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PeerJ 2022The single leg squat (SLS) test is a clinical functional test commonly used to evaluate clinically aberrant movement patterns of the knee. The SLS could be an...
BACKGROUND
The single leg squat (SLS) test is a clinical functional test commonly used to evaluate clinically aberrant movement patterns of the knee. The SLS could be an interesting option to analyze ankle control in the frontal plane during dynamic load analysis. However, to date, there are no studies that have analyzed the associations between the increased subtalar joint pronation by navicular drop (ND) test and ankle control with single leg squat (SLS) using a three-point scale. The purpose of this study was to evaluate the reliability of a clinical observation method to assess and determine the relationship between navicular drop (ND) and ankle control on the SLS score.
METHODS
A total of fifty-five healthy, physically active (31 females and 24 males) volunteers participated in this study. The degree of subtalar pronation was assessed through the ND test, and the ankle control was defined as the ankle displacement in the frontal plane during the SLS.
RESULTS
We found good intra-rater and inter-rater agreement during SLS, with Kappa values from 0.731 to 0.750. The relationship between the SLS and ND was significant ; the Spearman's rank correlation coefficient was 0.504 ( < 0.05).
CONCLUSIONS
The SLS score supplied the clinical practice with a reliable and valid alternative for quantifying foot mobility in comparison to the ND test.
Topics: Male; Female; Humans; Ankle; Leg; Reproducibility of Results; Lower Extremity; Ankle Joint
PubMed: 35186510
DOI: 10.7717/peerj.12990 -
BMC Musculoskeletal Disorders Jul 2022Restriction in foot and ankle joint range of motion, such as an ankle equinus, has been associated with increased plantar pressure and its complications. However,...
BACKGROUND
Restriction in foot and ankle joint range of motion, such as an ankle equinus, has been associated with increased plantar pressure and its complications. However, previous research is limited by its scope of measures and study populations. The aim of this study was to investigate the relationship between foot and ankle joint range of motion on barefoot plantar pressures during walking in healthy older adults.
METHODS
This cross-sectional study recruited 49 older adults. Participants underwent measures of foot (first metatarsophalangeal dorsiflexion range of motion, and navicular drop and drift) and ankle joint range of motion, foot posture, body mass index, and plantar pressure during barefoot walking. Spearman Rank Order Correlations were used to explore the relationship between foot and ankle measures, body mass index, and plantar pressure, with significant correlations explored in a hierarchical regression analysis. A Mann-Whitney U test was performed to compare plantar pressure values between those with and without ankle equinus per region of the foot.
RESULTS
Mean (SD) age and BMI were 72.4 years (5.2) and 29.8 kg/m (5.9) respectively. A total of 32 of the 49 participants (65%) identified as female sex. Mean (SD) ankle joint range of motion was 32.7 (6.4) degrees with 17/49 (34.7%) participants classified as having an ankle equinus (defined as < 30 degrees of ankle joint dorsiflexion range of motion). We found that an ankle equinus predicted a statistically significant amount of peak forefoot plantar pressure (p = 0.03). Participants with an ankle equinus displayed significantly higher forefoot peak pressure 677.8 kPa (589.9 to 810.4) compared to those with no equinus 565.58 kPa (447.3 to 651.2), p = 0.02. A statistically significant correlation was found between body mass index and midfoot peak pressure (p < 0.01) and pressure-time integral (p < 0.01). No other significant correlations were found.
CONCLUSION
Clinicians should consider screening for an ankle equinus and body mass index as a simple way to identify which healthy older adults may be at risk of pressure-related complications in the mid- and forefoot.
Topics: Aged; Ankle; Ankle Joint; Cross-Sectional Studies; Female; Humans; Pressure; Range of Motion, Articular; Walking
PubMed: 35906599
DOI: 10.1186/s12891-022-05618-w -
Foot & Ankle International Feb 2018Swelling and pain are common after foot and ankle procedures. We hypothesized that compressive stockings (CS) treatment after hindfoot surgery would positively influence...
BACKGROUND
Swelling and pain are common after foot and ankle procedures. We hypothesized that compressive stockings (CS) treatment after hindfoot surgery would positively influence patient outcomes.
METHODS
We undertook this randomized controlled trial in 87 consecutive patients to analyze the clinical effect of CS after hindfoot and ankle surgery and evaluate CS-wearing compliance using sensors that were implanted into CS. Ankle swelling, pain status, quality of life (SF-36 score), and the American Orthopaedic Foot & Ankle Score (AOFAS) were set as the primary end points. The CS wearing time in hours and percentage were investigated as the secondary end points. All participants with CS (group I) were informed about the implanted sensor after the CS were taken off. A subgroup analysis of group I was performed to detect differences between patients with high vs low compliance.
RESULTS
At 12 weeks, the results of ankle swelling (mean 234 mm in group I and 232 mm in group II), pain in the visual analog scale (1.7 group I vs 1.9 in group II), the SF-36 score (38 points in group I vs 30 points in group II), and the AOFAS score (a mean of 76 points in both groups) showed no statistical differences between the 2 groups. The mean wearing time was 136 (range, 0-470) hours, which corresponds to a compliance rate of 65%. Sixteen participants had high compliance (>80%, >170 hours), and 21 patients had low or noncompliance. The clinical results of patients with high wearing compliance were not significantly better compared to the results of patients with low compliance.
CONCLUSION
CS therapy after ankle and hindfoot surgery was associated with a low wearing compliance and did not influence ankle swelling, function, pain, and the quality of life compared to the control group. Furthermore, the clinical results of patients with high compliance were not better compared to the results of patients with low or noncompliance wearing behavior.
LEVEL OF EVIDENCE
Level II, prospective randomized study of lower quality.
Topics: Ankle; Ankle Joint; Foot; Humans; Orthopedics; Pain Measurement; Prospective Studies; Quality of Life
PubMed: 29195062
DOI: 10.1177/1071100717737518 -
Journal of Orthopaedic Surgery (Hong... 2023
Topics: Humans; Ankle; Ankle Joint; Joint Instability
PubMed: 37449813
DOI: 10.1177/10225536231182346 -
Journal of Orthopaedic Research :... Mar 2022Ankle arthritis is a debilitating disease marked by pain and limited function. Total ankle arthroplasty improves pain while preserving motion and offers an alternative...
Ankle arthritis is a debilitating disease marked by pain and limited function. Total ankle arthroplasty improves pain while preserving motion and offers an alternative to the traditional treatment of ankle fusion. Gait analysis and functional outcomes tools can provide an objective balanced analysis of ankle replacement for the treatment of ankle arthritis. Twenty-nine patients with end-stage ankle arthritis were evaluated before and after ankle arthroplasty. Multi-segment foot and ankle kinematics were assessed annually following surgery (average 3.5 years, range 1-6 years) using the Milwaukee Foot Model and a Vicon video motion analysis system. Functional outcomes (American Orthopedic Foot and Ankle Society [AOFAS] ankle/hindfoot scale, short form 36 [SF-36] questionnaire) and temporal-spatial parameters were also assessed. Kinematic results were compared to findings from a previously collected group of healthy ambulators. AOFAS and SF-36 mean scores improved postoperatively. Walking speed and stride length increased after surgery. There were significant improvements in tibial sagittal range of motion in terminal stance and hindfoot sagittal range of motion in preswing. Decreased external rotation of the tibia and increased external rotation of the hindfoot were noted throughout the gait cycle. Pain and function improved after ankle replacement as supported by better outcomes scores, increased temporal-spatial parameters, and significant improvement in tibial sagittal range of motion during terminal stance and hindfoot sagittal range of motion during preswing. While multi-segment foot kinematics were improved, they were not restored to control values. Statement of clinical significance: Total ankle arthroplasty does not fully normalize mutli-segment gait kinematics despite improved patient-reported outcomes and gait mechanics.
Topics: Ankle; Ankle Joint; Arthritis; Arthroplasty, Replacement, Ankle; Biomechanical Phenomena; Gait; Humans; Pain; Range of Motion, Articular
PubMed: 33913547
DOI: 10.1002/jor.25062 -
Journal of Orthopaedic Surgery (Hong... 2023Lateral ankle instability is a common condition which responds well to non-surgical management. However, the chronic symptomatic instability may require surgical... (Review)
Review
Lateral ankle instability is a common condition which responds well to non-surgical management. However, the chronic symptomatic instability may require surgical intervention. The acceptable and practiced procedure is the Brostom Gould modification and it has a high patient satisfaction score. However, the current understanding and newer techniques for stabilising the lateral ligament complex has resulted in arthroscopic repairs, augmentation and tendon graft reconstructions. The literature does not provide an answer to the efficacy of these new techniques but there is some preliminary information favouring some of the latest procedures. It is now accepted practise to include ankle arthroscopy as a pre repair step. Augmentation of anatomical repair is also favoured in a select group of patients. This article provides an up to date account of the newer techniques for lateral ankle stabilisation.
Topics: Humans; Lateral Ligament, Ankle; Ankle; Ankle Joint; Arthroscopy; Joint Instability; Arthroplasty, Replacement
PubMed: 37449536
DOI: 10.1177/10225536231182348 -
International Journal of Environmental... Feb 2022Functional ankle instability (FAI) is a condition that causes mechanical alterations to the ankle joint and leads to disability. Fear of movement can significantly...
Functional ankle instability (FAI) is a condition that causes mechanical alterations to the ankle joint and leads to disability. Fear of movement can significantly influence physical factors, and understanding their relationship is crucial in assessing and managing individuals with FAI. The present study aimed to (1) assess the impact of kinesiophobia on ankle joint position sense (JPS) and postural control and (2) evaluate if kinesiophobia can predict JPS and postural control in FAI individuals. This cross-sectional study included 55 FAI individuals. The Tampa Scale of Kinesiophobia (TSK) score was used to measure kinesiophobia. The ankle JPS was evaluated using a digital inclinometer. The individuals were asked to actively reposition to the target position of 10° and 15° of dorsiflexion and plantarflexion. The reposition accuracy is measured in degrees. The static postural control was evaluated in unilateral stance using a stabilometric force platform, including assessments for the ellipse area, anterior to posterior sway, and medial to lateral sway in mm2. Kinesiophobia showed a significant positive correlation (moderate) with the ankle JPS errors in dorsiflexion (10°: r = 0.51, p < 0.001; at 15°: = r = 0.52, p < 0.001) and plantarflexion (10°: r = 0.35, p = 0.009; at 15°: = r = 0.37, p = 0.005). Kinesiophobia also showed significant positive (moderate) correlation with postural control variables (ellipse area: r = 0.44, p = 0.001; Anterior−Posterior sway: r = 0.32, p = 0.015; Medial−Lateral sway: r = 0.60, p < 0.001). Kinesiophobia significantly predicted ankle JPS (p < 0.05) and postural control (p < 0.05). Increased fear of movement is associated with increased ankle JPS errors and postural sway in FAI individuals. Therefore, assessment of these factors is critical in FAI individuals.
Topics: Ankle; Ankle Joint; Cross-Sectional Studies; Humans; Joint Instability; Postural Balance
PubMed: 35270483
DOI: 10.3390/ijerph19052792 -
Journal of Foot and Ankle Research Oct 2022Tumors and tumor-like lesions of the foot and ankle are relatively rare and their postoperative clinical outcome has not been well reported.
BACKGROUND
Tumors and tumor-like lesions of the foot and ankle are relatively rare and their postoperative clinical outcome has not been well reported.
METHODS
This study retrospectively reviewed medical records of all patients who underwent excision of tumors and tumor-like lesions of the foot and ankle from 2008 to 2020. Preoperative and postoperative clinical outcomes were evaluated by the Japanese Society for Surgery of the Foot (JSSF) scales (pain, function, and alignment).
RESULTS
A total of 117 consecutive patients were analyzed in this study. Bone lesions accounted for 51 patients (benign: 45, intermediate malignancy: 1, malignant: 5), and soft tissue lesions accounted for 66 patients (benign: 57, intermediate malignancy: 2, malignant: 7). Four patients (8%) presenting with bone tumor and six (9%) soft tissue tumors resulted in recurrence. Eight (67%) patients with malignant lesions were alive continuously disease free and followed for a median of 50.5 (range: 18 to 82) months. Amputation at the first operation was done for five cases (33%) of malignant or intermediate malignancy (below-knee amputation: 1, Chopart disarticulation: 1, forefoot amputation: 3). Postoperative JSSF scores resulted in a significant 'positive' increase (bone lesion, 75.9 ± 13.7 to 91.4 ± 14.9, p < 0.001; soft tissue lesion, 84.7 ± 14.8 to 91.9 ± 12.5, p < 0.001). The score improvement in bone lesions was significantly higher than in soft tissue lesions (p = 0.003).
CONCLUSION
The surgical management of tumors and tumor-like lesions of the foot and ankle showed good post-operative functional outcomes with bone lesions exhibiting better results when compared to soft-tissue lesions.
Topics: Ankle; Ankle Joint; Bone Neoplasms; Humans; Retrospective Studies; Soft Tissue Neoplasms
PubMed: 36229823
DOI: 10.1186/s13047-022-00582-z -
PloS One 2021Kinetic data obtained during gait can be used to clarify the biomechanical pathogenesis of osteoarthritis of the lower extremity. This study aimed to investigate the...
BACKGROUND
Kinetic data obtained during gait can be used to clarify the biomechanical pathogenesis of osteoarthritis of the lower extremity. This study aimed to investigate the difference in ankle varus moment between the varus angulation and medial translation types of medial ankle osteoarthritis, and to identify the radiographic measurements associated with ankle varus moment.
METHODS
Twenty-four consecutive patients [mean age 65.8 (SD) 8.0 years; 9 men and 15 women] with medial ankle osteoarthritis were included. Fourteen and 10 patients had the varus angulation (tibiotalar tilt angle≥3 degrees) and medial translation (tibiotalar tilt angle<3 degrees) types, respectively. All patients underwent three-dimensional gait analysis, and the maximum varus moment of the ankle was recorded. Radiographic measurement included tibial plafond inclination, tibiotalar tilt angle, talar dome inclination, and lateral talo-first metatarsal angle. Comparison between the two types of medial ankle osteoarthritis and the relationship between the maximum ankle varus moment and radiographic measurements were analyzed.
RESULTS
The mean tibial plafond inclination, tibiotalar tilt angle, talar dome inclination, lateral talo-first metatarsal angle, and maximum ankle varus moment were 6.4 degrees (SD 3.3 degrees), 5.0 degrees (SD 4.6 degrees), 11.4 degrees (SD 5.2 degrees), -6.5 degrees (SD 11.7 degrees), and 0.185 (SD 0.082) Nm/kg, respectively. The varus angulation type showed a greater maximum ankle varus moment than the medial translation type (p = .005). The lateral talo-first metatarsal angle was significantly associated with the maximum ankle varus moment (p = .041) in the multiple regression analysis.
CONCLUSION
The varus angulation type of medial ankle osteoarthritis is considered to be more imbalanced biomechanically than the medial displacement type. The lateral talo-first metatarsal angle, being significantly associated with the ankle varus moment, should be considered for correction during motion-preserving surgeries for medial ankle osteoarthritis to restore the biomechanical balance of the ankle.
Topics: Aged; Ankle; Ankle Joint; Biomechanical Phenomena; Female; Gait; Humans; Male; Middle Aged; Osteoarthritis; Prospective Studies; Tomography Scanners, X-Ray Computed
PubMed: 34166436
DOI: 10.1371/journal.pone.0253570 -
PloS One 2023Ankle dorsiflexion range of motion (DF-ROM) has been shown to be associated with poor landing posture. However, previously used tasks have been controlled, and it is...
INTRODUCTION
Ankle dorsiflexion range of motion (DF-ROM) has been shown to be associated with poor landing posture. However, previously used tasks have been controlled, and it is unclear whether clinical measurements of the ankle DF-ROM, are associated with landing positions during sport-specific task. This study sought to determine the relationship between ankle DF-ROM and landing positions.
METHODS
Thirty male soccer players participated in this study. The ankle DF-ROM was measured by the weight bearing lunge test in degrees using a cell phone app (TiltMeter). Landing patterns were assessed during a soccer-specific task using landing error scoring system items using Kinovea software. Simple correlations were used to evaluate the relationships between ankle DF-ROM and landing error scores.
RESULTS
Significant correlations were found between ankle DF-ROM and landing errors (r = -0.450, P = 0.006). A decreased ankle DF-ROM was associated with greater landing errors in a soccer specific situation.
CONCLUSION
These results suggest that ankle DF-ROM may serve a useful clinical measure for identifying poor landing posture in the real-world environment. Therefore, assessment of ankle DF-ROM could be included in the screening process, which could help identify the cause of the faulty motion.
Topics: Male; Humans; Ankle; Ankle Joint; Soccer; Posture; Range of Motion, Articular; Biomechanical Phenomena
PubMed: 36928236
DOI: 10.1371/journal.pone.0283150