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Kinematics at the ankle joint complex in rheumatoid arthritis

By James Woodburn

Abstract

This thesis investigates the three-dimensional kinematics at the ankle joint complex in rheumatoid arthritis. Previous studies have identified the rearfoot as a common site for inflammatory activity in rheumatoid arthritis resulting in painful and disabling deformity for which there are no proven interventions.\ud \ud A generic electromagnetic tracking system was developed to undertake three-dimensional kinematics at the ankle joint complex in the bare and shod foot during gait. A joint simulator was designed, manufactured and commissioned in house to test the accuracy of the system. The results indicated errors of less than 1° in rotation and 1 mm in position measurements. Clinical testing of the measurement system was undertaken in both normal healthy adults and rheumatoid arthritis subjects. The technique was able to measure the characteristic three-dimensional kinematics for the ankle joint complex in the normal subjects and detected accurately abnormal angular rotations in the rheumatoid arthritis group. In both cohorts the within day repeatability of the measurements were good, and over a longer period data were stable in the rheumatoid\ud arthritis group allowing the technique to be used in longitudinal studies. Finally, skin movement artefact where the electromagnetic sensor is attached on the heel was investigated using a magnetic resonance imaging technique and found to be less than 1° across the range of motion\ud for the joint complex.\ud \ud Kinematic measurements were undertaken in two cohorts of rheumatoid arthritis subjects randomised to receive or not custom manufactured foot orthoses to correct early valgus heel deformity. The orthoses were constructed in rigid carbon graphite and modified to offer the correct degree of movement control for each patient. Kinematic data were compared between the rheumatoid arthritis groups and that measured from an age- and sex-matched healthy adult\ud population. In both rheumatoid arthritis groups abnormal kinematics were easily detected with significant alteration of inversion/eversion and internal/external rotation. With foot orthoses the inversion/eversion angular rotations were almost fully restored to normal, but little effect was\ud observed for internal/external rotation.\ud \ud The rheumatoid arthritis patients underwent repeat kinematic measurement over a period of 30-months. In the control group the angular rotations improved slightly from baseline, although in comparison with normal healthy population remained abnormal. In the intervention group the\ud orthotic control of inversion/eversion was sustainable for 30 months. Furthermore, coupling between inversion/eversion and internal/external rotation was partially restored towards the end of the study. In barefoot walking the intervention group demonstrated a substantial correction of\ud the deformity in the frontal plane. It was attempted to explain the results in terms of soft-tissue laxity and adaptation following correction of joint deformity. Three-dimensional kinematic measurements were also conducted at the knee and calcaneotalonavicular joint complex.\ud Abnormal rotations and orthotic response were demonstrable at these joints but with less satisfactory results because of technical limitations of the measurement technique.\ud \ud Plantar pressure distribution was also studied using an in-shoe measurement technique. Custom designed orthoses were found to alter the pressure and force distribution at the interface with the foot. The largest effects were observed at the heel and midfoot regions and these were sustainable\ud and significantly different from the non-intervention control group.\ud \ud The clinical effectiveness of the foot orthoses was also evaluated. A pragmatic randomised controlled trial was undertaken and serial measurements of foot pain and disability, using the Foot Function Index conducted at baseline and 3,6 12,18,24 and 30-months. The results\ud revealed an immediate and significant reduction in foot pain and disability with foot orthoses. Minor adverse reactions were reported but overall comfort levels and compliance were high. The overall reduction in foot pain and disability was sustained up to 30 months

Publisher: School of Medicine (Leeds)
Year: 2000
OAI identifier: oai:etheses.whiterose.ac.uk:753

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Citations

  1. (1855) Die Bewegung des fussess am prungbein.
  2. (1999). 3D MR image analysis of the morphology of the rear foot: application to the classification of bones.
  3. (1997). A 20-year follow-up study of subtalar changes in rheumatoid arthritis.
  4. (1999). A characterization of the geometric architecture of the peritalar joint complex via MRI: an aid to the classification of foot type.
  5. (1995). A comparison of two in-shoe plantar pressure measurement systems.
  6. (1997). A comparison of two motion analysis systems for the measurement of two-dimensional rearfoot motion during walking.
  7. (1983). A joint co-ordinate system for the clinical description of three-dimensional motions: application to the knee.
  8. (1995). A joint coordinate system for the ankle complex.
  9. (1983). A kinematic analysis of the tarsal joints. An X-ray photogrammetric study.
  10. (1967). A method for determination of pedal pressure changes during weightbearing: preliminary observations in normal and arthritic feet. Arthritis Rheum.
  11. (1993). A method for the measurement of threedimensional scapular movement.
  12. (1997). A method to determine bone movement in the ankle joint complex in vitro.
  13. (1993). A method to determine the range of motion of the ankle complex, in vivo.
  14. (1996). A new method for quantifying pronation in overpronating and normal runners.
  15. (1997). A new system for threedimensional gait recording using electromagnetic tracking.
  16. (1995). A six-degree-of-freedom test system for the study of joint mechnaics and ligament forces.
  17. (1996). A six-degrees-of-freedom instrumented linkage for measuring the flexibility characteristics of the ankle complex.
  18. (1996). A study of the foot problems of a consecutive group of patients with rheumatoid arthritis.
  19. (1990). A study of the inter-tester and intra-tester reliability in the measurement of resting calcaneal stance position and neutral calcaneal stance position. Australian Podiatrist
  20. (1995). A technique to evaluate foot function during the stance phase of gait.
  21. (1992). A three-dimensional morphometrical study of the distal human femur.
  22. (1985). A triplanar electrogoniometer investigation of running mechanics in runners with compensatory overpronation.
  23. (1990). A video-based technique for measuring ankle-subtalar motion during stance.
  24. (1996). Accuracy of an electromagnetic tracking device: a study of the optimal operating range and metal interference.
  25. (1964). Action of the subtalar and ankle joint complex during the stance phase of walking.
  26. (1987). Advances in orthotics for the patient with rheumatoid arthritis.
  27. (1961). An anatomical and functional study of the tarsal joints. Luctor et Emergo,
  28. (1982). An apparatus for measuring the loaddisplacement and load-dependent kinematic characteristics of articulating joints- application to the human ankle joint.
  29. (1966). An electromyographic study of the plantar flexors of the ankle in normal walking on the level.
  30. (1999). Analysis of HIV-1 clinical trials: statistical magic? The Lancet 353,2061-2064.
  31. (1998). Analysis of in vivo 3-D internal kinematics of the joints of the foot.
  32. (1990). Analysis of serial measurements in medical research.
  33. (1993). Anatomy of the foot and ankle.
  34. (1984). Ankle and subtalar motion during gait in arthritic patients.
  35. (1969). Anthropometric studies of the human foot and ankle.
  36. (1988). Application of a magnetic tracking device to kinesiologic studies.
  37. (1985). Applied linear statistical models. 2"d Edition, Richard D Irwin Inc.
  38. (1998). Applied regression analysis. A research tool. 2" Edition.
  39. (2000). Biomechanical analysis of the stance phase during barefoot and shod running.
  40. (1995). Biomechanical comparison between high tibial osteotomy (HTO) and combined HTO and fibular osteotomy.
  41. (1998). Biomechanical properties of human cadaveric ankle-subtalar joints in quasi-static loading.
  42. (1985). Biomechanics of the subtalar joint: a re-appraisal.
  43. (2000). Calibration of position and angular data from a magnetic tracking device.
  44. (1995). Can foot orthoses prevent hallux valgus deformity in rheumatoid arthritis? A randomised clinical trial.
  45. (1979). Changes in load bearing in the rheumatoid foot.
  46. (2000). Changes in the measurement of neutral and relaxed calcaneal stance positions with experience.
  47. (1995). Clinical hindfoot measurement: a critical review of the literature.
  48. (1985). Clinical measurement of the axis of the subtalar joint.
  49. (1988). Closed versus open kinematic chain measurement of subtalar joint eversion: implications for clinical practice.
  50. (1997). Comparative usefulness of C-reactive protein and erythrocyte sedimentation rate in patients with rheumatoid arthritis.
  51. (1995). Comparison of 2-dimensional and 3-dimensional rearfoot motion during walking.
  52. (1985). Computed tomography of the hindfoot with rheumatoid arthritis. Arthritis Rheum.
  53. (1993). Control of motion of tibial fractures with use of a functional brace or external fixator.
  54. (1987). Deformation of the adult rheumatoid rearfoot. A radiographic study.
  55. (1998). Destruction and arthroplasties of the metatarsophalangeal joints in sero-positive rheumatoid arthritis. A 20-year follow-up study.
  56. (1996). Development and validation of the European League Against Rheumatism Response criteria for rheumatoid arthritis. Arthritis Rheum.
  57. (1994). Development of the functional foot orthosis.
  58. (1999). Diagnostic injections of the hindfoot joints in patients with rheumatoid arthritis prior to surgical fusion. The Foot 9,40-43.
  59. (1903). Die mechanik der fusswurzel. MD Thesis,
  60. (1993). Differences in ankle complex range of motion as a function of age.
  61. (1988). Dynamic biomechanics of the normal foot and ankle during walking and running.
  62. (1992). Dynamics of human gait. Human Kinetics
  63. (1997). Effect of skin movement on the analysis of skeletal knee joint motion during running.
  64. (1997). Effect of the posterior tibial tendon on the arch of the foot during simulated weightbearing: biomechanical analysis.
  65. (1983). Effects of a soft orthotic device on rearfoot movement in running.
  66. (1993). Effects of arch height of the foot on angular motion of the lower extremities in running.
  67. (1989). Effects of foot orthoses on center-of-pressure patterns in women.
  68. (1979). Effects of ligamentous injury on ankle and subtalar joints: a kinematic study.
  69. (1994). Effects of three different posting methods on controlling abnormal subtalar pronation.
  70. (1992). Effects of tibial rotations on patellar tracking and patello-femoral contact areas.
  71. (1998). Effects of variations in calcaneocuboid fusion technique on kinematics of the normal hindfoot.
  72. (1994). Effects of walking speed on plantar pressure patterns and hindfoot angular motion.
  73. (2000). Electromagnetic interference susceptibility of electromagnetic motion measurement equipment. Gait and Posture 11,129.
  74. (1990). Elongation and forces of ankle ligaments in a physiological range of motion.
  75. (1999). Established rheumatoid arthritis.
  76. (1999). Estimation of missing values. The Lancet 354,686.
  77. (1985). Evaluation and management of the rheumatoid foot.
  78. (1997). Evaluation of early rheumatoid arthritis disease activity and outcome.
  79. (1988). Evaluation of the neutral position of the subtalar joint.
  80. (1997). Feasibility of using a magnetic tracking device for measuring carpal kinematics.
  81. (1987). Flattening of the rheumatoid foot in tarsal arthritis on X-ray.
  82. (1994). Foot and ankle problems in rheumatoid arthritis.
  83. (1994). Foot inversion-eversion and knee kinematics during walking.
  84. (1994). Foot movement and tendon excursion: An in vitro study.
  85. (1998). Foot pressure studies in the assessment of forefoot arthroplasty in rheumatoid arthritis.
  86. (1998). Forefoot deformity, pain and mobility in rheumatoid and nonarthritic subjects.
  87. (1995). Functional impairment and disability in early rheumatoid arthritis- development over 5 years.
  88. (1996). Gait analysis- an introduction. 2"d Edition.
  89. (1982). Gait analysis: alteration in support phase forces using supportive devices.
  90. (1992). Gait analysis. Normal and pathological function. Slack Incorporated,
  91. (1972). Gait characteristics of the rheumatoid knee.
  92. (1988). Gait in rheumatoid arthritis: an electrogoniometric investigation.
  93. (1999). Gait variables: appropriate objective outcome measures in rheumatoid arthritis.
  94. (1992). Heel movement within a court shoe.
  95. Hindfoot pain treated by a leghindfoot orthosis.
  96. (1996). Impacts of foot orthoses on pain and disability in rheumatoid arthritis.
  97. (1996). Impression casting techniques. In Clinical biomechanics of the lower extremities. ed Valmassey
  98. (1995). In vitro kinematics of the axially loaded ankle complex in response to dorsiflexion and plantarflexion.
  99. (1994). In vivo determination of the anatomical axes of the ankle joint complex: an optimization approach.
  100. (1992). In-shoe plantar pressure measurement: a review. The Foot
  101. (1995). Influences of inversion/eversion of the foot upon impact loading during locomotion.
  102. (1978). Injuries to runners.
  103. (1997). Introduction: How does evidence that is available affect decisions with an individual patient. In Early rheumatoid arthritis.
  104. (1987). Joints and movements of the foot: terminology and concepts.
  105. (1987). Kinematic analysis of the talocalcaneal/talocrural joint during running support.
  106. (1992). Kinematics of semiconstrained total elbow arthroplasty.
  107. (1989). Kinematics of the ankle/foot complex- part 3: influence of leg rotation.
  108. (1989). Kinematics of the ankle/foot complex-part 2: pronation and supination.
  109. (1989). Kinematics of the ankle/foot complex: plantarflexion and dorsiflexion.
  110. (1999). Kinematics of the human ankle complex in passive flexion; a single degree of freedom system.
  111. (1995). Kinematics of the normal arch of the foot and ankle under physiological loading.
  112. (1963). Kinesiology and mechanical anatomy of the tarsal joints.
  113. (1962). Lateral instability of the knee following polyarthritis.
  114. (1988). Ligament length relationship in the moving knee.
  115. (1979). Magnetic position and orientation tracking system.
  116. (1980). Measurement of patient outcome in arthritis. Arthritis Rheum.
  117. (1972). Measurement of pedal pressures. An illustration of a method.
  118. (1993). Measurement of the range and coupled movements observed in the lumbar spine.
  119. (1990). Measurement of three-dimensional shoulder movement by an electromagnetic sensor.
  120. (1987). Methods for determination of positional variations in the sub talar joint axis.
  121. (1999). Methods for handling missing values in clinical trials.
  122. (1981). Mid-foot disassociation in rheumatoid arthritis.
  123. (1995). Modified disease activity scores that include twenty-eight-joint counts. Arthritis Rheum.
  124. (1996). Moment arm length variations of selected muscles acting on talocrural and subtalar joints during movement: an in vitro study.
  125. (1941). Movements of the subtalar and transverse tarsal joints.
  126. (1994). MPhil Thesis,
  127. (1969). Muscles and movement. A basis for human kinesiology.
  128. (1975). Neurologic complications of rheumatoid arthritis.
  129. (1971). Neutral position casting techniques. Clinical Biomechanics Corp,
  130. (1999). New approaches to imaging of early rheumatoid arthritis.
  131. (1989). New Method for the non-invasive three-dimensional measurement of human back movement.
  132. (1996). No relation between the position of the rearfoot at its moment of heel contact and chronic instability: a video analysis.
  133. (1977). Normal and abnormal function of the foot. Clinical biomechanics, Vol IT Clinical Biomechanics Corp,
  134. (1996). On the use of bone and skin markers in kinematics research.
  135. (1996). Orthoses for rheumatoid feet: does it matter what's underfoot? The Lancet 347,1639
  136. (1999). Orthotic management of plantar pressure and pain in rheumatoid arthritis.
  137. (1973). Painful feet in rheumatoid arthritis.
  138. (1982). Pathomechanics, gait deviations, and treatment of the rheumatoid foot.
  139. (1997). Pedaldynographic measurement after forefoot reconstruction in rheumatoid arthritis patients.
  140. (1999). Pharmacotherapeutic combination strategies with disease-modifying antirheumatic drugs in well-established rheumatoid arthritis.
  141. (1997). Physiological elongation of ligamentous complex surrounding the hindfoot joints: In vitro biomechanical study.
  142. (1990). Post operative pressure under the rheumatic feet.
  143. (1995). Posterior tibial tendon dysfunction in rheumatoid arthritis.
  144. (1994). Predication of radiographic damage in hands and feet in rheumatoid arthritis by clinical evaluation.
  145. (1984). Pressure under the forefoot in rheumatoid arthritis: a comparison of static and dynamic methods of assessment.
  146. (1996). Proficiency of foot care specialists to place the rearfoot at subtalar neutral.
  147. (1995). progression and repair in radiographs of hands and forefeet in early rheumatoid arthritis.
  148. (1999). Progression of foot deformities in rheumatoid arthritis- a radiographic follow-up study over 5 years.
  149. (1999). Quantifying a relationship between tactile and vibration sensitivity of the human foot with plantar pressure distributions during gait.
  150. (1997). Radiographic changes in the feet of patients with early rheumatoid arthritis.
  151. (1997). Radiographic damage in large joints in early rheumatoid arthritis: relationship with radiographic damage in hands and feet, disease activity, and physical
  152. (1977). Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference film.
  153. (1994). Radiographic study of skin displacement errors in the foot and ankle during standing.
  154. (1992). Range of motion of the foot as a function of age.
  155. (1996). Rear foot inversion/eversion during gait relative to the subtalar joint neutral position.
  156. (1995). Rearfoot motion and pressure distribution patterns during running in shoes with varus and valgus wedges.
  157. (1998). Reconstruction operations for acquired flatfoot: Biomechanical evaluation.
  158. (1996). Relation between heel position and the distribution of forefoot plantar pressures and skin callosities in rheumatoid arthritis.
  159. (1994). Relationship between neutral subtalar joint position and pattern of rearfoot motion during walking.
  160. (1996). Reliability of an in-shoe pressure measurement system during treadmill walking.
  161. (1997). Reliability of clinical measurement of subtalar movement.
  162. (1993). Reliability of hindfoot goniometry when using a flexible electrogoniometer.
  163. (1997). Reliability of open kinetic chain subtalar joint measurement. The Foot 7,128-134.
  164. (1997). Reliability of two instruments in the measurement of closed chain subtalar joint position. The Foot 7,194-201.
  165. (1989). Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait.
  166. (1982). Rheumatoid arthritis in the foot and ankle- diagnosis, pathology, and treatment: the relationship between foot and ankle deformity and disease duration in 50 patients.
  167. (1967). Rheumatoid arthritis of the pantalar joints (a follow-up study of triple arthrodesis on 292 adult feet). Acta Orthopaedica Scandinavica Supplementum No.
  168. (1989). Rheumatoid Hindfoot.
  169. (1994). Right to left differences in the ankle joint complex range of motion.
  170. (1983). Rigid painful flatfoot secondary to tarsal coalition.
  171. (1976). Roentgen features of the rheumatoid mid- and hindfoot.
  172. (1992). Scapular inclination and inferior stability of the shoulder.
  173. (2000). Sonography is more sensitive at detecting synovitis in the metatarsal-phalangeal joints (MTPJ) than clinical examination. Rheumatology 39, Abstracts Supplement 1,86.
  174. (1987). Spatial reconstruction technique and kinematic modelling of the ankle.
  175. (1997). Stability of the arch of the foot.
  176. (1985). Stability of the loaded ankle. Relation between articular restraint and primary and secondary restraints.
  177. (1986). Stanford Health Assessment Questionnaire modified to assess disability in British patients with rheumatoid arthritis.
  178. (1997). Subtalar stability. Talocalcaneal interosseous ligament function studied in cadaver specimens.
  179. (1998). Support of the talus: a biomechanical investigation of the contributions of the talonavicular and talocalcaneal joints, and superomedial calcaneonavicular ligament. Foot and Ankle
  180. (1997). Surface movement errors in shank kinematics and knee kinetics during gait.
  181. (1991). Talocrural and talocalcaneal joint kinematics and kinetics during the stance phase of walking.
  182. (1951). Tarsal movements.
  183. (1994). Technique for in vivo measurement of the three-dimensional kinematics and laxity characteristics of the ankle joint complex.
  184. (1996). Technique for the measurement of hindfoot inversion and eversion and its use to study a normal population.
  185. (1988). The American Rheumatism Association
  186. (1965). The anatomy and function of the contents of the human tarsal sinus and canal.
  187. (1982). The ankle and subtalar joints. Clinics in Rheumatic Diseases.
  188. (1993). The axes of rotation of the talocalcaneal and talonavicular joints.
  189. (1993). The biomechanics of orthoses. In Biomechanical basis of orthotic management
  190. (1994). The centre of pressure index in the evaluation of foot orthoses in shoes.
  191. (1983). The Cherwell splint: an ankle and foot orthosis for rheumatoid arthritis.
  192. (1985). The constraint-mechanism of the human tarsus.
  193. (1999). The development of a three plane system for the measurement of the ankle/subtalar joint complex in gait. The Foot 9,31-39.
  194. (1996). The development of foot deformities in early rheumatoid arthritis.
  195. (1981). The dynamic vertical force distribution during level walking under normal and rheumatic feet.
  196. (1999). The effect of custom moulded ethyl vinyl acetate foot orthoses on the gait of patients with rheumatoid arthritis.
  197. (1995). The effect of foot orthotics on threedimensional kinematics of the leg and rearfoot during running.
  198. (1998). The effect of foot structure on the three-dimensional kinematic coupling behavior of the leg and rearfoot.
  199. (1986). The effects of soft and semirigid orthoses upon rearfoot movement in running.
  200. (1994). The effects of soft foot orthotics on three-dimensional lower-limb kinematics during walking and running.
  201. (1995). The foot and ankle in rheumatoid arthritis.
  202. (1990). The foot and ankle: biomechanical evaluation and treatment. In: Orthopaedic and Sports Physical Therapy.
  203. (1991). The foot function index: a measure of foot pain and disability.
  204. (1994). The foot in chronic rheumatoid arthritis: a continuing problem. The Foot.
  205. (1975). The foot in chronic rheumatoid arthritis.
  206. (1967). The function of the subtalar joint.
  207. (1995). The functional foot orthosis. Churchill
  208. (1945). The functional significance of the declination of the axis of the subtalar joint.
  209. (1990). The importance of toes in walking.
  210. (1990). The importance of valgus hindfoot in forefoot surgery in rheumatoid arthritis.
  211. (1978). The incidence of pain in the rheumatoid hindfoot and the significance of calcaneo-fibular impingement.
  212. (1976). The joints of the ankle. Williams and Wilkins,
  213. (1958). The ligamentous structures in the canalis and sinus tarsi.
  214. (2000). The links between joint damage and disability in rheumatoid arthritis.
  215. (1953). The mechanics of the foot. I- The joints.
  216. (1992). The movement of the heel within a running shoe.
  217. (1959). The normal movement at the sub-talar joint.
  218. (1994). The optimal management of early rheumatoid disease: the key to preventing disability.
  219. (1991). The pattern of pressure distribution under the weightbearing forefoot. The Foot.
  220. (1995). The planovalgus rheumatoid foot. Is tibialis posterior tendon rupture a factor?
  221. (1999). The posterior tibial tendon and tarsal sinus in rheumatoid flat foot: magnetic resonance imaging of 40 feet.
  222. (1975). The prediction of muscular load sharing and joint forces in the lower extremities during walking.
  223. (1991). The relationship of pain and deformity of the rheumatoid foot to gait and an index of functional limitation.
  224. (1998). The relative skin movement of the foot: a 2-D roentgen photogrammetry study.
  225. (1993). The rheumatoid foot and ankle: pathology and treatment. The Foot.
  226. (1985). The rheumatoid foot during gait.
  227. (1956). The rheumatoid foot: A clinical study with pathological and roentgenological comments.
  228. (1990). The rheumatoid foot: a sideways look.
  229. (1970). The rheumatoid foot.
  230. (1988). The stabilising effect of the ligamentous structures in the sinus and canalis tarsi on movements in the hindfoot.
  231. (1988). The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints-part 1: kinematics.
  232. (1960). The transverse tarsal joint and its control.
  233. (1992). The use of specially padded hosiery in the painful rheumatoid foot.
  234. (1998). Three-dimensional analysis of flatfoot deformity: cadaver study.
  235. (1997). Three-dimensional analysis of normal ankle and foot mobility.
  236. (1993). Three-dimensional analysis of the talocrural and subtalar joints in single-limb stance.
  237. (1999). Three-dimensional kinematics of the forefoot, rearfoot and leg without the function of tibialis posterior in comparison with normals during stance phase of walking.
  238. (1990). Three-dimensional kinematics of the human back.
  239. (1992). Three-dimensional kinematics of the human knee during walking.
  240. (1996). Three-dimensional kinematics of the rearfoot during the stance phase of walking in normal young adult males.
  241. (1990). Three-dimensional measurement of rearfoot motion during running.
  242. (1999). Three-dimensional movement of the foot during the stance phase of walking.
  243. (1988). Tibialis posterior tendon rupture: a cause of rheumatoid flat foot.
  244. (1989). Tibialis posterior tendon synovitis and rupture.
  245. (1997). Tibiofemoral and tibiocalcaneal motion during walking: external vs. skeletal markers.
  246. (1992). Timing of lower extremity joint actions during treadmill running.
  247. (1987). Torsion-transmitting properties of the hind foot.
  248. (1994). Transfer of movement between calcaneus and tibia in vitro.
  249. (1997). Treatment of early rheumatoid arthritis patients with slow-acting anti-rheumatic drugs (SAARDs).
  250. (1993). Twisting mobility of the human back in flexed postures.
  251. (1994). Two measurement techniques for assessing subtalar joint position- a reliability study.
  252. (1899). Uber die gelenke der fuszwurzel.
  253. (1990). Ultrasonography of the metatarsophalangeal and talocrural joints.
  254. (1994). Ultrasonography of the tibialis posterior tendon in rheumatoid arthritis.
  255. (1991). Valgus deformity of the feet and characteristics of gait in patients who have rheumatoid arthritis.
  256. (1992). Variation in lumbar spine mobility measured over a 24-hour period.
  257. (1997). What is early rheumatoid arthritis?: definition and diagnosis.

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