. 相似文献13.
14.
Biagio Moretti Angela Notarnicola Giulio Maggio Lorenzo Moretti Michele Pascone Silvio Tafuri Vittorio Patella 《BMC musculoskeletal disorders》2009,10(1):54
Background
Diabetes is becoming one of the most common chronic diseases, and ulcers are its most serious complication. Beginning with neuropathy, the subsequent foot wounds frequently lead to lower extremity amputation, even in the absence of critical limb ischemia. In recent years, some researchers have studied external shock wave therapy (ESWT) as a new approach to soft tissue wound healing. The rationale of this study was to evaluate if ESWT is effective in the management of neuropathic diabetic foot ulcers. 相似文献15.
Eriksson M Gutierrez-Farewik EM Broström E Bartonek A 《Journal of children's orthopaedics》2010,4(1):21-31
Purpose
Lower limb contractures and muscle weakness are common in children with arthrogryposis multiplex congenita (AMC). To enhance or facilitate ambulation, orthoses may be used. The aim of this study was to describe gait pattern among individuals wearing their habitual orthotic devices. 相似文献16.
Ram Haddas Sujal Patel Raj Arakal Akwasi Boah Theodore Belanger Kevin L. Ju 《The spine journal》2018,18(9):1645-1652
Background Context
Cervical spondylotic myelopathy (CSM) typically manifests with a slow, progressive stepwise decline in neurologic function, including hand clumsiness and balance difficulties. Gait disturbances are frequently seen in patients with CSM, with more advanced cases exhibiting a stiff, spastic gait.Purpose
To evaluate the spatiotemporal parameters and spine and lower extremity kinematics during the gait cycle of adult patients with CSM before surgical intervention.Study Design
Prospective cohort study.Patient Sample
Twenty-eight subjects with symptomatic CSM who have been scheduled for surgery and 30 healthy controls (HC).Outcome Measures
Spine and lower extremity kinematics and spatiotemporal parameters.Methods
Clinical gait analysis was performed for patients with CSM and HC. The data were analyzed with a one-way analysis of variance.Results
Patients with CSM have significantly more anterior pelvis tilt (CSM: 13.97°, HC: 5.56°), larger lumbar lordosis (CSM: 8.59°, HC: 2.7°), smaller cervical lordosis (CSM: 6.02°, HC: 11.35°), and less head flexion (CSM: 0.69°, HC: 8.66°) at the beginning of the gait cycle. There was a decrease in knee range of motion in patients with CSM compared with controls (CSM: 36.31°, HC: 50.17°). Furthermore, patients with CSM presented with slower walking speed (CSM: 0.81?m/s, HC: 1.05?m/s), decreased cadence (CSM: 95.57 step/m, HC: 107.64 step/m), increased double support time (CSM: 0.40?s, HC: 0.28?s) and stride time (CSM:1.28?s, HC: 1.13?s), shorter stride length (CSM: 1.04?m, HC: 1.18?m) and step length (CSM:0.51?m, HC: 0.58?m), and wider width (CSM: 0.14?m, HC:0.11?m).Conclusions
Our study shows that patients with CSM enter the gait cycle with a larger anterior pelvic tilt and lumbar lordosis as well as less cervical lordosis and head flexion. As a consequence of these abnormal spinal parameters at the onset of the gait cycle, lower extremity biomechanics are also altered. Our study is the first to demonstrate the relationship between aberrant spinal alignment and lower extremity function. Identification of this interrelationship as well as the specific gait and biomechanical disturbances seen in myelopathic patients can both inform our understanding of the disease and tailor rehabilitation protocols. 相似文献17.
Gonzalo Bonilla Gilda Di Masi Danilo Battaglia José María Otero Mariano Socolovsky 《Acta neurochirurgica》2011,153(1):171-176
Background
Peripheral nerve lesions usually are associated with neuropathic pain. In the present paper, we describe a simple scale to quantify pain after brachial plexus injuries and apply this scale to a series of patients to determine initial outcomes after reconstructive surgery. 相似文献18.
《Foot and Ankle Surgery》2014,20(3):195-200
BackgroundTotal ankle arthroplasty is being used more frequently as an alternative for arthrodesis in final stages of ankle osteoarthritis. However, there are few studies which describe the biomechanics of gait of these patients.MethodsBetween March 2006 and May 2011, 17 patients (n = 18 ankles) suffering end-stage osteoarthritis of the ankle who underwent an ankle replacement (HINTEGRA) were evaluated retrospectively. We evaluated clinical, radiological and biomechanical gait parameters using the NedAMH/IBV dynamometric platform.ResultsAt last follow-up (average: 37 months), the AOFAS score improved from 31 to 83 with a high rate of satisfaction (83.3%). Kinetic gait parameters were more similar to a healthy ankle. We detected a radiolucent line in 8 patients (44%) without any subsidence case.ConclusionsOur study showed a high rate of satisfaction and biomechanics of the gait similar to a healthy ankle. The complication rate was analogous to those previously published in the literature. 相似文献
19.
Alessandra Rezende Martinelli Alessandra Madia Mantovani Andrea Jeanne Lourenço Nozabieli Dalva Minonroze Albuquerque Ferreira José Angelo Barela Marcela Regina de Camargo Cristina Elena Prado Teles Fregonesi 《The Foot》2013,23(1):17-21
AimsTo evaluate the spatio-temporal variables of gait and the isometric muscle strength component of the ankle in patients with peripheral diabetic neuropathy. Also, verify the relationship between these variables and gait parameters.MethodsThis study involved 25 diabetic peripheral neuropathy (DPN) participants (62.4 ± 8.36 years) and 27 age-matched healthy control individuals (64.48 ± 6.21 years). The assessment of the spatio-temporal parameters of gait was performed using an electronic baropodometry treadmill. Prior to the collection data, each participant was instructed to walk on the treadmill in her/his habitual self-selected speed.ResultsDiabetic neuropathy group showed impairment of gait, with a smaller stride and length speed of the cycle, and increased duration of support time. Restricted dorsiflexion mobility and increased plantarflexion mobility were found, with a decrease in muscle strength of the dorsiflexors and plantiflexors. There was a significant relationship between plantiflexor muscle strength and the length and speed of the gait cycle. Also the muscle strengths of the plantiflexors and dorsiflexors, and the range of motion of dorsiflexion were predictors of gait performance.ConclusionsThe ankle, muscle strength and ankle mobility variables could explain changes in gait speed and range of motion in patients with DPN, allowing for the application of preventive strategies. 相似文献
20.
Remi Goulart Jr. Gustavo Ricardo Schütz Daniele Detanico Roberta Pires Vasconcellos Saray Giovana dos Santos 《European journal of plastic surgery》2013,36(4):225-230