Exploración de la flexión dorsal del tobillo: Una revisión

The ankle joint is an important part of the musculoskeletal system necessary for normal ambulation. Reduced range of movement at this joint has been termed as gastrocnemius contracture, limited ankle dorsiflexion and ankle equinus. This condition has been related to various functional lower extremity musculoskeletal conditions.This paper explores and provides an overview of ankle equinus, its effect on the lower extremities and someof the issues involved in the clinical measurement of ankle dorsiflexion.La articulación del tobillo es una parte importante del sistema musculoesquelético necesaria para la deambulación normal. A la reducción del rango de movimiento en esta articulación que se ha denominado como contractura de gemelo, flexión dorsal del tobillo limitado y equino del tobillo. Esta condición se ha relacionado con diversas condiciones patológicas funcionales de las extremidades inferiores musculoesqueléticos.Este artículo explora y proporciona una visión general de equino de tobillo, su efecto en las extremidades inferiores y algunas de las cuestiones relativas a la medición clínica de la flexión dorsal del tobillo

The Role of "Non-Traditional" Physical Activities in Improving Balance in Older Adults: A Review

Recent research indicates that the number of people aged over 60 years is rising faster than any other age group which will put increased financial and social strains on all countries. One major focus of various health and social care agencies is not only to keep these older individuals healthy but also physically active and independent. Many older people lead inactive lives which together with the ageing process lead to physiological changes which have potentially damaging effects on balance control and are risk factors for falls. Research shows that physical activity improves mental health, often stimulates social contacts and can help older people remain as independent as possible. This paper has attempted to review existing research on physical activities and exercise intervention used to improve balance in older adults. Using relevant databases and keywords, 68 studies that met the inclusion criteria were reviewed. Results indicate that many traditional activities can help to improve balance in older adults. However, further investigations need to be conducted into activities that are not generally considered appropriate for older people but may be enjoyable and have health benefits and may help to improve balance in this population

Everyday footwear: An overview of what we know and what we should know on ill-fitting footwear and associated pain and pathology.

Footwear has been used to protect feet for millennia with socially exclusive population adopting stylish and fashionable shoes with expensive materials. In terms of historic timeline, only more recently footwear has been worn by all classes in the western world as an integral part of their apparel. Traditionally, footwear has been constructed from natural materials, mainly leather, but has recently benefitted from the flexibility that technology has provided with a plethora materials and new design innovations. Although it has expanded the availability for a variety of consumers, the choice and fit continue to be problematic with many individuals wearing shoes that are ill-fitting. Provision of specific footwear advice for problem feet is poorly evidenced and is heavily practitioner dependant limiting its efficacy. There is limited understanding as to the changes that can occur from regularly wearing footwear that is unsuitable in shape, style and construction which is referred to as ill-fitting. Current research on the effect that everyday footwear has on foot function and pain focuses mainly on women’s shoes, particularly high heels. Defining what is a good fitting shoe, that does not damage the foot or mechanics of walking, may need to be individualised, but best fit is based on loose historical parameters rather than research evidence. The aim of this overview is to highlight aspects of current research, establishing what we know about the effect’s shoes have on the feet as well as exploring the mythology around footwear fit and advice that is often historical in nature

An MRI compatible loading device for the reconstruction of clinically relevant plantar pressure distributions and loading scenarios of the forefoot

This study aims to present a new MRI compatible loading device capable of reconstructing realistic loading scenarios of the human foot for research in the field of foot biomechanics. This device has two different configurations: one used to compress the forefoot and one to bend the metatarsophalangeal joints. Required plantar pressure distribution under the metatarsal heads can be achieved by modifying the distribution of the dorsally applied forces. To validate the device, subject-specific plantar pressures were measured and then reconstructed using the device. For quiet stance the peak pressure reconstruction error was 3% while for mid-stance phase of gait it was 8%. The device was also used to measure the passive bending stiffness of the metatarsophalangeal joints of one subject with low intra-subject variability. A series of preliminary MRI scans confirmed that the loading device can be used to produce static weight-bearing images of the foot (voxel size: 0.23mm×0.23mm×1.00mm). The results indicate that the device presented here can accurately reconstruct subject specific plantar pressure distributions and measure the foot’s metatarsophalangeal passive stiffness. Possible future applications include the validation of finite element models, the investigation of the relationship between plantar pressure and internal stresses/strains and the study of the foot’s inter-segmental passive stiffness

The application of generic CAD/CAM systems for the design and manufacture of foot orthoses

For many years, foot orthoses have been manufactured using traditional techniques over plaster of Paris casts or foam impressions. Other types of existing orthoses include pre-fabricated and heat-molded orthoses. More advanced methods of manufacturing orthoses have been developed using Computer Aided Design and Computer Aided Manufacturing (CAD/CAM) technology. However, this type of technology is still presently expensive and thus not available to the majority of practitioners to consider as part of their routine clinical service, notwithstanding the fact that these systems offer various advantages over traditional methods. This paper provides a new methodological approach towards integrating various readily-available technologies into a foot orthoses design and manufacturing system at a cost that is attainable by the majority of practitioners. This should encourage the further utilization of this technology, from which both practitioner services and patients could possibly benefit.peer-reviewe

THE EFFECT OF SUBMAXIMAL LOADS ON TRUNK POSTURE DURING THE CLEAN IN COMPETITIVE WEIGHTLIFTERS

The purpose of this study was to investigate the effect of submaximal loads on trunk posture during the clean in the aid of improving the technical and physical training of weightlifters. Weightlifters (n=10) with at least two years of training experience in weightlifting participated the study. Each participant performed 3 cleans at 65, 75, 85% of one repetition maximum (1RM). The results of this study highlighted the importance of a controlled trunk motion during the first pull followed by a maximal extension of the trunk in the second pull in relation to weightlifting performance. This study provided novel information about important technical aspects in weightlifting

Selected foot length ratios in a non-pathological sample

Este estudio presenta los ratios de longitud del pie en una muestra midiendo las impresiones del pie obtenidas con una plataforma de presiones plantares disponible en el mercado. Estimamos un cociente medio de 1.3 (SD = 0.04) entre la longitud del pie y la distancia entre el talón y la cabeza del primer metatarsiano, 5.5 (SD = 0.49) entre la longitud del pie y el ancho del talón y 3.3 (SD = 0.3) entre la longitud del pie y la anchura del mismo en la zona metatarsal. Estos cocientes fueron similares, en comparación a otros estudios publicados previamente. No solo estos resultados pueden proporcionar información útil a la hora de la clasificación de los diferentes tipos de pie, si no también pueden servir de ayuda a la industria del calzado para diseñar con rigor calzados terapéuticos.This study reports on selected foot length ratios using foot prints obtained from a commercially available pressure platform system. An average ratio of 1.3 (SD = 0.04 ) between the foot length and the distance between heel and the head of the first metatarsal, 5.5 (SD = 0.49 ) between the foot length and heel width and 3.3 (SD = 0.3) between the foot length and ball width, were estimated. These ratios were consistent across the subjects and are comparable to previously published studies. While the results may provide useful information in the classification of foot types, it will also help the footwear industry in the modelling of lasts for therapeutic footwear

A method for subject-specific modelling and optimisation of the cushioning properties of insole materials used in diabetic footwear

This study aims to develop a numerical method that can be used to investigate the cushioning properties of different insole materials on a subject-specific basis. Diabetic footwear and orthotic insoles play an important role for the reduction of plantar pressure in people with diabetes (type-2). Despite that, little information exists about their optimum cushioning properties. A new in-vivo measurement based computational procedure was developed which entails the generation of 2D subject-specific finite element models of the heel pad based on ultrasound indentation. These models are used to inverse engineer the material properties of the heel pad and simulate the contact between plantar soft tissue and a flat insole. After its validation this modelling procedure was utilised to investigate the importance of plantar soft tissue stiffness, thickness and loading for the correct selection of insole material. The results indicated that heel pad stiffness and thickness influence plantar pressure but not the optimum insole properties. On the other hand loading appears to significantly influence the optimum insole material properties. These results indicate that parameters that affect the loading of the plantar soft tissues such as body mass or a person’s level of physical activity should be carefully considered during insole material selection

An MRI compatible loading device for the reconstruction of clinically relevant plantar pressure distributions and loading scenarios of the forefoot.

The purpose of this study is to demonstrate a new MRI compatible loading device capable of reconstructing realistic loading scenarios of the human foot for research in the field of foot biomechanics. This device has two different configurations: one used to compress the forefoot and one to bend the metatarsophalangeal joints. Required plantar pressure distribution under the metatarsal heads can be achieved by modifying the distribution of the dorsally applied forces. To validate the device, subject-specific plantar pressures were measured and then reconstructed using the device. For quiet stance the peak pressure reconstruction error was 3% while for mid-stance phase of gait it was 8%. The device was also used to measure the passive bending stiffness of the metatarsophalangeal joints of one subject with low intra-subject variability. A series of preliminary MRI scans confirmed that the loading device can be used to produce static weight-bearing images of the foot (voxel size: 0.23 mm × 0.23 mm × 1.00 mm). The results indicate that the device presented here can accurately reconstruct subject specific plantar pressure distributions and measure the foot's metatarsophalangeal passive stiffness. Possible future applications include the validation of finite element models, the investigation of the relationship between plantar pressure and internal stresses/strains and the study of the foot's inter-segmental passive stiffness

Three-dimensional kinematics of the lumbar spine during gait using marker-based systems: a systematic review.

To review the current scientific literature on the assessment of three-dimensional movement of the lumbar spine with a focus on the utilisation of a 3D cluster. Electronic databases PubMed, OVID, CINAHL, The Cochrance Library, ScienceDirect, ProQuest and Web of Knowledge were searched between 1966 and March 2015. The reference lists of the articles that met the inclusion criteria were also searched. From the 1530 articles identified through an initial search, 16 articles met the inclusion criteria. All information relating to methodology and kinematic modelling of the lumbar segment along with the outcome measures were extracted from the studies identified for synthesis. Guidelines detailing 3D cluster construction were limited in the identified articles and the lack of information presented makes it difficult to assess the external validity of this technique. Scarce information was presented detailing time-series angle data of the lumbar spine during gait. Further developments of the 3D cluster technique are required and it is essential that the authors provide clear instruction, definitions and standards in their manuscript to improve clarity and reproducibility