The Effect of Subtalar Arthrodesis Alignment on Ankle Biomechanics

2012 ◽  
Author(s):  
James R. Jastifer ◽  
Peter A. Gustafson ◽  
Robert R. Gorman
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Neutral Position ◽  
Moment Arms ◽  
Subtalar Arthrodesis ◽  
Force Moment ◽  
Ankle Biomechanics

Background: The position, axis, and control of each lower extremity joint intimately affects adjacent joint function as well as whole limb performance. There is little describing the biomechanics of subtalar arthrodesis and none describing the effect that subtalar arthrodesis position has on ankle biomechanics. The purpose of the current study is to establish this effect on sagittal plane ankle biomechanics. Methods: A study was performed utilizing a three-dimensional, validated, computational model of the lower extremity. A subtalar arthrodesis was simulated from 20 degrees of varus to 20 degrees of valgus. For each of these subtalar arthrodesis positions, the ankle dorsiflexor and plantarflexor muscles’ fiber force, moment arm, and moments were calculated throughout a physiologic range of motion. Results: Throughout ankle range of motion, plantarflexion and dorsiflexion strength varies with subtalar arthrodesis position. When the ankle joint is in neutral position, plantarflexion strength is maximized in 10 degrees of subtalar valgus and strength varies by a maximum of 2.6% from the peak 221 Nm. In a similar manner, with the ankle joint in neutral position, dorsiflexion strength is maximized with a subtalar joint arthrodesis in 5 degrees of valgus and strength varies by a maximum of 7.5% from the peak 46.8 Nm. The change in strength is due to affected muscle fiber force generating capacities and muscle moment arms. Conclusion: The clinical significance of this study is that subtalar arthrodesis in a position of 5–10 degrees subtalar valgus has biomechanical advantage. This supports previous clinical outcome studies and offers biomechanical rationale for their generally favorable outcomes.

scholarly journals Static Range of Motion of the First Metatarsal in the Sagittal and Frontal Planes

2018 ◽  
Vol 7 (11) ◽  
pp. 456 ◽  
Author(s):  
Sandra Tavara-Vidalón ◽  
Manuel Monge-Vera ◽  
Guillermo Lafuente-Sotillos ◽  
Gabriel Domínguez-Maldonado ◽  
Pedro Munuera-Martínez
Keyword(s):  
Range Of Motion ◽  
Least Squares Method ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Neutral Position ◽  
Future Design ◽  
First Metatarsal ◽  
Medial Cuneiform ◽  
First Ray ◽  
Degree Equation

The first metatarsal and medial cuneiform form an important functional unit in the foot, called “first ray”. The first ray normal range of motion (ROM) is difficult to quantify due to the number of joints that are involved. Several methods have previously been proposed. Controversy exists related to normal movement of the first ray frontal plane accompanying that in the sagittal plane. The objective of this study was to investigate the ROM of the first ray in the sagittal and frontal planes in normal feet. Anterior-posterior radiographs were done of the feet of 40 healthy participants with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. They were digitalized and the distance between the tibial malleolus and the intersesamoid crest in the three positions mentioned was measured. The rotation of the first ray in these three positions was measured. A polynomic function that fits a curve describing the movement observed in the first ray was obtained using the least squares method. ROM of the first ray in the sagittal plane was 6.47 (SD 2.59) mm of dorsiflexion and 6.12 (SD 2.55) mm of plantarflexion. ROM in the frontal plane was 2.69 (SD 4.03) degrees of inversion during the dorsiflexion and 2.97 (SD 2.72) degrees during the plantarflexion. A second-degree equation was obtained, which represents the movement of the first ray. Passive dorsiflexion and plantarflexion of the first ray were accompanied by movements in the frontal plane: 0.45 degrees of movement were produced in the frontal plane for each millimeter of displacement in the sagittal plane. These findings might be useful for the future design of instruments for clinically quantifying first ray mobility.

Lower Extremity Joint Work During Acceleration, Deceleration, and Steady State Running

2017 ◽  
Vol 33 (1) ◽  
pp. 56-63 ◽  
Author(s):  
D.S. Blaise Williams ◽  
Jonathan H. Cole ◽  
Douglas W. Powell
Keyword(s):  
Steady State ◽  
Lower Extremity ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Joint Work ◽  
Negative Work ◽  
Relative Contribution ◽  
Acceleration And Deceleration ◽  
The Individual ◽  
Positive Work

Running during sports and for physical activity often requires changes in velocity through acceleration and deceleration. While it is clear that lower extremity biomechanics vary during these accelerations and decelerations, the work requirements of the individual joints are not well understood. The purpose of this investigation was to measure the sagittal plane mechanical work of the individual lower extremity joints during acceleration, deceleration, and steady-state running. Ten runners were compared during acceleration, deceleration, and steady-state running using three-dimensional kinematics and kinetics measures. Total positive and negative joint work, and relative joint contributions to total work were compared between conditions. Total positive work progressively increased from deceleration to acceleration. This was due to greater ankle joint work during acceleration. While there was no significant change in total negative work during deceleration, there was a greater relative contribution of the knee to total negative work with a subsequent lower relative ankle negative work. Each lower extremity joint exhibits distinct functional roles in acceleration compared with deceleration during level running. Deceleration is dominated by greater contributions of the knee to negative work while acceleration is associated with a greater ankle contribution to positive work.

scholarly journals Ankle morphology amplifies calcaneus movement relative to triceps surae muscle shortening

2013 ◽  
Vol 115 (4) ◽  
pp. 468-473 ◽  
Author(s):  
R. Csapo ◽  
J. Hodgson ◽  
R. Kinugasa ◽  
V. R. Edgerton ◽  
S. Sinha
Keyword(s):  
Magnetic Resonance ◽  
Achilles Tendon ◽  
Ankle Joint ◽  
Sagittal Plane ◽  
Triceps Surae ◽  
Myotendinous Junction ◽  
Joint Movement ◽  
Center Of Rotation ◽  
Moment Arms ◽  
Plantarflexor Muscles

The present study investigated the mechanical role of the dorsoventral curvature of the Achilles tendon in the conversion of the shortening of the plantarflexor muscles into ankle joint rotation. Dynamic, sagittal-plane magnetic resonance spin-tagged images of the ankle joint were acquired in six healthy subjects during both passive and active plantarflexion movements driven by a magnetic resonance compatible servomotor-controlled foot-pedal device. Several points on these images were tracked to determine the 1) path and deformation of the Achilles tendon, 2) ankle's center of rotation, and 3) tendon moment arms. The degree of mechanical amplification of joint movement was calculated as the ratio of the displacements of the calcaneus and myotendinous junction. In plantarflexion, significant deflection of the Achilles tendon was evident in both the passive (165.7 ± 7.4°; 180° representing a straight tendon) and active trials (166.9 ± 8.8°). This bend in the dorsoventral direction acts to move the Achilles tendon closer to the ankle's center of rotation, resulting in an ∼5% reduction of moment arm length. Over the entire range of movement, the overall displacement of the calcaneus exceeded the displacement of the myotendinous junction by ∼37%, with the mechanical gains being smaller in dorsi- and larger in plantarflexed joint positions. This is the first study to assess noninvasively and in vivo using MRI the curvature of the Achilles tendon during both passive and active plantarflexion movements. The dorsoventral tendon curvature amplifies the shortening of the plantarflexor muscles, resulting in a greater displacement of the tendon's insertion into the calcaneus compared with its origin.

Effect of prosthetic ankle units on the gait of persons with bilateral trans-femoral amputations

2008 ◽  
Vol 32 (1) ◽  
pp. 111-126 ◽  
Author(s):  
Lexyne L. McNealy ◽  
Steven A. Gard
Keyword(s):  
Power Generation ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Lower Limb ◽  
Stance Phase ◽  
Sagittal Plane ◽  
The Body ◽  
Control Group ◽  
Initial Contact ◽  
Ankle Motion

In able-bodied individuals, the ankle joint functions to provide shock absorption, aid in foot clearance during the swing phase, and provides a rocker mechanism during stance phase to facilitate forward progression of the body. Prosthetic ankles currently used by persons with lower limb amputations provide considerably less function than their anatomical counterparts. However, increased ankle motion in the sagittal plane may improve the gait of persons with lower limb amputations while providing a more versatile prosthesis. The primary aim of this study was to examine and quantify temporal-spatial, kinematic, and kinetic changes in the gait of four male subjects with bilateral trans-femoral amputations who walked with and without prosthetic ankle units. Two prosthesis configurations were examined: (i) Baseline with only two Seattle LightFoot2 prosthetic feet, and (ii) with the addition of Endolite Multiflex Ankle units. Data from the gait analyses were compared between prosthetic configurations and with a control group of able-bodied subjects. The amputee subjects' freely-selected walking speeds, 0.74 ± 0.19 m/s for the Baseline condition and 0.81 ± 0.15 m/s with the ankle units, were much less than that of the control subjects (1.35 ± 0.10 m/s). The amputee subjects demonstrated no difference in walking speed, step length, cadence, or ankle, knee, and hip joint moments and powers between the two prosthesis configurations. Sagittal plane ankle range of motion, however, increased by 3–8° with the addition of the prosthetic ankle units. Compared to the control group, following initial contact the amputee subjects passively increased the rate of energy storage or dissipation at the prosthetic ankle joint, actively increased the power generation at the hip, and increased the extension moment at the hip while wearing the prosthetic ankle configuration. The amputee subjects increased the power generation at their hips, possibly as compensation for the reduced rate of energy return at their prosthetic ankles. Results from subject questionnaires administered following the gait analyses revealed that the prosthetic ankle units provided more comfort during gait and did not increase the perceived effort to walk. The subjects also indicated that they preferred walking with the prosthetic ankle units compared to the Baseline configuration. The results of the study showed that the prosthetic ankle units improved sagittal plane ankle range of motion and increased the comfort and functionality of the amputee subjects’ prostheses by restoring a significant portion of the ankle rocker mechanism during stance phase. Therefore, prosthetic ankle mechanisms should be considered a worthwhile option when prostheses are prescribed for persons with trans-femoral amputations.

scholarly journals The effect of prosthetic torsional stiffness on the golf swing kinematics of a left and a right-sided trans-tibial amputee

2004 ◽  
Vol 28 (2) ◽  
pp. 121-131 ◽  
Author(s):  
J. P. Rogers ◽  
S. C. Strike ◽  
E. S. Wallace
Keyword(s):  
Ankle Joint ◽  
Perceived Stress ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Transverse Plane ◽  
Golf Swing ◽  
Torsional Stiffness ◽  
The Difference ◽  
The Right ◽  
Socket Interface

The golf swing is a biomechanically complex movement requiring three-dimensional movements at the ankle joint complex (AJC), the hips and shoulders. Trans-tibial amputees lose the natural AJC movements as many prostheses do not allow three dimensional foot movements. Torsion devices have been developed and incorporated into prostheses to facilitate internal and external transverse plane rotations. These devices can help amputees to compensate for the loss of movement and to reduce shearing stresses at the stump-socket interface. The primary aim of the present study was to investigate the effects of three torsion devices on body rotations during the golf swing. Two trans-tibial amputees (one right-sided and one left-sided) were analysed using three-dimensional video analysis at address (ADR), the top of the backswing (TBS) and at the end of the follow-through (EFT). The participants played shots with a 3-wood under three different prosthetic conditions (two with a torsion device set to different stiffness values, and one with no torsion device). The results showed that the torsion device served to improve the hip and shoulder rotations of the left-side amputee without increasing perceived stress at the stump. The torsion device had minimal effect on the hip and shoulder rotations of the right-side amputee, although perceived stress was reduced. The difference in results between the right-sided and left-sided amputees was due to the different requirements of each foot during the golf swing. The main problem faced by the right-side amputee was a loss of the sagittal plane movement of ankle joint plantarflexion at EFT, rather than the transverse plane movement.

Kinematics of the Axially Loaded Ankle

1995 ◽  
Vol 16 (9) ◽  
pp. 577-582 ◽  
Author(s):  
James D. Michelson ◽  
Stephen L. Helgemo
Keyword(s):  
Axial Load ◽  
Sagittal Plane ◽  
External Rotation ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Ankle Injuries ◽  
Knee Amputation ◽  
Precise Understanding ◽  
Ankle Biomechanics

An apparatus that allowed the application of a 900 N axial load and the simultaneous measurement of rotation in the sagittal, coronal, and axial planes was used to study the normal kinematics of the ankle in 13 below-knee amputation specimens. Two testing routines were done on all specimens. In the first sequence, specimens were moved through a dorsiflexion (DF) and plantarflexion (PF) arc of 60° (25° DF and 35° PF). DF was associated with an average of 2.5° of external rotation, and PF was associated with an average of <1° of internal rotation. In the coronal plane, PF and DF were both associated with <1° of varus. In the second part of the testing, the ankle position in the sagittal plane (DF/PF) was fixed and the axial load was increased from 50 N to 750 N in 100-N intervals. Increasing the axial load caused an increase in external rotation and valgus of 1° to 2°. For axial rotation, external rotation was more pronounced in PF than DF. The effect of load on the increase on valgus was not affected by sagittal ankle position. The effect of increasing axial load on sagittal rotation was to increase DF or PF <2° over the entire range of loads and sagittal positions. The understanding of ankle biomechanics is essential to the formulation of rational guidelines for the treatment of ankle pathology and the prediction of the long-term consequences of ankle injuries. The incomplete understanding of this subject is evident when the disparate recommendations for a number of common conditions are considered. By examining the three-dimensional motion of the stable ankle, a more precise understanding of the abnormal three-dimensional motions associated with instability can be achieved. This knowledge will permit a logical approach to treatment of ankle fractures.

A Three-Dimensional Biomechanical Analysis of the Cat Ankle Joint Complex: I. Active and Passive Postural Mechanics

1999 ◽  
Vol 15 (2) ◽  
pp. 95-105 ◽  
Author(s):  
John H. Lawrence ◽  
T. Richard Nichols
Keyword(s):  
Ankle Joint ◽  
Three Dimensional ◽  
Joint Stiffness ◽  
Biomechanical Analysis ◽  
Reference Plane ◽  
Joint Orientation ◽  
Orthogonal Axis ◽  
Joint Torques ◽  
Flexion Extension ◽  
Force Moment

Muscle actions are often defined with respect to a single anatomical reference plane based on a “predominant” functional activity. Yet animals must control posture and movement within a three-dimensional (3-D) environment, exerting control over more than one reference plane when responding to a 3-D array of perturbing forces. Consequently, enhanced knowledge concerning the 3-D torque capabilities of certain appendicular muscles might provide for greater understanding of the biomechanical basis for motor control. We propose that the cat postural control mechanism utilizes the inherent 3-D mechanical actions of ankle flexors and extensors to maintain extra-saggital joint stiffness. We used a 6 degree-of-freedom force-moment sensor to assess the effect of ankle joint orientation on the 3-D nature of isometric joint torques evoked by electrical stimulation of muscles crossing the AJC in the deeply anesthetized cat. An orthogonal axis system was established at the designated ankle rotation center, such that pitch (defining flexion-extension), yaw (abduction-adduction), and roll (inversion-eversion) axis torques were calculated. Experimental results show that the classical cat ankle flexor and extensors evoke large extra-sagittal torques as well. Also, the hind limb levering system stabilizes the AJC against large yaw and roll rotations away from the control position.

scholarly journals Validity and Reliability of a Smartphone and Digital Inclinometer in Measuring the Lower Extremity Joints Range of Motion

2021 ◽  
Vol 10 (2) ◽  
pp. 47-52
Author(s):  
Walaa S. Mohammad ◽  
◽  
Faten F. Elattar ◽  
Walaa M. Elsais ◽  
Salameh O. AlDajah ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Sagittal Plane ◽  
Low Cost ◽  
Smart Phone ◽  
Correlation Coefficients ◽  
Plane Motion ◽  
Clinical Settings ◽  
Validity And Reliability ◽  
Digital Inclinometer

In clinical settings, available valid and reliable tools are important components in evaluating the lower extremity range of motion. Although the digital inclinometer is highly reliable compared to the universal goniometer, its availability and high cost impede its extensive use. Nowadays, smartphone applications have become widely available to clinicians for assessing the joint range of motion. The present study aims to assess the validity and intra-rater reliability of the smart- phone application “Clinometer” for measuring hip, knee, and ankle sagittal ranges of motion, using the digital inclinom- eter as the reference standard. Active hip, knee flexion and ankle dorsiflexion and plantarflexion range-of-motion mea- surements were recorded in 102 young, healthy female participants on two separate occasions using Clinometer and a digital inclinometer. Pearson’s correlation coefficients (r) were used to evaluate the smartphone application’s validity against the digital inclinometer. To assess the reliability of the Clinometer app, the intra-class correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable difference (MDD) were used. Clinometer displayed excellent validity when compared to the digital inclinometer for hip and knee movements (r>0.90), while ankle ROM displayed moderate validity (r = 0.52-0.57). Additionally, Clinometer demonstrated excellent reliability (ICC > 0.90) for hip and knee sagittal plane motion and moderate reliability for the ankle sagittal plane motion (ICC = 0.53–0.67). Cli- nometer is a portable, low-cost, valid, and reliable tool for assessing active hip and knee range of motions and can be easily incorporated into clinical settings; however, it cannot be used interchangeably for ankle measures.

scholarly journals Musculoskeletal modeling of an ostrich (Struthio camelus) pelvic limb: Influence of limb orientation on muscular capacity during locomotion

2014 ◽  
Author(s):  
John R Hutchinson ◽  
Jeffery W Rankin ◽  
Jonas Rubenson ◽  
Kate H Rosenbluth ◽  
Robert A Siston ◽  
...  
Keyword(s):  
Muscle Function ◽  
Sagittal Plane ◽  
Dynamic Properties ◽  
Three Dimensional ◽  
Limb Muscle ◽  
Struthio Camelus ◽  
Moment Arms ◽  
Extensor Muscles ◽  
Pelvic Limb ◽  
The Moment

We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus) to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics, body size, anatomy and evolution. Combined with experimental data, we use this model to test two main hypotheses. We first query whether ostriches use limb orientations (joint angles) that optimize the moment-generating capacities of their muscles during walking or running. Next, we test whether ostriches use limb orientations at mid-stance that keep their extensor muscles near maximal, and flexor muscles near minimal, moment arms. Our two hypotheses relate to the control priorities that a large bipedal animal might evolve under biomechanical constraints to achieve more effective static weight support. We find that ostriches do not use limb orientations to optimize the moment-generating capacities or moment arms of their muscles. We infer that dynamic properties of muscles or tendons might be better candidates for locomotor optimization. Regardless, general principles explaining why species choose particular joint orientations during locomotion are lacking, raising the question of whether such general principles exist or if clades evolve different patterns (e.g. weighting of muscle force-length or force-velocity properties in selecting postures). This leaves theoretical studies of muscle moment arms estimated for extinct animals at an impasse until studies of extant taxa answer these questions. Finally, we compare our model’s results against those of two prior studies of ostrich limb muscle moment arms, finding general agreement for many muscles. Some flexor and extensor muscles exhibit self-stabilization patterns (posture-dependent switches between flexor/extensor action) that ostriches may use to coordinate their locomotion. However, some conspicuous areas of disagreement in our results illustrate some cautionary principles. Importantly, tendon-travel empirical measurements of muscle moment arms must be carefully designed to preserve 3D muscle geometry lest their accuracy suffer relative to that of anatomically realistic models. The dearth of accurate experimental measurements of 3D moment arms of muscles in birds leaves uncertainty regarding the relative accuracy of different modelling or experimental datasets such as in ostriches. Our model, however, provides a comprehensive set of 3D estimates of muscle actions in ostriches for the first time, emphasizing that avian limb mechanics are highly three-dimensional and complex, and how no muscles act purely in the sagittal plane. A comparative synthesis of experiments and models such as ours could provide powerful synthesis into how anatomy, mechanics and control interact during locomotion and how these interactions evolve. Such a framework could remove obstacles impeding the analysis of muscle function in extinct taxa.

Muscle activities of lower extremity and erector spinae muscles according to ankle joint position during squat exercise

2021 ◽  
pp. 1-6
Author(s):  
Ha-Rim Sung ◽  
Se-Jung Oh ◽  
Jun-Nam Ryu ◽  
Yong-Jun Cha
Keyword(s):  
Lower Extremity ◽  
Ankle Joint ◽  
Muscle Activity ◽  
Vastus Lateralis ◽  
Plantar Flexion ◽  
Erector Spinae ◽  
Neutral Position ◽  
Vastus Medialis ◽  
Joint Position ◽  
Squat Exercise

OBJECTIVE: The purpose of this study was to investigate the most effective ankle joint position for squat exercise by comparing muscle activities of lower extremity and erector spinae muscles in different ankle joint positions. METHODS: Thirty-seven normal healthy adults in their 20s participated in this study. Muscle activities of dominant vastus medialis oblique, vastus lateralis, biceps femoris, and erect spinae were measured in three ankle joint positions; dorsiflexion, neutral, and plantar flexion. RESULTS: Muscle activities of the vastus medialis oblique, vastus lateralis, and erector spinae muscles were statistically different in the three ankle joint positions during squat exercise (p< 0.05). Vastus medialis oblique muscles showed higher muscle activity in ankle plantar flexion than in the dorsiflexion or neutral positions (plantar flexion > neutral position, +3.3% of maximal voluntary isometric contraction (MVIC); plantar flexion > dorsiflexion, +12.2% of MVIC, respectively). Vastus lateralis muscles showed 7.1% of MVIC greater muscle activity in the neutral position than in dorsiflexion, and erector spinae muscles showed higher muscle activity in dorsiflexion than in plantar flexion or in the neutral position (dorsiflexion > neutral position, +4.3% of MVIC; dorsiflexion > plantar flexion, +7.1% of MVIC, respectively). CONCLUSION: In squat exercises designed to strengthen the vastus medialis oblique, ankle joint plantar flexion is probably the most effective ankle training position, and the dorsiflexion position might be the most effective exercise for strengthening the erector spinae muscle.

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