Journal articles on the topic 'Hip-knee-ankle angle'
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1
Di Giminiani, Riccardo, Davide Di Lorenzo, Stefano La Greca, Luca Russo, Francesco Masedu, Rocco Totaro, and Elvira Padua. "Angle-Angle Diagrams in the Assessment of Locomotion in Persons with Multiple Sclerosis: A Preliminary Study." Applied Sciences 12, no. 14 (July 18, 2022): 7223. http://dx.doi.org/10.3390/app12147223.
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Gait analysis is clinically relevant in persons with multiple sclerosis (PwMS) and consists of several joint angular displacement–time relationships and spatiotemporal parameters. However, it lacks representation by means of diagrams in which knee-angle/hip-angle and knee-angle/ankle-angle variations are plotted against each other at the same points of time. Three-dimensional kinematic analysis was performed on 20 subjects (10 PwMS/10 healthy controls, HCs), and the knee-angle/hip-angle and knee-angle/ankle-angle diagrams of both lower limbs were determined in the sagittal plane while walking on a motorized treadmill. The area (a quantifier of range of motion) and the perimeter (a quantifier of coordination) of angle-angle diagram loops were calculated. PwMS showed reduced knee-angle/ankle-angle loops compared to HCs (p < 0.05), whereas the hip-angle/ankle-angle loops between the PwMS and HCs was not significant (p > 0.05). Similarly, the activation of leg muscles showed significant differences between PwMS and HCs (p ranged from 0.05 to 0.001). The results indicate that the proposed knee-angle/hip-angle diagram is feasible and could be applied as a reliable tool in future studies aimed at assessing the acute and long-term effects of specific exercise programmes and/or pharmacological treatment in PwMS.
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Usami, Takuya, Kazuki Nishida, Hirotaka Iguchi, Taro Okumura, Hiroaki Sakai, Ruido Ida, Mitsuya Horiba, et al. "Evaluation of lower extremity gait analysis using Kinect V2® tracking system." SICOT-J 8 (2022): 27. http://dx.doi.org/10.1051/sicotj/2022027.
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Introduction: Microsoft Kinect V2® (Kinect) is a peripheral device of Xbox® and acquires information such as depth, posture, and skeleton definition. In this study, we investigated whether Kinect can be used for human gait analysis. Methods: Ten healthy volunteers walked 20 trials, and each walk was recorded by a Kinect and infrared- and marker-based-motion capture system. Pearson’s correlation and overall agreement with a method of meta-analysis of Pearson’s correlation coefficient were used to assess the reliability of each parameter, including gait velocity, gait cycle time, step length, hip and knee joint angle, ground contact time of foot, and max ankle velocity. Hip and knee angles in one gait cycle were calculated in Kinect and motion capture groups. Results: The coefficients of correlation for gait velocity (r = 0.92), step length (r = 0.81) were regarded as strong reliability. Gait cycle time (r = 0.65), minimum flexion angle of hip joint (r = 0.68) were regarded as moderate reliability. The maximum flexion angle of the hip joint (r = 0.43) and maximum flexion angle of the knee joint (r = 0.54) were regarded as fair reliability. Minimum flexion angle of knee joint (r = 0.23), ground contact time of foot (r = 0.23), and maximum ankle velocity (r = 0.22) were regarded as poor reliability. The method of meta-analysis revealed that participants with small hip and knee flexion angles tended to have poor correlations in maximum flexion angle of hip and knee joints. Similar trajectories of hip and knee angles were observed in Kinect and motion capture groups. Conclusions: Our results strongly suggest that Kinect could be a reliable device for evaluating gait parameters, including gait velocity, gait cycle time, step length, minimum flexion angle of the hip joint, and maximum flexion angle of the knee joint.
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Harrison, Kathryn, Adam Sima, Ronald Zernicke, Benjamin J. Darter, Mary Shall, D. S. Blaise Williams, and Sheryl Finucane. "Comparison of Frontal and Transverse Plane Kinematics Related to Knee Injury in Novice Versus Experienced Female Runners." Journal of Applied Biomechanics 37, no. 3 (June 1, 2021): 254–62. http://dx.doi.org/10.1123/jab.2020-0140.
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Novice runners experience a higher incidence of knee injury than experienced runners, which may be related to aberrant frontal and transverse plane kinematics. However, differences in kinematics between novice and experienced runners have not been fully explored. For this study, 10 novice and 10 experienced female runners ran on a treadmill at 2.68 m/s. Ankle, knee, and hip joint angles during the stance phase were measured using a 3-dimensional motion capture system and modeled using cubic splines. Spline models were compared between groups using a generalized linear model (α = .05). Ninety-five percent confidence intervals of the difference between joint angles throughout stance were constructed to identify specific periods of stance where groups differed in joint position. Angle–angle diagrams of ankle and hip position in the frontal and transverse planes were constructed to depict joint coordination. Novice runners displayed less hip adduction, but greater knee abduction and knee internal rotation compared to experienced runners. Differences in knee joint position may be explained by coordination of hip and ankle motion. Greater knee abduction and knee internal rotation displayed by novice runners compared with experienced runners may help to explain their higher risk for injury.
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Kolodziej, Mathias, Steffen Willwacher, Kevin Nolte, Marcus Schmidt, and Thomas Jaitner. "Biomechanical Risk Factors of Injury-Related Single-Leg Movements in Male Elite Youth Soccer Players." Biomechanics 2, no. 2 (May 26, 2022): 281–300. http://dx.doi.org/10.3390/biomechanics2020022.
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Altered movement patterns during single-leg movements in soccer increase the risk of lower-extremity non-contact injuries. The identification of biomechanical parameters associated with lower-extremity injuries can enrich knowledge of injury risks and facilitate injury prevention. Fifty-six elite youth soccer players performed a single-leg drop landing task and an unanticipated side-step cutting task. Three-dimensional ankle, knee and hip kinematic and kinetic data were obtained, and non-contact lower-extremity injuries were documented throughout the season. Risk profiling was assessed using a multivariate approach utilising a decision tree model (classification and regression tree method). The decision tree model indicated peak knee frontal plane angle, peak vertical ground reaction force, ankle frontal plane moment and knee transverse plane angle at initial contact (in this hierarchical order) for the single-leg landing task as important biomechanical parameters to discriminate between injured and non-injured players. Hip sagittal plane angle at initial contact, peak ankle transverse plane angle and hip sagittal plane moment (in this hierarchical order) were indicated as risk factors for the unanticipated cutting task. Ankle, knee and hip kinematics, as well as ankle and hip kinetics, during single-leg high-risk movements can provide a good indication of injury risk in elite youth soccer players.
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Umberger, Brian R., and Philip E. Martin. "Testing the Planar Assumption during Ergometer Cycling." Journal of Applied Biomechanics 17, no. 1 (February 2001): 55–62. http://dx.doi.org/10.1123/jab.17.1.55.
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Lower extremity motions during cycling are often assumed to occur in the sagittal plane. While seemingly logical, this assumption has not been rigorously tested. Frontal plane rotation of the ankle joint (inversion/eversion) has been studied extensively during gait but infrequently during cycling despite the suggestion that excessive eversion or pronation may be related to overuse knee injuries. Two-dimensional sagittal plane hip, knee, and ankle joint kinematics were generally found to be similar to simultaneously measured 3-D values. Despite the similarity in motion patterns, maximum hip angle was 34° more flexed in 2-D than 3-D. Maximum and minimum frontal plane ankle joint angles were similar in 2-D and 3-D. However, during the middle of the pedal cycle, 2-D frontal plane ankle joint motion deviated from 3-D, such that maximum ankle eversion was reached 36% of the pedal cycle later in 2-D versus 3-D. The discrepancy at the hip was due primarily to differences in hip angle definition for 2-D and 3-D approaches, and an alternate convention for hip angle in 2-D is suggested. Discrepancies in frontal plane ankle joint motion are due to weaknesses in the planar approach and would be difficult to overcome without resorting to 3-D measurement.
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Yu, Peimin, Zhen Gong, Yao Meng, Julien S. Baker, Bíró István, and Yaodong Gu. "The Acute Influence of Running-Induced Fatigue on the Performance and Biomechanics of a Countermovement Jump." Applied Sciences 10, no. 12 (June 23, 2020): 4319. http://dx.doi.org/10.3390/app10124319.
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Lower limb kinematics and kinetics during the landing phase of jumping might change because of localized muscle fatigue. This study aimed to investigate the acute influence of running-induced fatigue on the performance and lower limb kinematics and kinetics of a countermovement jump. A running-induced fatigue protocol was applied to fifteen male subjects. Participants were asked to perform three successful countermovement jumps before and after fatigue. Kinematic and kinetic data were collected to compare any fatigue influences. Wilcoxon signed-rank tests and paired-sample t-tests were used to analyze the data. Running-induced fatigue did not significantly change vertical jump height and peak vertical ground reaction forces (GRF) during the push-off and landing phases. Lower limb biomechanics significantly changed, especially kinematic parameters. During the push-off phase, fatigue resulted in an increased ankle peak inversion angle, knee minimal flexion angle, knee peak abduction angle, and hip peak flexion moment. In addition, the range of motion (ROM) of the ankle and knee joints in the frontal plane was also increased. Certain parameters decreased as a result of fatigue, such as the ankle peak internal rotation angle, hip peak abduction angle, the ROM of the ankle joint in the sagittal plane, and ROM of the hip joint in the frontal plane. During the landing phase, the peak inversion angle and peak external rotation angle of the ankle joint, peak abduction angle of the knee and hip joint, ROM of the ankle joint in the horizontal plane, ROM of the ankle and knee joint in the frontal plane were all increased as a result of fatigue. The knee peak flexion moment and hip peak extension moment, however, were decreased. Under fatigue conditions, lower limb kinetics and kinematics were changed during both the push-off and landing phases. More attention should be focused on the landing phase and the last period of the push-off phase due to potentially higher risks of injury. The findings of the current study may be beneficial to athletes and coaches in preventing jumping related injuries.
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Kondo, Hitoshi. "Changes in the Ground Reaction Force, Lower-Limb Muscle Activity, and Joint Angles in Athletes with Unilateral Ankle Dorsiflexion Restriction During A Rebound-Jump Task." Journal of Functional Morphology and Kinesiology 3, no. 4 (October 26, 2018): 52. http://dx.doi.org/10.3390/jfmk3040052.
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Background: This study compared differences between a control group and a group with unilateral ankle dorsiflexion restriction in the ground reaction force (GRF), angles of the lower limbs joints, and muscular activity during a rebound-jump task in athletes who continue to perform sports activities with unilateral ankle dorsiflexion restriction. Methods: The athletes were divided into the following two groups: The dorsiflexion group included those with a difference of ≥7° between bilateral ankle dorsiflexion angles (DF), and the control group included those with a difference of <7° between the two ankles (C). An ankle foot orthosis was attached to subjects in group C to apply a restriction on the right-angle dorsiflexion angle. The percentage of maximum voluntary contraction (%MVC) of the legs musculature, components of the GRF, and the hip and knee joint angles during the rebound-jump task were compared between groups DF and C. Results: Group DF showed increased %MVC of the quadriceps muscle, decreased upward component of the GRF, decreased hip flexion, and increased knee eversion angles. Conclusions: This study highlighted that athletes with ankle dorsiflexion restriction had significantly larger knee eversion angles in the rebound-jump task. The reduced hip flexion was likely caused by the restricted ankle dorsiflexion and compensated by the observed increase in quadriceps muscle activation when performing the jump.
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Molina-Rueda, Francisco, Pilar Fernández-González, Alicia Cuesta-Gómez, Aikaterini Koutsou, María Carratalá-Tejada, and Juan Carlos Miangolarra-Page. "Test–Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects." International Journal of Environmental Research and Public Health 18, no. 3 (February 2, 2021): 1343. http://dx.doi.org/10.3390/ijerph18031343.
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The aim of this study was to evaluate the test–retest reliability of a conventional gait model (CGM), the Plug-in Gait model, to calculate the angles of the hip, knee, and ankle during initial contact (IC) and toe-off (TO). Gait analysis was performed using the Vicon Motion System® (Oxford Metrics, Oxford, UK). The study group consisted of 50 healthy subjects. To evaluate the test–retest reliability, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland–Altman analysis with 95% limits of agreement were calculated. The ICC for the joint angles of the hip, knee, and ankle was higher than 0.80. However, the ankle angle at IC had an ICC lower than 0.80. The SEM was <5° for all parameters. The MDC was large (>5°) for the hip angle at IC. The Bland–Altman analysis indicated that the magnitude of divergence was between ±5° and ±9° at IC and around ±7° at TO. In conclusion, the ICC for the plug-in gait model was good for the hip, knee, and ankle angles during IC and TO. The plots revealed a disagreement between measurements that should be considered in patients’ clinical assessments.
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Biscarini, Andrea, Samuele Contemori, Cristina V. Dieni, and Roberto Panichi. "Joint Torques and Tibiofemoral Joint Reaction Force in the Bodyweight “Wall Squat” Therapeutic Exercise." Applied Sciences 10, no. 9 (April 26, 2020): 3019. http://dx.doi.org/10.3390/app10093019.
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This study provides a biomechanical analysis of the bodyweight wall-squat exercise considering four exercise variants: knee angle; horizontal hip-ankle distance (d); shift between the rearfoot and forefoot of the centre of pressure (xGR) of the ground reaction force; back supported via the scapular or pelvic zone. The ankle and hip angles corresponding to a given knee angle can be modulated, changing the distance d, to manage limitation in lumbopelvic and ankle mobility. The knee-extensor muscles can be overloaded (250 Nm muscle torque) with knees flexed at 90°, back supported through the pelvic zone, and feet away from the wall (d = 50 cm). Scapular support, xGR at forefoot, and d = 50 cm, yield a higher level of muscle-torque for hip-extension (130 Nm) and knee-flexion (65 Nm), with knees at 90° of flexion or near full extension, respectively. Ankle-dorsiflexion (plantarflexion) muscle torque up to 40 Nm is reached with xGR at the forefoot (rearfoot). This study may aid trainers and therapists to finely modulate the muscle torques (up to the above-mentioned levels) by an appropriate selection of exercise variants for training or rehabilitation purposes. Low levels (60 N) of anterior tibial pull may occur near 25° of knee flexion with x GR at the rearfoot.
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Ewing, Katie A., Rezaul K. Begg, Mary P. Galea, and Peter V. S. Lee. "Effects of Prophylactic Knee Bracing on Lower Limb Kinematics, Kinetics, and Energetics During Double-Leg Drop Landing at 2 Heights." American Journal of Sports Medicine 44, no. 7 (April 13, 2016): 1753–61. http://dx.doi.org/10.1177/0363546516637178.
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Background: Anterior cruciate ligament (ACL) injuries commonly occur during landing maneuvers. Prophylactic knee braces were introduced to reduce the risk of ACL injuries, but their effectiveness is debated. Hypotheses: We hypothesized that bracing would improve biomechanical factors previously related to the risk of ACL injuries, such as increased hip and knee flexion angles at initial contact and at peak vertical ground-reaction force (GRF), increased ankle plantar flexion angles at initial contact, decreased peak GRFs, and decreased peak knee extension moment. We also hypothesized that bracing would increase the negative power and work of the hip joint and would decrease the negative power and work of the knee and ankle joints. Study Design: Controlled laboratory study. Methods: Three-dimensional motion and force plate data were collected from 8 female and 7 male recreational athletes performing double-leg drop landings from 0.30 m and 0.60 m with and without a prophylactic knee brace. GRFs, joint angles, moments, power, and work were calculated for each athlete with and without a knee brace. Results: Prophylactic knee bracing increased the hip flexion angle at peak GRF by 5.56° ( P < .001), knee flexion angle at peak GRF by 4.75° ( P = .001), and peak hip extension moment by 0.44 N·m/kg ( P < .001). Bracing also increased the peak hip negative power by 4.89 W/kg ( P = .002) and hip negative work by 0.14 J/kg ( P = .001) but did not result in significant differences in the energetics of the knee and ankle. No differences in peak GRFs and peak knee extension moment were observed with bracing. Conclusion: The application of a prophylactic knee brace resulted in improvements in important biomechanical factors associated with the risk of ACL injuries. Clinical Relevance: Prophylactic knee braces may help reduce the risk of noncontact knee injuries in recreational and professional athletes while playing sports. Further studies should investigate different types of prophylactic knee braces in conjunction with existing training interventions so that the sports medicine community can better assess the effectiveness of prophylactic knee bracing.
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Jiang, Xinyan, Xiaoyi Yang, Huiyu Zhou, Julien S. Baker, and Yaodong Gu. "Prolonged Running Using Bionic Footwear Influences Lower Limb Biomechanics." Healthcare 9, no. 2 (February 23, 2021): 236. http://dx.doi.org/10.3390/healthcare9020236.
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The running biomechanics of unstable shoes have been well investigated, however, little is known about how traditional neutral shoes in combination with unstable design elements and scientifically (bionic) designed shoes influence prolonged running biomechanics. The purpose of this study was to investigate biomechanical changes for a typical 5 km run and how footwear technology may affect outcomes. Sixteen healthy male recreational heel strike runners participated in this study, and completed two prolonged running sessions (neutral shoe session and bionic shoe session), with 7 to 10 days interval between sessions. A two-way repeated-measures analysis of variance (ANOVA, shoe × time) was conducted to determine any differences in joint biomechanics. Main effects for shoe type were observed at the ankle, knee and hip joints during the stance phase. In particular, decreased range of motion (ROM) was observed using the bionic shoes for all three joints, and the joint moments also had significant changes except for the frontal plane of the hip. Main effects for time were also observed at the ankle, knee and hip joints. The ROM of the sagittal plane in the knee and hip decreased post-5 km running. The reduction of ankle dorsiflexion, hip flexion, hip adduction and hip internal rotation angles were observed post-5 km running, as well as the increase of ankle eversion and external rotation, knee adduction and internal rotation angles. The kinetics also exhibited significant differences between pre-5 km running and post-5 km running. The interaction effects only existed in the ROM of the hip sagittal plane, hip adduction angle and hip internal rotation angle. The results suggested that bionic shoes could be beneficial for strengthening muscle control, enhancing postural stability and proprioceptive ability. Footwear personalization could be a solution that benefits runners, reduces injury risk and improves running performance.
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Felix Rodacki, André Luiz, Neil Edward Fowler, and Simon Bennett. "The Effect of Postural Variations in Movement Co-Ordination during Plyometric Rebound Exercises." Journal of Applied Biomechanics 17, no. 1 (February 2001): 14–27. http://dx.doi.org/10.1123/jab.17.1.14.
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The aim of this study was to compare the kinematic pattern and the segmental movement co-ordination when the trunk segment was constrained in different positions during plyometric rebound jumps. Nine skilled volleyball players, experienced in plyometric training, were asked to perform a random series of maximal rebound jumps, using three different seat arrangements (90°, 135°, and 180°) in a pendulum swing device. From two-dimensional filming, performed in a right sagittal plane at 200 Hz, it was possible to calculate ankle, knee, and hip displacements; velocities; and muscle-tendon lengths. The subjects showed similar ankle and knee angles between experimental conditions. The hip joint angle differed significantly between conditions. Only the muscle-tendon lengths of the biarticular muscles spanning the knee/hip were affected by the seat arrangement variations. Significantly greater knee angular velocities were observed in the upright sitting posture (90°). The hip was consistently the first joint to extend. The ankle and knee joint reversals were not invariant, regardless of the seat arrangement. The movement co-ordination strategy did not differ across postural variations.
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Chun, Dong-Il, Jahyung Kim, Sung Hun Won, Jaeho Cho, Jeongku Ha, Minkyu Kil, and Young Yi. "Changes in Coronal Alignment of the Knee Joint after Supramalleolar Osteotomy." BioMed Research International 2021 (February 19, 2021): 1–8. http://dx.doi.org/10.1155/2021/6664279.
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Background. Assessing knee joint orientation changes after SMO may help clinical advancement in managing patients with ipsilateral ankle and knee joint arthritis. However, knee joint changes after supramalleolar osteotomy (SMO) have not been reported. We investigated changes in coronal alignment of the knee joint after SMO. Methods. In this multicentre study, from January 2014 to December 2018, 47 ankles with varus osteoarthritis treated with SMO were retrospectively identified. Ankle joint changes were assessed using the tibiotalar angle, talar tilt angle, and lateral distal tibial angle (LDTA); knee joint changes using the medial proximal tibial angle (MPTA), medial and lateral joint space widths (mJSW and lJSW, respectively), and medial and lateral joint line convergence angles (JLCA); and lower limb alignment changes using mechanical axis deviation angle (MADA) and the hip-knee-ankle (HKA) angle measured on full-length anteroposterior radiographs of the lower extremity. Correlation analysis and binary logistic regression analysis were performed. Results. Postoperatively, LDTA ( p < 0.001 ) and tibiotalar angle ( p < 0.001 ) significantly changed, indicating meaningful improvement in the ankle joint varus deformity. Regarding the knee joint changes, JLCA significantly changed into valgus direction ( p = 0.044 ). As for lower limb alignment changes, MADA significantly decreased ( p < 0.001 ), whereas the HKA angle significantly increased ( p < 0.001 ). In univariate and multivariate logistic regression analyses, changes in the MADA ( p < 0.001 ) and the HKA angle ( p < 0.001 ) were significantly correlated with the correction angle. Conclusions. SMO remarkably improves ankle joint varus deformity, followed by significant lower limb alignment changes. Despite meaningful changes in JLCA, the relationship between the amount of osteotomy near the ankle joint and improvement in knee joint radiographic parameters was not significant. Radiographic parameters of the knee joint would less likely be changed following SMO.
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Xu, Xinghui, Jin Yang, Jun Li, Deping Yao, Pan Deng, Boliang Chen, and Yifei Liu. "Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis." Open Medicine 17, no. 1 (January 1, 2022): 1330–37. http://dx.doi.org/10.1515/med-2022-0523.
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Abstract The purpose of this study was to investigate the correlation between fibular head height and the incidence and severity of osteoarthritis associated with varus knee deformity. The fibular head height, joint line convergence angle (JLCA) and medial proximal tibial angle (MPTA) were measured in a three-dimensional model. Ordinal multivariate logistic regression was used to analyze the correlation between fibular head height and Kellgren–Lawrence (K–L) grade. Pearson correlation was used to analyze the correlation between fibular head height and K–L grade. A total of 232 patients (232 knees) were finally included in the study. There were significant differences in JLCA and hip–knee–ankle angle (P < 0.05), and both JLCA and hip–knee–ankle angle increased with severe aggravation of K–L grade. Both fibular head height and MPTA decreased as the K–L grade was severely aggravated. There was a significant negative correlation between K–L grade and fibular head height (r = −0.812, P < 0.001). Furthermore, there was a significant negative correlation between fibular head height and hip–knee–ankle angle (r = −0.7905, P < 0.001). In addition to body mass index, fibular head height is a risk factor for the pathogenesis of osteoarthritis associated with varus knee deformity; the smaller the fibular head height, the more severe the degree of varus deformity.
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Ali, Nicholas, Gholamreza Rouhi, and Gordon Robertson. "Gender, Vertical Height and Horizontal Distance Effects on Single-Leg Landing Kinematics: Implications for Risk of non-contact ACL Injury." Journal of Human Kinetics 37, no. 1 (June 1, 2013): 27–38. http://dx.doi.org/10.2478/hukin-2013-0022.
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There is a lack of studies investigating gender differences in whole-body kinematics during single-leg landings from increasing vertical heights and horizontal distances. This study determined the main effects and interactions of gender, vertical height, and horizontal distance on whole-body joint kinematics during single-leg landings, and established whether these findings could explain the gender disparity in non-contact anterior cruciate ligament (ACL) injury rate. Recreationally active males (n=6) and females (n=6) performed single-leg landings from a takeoff deck of vertical height of 20, 40, and 60 cm placed at a horizontal distance of 30, 50 and 70 cm from the edge of a force platform, while 3D kinematics and kinetics were simultaneously measured. It was determined that peak vertical ground reaction force (VGRF) and the ankle flexion angle exhibited significant gender differences (p=0.028, partial η2=0.40 and p=0.035, partial η2=0.37, respectively). Peak VGRF was significantly correlated to the ankle flexion angle (r= -0.59, p=0.04), hip flexion angle (r= -0.74, p=0.006), and trunk flexion angle (r= -0.59, p=0.045). Peak posterior ground reaction force (PGRF) was significantly correlated to the ankle flexion angle (r= -0.56, p=0.035), while peak knee abduction moment was significantly correlated to the knee flexion angle (r= -0.64, p=0.03). Rearfoot landings may explain the higher ACL injury rate among females. Higher plantar-flexed ankle, hip, and trunk flexion angles were associated with lower peak ground reaction forces, while higher knee flexion angle was associated with lower peak knee abduction moment, and these kinematics implicate reduced risk of non-contact ACL injury.
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Masad, Ihssan S., Sami Almashaqbeh, Othman Smadi, Mariam Abu Olaim, and Abeer Obeid. "Spinal Curvature and Lower Extremities Kinematics of Simulated Pregnancy during Stair Ascending and Descending." Journal of Biomimetics, Biomaterials and Biomedical Engineering 41 (April 2019): 11–22. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.41.11.
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The purpose of this work is to investigate the effect of anteriorly-added mass to simulate pregnancy on lower extremities kinematic and lumbar and thoracic angles during stair ascending and descending. 18 healthy females ascended and descended, with and without a pseudo-pregnancy sac of 12 kg (experimental and control groups, respectively), a costume-made wooden staircase while instrumented with 20 reflective markers placed on the lower extremities and the spine. The movements were captured by 12 infrared cameras surrounding the staircase. Tracked position data were exported to MATLAB to calculate the required joints angles. SPSS was used to compare the ascent and descent phases of control group, and to find if there are any significant differences between control and experimental groups in the ascent phase as well as in the descent phase. When comparing the ascent and descent phases of control group, data revealed a higher hip flexion during ascending and greater ankle planter-flexion and dorsiflexion, lumbar, and thoracic angles during descending; however, no significant difference was shown in the knee flexion angle between ascending and descending. Non-pregnant data showed greater maximum hip flexion and ankle dorsiflexion during stair ascending compared to simulated-pregnant group; while ankle planter-flexion, knee flexion, and lumbar angle were greater for simulated-pregnant status. During stair descending, non-pregnant group had greater minimum hip flexion and ankle dorsiflexion compared to simulated pregnant group; while ankle planter-flexion, knee flexion, and maximum hip flexion were greater for simulated-pregnant group. However, the lumbar and thoracic angles were found to be similar for simulated-pregnant and non-pregnant groups during stair descending. In conclusion, the current study revealed important kinematic modifications pregnant women adopt while ascending and descending stairs at their final stage of pregnancy to increase their stability.
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Yang, Jianyu, Guanchao Li, Xiaofei Zhao, and Hualong Xie. "Research on Joint-Angle Prediction Based on Artificial Neural Network for Above-Knee Amputees." Sensors 21, no. 21 (October 29, 2021): 7199. http://dx.doi.org/10.3390/s21217199.
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In the current study, our research group proposed an asymmetric lower extremity exoskeleton to enable above-knee amputees to walk with a load. Due to the absence of shank and foot, the knee and ankle joint at the amputation side of the exoskeleton lack tracking targets, so it is difficult to realize the function of assisted walking when going up and downstairs. Currently, the use of lower-limb electromyography to predict the angles of lower limb joints has achieved remarkable results. However, the prediction effect was poor when only using electromyography from the thigh. Therefore, this paper introduces hip-angle and plantar pressure signals for improving prediction effect and puts forward a joint prediction method of knee- and ankle-joint angles by electromyography of the thigh, hip-joint angle, and plantar pressure signals. The generalized regression neural network optimized by the golden section method is used to predict the joint angles. Finally, the parameters (the maximum error, the Root-Mean-Square error (RMSE), and correlation coefficient (γ)) were calculated to verify the feasibility of the prediction method.
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Hodgson, Brad, Laurie Tis, Steven Cobb, and Elizabeth Higbie. "The Effect of External Ankle Support on Vertical Ground-Reaction Force and Lower Body Kinematics." Journal of Sport Rehabilitation 14, no. 4 (November 2005): 301–12. http://dx.doi.org/10.1123/jsr.14.4.301.
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Objective:To examine the effects of external ankle support on vertical ground-reaction forces (VGRF) and kinematic data.Methods:Subjects completed 2 braced and 2 nonbraced 0.61-m hanging drop landings onto a force platform. Kinematic data were collected with 8 digital-optical cameras sampling at 120 Hz.Subjects:12 Division I female volleyball players.Statistical Analysis:A repeated-measures ANOVA with Bonferroni correction (P < .05) was used to determine whether significant differences existed between test conditions for peak VGRF, loading rate, hip angle, knee angle, and ankle angle at right-foot contact for peak 1 and peak 2 of the VGRF curve over the first 100 milliseconds of the landing phase, as well as total hip range of motion (ROM), total knee ROM, and total ankle ROM for the entire landing phase.Results:There were significant increases in peak P1 and LR1 and a significant decrease in ankle-angle change at right-foot contact in braced trials compared with the nonbraced condition.
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Duncan, Rebekha, Catherine Wild, Leo Ng, Danica Hendry, Sarah Carter, Luke Hopper, and Amity Campbell. "Dancers’ Joint Strategies for Achieving Turnout in Low and High Friction Conditions." Medical Problems of Performing Artists 35, no. 2 (June 1, 2020): 96–102. http://dx.doi.org/10.21091/mppa.2020.2015.
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BACKGROUND: Dancing with legs externally rotated (turnout) is a fundamental element of ballet technique. A reliance on floor friction to achieve turnout may contribute toward the high injury rate in dancers. Joint strategies used by dancers in high and low friction turnout conditions are not well understood. OBJECTIVES: To quantify the lower limb and lumbar spine joint strategies used by female pre-professional dancers to achieve turnout in low-friction (rotation discs) and high-friction (functional and forced) conditions. METHODS: Twenty-three pre-professional female dancers participated in the study. A 12-camera motion analysis system collected hip and knee external rotation (ER), ankle abduction, and lumbar extension angles in three turnout conditions and passive hip ER range of motion angles. Repeated measures ANOVA analysed the differences between joint angles, maximum turnout angle (foot relative to pelvis), and available hip ER. RESULTS: Dancers demonstrated lower knee ER (18.5±4.8°) and ankle abduction (6.0±7.7°) angles during low-friction turnout compared to higher friction conditions (p<0.05). Dancers utilised between 70–83% of available hip ER within all conditions. Low-friction turnout demonstrated greater hip ER contribution within maximum turnout (43%) compared to higher friction conditions. Dancers demonstrated greater lumbar extension angles in low-friction turnout compared to higher friction conditions (p<0.05). CONCLUSIONS: Further hip ER strength training is required to promote greater hip ER range within the position. Rotation discs may be a valuable training tool as dancers demonstrated greater hip ER utilisation with less knee ER and ankle abduction; however, this position did promote undesirable lumbar extension.
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Xu, Zhi, Duo Wai-Chi Wong, Fei Yan, Tony Lin-Wei Chen, Ming Zhang, Wen-Tao Jiang, and Yu-Bo Fan. "Lower Limb Inter-Joint Coordination of Unilateral Transfemoral Amputees: Implications for Adaptation Control." Applied Sciences 10, no. 12 (June 12, 2020): 4072. http://dx.doi.org/10.3390/app10124072.
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The gait of transfemoral amputees can be made smoother by adjusting the inter-joint coordination of both lower limbs. In this study, we compared the inter-joint coordination of the amputated and non-amputated limbs of unilateral amputees to able-bodied controls. Eight amputees and eight able-bodied control participants were recruited. Walking speed, stance–swing time ratio, joint angle, joint angular velocity, and inter-joint coordination parameters—including continuous relative phase (CRP) and decomposition index (DI)—of the lower-limb joint pairs in stance and swing phases were investigated. Similarity of the CRP between groups was evaluated using cross-correlation measures and root-mean-square, and the variability of the CRP was examined by deviation phase (DP). There were significant differences between the amputated limbs and controls in CRP of hip–knee and knee–ankle in stance and swing, DP of knee–ankle and hip–ankle in stance, and DI of hip–knee in swing. For the non-amputated limbs, there were significant differences in CRP and DP of knee–ankle, and DI of hip–knee in swing compared to controls. The amputees utilized unique inter-joint coordination patterns for both limbs—particularly the hip joint—to compensate for the support-capability impairment due to limb salvage and ensure foot placement accuracy.
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Schütz, Pascal, Renate List, Roland Zemp, Florian Schellenberg, William R. Taylor, and Silvio Lorenzetti. "Joint Angles of the Ankle, Knee, and Hip and Loading Conditions During Split Squats." Journal of Applied Biomechanics 30, no. 3 (June 2014): 373–80. http://dx.doi.org/10.1123/jab.2013-0175.
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The aim of this study was to quantify how step length and the front tibia angle influence joint angles and loading conditions during the split squat exercise. Eleven subjects performed split squats with an additional load of 25% body weight applied using a barbell. Each subject’s movements were recorded using a motion capture system, and the ground reaction force was measured under each foot. The joint angles and loading conditions were calculated using a cluster-based kinematic approach and inverse dynamics modeling respectively. Increases in the tibia angle resulted in a smaller range of motion (ROM) of the front knee and a larger ROM of the rear knee and hip. The external flexion moment in the front knee/hip and the external extension moment in the rear hip decreased as the tibia angle increased. The flexion moment in the rear knee increased as the tibia angle increased. The load distribution between the legs changed < 25% when split squat execution was varied. Our results describing the changes in joint angles and the resulting differences in the moments of the knee and hip will allow coaches and therapists to adapt the split squat exercise to the individual motion and load demands of athletes.
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McVea, D. A., J. M. Donelan, A. Tachibana, and K. G. Pearson. "A Role for Hip Position in Initiating the Swing-to-Stance Transition in Walking Cats." Journal of Neurophysiology 94, no. 5 (November 2005): 3497–508. http://dx.doi.org/10.1152/jn.00511.2005.
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In this investigation, we obtained data that support the hypothesis that afferent signals associated with hip flexion play a role in initiating the swing-to-stance transition of the hind legs in walking cats. Direct evidence came from observations in walking decerebrate cats. Assisting the flexion of the hip joint during swing advanced the onset of activity in ankle extensor muscles, and this advance was strongly correlated with a reduction in the duration of hip flexor muscle activity. The hip angle at the time of onset of the flexion to extension transition was similar during assisted and unassisted steps. Additional evidence for the hypothesis that sensory signals related to hip flexion are important in regulating the swing-to-stance transition came from four normal animals trained to walk in a variety of situations designed to alter the coordination of movements at the hip, knee, and ankle joints during the swing phase. Although there were exceptions in some tasks and preparations, the angle of the hip joint at the time of onset of extensor activity was generally less variable than that of the knee and ankle joints. We also found no clear relationships between the angle of the limb and body axes, or the length of the limb axis, and the time of onset of extensor activity. Finally, there were no indications that the stretching of ankle extensor muscles during swing was a factor in regulating the transition from swing-to-stance.
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Macrum, Elisabeth, David Robert Bell, Michelle Boling, Michael Lewek, and Darin Padua. "Effect of Limiting Ankle-Dorsiflexion Range of Motion on Lower Extremity Kinematics and Muscle-Activation Patterns During a Squat." Journal of Sport Rehabilitation 21, no. 2 (May 2012): 144–50. http://dx.doi.org/10.1123/jsr.21.2.144.
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Context:Limitations in gastrocnemius/soleus flexibility that restrict ankle dorsiflexion during dynamic tasks have been reported in individuals with patellofemoral pain (PFP) and are theorized to play a role in its development.Objective:To determine the effect of restricted ankle-dorsiflexion range of motion (ROM) on lower extremity kinematics and muscle activity (EMG) during a squat. The authors hypothesized that restricted ankle-dorsiflexion ROM would alter knee kinematics and lower extremity EMG during a squat.Design:Cross-sectional.Participants:30 healthy, recreationally active individuals without a history of lower extremity injury.Interventions:Each participant performed 7 trials of a double-leg squat under 2 conditions: a nowedge condition (NW) with the foot flat on the floor and a wedge condition (W) with a 12° forefoot angle to simulate reduced plantar-flexor flexibility.Main Outcome Measures:3-dimensional hip and knee kinematics, medial knee displacement (MKD), and ankle-dorsiflexion angle. EMG of vastus medialis oblique (VMO), vastus lateralis (VL), lateral gastrocnemius (LG), and soleus (SOL). One-way repeated-measures ANOVAs were performed to determine differences between the W and NW conditions.Results:Compared with the NW condition, the wedge produced decreased peak knee flexion (P < .001, effect size [ES] = 0.81) and knee-flexion excursion (P < .001, ES = 0.82) while producing increased peak ankle dorsiflexion (P = .006, ES = 0.31), ankle-dorsiflexion excursion (P < .001, ES = 0.31), peak knee-valgus angle (P = .02, ES = 0.21), and MKD (P < .001, ES = 2.92). During the W condition, VL (P = 0.002, ES = 0.33) and VMO (P = .049, ES = 0.20) activity decreased while soleus activity increased (P = .03, ES = 0.64) compared with the NW condition. No changes were seen in hip kinematics (P > .05).Conclusions:Altering ankle-dorsiflexion starting position during a double-leg squat resulted in increased knee valgus and MKD, as well as decreased quadriceps activation and increased soleus activation. These changes are similar to those seen in people with PFP.
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Chun, Youngmin, Joshua P. Bailey, Jinah Kim, Sung-Cheol Lee, and Sae Yong Lee. "Sex and Limb Differences in Lower Extremity Alignment and Kinematics during Drop Vertical Jumps." International Journal of Environmental Research and Public Health 18, no. 7 (April 3, 2021): 3748. http://dx.doi.org/10.3390/ijerph18073748.
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Sex and limb differences in lower extremity alignments (LEAs) and dynamic lower extremity kinematics (LEKs) during a drop vertical jump were investigated in participants of Korean ethnicity. One hundred healthy males and females participated in a drop vertical jump, and LEAs and LEKs were determined in dominant and non-dominant limbs. A 2-by-2 mixed model MANOVA was performed to compare LEAs and joint kinematics between sexes and limbs (dominant vs. non-dominant). Compared with males, females possessed a significantly greater pelvic tilt, femoral anteversion, Q-angle, and reduced tibial torsion. Females landed on the ground with significantly increased knee extension and ankle plantarflexion with reduced hip abduction and knee adduction, relatively decreased peak hip adduction, knee internal rotation, and increased knee abduction and ankle eversion. The non-dominant limb showed significantly increased hip flexion, abduction, and external rotation; knee flexion and internal rotation; and ankle inversion at initial contact. Further, the non-dominant limb showed increased peak hip and knee flexion, relatively reduced peak hip adduction, and increased knee abduction and internal rotation. It could be suggested that LEAs and LEKs observed in females and non-dominant limbs might contribute to a greater risk of anterior cruciate ligament injuries.
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Reilly, Kathleen Anne, Karen Louise Barker, Delva Shamley, and Susan Sandall. "Influence of Foot Characteristics on the Site of Lower Limb Osteoarthritis." Foot & Ankle International 27, no. 3 (March 2006): 206–11. http://dx.doi.org/10.1177/107110070602700310.
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Background: Foot structure and range of motion have been linked to lower limb musculoskeletal injuries in sports medicine, 11 , 14 , 41 and recently there have been attempts to establish a connection between the foot and lower limb osteoarthritis (OA). 19 , 13 Considering the fact that OA of the knee and hip are the most important causes of pain and disability in older people, 12 , 25 it is surprising that there has been no research comparing the foot types of those with knee OA and those with hip OA. To evaluate an apparent difference in the feet and gaits of patients with hip OA and medial compartment OA of the knee that was noted during routine clinical assessment, a prospective observation study was undertaken. Methods: The study included patients with OA either of the hip or the medial compartment of the knee and a control group of healthy subjects. There were 60 in each group determined by sample size calculation. The groups were matched for age and gender. Dorsiflexion and plantarflexion of the ankle, calcaneal angle, and navicular height in both sitting and standing were measured. Results were analyzed by ANOVA and linear regression analysis. Results: There were significant differences among all three groups, particularly in ankle dorsiflexion ( p >0.001) and calcaneal angle ( p >0.001). Conclusions: Differences in foot type between patients with OA of hip and knee were confirmed. These two groups also were different from the control group of healthy subjects. The lack of ankle dorsiflexion and high arches of patients with OA of the hip contrasted with the ample dorsiflexion and flatfeet of patients with OA of the knee.
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WANG, LIN-HWA, KUO-CHENG LO, CHIEN-JU LIN, and FONG-CHIN SU. "MULTIJOINT COORDINATION OF LOWER EXTREMITY IN TAI CHI EXERCISE." Journal of Mechanics in Medicine and Biology 10, no. 03 (September 2010): 479–93. http://dx.doi.org/10.1142/s0219519410003526.
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The goal of this study was to investigate the movement coordination among the hip, knee, and ankle joints during solo performance of the Tai Chi (TC) basic movements in order to understand its dynamic postural control. Nine male community-dwelling adults with experienced TC pushing hands participated in this cross-sectional study. The Eagle®motion analysis system with eight cameras was used to collect the trajectories of all reflective markers at sampling rate 100 Hz while the subject performed the ward-off, rollback, press, and push movements. Motion among the hip, knee, and ankle joints was highly coupled. Coupled joint motion, hip flexion-knee flexion-ankle dorsiflexion or reverse, existed in ward-off, rollback, and press phases for the front leg. However, in the push phase, the hip joint angle was kept almost constant with coupled knee and ankle motions. For the rear leg, coupled motion existed between the hip and the knee joints only. The ankle joint motion differed between the front and the rear legs during the basic movements of TC (p < 0.05). Basic characteristics were documented such as the forward knee never extending further than forward toe and both legs maintaining flexion during the full exercise cycle with hip and knee of front and rear legs having synchronized movements in opposite directions. The forward and backward shifts of TC basic movements have considerable contributions to the posture control in terms of the fine coordination of three lower extremity joints. This information could improve training protocol design for TC Chuan teaching and help beginners make an efficient and less damaging movement.
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Xu, Yi, Qinghua Hou, Chuhuai Wang, Andrew J. Sellers, Travis Simpson, Bradford C. Bennett, and Shawn D. Russell. "Full Step Cycle Kinematic and Kinetic Comparison of Barefoot Walking and a Traditional Shoe Walking in Healthy Youth: Insights for Barefoot Technology." Applied Bionics and Biomechanics 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/2638908.
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Objective. Barefoot technology shoes are becoming increasingly popular, yet modifications are still needed. The present study aims to gain valuable insights by comparing barefoot walking to neutral shoe walking in a healthy youth population. Methods. 28 healthy university students (22 females and 6 males) were recruited to walk on a 10-meter walkway both barefoot and in neutral running shoes at their comfortable walking speed. Full step cycle kinematic and kinetic data were collected using an 8-camera motion capture system. Results. In the early stance phase, the knee extension moment (MK1), the first peak absorbed joint power at the knee joint (PK1), and the flexion angle of knee/dorsiflexion angle of the ankle were significantly reduced when walking in neutral running shoes. However, in the late stance, barefoot walking resulted in decreased hip joint flexion moment (MH2), second peak extension knee moment (MK3), hip flexors absorbed power (PH2), hip flexors generated power (PH3), second peak absorbed power by knee flexors (PK2), and second peak anterior-posterior component of joint force at the hip (APFH2), knee (APFK2), and ankle (APFA2). Conclusions. These results indicate that it should be cautious to discard conventional elements from future running shoe designs and rush to embrace the barefoot technology fashion.
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Lin, Cheng-Chieh, Wan-Chin Lee, Jih-Ching Chen, Shing-Jye Chen, and Cheng-Feng Lin. "The Influence of Kinesio Tape and an Ankle Brace on the Lower Extremity Joint Motion in Fatigued, Unstable Ankles during a Lateral Drop Landing." International Journal of Environmental Research and Public Health 18, no. 11 (June 4, 2021): 6081. http://dx.doi.org/10.3390/ijerph18116081.
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Background: An unstable ankle along with plantar flexor muscle fatigue may exacerbate landing performance. External support may be an option to control the ankle motion and protect joints from injuries. Research goal: To investigate the immediate changes in the joint motion of a lower extremity under ankle plantar flexors fatigue conditions in athletes with unstable ankles using different external supports. Methods: A total of 44 participants were allocated to a control (Cn) group, an ankle brace (AB) group, and a kinesio tape (KT) group, and were asked to perform a lateral drop landing before and after a fatigue protocol. The outcome measures were fatigue-induced changes in the maximal joint angle and changes in the angle ranges of the hip, knee, and ankle. Results: Smaller changes in the maximal hip abduction were found in the AB group (p = 0.025), and the KT group exhibited smaller changes in the maximal ankle dorsiflexion (p = 0.009). The AB group landed with a smaller change in the range of hip flexion and knee flexion (p = 0.008 and 0.006). The Cn group had greater fatigue-induced changes in the COM range than AB and KT group (p = 0.002 and 0.028). Significance: Despite the beneficial effect in the postural control in the frontal plane, the use of AB might constrain the distal joint motion which might lead to an extended knee landing posture resulting in secondary injuries to the knee joint. Therefore, the use of AB in conjunction with an additional training of landing strategy might be recommended from the injury prevention perspective.
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Wu, Shyi-Kuen, Jia-Yuan You, Han-Yu Chen, and Shu-Zon Lou. "GASTROCNEMIUS TIGHTNESS AFFECTS HIP AND PELVIC MOVEMENT IN GAIT." Biomedical Engineering: Applications, Basis and Communications 32, no. 04 (July 29, 2020): 2050031. http://dx.doi.org/10.4015/s1016237220500313.
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The passive extensibility of skeletal muscles is an important health-related component of physical fitness. Tight gastrocnemius is a common orthopedic problem and frequently leads to overuse injuries of the lower extremity. Moreover, gastrocnemius tightness is commonly associated with lower back pain. Previous studies have reported that tight gastrocnemius results in kinematic and kinetic deviations of the ankle and knee during gait and a greater hip flexion at the moment of maximal ankle dorsiflexion. Accordingly, this study performs an experimental investigation into the effects of tight gastrocnemius on the hip and pelvic movements in gait. Sixteen subjects with tight gastrocnemius (defined as [Formula: see text] of ankle dorsiflexion with knee extended) and 16 healthy individuals matched by age and gender participated in the study. The three-dimensional angles of the hip and pelvis and moments of the hip were obtained for both groups during the stance phase of gait using force plates and a motion analysis system. Compared with the control group, the peak hip flexion angle is significantly higher in the tight group ([Formula: see text]), while the peak hip extension angle is significantly lower ([Formula: see text]). Moreover, the peak pelvic anterior tilt is significantly higher than that of the control group ([Formula: see text]), while the peak pelvic posterior tilt is significantly lower ([Formula: see text]). Finally, the peak extensor moment of the tight group is significantly higher than that of the control group ([Formula: see text]), while the peak flexor moment is significantly lower ([Formula: see text]). The results confirm that tight gastrocnemius leads to changes in the three-dimensional hip and pelvic angles and hip moments during gait. Disturbance of the hip and pelvic movement is thus a critical clinical consideration when evaluating soft tissue injuries in patients with tight gastrocnemius.
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Ugbolue, Ukadike Chris, Chloe Robson, Emma Donald, Kerry L. Speirs, Frédéric Dutheil, Julien S. Baker, Tilak Dias, and Yaodong Gu. "Joint Angle, Range of Motion, Force, and Moment Assessment: Responses of the Lower Limb to Ankle Plantarflexion and Dorsiflexion." Applied Bionics and Biomechanics 2021 (September 18, 2021): 1–13. http://dx.doi.org/10.1155/2021/1232468.
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There is limited research on the biomechanical assessment of the lower limb joints in relation to dynamic movements that occur at the hip, knee, and ankle joints when performing dorsiflexion (DF) and plantarflexion (PF) among males and females. This study investigated the differences in joint angles (including range of motion (ROM)) and forces (including moments) between the left and right limbs at the ankle, knee, and hip joints during dynamic DF and PF movements in both males and females. Using a general linear model employing multivariate analysis in relation to the joint angle, ROM, force, and moment datasets, the results revealed significant main effects for gender, sidedness, phases, and foot position with respect to joint angles. Weak correlations were observed between measured biomechanical variables. These results provide insightful information for clinicians and biomechanists that relate to lower limb exercise interventions and modelling efficacy standpoints.
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Porta, Micaela, Massimiliano Pau, Bruno Leban, Michela Deidda, Marco Sorrentino, Federico Arippa, and Giuseppe Marongiu. "Lower Limb Kinematics in Individuals with Hip Osteoarthritis during Gait: A Focus on Adaptative Strategies and Interlimb Symmetry." Bioengineering 8, no. 4 (April 13, 2021): 47. http://dx.doi.org/10.3390/bioengineering8040047.
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Among the functional limitations associated with hip osteoarthritis (OA), the alteration of gait capabilities represents one of the most invalidating as it may seriously compromise the quality of life of the affected individual. The use of quantitative techniques for human movement analysis has been found valuable in providing accurate and objective measures of kinematics and kinetics of gait in individuals with hip OA, but few studies have reported in-depth analyses of lower limb joint kinematics during gait and, in particular, there is a scarcity of data on interlimb symmetry. Such aspects were investigated in the present study which tested 11 individuals with hip OA (mean age 68.3 years) and 11 healthy controls age- and sex-matched, using 3D computerized gait analysis to perform point-by-point comparisons of the joint angle trends of hip, knee, and ankle. Angle-angle diagrams (cyclograms) were also built to compute several parameters (i.e., cyclogram area and orientation and Trend Symmetry) from which to assess the degree of interlimb symmetry. The results show that individuals with hip OA exhibit peculiar gait patterns characterized by severe modifications of the physiologic trend at hip level even in the unaffected limb (especially during the stance phase), as well as minor (although significant) alterations at knee and ankle level. The symmetry analysis also revealed that the effect of the disease in terms of interlimb coordination is present at knee joint as well as hip, while the ankle joint appears relatively preserved from specific negative effects from this point of view. The availability of data on such kinematic adaptations may be useful in supporting the design of specific rehabilitative strategies during both preoperative and postoperative periods.
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Cho, Jin-Ho, Jun Young Choi, and Sung-Sahn Lee. "Accuracy of the Tibial Component Alignment by Extramedullary System Using Simple Radiographic References in Total Knee Arthroplasty." Medicina 58, no. 9 (September 2, 2022): 1212. http://dx.doi.org/10.3390/medicina58091212.
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Background and Objectives: The tibial component alignment is an important issue for the longevity of total knee arthroplasty (TKA). The purpose of our study was to investigate the usefulness of proximal tibial references determined by pre-operative radiography and intraoperative C-arm-guided hip and ankle center marking for the extramedullary guided tibial cut in mild (<10°) and severe (≥10°) varus knee TKA. Materials and Methods: A total of 150 consecutive patients (220 cases) who underwent total knee arthroplasty who were recruited from July 2011 to April 2017 were reviewed retrospectively. Before surgery, the proximal tibial reference point and medio-lateral cut thickness difference were identified. Then, hip and ankle centers were checked using a C-arm intensifier intraoperatively. The hip–knee–ankle (HKA) alignment and medial proximal tibial angle (MPTA) were assessed pre-operatively and post-operatively. More than 3° varus or valgus of HKA alignment or tibial component angle was defined as an outlier. Results: Mean follow-up duration was 26.9 months. Among 220 cases, 111 cases are classified as mild varus group and 109 cases are classified as severe varus group. The HKA alignment is significantly improved (p < 0.001). The average tibial component angle after surgery is 90.1°. A total of 21 cases (9.5%) and 3 cases (1.4%) are classified as outliers of HKA alignment and MPTA, respectively. Among MPTA outliers, one case is in the mild varus group and two cases are in the in severe varus group (p = 0.62). Conclusion: Measurement of proximal tibial radiographic references and checking the C-arm-guided intraoperative hip and ankle center could be helpful to obtain the favorable coronal position of the tibial component in the extramedullary guided tibial cut.
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Sigward, Susan M., Kathryn L. Havens, and Christopher M. Powers. "Knee Separation Distance and Lower Extremity Kinematics During a Drop Land: Implications for Clinical Screening." Journal of Athletic Training 46, no. 5 (September 1, 2011): 471–75. http://dx.doi.org/10.4085/1062-6050-46.5.471.
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Context: Excessive knee valgus during dynamic tasks is thought to contribute to lower extremity overuse and traumatic injuries. Clinically, assessments of frontal-plane knee motion typically include measures of the distance between the knees during landing. However, it is not clear how this clinical assessment relates to knee-abduction angle or how it is influenced by the position of the lower extremities in the transverse and frontal planes. Objective: To determine whether normalized knee separation distance (NKSD) is a predictor of knee-abduction angles and to assess the influence of lower extremity transverse-plane and frontal-plane angles on NKSD during a drop land. Design: Cross-sectional study. Setting: Motion analysis laboratory. Patients or Other Participants: Twenty-five healthy female athletes. Intervention(s): The frontal-plane distance between the 2- dimensional coordinates of markers over the greater trochanters (intertrochanteric distance), lateral femoral epicondyles (knee separation distance), and lateral malleoli (stance width) bilaterally was calculated during a drop land. The knee separation distance was normalized by intertrochanteric distance (NKSD). Concurrently, 3-dimensional lower extremity transverse-plane and frontal-plane kinematics were obtained. Main Outcome Measure(s): We assessed NKSD, stance width, and bilateral average knee and hip transverse plane and frontal-plane angles and ankle frontal-plane angles. Linear regression was used to determine the association between NKSD and bilateral average knee frontal-plane angles. Stepwise multiple regression was used to identify the best predictors of NKSD during the drop land. Results: After we controlled for stance width, NKSD explained 52% of the variance in the knee frontal-plane angle. When we took lower extremity kinematics into account, after controlling for stance width, the average hip frontal-plane angle was the best predictor of NKSD, explaining 97% of the variance. Conclusions: Although NKSD is a predictor of knee- abduction angle, frontal-plane hip angle and stance width are strongly related to NKSD. Caution must be taken when interpreting NKSD as knee abduction.
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Lee, Seung Yeol, Soon-Sun Kwon, and Kyoung Min Lee. "Changes in the Mechanical Axis and Weight-Bearing Line of the Ankle After Varus Knee Correction." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0026. http://dx.doi.org/10.1177/2473011419s00269.
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Category: Ankle, Hindfoot Introduction/Purpose: Varus limb malalignment results in an imbalance of force transmission to the knee joint, resulting in a concentrated load in the medial compartment. A varus knee correction may affect the ankle and subtalar joint, because the weight-bearing load on the lower extremity extends from the hip to the foot. A previous study suggested that the true mechanical axis of the lower limb should be calculated with a line from the center of the femoral head to the lowest point of the calcaneus, not to the center of the tibial plafond. Therefore, we performed this study to evaluate changes in the mechanical axis and weight- bearing line of the ankle after varus knee correction. Methods: Patients with a varus knee who were followed-up after they had undergone high tibial osteotomy (HTO) or total knee replacement arthroplasty (TKA) at an age of >20 years, and who had undergone preoperative and postoperative scanogram were included in this study. The hip-knee-ankle (HKA) angle, mechanical axis, and weight-bearing line (line from the center of the femoral head to the lowest point of the calcaneus) were measured on the radiographs. The point at which the mechanical axis and weight-bearing line passed through the tibial plafond was the ankle joint axis point. The postoperative change in the ankle joint axis point on the mechanical axis and weight-bearing line according to the HKA angle correction was adjusted by multiple factors using a linear mixed model. Results: A total of 257 limbs from 198 patients were included in this study. The preoperative HKA was 7.3 ± 4.7° and corrected to 0.4 ± 3.8°. Although the ankle axis points on both axes moved laterally after HTO and TKA, the ankle joint axis of the weight- bearing line showed a significant larger lateral movement (22.5±35.7%) (Fig.) than that of the mechanical axis (15.7±16.0%) in terms of rate of change (p = 0.006). The ankle joint axis point on the weight-bearing line moved laterally by 0.9% per degree of postoperative HKA angle decrease (p < 0.001). The change in the ankle joint axis point on the mechanical axis was not statistically significant after HTO and TKA (p = 0.223). Conclusion: The mechanical axis and weight-bearing line of the ankle moved laterally after the varus knee correction. The ankle joint axis on the weight-bearing line moved laterally as the HKA angle decreased after the surgery, whereas the varus knee correction did not significantly affect the ankle joint axis on the mechanical axis. The varus knee correction might affect the subtalar joint as well as the ankle joint. Therefore, we believe that our findings warrant consideration in pre- and postoperative evaluations using the weight-bearing line of patients undergoing varus knee correction.
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Santos, Thiago R. T., Sergio T. Fonseca, Vanessa L. Araújo, Sangjun Lee, Fabricio Saucedo, Stephen Allen, Christopher Siviy, Thales R. Souza, Conor Walsh, and Kenneth G. Holt. "Load Carriage During Walking Increases Dynamic Stiffness at Distal Lower Limb Joints." Journal of Applied Biomechanics 37, no. 4 (August 1, 2021): 373–79. http://dx.doi.org/10.1123/jab.2020-0346.
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The addition of a load during walking requires changes in the movement pattern. The investigation of the dynamic joint stiffness behavior may help to understand the lower limb joints’ contribution to these changes. This study aimed to investigate the dynamic stiffness of lower limb joints in response to the increased load carried while walking. Thirteen participants walked in two conditions: unloaded (an empty backpack) and loaded (the same backpack plus added mass corresponding to 30% of body mass). Dynamic stiffness was calculated as the linear slope of the regression line on the moment–angle curve during the power absorption phases of the ankle, knee, and hip in the sagittal plane. The results showed that ankle (P = .002) and knee (P < .001) increased their dynamic stiffness during loaded walking compared with unloaded, but no difference was observed at the hip (P = .332). The dynamic stiffness changes were different among joints (P < .001): ankle and knee changes were not different (P < .992), but they had a greater change than hip (P < .001). The nonuniform increases in lower limb joint dynamic stiffness suggest that the ankle and knee are critical joints to deal with the extra loading.
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Stučinskas, Justinas, Mindaugas Bakevičius, Aleksej Lebedev, Otto Robertsson, Alfredas Smailys, and Šarūnas Tarasevičius. "Radiological Parameters of the Femur in Lithuanian Patients with Knee Osteoarthritis and its Significance for Accuracy of the Total Knee Arthroplasty." Sveikatos mokslai 25, no. 2 (April 20, 2015): 41–45. http://dx.doi.org/10.5200/sm-hs.2015.029.
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Malalignment of the components affects long term total knee arthroplasty (TKA) survival. One of the options for achieving better TKA alignment may be a detailed preoperative radiological assessment. The aim of the study – to investigate the femoral valgus angle variations and affecting factors in patients with knee osteoarthritis (OA). Material and methods: We prospectively investigated severe OA patients, admitted for elective TKA. The standardized radiological assessment was performed – long standing hip-knee- ankle radiographs and the measurements were taken. We evaluated the relationship between the patients’, radiological parameters and femoral valgus angle. Results: 110 patients were included in the study and the mean measured femoral valgus angle was 6,7±1,3° and ranged from 4° to 10°. It was not significantly different between genders or varus/ valgus knee deformation. There was a significant relation between femoral valgus angle and neck-shaft, femoral bowing angles. Femoral valgus angle significantly increased with larger femoral bowing and smaller neck-shaft angles. Conclusions: Lithuanian patients with knee OA scheduled for TKA had a mean femoral valgus angle of 6,7±1,3° which ranged from 4° to 10°. Femoral neck-shaft and bowing angles significantly affects the femoral valgus angle.
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Yokoi, Takashi, Akihiko Takahashi, and Tomohiro Kizuka. "Kinematic Description of Self-Organized Leg Motion Transition in Human Locomotion Learning." Journal of Robotics and Mechatronics 10, no. 4 (August 20, 1998): 333–37. http://dx.doi.org/10.20965/jrm.1998.p0333.
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Leg motion learning while walking backward with eyes closed on a treadmill was studied to gain information on self-organization in locomotion learning. Eight adults walked on a treadmill at a belt speed of 50 m/min for five minutes,, four times. The angles of the hip, knee, and ankle joints were calculated to describe lower limb motion transition with learning progress. The attractor of a dynamical system creating joint flexion and extension was reconstructed from time-series joint angle data by the method of Takens (1981). Main findings were that: 1) the joint motion transition pattern with learning progress differs for the three leg joints; 2) with learning progress, ankle joint motion converged from complex to a certain clear pattern and, as a result, the chaotic property of the joint became weak; and 3) with learning motion, the fractal dimension of the attractor for knee joint motion exceeded those for the ankle and hip joints.
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Rosso, Federica, Roberto Rossi, Antonino Cantivalli, Carola Pilone, and Davide Edoardo Bonasia. "Joint Line Obliquity Does Not Affect the Outcomes of Opening Wedge High Tibial Osteotomy at an Average 10-Year Follow-up." American Journal of Sports Medicine 50, no. 2 (December 2, 2021): 461–70. http://dx.doi.org/10.1177/03635465211059811.
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Background: A significant number of high tibial osteotomies (HTOs) result in an overcorrected tibia and subsequent excessive lateral joint line obliquity (JLO). The correlation between excessive JLO and poor outcomes is controversial. Purpose: To evaluate the prognostic factors (including a pathological postoperative JLO) related with the outcomes of opening wedge HTO at 10 years of follow-up. Study Design: Case series; Level of evidence, 4. Methods: All patients undergoing HTO between 2004 and 2017 for medial osteoarthritis and with a postoperative hip-knee-ankle angle between 176° and 185° were included. Clinical evaluation included Knee Society Score (KSS; knee score and function score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and visual analog scale for pain. Several mechanical and anatomic angles were measured pre- and postoperatively on long-leg weightbearing radiographs. Abnormal JLO was defined as a Mikulicz–joint line angle (MJL) ≥94° or a mechanical medial proximal tibial angle (mMPTA) ≥95°. Regression analysis was performed to evaluate the association between independent variables and each outcome. A Kaplan-Meier cumulative survival analysis was performed. Results: A total of 92 knees in 76 patients were included. The mean age of the patients was 53.5 years (SD, 9.7 years), and the mean follow-up was 129.4 months (SD, 44.4 months). Increased JLO was associated with a significant preoperative varus deformity (small preoperative hip-knee-ankle angle), increased mechanical lateral distal femoral angle, increased joint line congruency angle, and increased knee-ankle joint angle. Male sex was associated with better WOMAC scores ( P = .0277), and increased body mass index (BMI) was associated with inferior WOMAC scores ( P = .0024). A good preoperative range of motion was associated with better knee score ( P = .0399) and function score ( P = .0366) on the KSS. An increased BMI was associated with inferior KSS function scores ( P = .0317). MJL ≥94° and mMPTA ≥95° were not associated with inferior WOMAC or KSS outcomes. With indication to total knee arthroplasty as an endpoint, Kaplan-Meier analysis showed a survival rate of 98.7% at 5 years, 95.5% at 10 years, and 92.7% at 12 years. Conclusion: Increased lateral JLO (MJL ≥94° or mMPTA ≥95°) was not correlated with the clinical outcomes of opening wedge HTO at 10 years of follow-up.
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Fallahtafti, Farahnaz, Zahra Salamifar, Mahdi Hassan, Hafizur Rahman, Iraklis Pipinos, and Sara A. Myers. "Joint Angle Variability Is Altered in Patients with Peripheral Artery Disease after Six Months of Exercise Intervention." Entropy 24, no. 10 (October 6, 2022): 1422. http://dx.doi.org/10.3390/e24101422.
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Supervised exercise therapy (SET) is a conservative non-operative treatment strategy for improving walking performance in patients with peripheral artery disease (PAD). Gait variability is altered in patients with PAD, but the effect of SET on gait variability is unknown. Forty-three claudicating patients with PAD underwent gait analysis before and immediately after a 6-month SET program. Nonlinear gait variability was assessed using sample entropy, and the largest Lyapunov exponent of the ankle, knee, and hip joint angle time series. Linear mean and variability of the range of motion time series for these three joint angles were also calculated. Two-factor repeated measure analysis of variance determined the effect of the intervention and joint location on linear and nonlinear dependent variables. After SET, walking regularity decreased, while the stability remained unaffected. Ankle nonlinear variability had increased values compared with the knee and hip joints. Linear measures did not change following SET, except for knee angle, in which the magnitude of variations increased after the intervention. A six-month SET program produced changes in gait variability toward the direction of healthy controls, which indicates that in general, SET improved walking performance in individuals with PAD.
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Ucpunar, H., S. K. Tas, Y. Camurcu, H. Sofu, M. Mert, and A. I. Bayhan. "The effects of residual hip deformity on coronal alignment of the lower extremity in patients with unilateral slipped capital femoral epiphysis." Journal of Children's Orthopaedics 12, no. 6 (December 2018): 599–605. http://dx.doi.org/10.1302/1863-2548.12.180137.
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Purpose The aim of our explorative study was to compare the differences in the coronal alignments of the hip, knee and ankle on the slip side and non-slip sides in patients with slipped capital femoral epiphysis (SCFE). Methods The study group consisted of 28 patients. On the full-length standing radiographs, measurements of articulo-trochanteric distance (ATD), neck-shaft angle (NSA), femoral offset, hip-knee-ankle axis, femur-tibial angle, mechanical axis deviation ratio (MAD-r), anatomical medial proximal femoral angle (aMPFA), mechanical lateral proximal femoral angle (mLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral distal femoral angle (mLDFA), knee joint line congruency angle, mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal tibial angle (mLDTA), ankle joint line orientation angle (AJOA), and leg length discrepancy (LLD) were performed. The data from the slip side were compared with those from the non-slip side. Results At skeletal maturity, there were significant differences between the slip side and non-slip side in ATD (p <0.001), NSA (p <0.001), MAD-r (p <0.001), aMPFA (p <0.001), aLDFA (p = 0.03), mLDFA (p = 0.04), mLDTA (p = 0.02), AJOA (p <0.001) and LLD (p<0.001). Conclusion Residual deformity in the proximal femur after epiphyseal slip and premature epiphysiodesis could cause changes in the coronal alignment of the lower extremity. We can add lower extremity alignment examination to follow-up protocol to rule out secondary problems in patients with SCFE. Level of Evidence Level III, retrospective comparative study
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Trybała, Agnieszka, Iwona Sulowska-Daszyk, and Grzegorz Głąb. "Correlation between video-analysed running technique and the lower limb injuries in long-distance runners." Journal of Kinesiology and Exercise Sciences 31, no. 94 (June 27, 2021): 11–22. http://dx.doi.org/10.5604/01.3001.0015.7300.
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Objective: The main goal of this study was to determine the correlation between running pattern and the lower limb injuries in long-distance runners. Materials and methods: The study comprised 23 long-distance runners (7 women, 16 men). The research used a questionnaire and video-analysis of running technique on a treadmill. The running on the treadmill was recorded from 3 views. Recordings were assessed in slow-motion. The following features were assessed: a foot strike pattern, a tibia angle at loading response, the maximum knee flexion angle during the stance phase, the maximum hip extension during the late stance phase, the maximum heel eversion angle, the distance between the knees and the pelvic drop angle. The subjects were divided into two groups – without previous trauma and with a history of previous trauma of a particular part of the lower limb. Results: The studies revealed two correlations. Firstly, in the group without a previous knee joint injury, there were significantly more people with a correct ankle-calcaneus eversion when compared to the group with a previous knee joint injury. Secondly, in the group without a hip joint injury, there were significantly more people with a correct hip extension than in the group with a previous hip joint injury. Moreover, it was shown that the correct position of tibia was strongly correlated with a correct foot positioning pattern. Conclusions: Previous knee joint injury may have influence on the enlarged ankle-calcaneus eversion. Having suffered a hip joint injury may limit the extension of a hip joint, thus affecting the running technique. It is necessary to continue research on a larger study group and with more precise research methods such as using 3- instead of 2-dimensional motion analysis.
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Myers, Peter S., Kerri S. Rawson, Elinor C. Harrison, Adam P. Horin, Ellen N. Sutter, Marie E. McNeely, and Gammon M. Earhart. "Cross-Sectional Analysis of Backward, Forward, and Dual Task Gait Kinematics in People With Parkinson Disease With and Without Freezing of Gait." Journal of Applied Biomechanics 36, no. 2 (April 1, 2020): 85–95. http://dx.doi.org/10.1123/jab.2019-0253.
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People with Parkinson disease demonstrate increased gait variability, but the primary variability sources are poorly understood. People with Parkinson disease and freezing of gait (freezers) have greater gait impairments than people with Parkinson disease without freezing of gait (nonfreezers), which may relate to cerebellar dysfunction. Thirteen freezers and 31 nonfreezers completed backward, forward, and forward with dual task gait trials. Sagittal joint angle waveforms were extracted for the hip, knee, and ankle using 3D motion capture. Decomposition indices were calculated for the 3 joint combinations. Principal component analysis extracted variance sources from the joint waveforms. Freezers had significantly greater decomposition between hip–ankle (F1,42 = 5.1, P = .03) and hip–knee (F1,42 = 5.3, P = .03) movements. The principal component analysis did not differentiate freezers and nonfreezers; however, primary variance sources differed between conditions. Primary variance during forward and forward with dual task gait came from joint angle magnitude and peak angle timing. Backward gait showed primary variance from joint angle magnitude and range of motion. The results show that freezers decompose movement more than nonfreezers, implicating cerebellar involvement in freezing of gait. Primary variance differs between gait conditions, and tailoring gait interventions to address variability sources may improve intervention efficacy.
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Gittoes, Marianne J. R., David G. Kerwin, and Mark A. Brewin. "Sensitivity of Loading to the Timing of Joint Kinematic Strategies in Simulated Forefoot Impact Landings." Journal of Applied Biomechanics 25, no. 3 (August 2009): 229–37. http://dx.doi.org/10.1123/jab.25.3.229.
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The impact loads experienced in landing may be influenced by the joint kinematic strategy used. This study aimed to enhance the understanding of the sensitivity of impact loading to the timing of joint kinematic strategies in simulated forefoot landings. Coordinate and force data of drop landings were used to initiate, drive, and evaluate a wobbling mass model. Ankle, knee, and hip joint angle profile timings were modified in the simulated motions. Changes to the timing of the ankle and knee joint angle profiles were associated with substantial changes in the peak vertical ground reaction force (GFzmax) of up to 3.9 body-weights (BW) and 1.5 BW, respectively, whereas loading was less sensitive to temporal changes in the hip joint strategy. Accentuated impact loads incurred by a modified knee flexion action may be explained by the need to maintain an ordered and controlled load attenuation strategy. Individual strategies and external and joint reaction forces should be considered for developing insight into loading in impact landings.
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Mousavi, Seyed Hamed, Laurens van Kouwenhove, Reza Rajabi, Johannes Zwerver, and Juha M. Hijmans. "The effect of changing foot progression angle using real-time visual feedback on rearfoot eversion during running." PLOS ONE 16, no. 2 (February 10, 2021): e0246425. http://dx.doi.org/10.1371/journal.pone.0246425.
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Atypical rearfoot in/eversion may be an important risk factor for running-related injuries. Prominent interventions for atypical rearfoot eversion include foot orthoses, footwear, and taping but a modification derived from gait retraining to correct atypical rearfoot in/eversion is lacking. We aimed to investigate changes in rearfoot in/eversion, subtalar pronation, medial longitudinal arch angle, and selected lower limb joint biomechanics while performing toe-in/toe-out running using real-time visual feedback. Fifteen female runners participated in this study. Subjects performed toe-in/toe-out running using real-time visual feedback on foot progression angle, which was set ±5° from habitual foot progression angle. 3D kinematics of rearfoot in/eversion, subtalar supination/pronation, medial longitudinal arch angle, foot progression angle, hip flexion, ab/adduction and internal/external rotation, knee flexion, ankle dorsiflexion, and ankle power were analyzed. A repeated-measures ANOVA followed by pairwise comparisons was used to analyze changes between three conditions. Toe-in running compared to normal and toe-out running reduced peak rearfoot eversion (mean difference (MD) with normal = 2.1°; p<0.001, MD with toe-out = 3.5°; p<0.001), peak pronation (MD with normal = -2.0°; p<0.001, MD with toe-out = -3.4; p = <0.001), and peak medial longitudinal arch angle (MD with normal = -0.7°; p = 0.022, MD with toe-out = -0.9; p = 0.005). Toe-out running significantly increased these kinematic factors compared to normal and toe-in running. Toe-in running compared to normal running increased peak hip internal rotation (MD = 2.3; p<0.001), and reduced peak knee flexion (MD = 1.3; p = 0.014). Toe-out running compared to normal running reduced peak hip internal rotation (MD = 2.5; p<0.001), peak hip ab/adduction (MD = 2.5; p<0.001), peak knee flexion (MD = 1.5; p = 0.003), peak ankle dorsiflexion (MD = 1.6; p<0.001), and peak ankle power (MD = 1.3; p = 0.001). Runners were able to change their foot progression angle when receiving real-time visual feedback for foot progression angle. Toe-in/toe-out running altered rearfoot kinematics and medial longitudinal arch angle, therefore supporting the potential value of gait retraining focused on foot progression angle using real-time visual feedback when atypical rearfoot in/eversion needs to be modified. It should be considered that changes in foot progression angle when running is accompanied by changes in lower limb joint biomechanics.
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Matsuzawa, Yuta, Takasuke Miyazaki, Yasufumi Takeshita, Naoto Higashi, Hiroyuki Hayashi, Sota Araki, Shintaro Nakatsuji, Seiji Fukunaga, Masayuki Kawada, and Ryoji Kiyama. "Effect of Leg Extension Angle on Knee Flexion Angle during Swing Phase in Post-Stroke Gait." Medicina 57, no. 11 (November 9, 2021): 1222. http://dx.doi.org/10.3390/medicina57111222.
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Background and Objectives: Leg extension angle is important for increasing the propulsion force during gait and is a meaningful indicator for evaluating gait quality in stroke patients. Although leg extension angle during late stance might potentially also affect lower limb kinematics during the swing phase, the relationship between these two remains unclear. This study aimed to investigate the relationship between leg extension angle and knee flexion angle during pre-swing and swing phase in post-stroke gait. Materials and Methods: Twenty-nine stroke patients walked along a 16 m walkway at a self-selected speed. Tilt angles and acceleration of pelvis and paretic lower limb segments were measured using inertial measurement units. Leg extension angle, consisting of a line connecting the hip joint with the ankle joint, hip and knee angles, and increments of velocity during pre-swing and swing phase were calculated. Correlation analysis was conducted to examine the relationships between these parameters. Partial correlation analysis adjusted by the Fugl-Meyer assessment-lower limb (FMA-LL) was also performed. Results: On the paretic side, leg extension angle was positively correlated with knee flexion angle during the swing phase (r = 0.721, p < 0.001) and knee flexion angle and increments of velocity during the pre-swing phase (r = 0.740–0.846, p < 0.001). Partial correlation analysis adjusted by the FMA-LL showed significant correlation between leg extension angle and knee flexion angle during the swing phase (r = 0.602, p = 0.001) and knee flexion angle and increments of velocity during the pre-swing phase (r = 0.655–0.886, p < 0.001). Conclusions: Leg extension angle affected kinematics during the swing phase in post-stroke gait regardless of the severity of paralysis, and was similar during the pre-swing phase. These results would guide the development of effective gait training programs that enable a safe and efficient gait for stroke patients.
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BISCARINI, ANDREA, DANIELE BUSTI, ANDREA CALANDRA, and SAMUELE CONTEMORI. "THE “SUPINE BRIDGE” THERAPEUTIC EXERCISE: DETERMINATION OF JOINT TORQUES BY MEANS OF BIOMECHANICAL MODELING AND TECHNOLOGIES." Journal of Mechanics in Medicine and Biology 17, no. 06 (September 2017): 1750104. http://dx.doi.org/10.1142/s0219519417501044.
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We developed a quantitative biomechanical analysis of the supine bridge exercise by combining biomechanical modeling with kinematic and kinetic measurements recorded with an optoelectronic motion capture system and a grid of force platforms embedded in the ground. The relevant joint angles and joint torques were determined accounting for three exercise variants: the distance L of the feet from upper back, the degree of pelvic elevation, and the change in shear ground reaction force intentionally induced by voluntary isometric knee-flexion/extension efforts. Contrary to the ankle and hip, the knee angle displays a nonmonotonic dependence on pelvic elevation. A voluntary isometric knee-flexion (knee-extension) effort enhances (reduces) the hip extensor torque when the hips are above the level of the ground. Progressive pelvic elevation and decrease in L gradually change the knee flexor torque into a knee extensor torque, while reducing the hip extensor torque, to reach a limit configuration where a knee extensor torque sustains the bridge position with a negligible contribution of the hip extensors. Moreover, in this configuration, a hip flexor torque is needed to counteract the hip extension thrust induced by a voluntary quadriceps effort across the closed kinetic chain constituted by the lower limbs and trunk.
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Clément, Julien, William Blakeney, Nicola Hagemeister, François Desmeules, Neila Mezghani, Véronique Lowry, and Pascal-André Vendittoli. "Hip-Knee-Ankle (HKA) angle modification during gait in healthy subjects." Gait & Posture 72 (July 2019): 62–68. http://dx.doi.org/10.1016/j.gaitpost.2019.05.025.
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Lee, Jong-Hak, and Ho-Seong Lee. "Comparisons of Vastus Lateralis Architecture and Biomechanical Characteristics during Drop Landing in Young Football Players." Exercise Science 30, no. 3 (August 31, 2021): 378–86. http://dx.doi.org/10.15857/ksep.2021.30.3.378.
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PURPOSE: The purpose of this study was to compare the vastus lateralis (VL) architecture and exercise biomechanics indices during drop landing in young football players.METHODS: Fifteen young football players were divided into a long vastus lateralis muscle fascicle length group (LFG, n=8) and short vastus lateralis muscle fascicle length group (SFG, n=7). All of the participants performed drop landing onto the ground reaction force plate from a platform 30 cm high. The muscle activities of the VL, tibialis anterior (TA), and gastrocnemius (GCM), angular velocity, and ground reaction force in the ankle, knee, and hip joints were measured during drop landing.RESULTS: The VL muscle activity (p=.032), ankle ground contact angle (p=.027), ankle maximum flexion angle (p=.014), knee maximum flexion angle (p=.007), and ground reaction force per body weight (p=.032) were significantly higher in the LFG than in the SFG. Muscle activity of the TA (p=.017), ankle (p=.033), and hip (p=.045) time to stability and the ground reaction force time to stability (p=.043) were significantly lower in the LFG than in the SFG. Muscle activity of the GCM (p=.053) and knee time to stability (p=.057) tended to be lower in the LFG than in the SFG.CONCLUSIONS: These results confirmed that muscle activity, angular velocity, and ground reaction force variables during drop landing are affected by the VL muscle fascicle length in young football players.
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Pau, Massimiliano, Bruno Leban, Micaela Porta, Jessica Frau, Giancarlo Coghe, and Eleonora Cocco. "Cyclograms Reveal Alteration of Inter-Joint Coordination during Gait in People with Multiple Sclerosis Minimally Disabled." Biomechanics 2, no. 3 (July 13, 2022): 331–41. http://dx.doi.org/10.3390/biomechanics2030026.
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Subtle alterations of gait patterns in people with Multiple Sclerosis (pwMS) with minimal or no disability often coexist with normal spatio-temporal parameters. Here, we retrospectively investigate the existence of possible anomalies in lower limb inter-joint coordination (i.e., the functional relationship between joint pairs) in pwMS with apparently physiologic gait features. Twenty-seven pwMS with Expanded Disability Status Scale scores ≤ 2, and 27 unaffected age-and-sex-matched individuals, were tested using 3D computerized gait analysis. Raw data were processed to extract the main spatio-temporal parameters and the kinematics in the sagittal plane at the hip, knee, and ankle joints. Angle-angle diagrams (cyclograms) were obtained by coupling the flexion-extension values for the hip-knee and knee-ankle joint pairs at each point of the gait cycle. Cyclogram area, perimeter, and dimensionless ratio were employed to quantify inter-joint coordination. The results demonstrate that cyclograms of pwMS are characterized by significantly reduced perimeters for both investigated joint pairs and reduced area at the hip–knee joint pair. In the latter pair, the differences between groups involved the entire swing phase. For the knee-ankle pair, the average cyclogram of pwMS departed from normality from the late stance until the mid-swing phase. Such findings suggest that inter-joint coordination is impaired even in minimally disabled pwMS who exhibit a normal gait pattern in terms of spatio-temporal parameters. The quantitative and qualitative study of cyclogram features may provide information that is useful for better understanding the underlying mechanisms of walking dysfunctions in MS.
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Jeong, Jiyoung, Dai-Hyuk Choi, and Choongsoo S. Shin. "Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury." American Journal of Sports Medicine 49, no. 1 (December 31, 2020): 183–92. http://dx.doi.org/10.1177/0363546520972990.
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Background: Core stability is influential in the incidence of lower extremity injuries, including anterior cruciate ligament (ACL) injuries, but the effects of core strength training on the risk for ACL injury remain unclear. Hypothesis: Core muscle strength training increases the knee flexion angle, hamstring to quadriceps (H:Q) coactivation ratio, and vastus medialis to vastus lateralis (VM:VL) muscle activation ratio, as well as decreases the hip adduction, knee valgus, and tibial internal rotation angles. Study Design: Controlled laboratory study. Methods: A total of 48 male participants were recruited and randomly assigned to either the intervention group (n = 32) or the control group (n = 16). Three-dimensional trunk, hip, knee, and ankle kinematic data and muscle activations of selected trunk and lower extremity muscles were obtained while the participants performed side-step cutting. The core endurance scores were measured before and after training. Two-way analyses of variance were conducted for each dependent variable to determine the effects of 10 weeks of core strength training. Results: The trunk endurance scores in the intervention group significantly increased after training ( P < .05 for all comparisons). The intervention group showed decreased knee valgus ( P = .038) and hip adduction angles ( P = .032) but increased trunk flexion angle ( P = .018), rectus abdominis to erector spinae coactivation ratio ( P = .047), H:Q coactivation ratio ( P = .021), and VM:VL activation ratio ( P = .016). In addition, the knee valgus angle at initial contact was negatively correlated with the VM:VL activation ratio in the precontact phase ( R2 = 0.188; P < .001) but was positively correlated with the hip adduction angle ( R2 = 0.120; P < .005). No statistically significant differences were observed in the trunk endurance scores, kinematics, and muscle activations for the control group. Conclusion: Core strength training altered the motor control strategies and joint kinematics for the trunk and the lower extremity by increasing the trunk flexion angle, VM:VL activation ratio, and H:Q activation ratio and reducing the knee valgus and hip adduction angles. Clinical Relevance: Training core muscles can modify the biomechanics associated with ACL injuries in a side-step cutting task; thus, core strength training might be considered in ACL injury prevention programs to alter the lower extremity alignment in the frontal plane and muscle activations during sports-related tasks.