The influence of barefoot and barefoot inspired footwear on the kinetics and kinematics of running in comparison to conventional running shoes.

Barefoot running has experienced a resurgence in footwear biomechanics literature, based on the supposition that it serves to reduce the occurrence of overuse injuries in comparison to conventional shoe models. This consensus has lead footwear manufacturers to develop shoes which aim to mimic the mechanics of barefoot locomotion. This study compared the impact kinetics and 3-D joint angular kinematics observed whilst running: barefoot, in conventional cushioned running shoes and in shoes designed to integrate the perceived benefits of barefoot locomotion. The aim of the current investigation was therefore to determine whether differences in impact kinetics exist between the footwear conditions and whether shoes which aim to simulate barefoot movement patterns can closely mimic the 3-D kinematics of barefoot running. Twelve participants ran at 4.0 m.s-1±5% in each footwear condition. Angular joint kinematics from the hip, knee and ankle in the sagittal, coronal and transverse planes were measured using an eight camera motion analysis system. In addition simultaneous tibial acceleration and ground reaction forces were obtained. Impact parameters and joint kinematics were subsequently compared using repeated measures ANOVAs. The kinematic analysis indicates that in comparison to the conventional and barefoot inspired shoes that running barefoot was associated significantly greater plantar-flexion at footstrike and range of motion to peak dorsiflexion. Furthermore, the kinetic analysis revealed that compared to the conventional footwear impact parameters were significantly greater in the barefoot condition. Therefore this study suggests that barefoot running is associated with impact kinetics linked to an increased risk of overuse injury, when compared to conventional shod running. Furthermore, the mechanics of the shoes which aim to simulate barefoot movement patterns do not appear to closely mimic the kinematics of barefoot locomotion

The manipulation of midsole properties to alter impact characteristics in walking

The midsole of footwear can provide an opportunity to attenuate the impact at the foot-ground interface. The present study was undertaken to quantify impact in walking in different footwear midsoles, comparing footwear thickness and hardness variations. Methods: Footbed thickness (28-41 mm) and hardness (30-55 Shore A) were varied independently in 7 flip-flops. Thirteen subjects walked in the footwear variations on a level walkway in the gait laboratory as lower limb kinematics, vertical ground reaction force and peak positive axial tibial acceleration were quantified. Peak magnitude and time of the acceleration were quantified and the heel-strike transient was characterised for comparison between conditions with a repeated-measures ANOVA. Thickness and hardness variations were also compared using a drop-test protocol to replicate walking. Results: Lower limb joint angles did not vary at heel-strike, however, a faster vertical heel-velocity was recorded in the softer midsoles (e.g. 55 Shore A = -0.294±0.055, 30 Shore A= -0.328±0.052, p<.001). Varying the hardness of the midsoles also significantly altered tibial acceleration and force variables, however limited significant differences existed between the thickness variations in walking. Increasing the hardness of the heel section of the footwear increased the peak positive axial tibial acceleration values, for example increasing Shore A from 30 to 40 resulted in a 35% increase in this variable. Concurrently, the occurrence of heel-strike transients increased from 5.8% in the 30 Shore A condition to 22.5%, 46.7% and 71.7% of all trials in the 40, 47 and 55 Shore A conditions respectively. The drop-test protocol replicated the differences evident in the walking protocol despite magnitudes being elevated. Conclusion: Modifying midsole properties of flip-flop footwear, particularly hardness, alters the gait kinematics and the shock experienced by the wearer in walking. This may pose benefits in terms of comfort and reduction in loading to the lower limb, however the influence on foot motion at initial contact and footwear longevity should be further quantified

The assessment of direct results of drainage operations in the biliary tract in patients with obstructive jaundice

The article presents the results of a clinical examination of 88 patients aged 22 to 91 years who underwent drainage operations for obstructive jaundice in the Gomel Clinical Oncology Center between January 2017 and October 2019. The analysis of drainage interventions on the biliary tract, the duration of jaundice, hospitalization, complications.В статье представлены результаты клинического обследования 88 пациентов в возрасте от 22 до 91 года, перенесших дренирующие операции по поводу механической желтухи в Гомельском клиническом онкологическом диспансере в период с января 2017 по октябрь 2019 года. Проводился анализ дренирующих вмешательств на желчевыводящих путях, длительность желтухи, госпитализации, осложнений