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Sensors (Basel, Switzerland) Aug 2022A greater variety of technologies are being applied in sports and health with the advancement of technology, but most optoelectronic systems have strict environmental...
A greater variety of technologies are being applied in sports and health with the advancement of technology, but most optoelectronic systems have strict environmental restrictions and are usually costly. To visualize and perform quantitative analysis on the football kick, we introduce a 3D motion analysis system based on a six-axis inertial measurement unit (IMU) to reconstruct the motion trajectory, in the meantime analyzing the velocity and the highest point of the foot during the backswing. We build a signal processing system in MATLAB and standardize the experimental process, allowing users to reconstruct the foot trajectory and obtain information about the motion within a short time. This paper presents a system that directly analyzes the instep kicking motion rather than recognizing different motions or obtaining biomechanical parameters. For the instep kicking motion of path length around 3.63 m, the root mean square error (RMSE) is about 0.07 m. The RMSE of the foot velocity is 0.034 m/s, which is around 0.45% of the maximum velocity. For the maximum velocity of the foot and the highest point of the backswing, the error is approximately 4% and 2.8%, respectively. With less complex hardware, our experimental results achieve excellent velocity accuracy.
Topics: Biomechanical Phenomena; Foot; Football; Lower Extremity; Motion; Soccer
PubMed: 36016005
DOI: 10.3390/s22166244 -
International Wound Journal Oct 2020About one-third of admissions to the surgical unit annually are diabetes foot infections in need of amputation In St. Kitts and Nevis. However, the risk factors related...
About one-third of admissions to the surgical unit annually are diabetes foot infections in need of amputation In St. Kitts and Nevis. However, the risk factors related to diabetes foot and amputation remain unknown. This study investigated factors associated with diabetic foot and amputation (DFA). Retrospective case control study design, and purposive and quota sampling method was used to recruit the participants. Patients with and without DFA were interviewed at two main hospitals, several primary health centres, and a private doctor's office during July and August 2018. Self-development questionnaires were applied to assess patients' demographic, physical and behaviour, foot care knowledge, attitudes, and practices related to DFA. Chi-square, t-test, and multiple logistic regressions were used to analyse the data. A total of 210 patients were evaluated, 89 had DFA, while 121 did not, with a mean age of 61.10 (SD = 11.85). Participants' responses indicated good knowledge, favourable attitudes, and adequate practices related to foot care. The two items of the questionnaire, ways to maintain blood flow in the lower extremities and wash their feet daily, had significant lower score in DFA group. In multiple logistic regression, knowledge, attitudes, and practices related to foot care were not a significant predictor of DFA. Being male was a predictor of DFA than female (OR = 3.53; 95% CI = 1.65-7.57; P < .01). Participants who were currently unemployed were less likely to have DFA than those who were employed (OR = 0.38; 95% Cl = 0.17-0.86; P < .05). Comparing patients with the longest experience of diabetes mellitus (31 years or more) with those who had diabetes for the shortest period of time (between 1 and 10 years) was less likely to have DFA (OR = 0.38; 95% CI = 0.15-0.97; P = <.05). The combination of these independent variables could explain 29% of the variance in DFA. Based on these findings, strategies to prevent diabetic foot and amputation should focus on male and outdoor heavy worker, and longer duration of diabetes patients which are identified in this study.
Topics: Amputation, Surgical; Case-Control Studies; Diabetes Mellitus; Diabetic Foot; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Retrospective Studies; Saint Kitts and Nevis
PubMed: 32744425
DOI: 10.1111/iwj.13446 -
Insights Into Imaging May 2022Diabetic foot infections are frequent and associated with substantial morbidity and substantial cost to the healthcare system. Up to 34% of diabetic patients will...
BACKGROUND
Diabetic foot infections are frequent and associated with substantial morbidity and substantial cost to the healthcare system. Up to 34% of diabetic patients will develop an ulcer potentially leading to osteomyelitis. Imaging plays a crucial role in the diagnostic process. Imaging modalities to investigate the diabetic foot infection are many and imaging prescription habits remain heterogeneous across physicians. We aimed to improve the appropriateness of imaging examination requested, and performed, for diabetic foot osteomyelitis and we aimed to reduce the overall imaging-related cost.
METHODS
Local committee was created to develop an algorithm for suspected diabetic foot osteomyelitis. Best practices were defined by the local algorithm. The algorithm was shared with our physicians. Pre- and post-intervention analysis was conducted retrospectively. All adult diabetic patients with suspected foot osteomyelitis were included. Adherence to best practices was measured. Statistical analysis with Chi-Square and two tailed unpaired t-test was performed.
RESULTS
Pre-intervention cohort had 223 patients (mean age: 63; 168 men). Adherence to best practice was 43%. Scintigraphy (48%) preferred over MRI (44%) and performed simultaneously in 15 patients. Post-intervention cohort had 73 patients (mean age: 66; 62 men). Adherence to best practice was 78%, improved by 35% (p < 0.001). MRI (51%) preferred over scintigraphy (23%) and performed simultaneously in three patients. Scintigraphy examinations decreased by 25% (p < 0.001). MRI examinations increased by 7% (p = 0.32). Hospital imaging related fees decreased by 22% per patient (p = 0.002).
CONCLUSION
Interval improvement in adequate adherence while reducing unnecessary examinations for patients and decreasing costs for the healthcare system was observed.
PubMed: 35536462
DOI: 10.1186/s13244-022-01228-1 -
BMC Musculoskeletal Disorders Aug 2022Post-injection paralysis (PIP) of the sciatic nerve is an iatrogenic paralysis that occurs after an intramuscular injection, with resultant foot deformity and...
BACKGROUND
Post-injection paralysis (PIP) of the sciatic nerve is an iatrogenic paralysis that occurs after an intramuscular injection, with resultant foot deformity and disability. This study investigates the epidemiology and treatment of PIP in Uganda.
METHODS
Health records of pediatric patients surgically treated for PIP at the CoRSU Rehabilitation Hospital from 2013 to 2018 were retrospectively reviewed. Pre-operative demographics, perioperative management, and outcomes were coded and analyzed with descriptive statistics, chi-square for categorical variables, and linear models for continuous variables.
RESULTS
Four-hundred and two pediatric patients underwent 491 total procedures. Eighty-three percent of reported injection indications were for febrile illness. Twenty-five percent of reported injections explicitly identified quinine as the agent. Although ten different procedures were performed, achilles tendon lengthening, triple arthrodesis, tibialis posterior and anterior tendon transfers composed 83% of all conducted surgeries. Amongst five different foot deformities, equinus and varus were most likely to undergo soft tissue and bony procedures, respectively (p=0.0223). Ninteen percent of patients received two or more surgeries. Sixty-seven percent of patients achieved a plantigrade outcome; 13.61% had not by the end of the study period; 19.3% had unreported outcomes. Those who lived further from the facility had longer times between the inciting injection and initial hospital presentation (p=0.0216) and were more likely to be lost to follow-up (p=0.0042).
CONCLUSION
PIP is a serious iatrogenic disability. Prevention strategies are imperative, as over 400 children required 491 total surgical procedures within just six years at one hospital in Uganda.
Topics: Child; Foot Deformities; Humans; Iatrogenic Disease; Injections, Intramuscular; Paralysis; Retrospective Studies; Treatment Outcome
PubMed: 35932071
DOI: 10.1186/s12891-022-05664-4 -
Journal of Physical Therapy Science Mar 2022[Purpose] This study aimed to compare the muscle activity around the foot and ankle joints, notably of the abductor digiti minimi, between affected and unaffected sides...
[Purpose] This study aimed to compare the muscle activity around the foot and ankle joints, notably of the abductor digiti minimi, between affected and unaffected sides of individuals with chronic ankle instability. [Participants and Methods] Twelve adult males with chronic ankle instability in one ankle (age, 27.7 ± 5.4 years; height, 172.5 ± 8.1 cm; weight, 67.5 ± 8.1 kg) were included and underwent surface electromyography assessments in multiple positions on both affected and unaffected sides. Measurements were obtained for eight muscles including the abductor digiti minimi. Each measurement included a 5-s segment of the stable waveform, with the root mean square-processed and normalized to the resting position set to 1. [Results] Abductor digiti minimi activity on the affected side was significantly reduced during maximal toe extension/abduction with both ankle dorsiflexion and plantarflexion. Peroneus longus activity on the affected side was significantly greater during maximal toe extension/abduction with ankle plantarflexion; peroneus longus and tibialis anterior muscle activities were significantly greater on the affected side during maximal toe extension/abduction with ankle dorsiflexion. [Conclusion] In the absence of load, muscle imbalance in the intrinsic and extrinsic muscles of the foot was suggested. However, no significant differences were observed under loading conditions.
PubMed: 35291477
DOI: 10.1589/jpts.34.242 -
PloS One 2023Research has shown that insulin resistance (IR) is a known risk factor for diabetic foot (DF), and the triglyceride-glucose (TyG) index is a reliable and simple...
BACKGROUND
Research has shown that insulin resistance (IR) is a known risk factor for diabetic foot (DF), and the triglyceride-glucose (TyG) index is a reliable and simple indicator of IR. However, less is known about the relationship between the TyG and the risk of DF. Here, we investigated the association between the TyG index and the prevalence of DF.
METHODS
The eligible records from the Departments of Endocrinology of Shandong Provincial Hospital Affiliated to Shandong First Medical University were screened (from December 1, 2012, to December 31, 2021), and a total of 8866 patients were enrolled. The TyG index was calculated as ln[(fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2)]. The continuous variables between the DF and the non-DF groups were compared by Student's t test or the Mann-Whitney U test, and categorical variables were compared by the chi-square test. Receiver operating characteristic curve (ROC) analysis was carried out to estimate the predictive value of the TyG index for DF. Logistic regression models were used to evaluate the associations between the quartiles of the TyG index and the risk of DF. Subgroup and sensitivity analyses were conducted.
RESULTS
The TyG index was significantly lower in the DF group than in the no-DF group. The logistic regression revealed that an increased TyG index was associated with a lower risk of DF after adjusting for potential confounders. In addition, an ROC analysis indicated the discriminatory ability of the TyG index in DF presence with an area under the curve (AUC) of 0.661 (95% CI 0.642-0.680, P < 0.001). Subgroup and sensitivity analysis also supported these robust results.
CONCLUSIONS
The TyG index was inversely and dose-dependently associated with the risk of DF in diabetes patients, indicating that elevated TyG index was a protective factor for DF. Future studies are therefore warranted to confirm our finding and to explore the detailed pathological mechanism involved in this process.
Topics: Humans; Glucose; Cross-Sectional Studies; Blood Glucose; Diabetic Foot; Triglycerides; Risk Factors; Insulin Resistance; Biomarkers; Diabetes Mellitus
PubMed: 37922259
DOI: 10.1371/journal.pone.0293872 -
BMC Musculoskeletal Disorders May 2024Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg...
BACKGROUND
Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP.
METHOD
This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg.
RESULTS
In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age. Overall, 1,077 (21%) reported pain in the foot/lower leg. The odds ratios (ORs) of pain were higher in females (OR 1.31, 95% confidence interval (CI) 1.13-1.53), individuals who could ambulate (Gross Motor Function Classification System Level I (OR 1.84, CI 1.32-2.57) and II (OR 2.01, CI 1.46-2.79) compared to level V), and in individuals with decreased range of motion of the ankle (dorsiflexion 1-10 degrees (OR 1.43, CI 1.13-1.83) and ≤ 0 degrees (OR 1.46, CI 1.10-1.93) compared to ≥ 20 degrees). With increasing age the OR of pain increased (OR 1.02, CI 1.01-1.03) as well as the reported pain intensity (p < 0.001).
CONCLUSIONS
Pain in the foot and lower leg appears to be a significant problem in individuals with CP, particularly in those who walk. As with pain in general in this population, both pain intensity and frequency increase with age. The odds of pain in the foot and lower leg were increased in individuals with limited dorsiflexion of the ankle. Given the cross-sectional design causality cannot be inferred and it is unknown if pain causes decreased range of motion of the ankle or if decreased range of motion causes pain. Further research is needed on causal pathways and importantly on prevention.
Topics: Humans; Cerebral Palsy; Male; Female; Registries; Cross-Sectional Studies; Adult; Adolescent; Child; Young Adult; Sweden; Leg; Child, Preschool; Prevalence; Foot; Middle Aged; Pain; Pain Measurement
PubMed: 38762469
DOI: 10.1186/s12891-024-07486-y -
Aging Clinical and Experimental Research Jul 2019Falling is a significant concern for many elderly adults but identifying individuals at risk of falling is difficult, and it is not clear how elderly adults adapt to...
BACKGROUND
Falling is a significant concern for many elderly adults but identifying individuals at risk of falling is difficult, and it is not clear how elderly adults adapt to challenging walking.
AIMS
The aim of the current study was to determine the effects of walking at non-preferred speeds on the coordination between foot and trunk acceleration variability in healthy elderly adults with and without fall history compared to healthy young adults.
METHODS
Subjects walked on a treadmill at 80%-120% of their preferred walking speed while trunk and foot accelerations were recorded with wireless inertial sensors. Variability of accelerations was measured by root mean square, range, sample entropy, and Lyapunov exponent. The gait stability index was calculated using each variability metric in the frontal and sagittal plane by taking the ratio of trunk acceleration variability divided by foot acceleration variability.
RESULTS
Healthy young adults demonstrated larger trunk accelerations relative to foot accelerations at faster walking speeds compared to elderly adults, but both young and elderly adults show similar adaption to their acceleration regularity. Between group differences showed that elderly adult fallers coordinate acceleration variability between the trunk and feet differently compared to elderly non-fallers and young adults.
DISCUSSION
The current results indicate that during gait, elderly fallers demonstrate more constrained, less adaptable trunk movement relative to their foot movement and this pattern is different compared to elderly non-fallers and healthy young.
CONCLUSIONS
Coordination between trunk and foot acceleration variability plays an important role in maintaining stability during gait.
Topics: Acceleration; Accidental Falls; Adult; Aged; Aged, 80 and over; Case-Control Studies; Exercise Test; Female; Foot; Gait; Humans; Male; Postural Balance; Risk Assessment; Torso; Walking; Walking Speed; Young Adult
PubMed: 30194680
DOI: 10.1007/s40520-018-1036-4 -
Cardiovascular Diabetology Jul 2021Some studies have suggested that patients with diabetes and foot complications have worse cardiovascular and cerebrovascular risk profiles, higher degrees of endothelial...
Assessment of heart rate variability (HRV) in subjects with type 2 diabetes mellitus with and without diabetic foot: correlations with endothelial dysfunction indices and markers of adipo-inflammatory dysfunction.
BACKGROUND
Some studies have suggested that patients with diabetes and foot complications have worse cardiovascular and cerebrovascular risk profiles, higher degrees of endothelial dysfunction and arterial stiffness and a higher inflammatory background than patients with diabetes without diabetic foot complications. Patients with diabetes mellitus have an alteration in the sympathovagal balance as assessed by means of heart rate variability (HRV) analysis, which is also related to the presence of endothelial dysfunction. Other studies suggest a possible role of inflammation coexisting with the alteration in the sympathovagal balance in favor of the atherosclerotic process in a mixed population of healthy subjects of middle and advanced age.
AIMS
The aim of this study was to evaluate the degree of alteration of sympathovagal balance, assessed by HRV analysis, in a cohort of patients with diabetes mellitus with diabetic foot and in control subjects without diabetic foot compared with a population of healthy subjects and the possible correlation of HRV parameters with inflammatory markers and endothelial dysfunction indices.
METHODS
We enrolled all patients with diabetic ulcerative lesions of the lower limb in the Internal Medicine with Stroke Care ward and of the diabetic foot outpatient clinic of P. Giaccone University Hospital of Palermo between September 2019 and July 2020. 4-h ECG Holter was performed. The following time domain HRV measures were analyzed: average heart rate, square root of the mean of successive differences of NN (RMSSD), standard deviation or square root of the variance (SD), and standard deviation of the means of the NN intervals calculated over a five-minute period (SDANN/5 min). The LF/HF ratio was calculated, reactive hyperemia was evaluated by endo-PAT, and serum levels of vaspine and omentin-1 were assessed by blood sample collection.
RESULTS
63 patients with diabetic foot, 30 patients with diabetes and without ulcerative complications and 30 patients without diabetes were enrolled. Patients with diabetic ulcers showed lower mean diastolic blood pressure values than healthy controls, lower MMSE scores corrected for age, lower serum levels of omentin-1, lower RHI values, higher body weight values and comparable body height values, HF% and LF/HF ratio values. We also reported a negative correlation between the RHI value and HRV indices and the expression of increased parasympathetic activity (RMSDD and HF%) in subjects with diabetic foot and a statistically significant positive correlation with the LF/HF ratio and the expression of the sympathovagal balance.
DISCUSSION
Patients with diabetic foot show a higher degree of activation of the parasympathetic system, expressed by the increase in HF values, and a lower LF/HF ratio. Our findings may corroborate the issue that a parasympathetic dysfunction may have a possible additive role in the pathogenesis of other vascular complications in subjects with diabetic foot.
Topics: Aged; Biomarkers; Case-Control Studies; Cross-Sectional Studies; Cytokines; Diabetes Mellitus, Type 2; Diabetic Foot; Endothelium, Vascular; Female; GPI-Linked Proteins; Heart; Heart Rate; Humans; Hyperemia; Inflammation Mediators; Lectins; Male; Middle Aged; Serpins; Sympathetic Nervous System; Vagus Nerve
PubMed: 34261479
DOI: 10.1186/s12933-021-01337-z -
Archives of Endocrinology and Metabolism Sep 2023This study investigated the nutritional status, 25-hydroxyvitamin D (25OHD), albumin and risk factors associated with complications in patients with foot and ankle...
OBJECTIVE
This study investigated the nutritional status, 25-hydroxyvitamin D (25OHD), albumin and risk factors associated with complications in patients with foot and ankle fragility fractures.
SUBJECTS AND METHODS
Prospective study, developed with patients who suffered fractures due to fragility of the foot and ankle (n = 108); the type of fractured bone, fracture mechanisms and classification were studied and also pseudoarthrosis, treatment, surgical dehiscence, anthropometry, 25OHD and albumin. The Chi-square or Fisher's exact test, Mann-Whitney and Kruskal-Wallis tests were used in the statistical analysis and the multiple logistic regression analysis was used to identify the risk factors associated with complications.
RESULTS
The factors that, together, were associated with treatment complications were the level of 25OHD (p = 0.0055; OR = 0.868 [1,152]; 95% CI = 0.786; 0.959 [1.043;1.272]) and diabetes (p = 0.0034; OR = 30,181; 95% CI = 3.087; 295.036). The factors that, together, were associated with the presence of any complication, were age (p = 0.0139; OR = 1.058; 95% CI = 1.011; 1,106) and 25OHD level (p = 0.0198; OR = 0.917; 95% CI = 0.852; 0.986). There was a complication probability above 0.40 associated with lower 25OHD levels (values below 20 ng/mL) and older age (over 50 years).
CONCLUSION
Lower or abnormal levels of 25OHD were associated with pseudoarthrosis, and age and 25OHD were both risk factors for treatment complications in patients with foot and ankle fractures.
Topics: Humans; Adult; Ankle Fractures; Prospective Studies; Pseudarthrosis; Diabetes Mellitus; Risk Factors; Albumins
PubMed: 37738466
DOI: 10.20945/2359-4292-2022-0020