scholarly journals Biomechanical Response to External Biofeedback During Functional Tasks in Individuals with Chronic Ankle Instability

2020 ◽  
Author(s):  
Danielle M Torp ◽  
Abbey C Thomas ◽  
Tricia Hubbard-Turner ◽  
Luke Donovan
Keyword(s):  
Real Time ◽  
Plantar Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Static Balance ◽  
Visual Biofeedback ◽  
Time Integral ◽  
Pressure Time ◽  
Eyes Open ◽  
Functional Task

Abstract Context: Altered biomechanics displayed by individuals with chronic ankle instability (CAI) is a potential cause for recurring injuries and posttraumatic osteoarthritis. Current interventions are unable to modify aberrant biomechanics leading research efforts to determine if real-time external biofeedback is capable of producing changes. Objective: Determine real-time effects of visual and auditory biofeedback on functional task biomechanics in individuals with CAI Design: Crossover study Setting: Laboratory Patients or Other Participants: Nineteen physically active adults with CAI (23.95±5.52 years; 168.87±6.94 cm; 74.74±15.41 kg, female=12) volunteered. Intervention: Participants randomly performed single-leg static balance, step-downs, lateral-hops, and forward-lunges during a baseline and two biofeedback conditions. Auditory biofeedback was given through a pressure sensor placed under the lateral foot connected to a buzzer eliciting a noise when pressure exceeded the set threshold. Visual biofeedback was given through a cross-line laser secured to the dorsum of the foot. Cues given during the biofeedback conditions were used to promote proper biomechanics during each respective task. Main Outcome Measure(s): Location of center of pressure (COP) data points during balance with eyes-open and closed during each condition. Plantar pressure during functional tasks were extracted in the lateral column of the foot. Secondary outcomes of interested were COP area and velocity, time-to-boundary during static balance, and additional plantar pressure measures. Results: Both biofeedback conditions reduced COP in the anterolateral quadrant while increasing COP in the posteromedial quadrant of the foot during eyes open balance, the auditory condition produced similar changes during eyes closed trials. Auditory biofeedback increased heel pressure during step-downs, while decreasing lateral forefoot pressure-time integral during lunges. Visual biofeedback increased lateral heel pressure and increased lateral heel and midfoot pressure-time integral during hops. Conclusions: Real-time improvements in balance strategies were observed during both external biofeedback conditions. Visual and auditory biofeedback appear to effectively moderate different functional task biomechanics.

Biomechanical Response to External Biofeedback During Functional Tasks in Individuals With Chronic Ankle Instability

2021 ◽  
Author(s):  
Danielle M. Torp ◽  
Abbey C. Thomas ◽  
Tricia Hubbard-Turner ◽  
Luke Donovan
Keyword(s):  
Real Time ◽  
Plantar Pressure ◽  
Ankle Instability ◽  
Static Balance ◽  
Eyes Closed ◽  
Visual Biofeedback ◽  
Time Integral ◽  
Pressure Time ◽  
Eyes Open ◽  
Functional Task

Context Altered biomechanics displayed by individuals with chronic ankle instability (CAI) is a possible cause of recurring injuries and posttraumatic osteoarthritis. Current interventions are unable to modify aberrant biomechanics, leading to research efforts to determine if real-time external biofeedback can result in changes. Objective To determine the real-time effects of visual and auditory biofeedback on functional-task biomechanics in individuals with CAI. Design Crossover study. Setting Laboratory. Patients or Other Participants Nineteen physically active adults with CAI (7 men, 12 women; age = 23.95 ± 5.52 years, height = 168.87 ± 6.94 cm, mass = 74.74 ± 15.41 kg). Intervention(s) Participants randomly performed single-limb static balance, step downs, lateral hops, and forward lunges during a baseline and 2 biofeedback conditions. Visual biofeedback was given through a crossline laser secured to the dorsum of the foot. Auditory biofeedback was given through a pressure sensor placed under the lateral foot and connected to a buzzer that elicited a noise when pressure exceeded the set threshold. Cues provided during the biofeedback conditions were used to promote proper biomechanics during each task. Main Outcome Measure(s) We measured the location of center-of-pressure (COP) data points during balance with eyes open and eyes closed for each condition. Plantar pressure in the lateral column of the foot during functional tasks was extracted. Secondary outcomes of interest were COP area and velocity, time to boundary during static balance, and additional plantar-pressure measures. Results Both biofeedback conditions reduced COP in the anterolateral quadrant while increasing COP in the posteromedial quadrant of the foot during eyes-open balance. Visual biofeedback increased lateral heel pressure and the lateral heel and midfoot pressure-time integral during hops. The auditory condition produced similar changes during the eyes-closed trials. Auditory biofeedback increased heel pressure during step downs and decreased the lateral forefoot pressure-time integral during lunges. Conclusions Real-time improvements in balance strategies were observed during both external biofeedback conditions. Visual and auditory biofeedback appeared to effectively moderate different functional-task biomechanics.

Effects of Real-Time Video Feedback on Plantar Pressure Measures in Individuals With Chronic Ankle Instability During Walking

2019 ◽  
Vol 24 (6) ◽  
pp. 229-234
Author(s):  
Anna M. Ifarraguerri ◽  
Danielle M. Torp ◽  
Abbey C. Thomas ◽  
Luke Donovan
Keyword(s):  
Real Time ◽  
Plantar Pressure ◽  
Ankle Instability ◽  
Video Feedback ◽  
Chronic Ankle Instability ◽  
Treadmill Walking ◽  
Gait Retraining ◽  
Pressure System ◽  
Time Integral ◽  
Pressure Time

Individuals with chronic ankle instability (CAI) have been shown to have increased lateral plantar pressure during walking which is thought to contribute to symptoms associated with CAI. The objective of this study was to determine whether real-time video feedback can reduce lateral plantar pressure in individuals with CAI. Twenty-six participants with CAI completed 30 s of treadmill walking while plantar pressure was measured using an in-shoe plantar pressure system (baseline). Next, participants completed an additional 30 s of treadmill walking while receiving video feedback (VID FB). During the VID FB condition, participants had a significant decrease in medial forefoot peak pressure and medial midfoot pressure-time integral; however, both changes were associated with small effect sizes. Real-time video feedback did not reduce lateral plantar pressure in individuals with CAI; therefore, other gait retraining strategies should be considered when treating patients with CAI.

Increased In-Shoe Lateral Plantar Pressures with Chronic Ankle Instability

2011 ◽  
Vol 32 (11) ◽  
pp. 1075-1080 ◽  
Author(s):  
Heather Schmidt ◽  
Lindsay D. Sauer ◽  
Sae Yong Lee ◽  
Susan Saliba ◽  
Jay Hertel
Keyword(s):  
Plantar Pressure ◽  
Peak Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Maximum Force ◽  
Pressure System ◽  
Time To Peak ◽  
Time Integral ◽  
Pressure Time ◽  
Force Time

Background: Previous plantar pressure research found increased loads and slower loading response on the lateral aspect of the foot during gait with chronic ankle instability compared to healthy controls. The studies had subjects walking barefoot over a pressure mat and results have not been confirmed with an in-shoe plantar pressure system. Our purpose was to report in-shoe plantar pressure measures for chronic ankle instability subjects compared to healthy controls. Methods: Forty-nine subjects volunteered (25 healthy controls, 24 chronic ankle instability) for this case-control study. Subjects jogged continuously on a treadmill at 2.68 m/s (6.0 mph) while three trials of ten consecutive steps were recorded. Peak pressure, time-to-peak pressure, pressure-time integral, maximum force, time-to-maximum force, and force-time integral were assessed in nine regions of the foot with the Pedar-x in-shoe plantar pressure system (Novel, Munich, Germany). Results: Chronic ankle instability subjects demonstrated a slower loading response in the lateral rearfoot indicated by a longer time-to-peak pressure (16.5% ± 10.1, p = 0.001) and time-to-maximum force (16.8% ± 11.3, p = 0.001) compared to controls (6.5% ± 3.7 and 6.6% ± 5.5, respectively). In the lateral midfoot, ankle instability subjects demonstrated significantly greater maximum force (318.8 N ± 174.5, p = 0.008) and peak pressure (211.4 kPa ± 57.7, p = 0.008) compared to controls (191.6 N ± 74.5 and 161.3 kPa ± 54.7). Additionally, ankle instability subjects demonstrated significantly higher force-time integral (44.1 N/s ± 27.3, p = 0.005) and pressure-time integral (35.0 kPa/s ± 12.0, p = 0.005) compared to controls (23.3 N/s ± 10.9 and 24.5 kPa/s ± 9.5). In the lateral forefoot, ankle instability subjects demonstrated significantly greater maximum force (239.9N ± 81.2, p = 0.004), force-time integral (37.0 N/s ± 14.9, p = 0.003), and time-to-peak pressure (51.1% ± 10.9, p = 0.007) compared to controls (170.6 N ± 49.3, 24.3 N/s ± 7.2 and 43.8% ± 4.3). Conclusion: Using an in-shoe plantar pressure system, chronic ankle instability subjects had greater plantar pressures and forces in the lateral foot compared to controls during jogging. Clinical Relevance: These findings may have implications in the etiology and treatment of chronic ankle instability. Level of Evidence: III, Retrospective Case Control Study

Effect of Orthotic Therapy on Claw Toe Loading

2004 ◽  
Vol 94 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Penny J. Claisse ◽  
Jodi Binning ◽  
Julia Potter
Keyword(s):  
Pressure Measurement ◽  
Plantar Pressure ◽  
Metatarsal Head ◽  
Plantar Surface ◽  
Time Integral ◽  
Pressure Time ◽  
Second Metatarsal ◽  
Plantar Pressure Measurement ◽  
Access To Data ◽  
Toe Deformity

This study demonstrates the effect of orthotic therapy for toe deformity on toe and metatarsal head pressures using a new analysis method facilitated by an in-shoe pressure-measurement system’s ability to export detailed data. Plantar pressure–time integrals in 11 individuals (22 feet) with claw deformity of the lesser toes were measured with and without toe props. Differences in pressure–time integrals at every individual sensor unit were then calculated for the two conditions, and significance was tested using the paired t-test. Plantar surface charts with contours of equal significant pressure–time integral change showed significant reduction under 17 second toes (77%), 22 third toes (100%), 15 fourth toes (68%), 13 second metatarsal heads (59%), 16 third metatarsal heads (73%), and 16 fourth metatarsal heads (73%). All 22 feet showed increases under the prop in the area of the third toe sulcus. This innovative approach to plantar pressure analysis could improve access to data that show significant pressure–time integral changes and, therefore, could advance the clinical application of plantar pressure measurement. (J Am Podiatr Med Assoc 94(3): 246–254, 2004)

scholarly journals Comparative Effectiveness of Plantar-Massage Techniques on Postural Control in Those With Chronic Ankle Instability

2017 ◽  
Vol 52 (7) ◽  
pp. 629-635 ◽  
Author(s):  
Erik A. Wikstrom ◽  
Kyeongtak Song ◽  
Ashley Lea ◽  
Nastassia Brown
Keyword(s):  
Postural Control ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Balance Test ◽  
Physically Active ◽  
Lateral Ankle ◽  
Massage Treatment ◽  
Eyes Open ◽  
University Setting ◽  
Stimulation Of

Context:  One of the major concerns after an acute lateral ankle sprain is the potential for development of chronic ankle instability (CAI). The existing research has determined that clinician-delivered plantar massage improves postural control in those with CAI. However, the effectiveness of self-administered treatments and the underlying cause of any improvements remain unclear. Objectives:  To determine (1) the effectiveness of a self-administered plantar-massage treatment in those with CAI and (2) whether the postural-control improvements were due to the stimulation of the plantar cutaneous receptors. Design:  Crossover study. Setting:  University setting. Patients or Other Participants:  A total of 20 physically active individuals (6 men and 14 women) with self-reported CAI. Intervention(s):  All participants completed 3 test sessions involving 3 treatments: a clinician-delivered manual plantar massage, a patient-delivered self-massage with a ball, and a clinician-delivered sensory brush massage. Main Outcome Measure(s):  Postural control was assessed using single-legged balance with eyes open and the Star Excursion Balance Test. Results:  Static postural control improved (P ≤ .014) after each of the interventions. However, no changes in dynamic postural control after any of the interventions were observed (P > .05). No differences were observed between a clinician-delivered manual plantar massage and either a patient-delivered self-massage with a ball or a clinician-delivered sensory brush massage in any postural-control outcome. Conclusions:  In those with CAI, single 5-minute sessions of traditional plantar massage, self-administered massage, and sensory brush massage each resulted in comparable static postural-control improvements. The results also provide empirical evidence suggesting that the mechanism for the postural-control improvements is the stimulation of the plantar cutaneous receptors.

Surface electromyography and plantar pressure during walking in young adults with chronic ankle instability

2016 ◽  
Vol 24 (4) ◽  
pp. 1060-1070 ◽  
Author(s):  
Rachel M. Koldenhoven ◽  
Mark A. Feger ◽  
John J. Fraser ◽  
Susan Saliba ◽  
Jay Hertel
Keyword(s):  
Young Adults ◽  
Plantar Pressure ◽  
Surface Electromyography ◽  
Ankle Instability ◽  
Chronic Ankle Instability

scholarly journals Association between the levels of physical activity and plantar pressure in 6-14-year-old children

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8551 ◽  
Author(s):  
Lovro Štefan ◽  
Mario Kasović ◽  
Martin Zvonar
Keyword(s):  
Physical Activity ◽  
Plantar Pressure ◽  
Contact Time ◽  
Cross Sectional Study ◽  
Linear Regression Models ◽  
Older Children ◽  
Cross Sectional ◽  
Time Integral ◽  
Pressure Time ◽  
The Right

Background The main purpose of the study was to determine whether lower levels of physical activity were associated with higher plantar pressure generated under each foot. Methods In this cross-sectional study, we recruited 641 children aged 6–14 years (agemean ± SD = 9.7  ± 2.4 years; heightmean ± SD = 143.6  ± 15.3 cm, weightmean ± SD = 37.6  ± 13.4 kg; body-mass indexmean ± SD = 17.6  ± 3.2 kg/m2; 44.2% girls). We used EMED –XL pressure platform to measure force time integral, pressure-time integral, contact-time and contact area, peak plantar pressure and mean plantar pressure of the right and the left foot during the gait analysis. The level of physical activity was measured by using The Physical Activity Questionnaire for Older Children (PAQ–C). The associations were calculated by using generalized estimating equations with linear regression models. Results Lower levels of physical activity were associated with higher force- and pressure-time integrals, longer contact time and higher peak and mean plantar pressures in both feet. Conclusion Our study shows that the level of physical activity is strongly and inversely associated with plantar pressure in a sample of 6–14 year olds.

scholarly journals The Difference of In-Shoe Plantar Pressure Between Level Walking and Stair Walking

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0026
Author(s):  
Min Gyu Kyung ◽  
Chungho Lee ◽  
Jae Hee Lee ◽  
Yoon Jae Cho ◽  
Cao Linying ◽  
...  
Keyword(s):  
High Pressure ◽  
Plantar Pressure ◽  
Pressure Load ◽  
Stair Ascent ◽  
Time Integral ◽  
Stair Descent ◽  
Level Walking ◽  
Pressure Time ◽  
Stair Walking ◽  
Peak Pressures

Category: Basic Sciences/Biologics Introduction/Purpose: Stair walking is one of common activities of daily living. It is more demanding than level walking and can aggravate discomfort of the foot, such as Morton’s neuroma, plantar fasciitis, Achilles tendinitis, pressure related-ulcer, and etc. Therefore, analysis of increased pressure in specific plantar area at stair walking can be used as a risk assessment of foot discomfort and basic data in the clinical field. The purpose of this study is to analyze plantar pressure distribution and pressure patterns during gait cycle at stair walking compared to level walking. Methods: Fourty healthy male adults were recruited. Radiologic measurements and gait analysis were performed to check participants’ normality, and 35 healthy males with 20-28 years old were included. They performed level walking (18 meters walkway), stair (26 steps stair, height:16.7 cm, depth:29.8 cm) ascending, and descending in same type of running shoes. Measurements of in-shoe plantar pressure including peak pressure, pressure-time integral (PTI) were done by Pedar-X system. Only measurements of right steps were used to exclude the effect of the dominant foot. The sole was masked in 7 segments (hallux, 2nd-5th toes, medial forefoot, central forefoot, lateral forefoot, midfoot, heel region) to analyze properly. Percentages were assigned in relation to the size for each mask segment. Statistical analysis was performed using repeated measure ANOVA, and Bonferroni post hoc test was done. Results: Mean peak pressures in all regions except for the midfoot were higher during level walking than stair walking. During stair descent, mean peak pressures in all the regions except for the midfoot were generally lower than other types of walking, but it was the highest in the midfoot region. Pressure time integral (PTI) in the medial and central forefoot was higher during stair descent than level walking. PTI in the central and lateral forefoot, and the midfoot was higher when stair ascending than level walking. Pressure time integral (PTI) in the heel region was the highest during level walking, followed by stair ascent, stair descent. Conclusion: The risk of aggravation of discomfort in the midfoot area increases when stair descending. The medial region of forefoot bear high pressure load during stair descent, and the lateral region of forefoot and the midfoot region bear high pressure load during stair ascent. This is the first study to show plantar pressure patterns during level and stair walking in the large healthy gender-controlled population. We recommend that patients with pressure related foot lesions in the forefoot or midfoot avoid stair walking.

Static Postural Stability in Chronic Ankle Instability, an Ankle Sprain and Healthy Ankles

2018 ◽  
Vol 39 (08) ◽  
pp. 625-629 ◽  
Author(s):  
Yong Kwon
Keyword(s):  
Postural Stability ◽  
Ankle Instability ◽  
Mean Amplitude ◽  
Chronic Ankle Instability ◽  
Medial Gastrocnemius ◽  
Muscle Type ◽  
Eyes Closed ◽  
Ankle Muscles ◽  
Eyes Open ◽  
Balance Error

AbstractTo identify the single leg balance (SLB) test that discriminates among healthy, coper, and chronic ankle instability (CAI) groups and to determine effects of ankle muscles on the balance error scoring system (BESS) among the three populations. 60 subjects (20 per group) performed the SLB test with eyes open (EO) and eyes closed (EC). Normalized mean amplitude (NMA) of the tibia anterior (TA), fibularis longus (FL), and medial gastrocnemius (MG) muscles and BESS were measured while performing the SLB test. The coper group had a lower error score than the CAI group in the EC. NMA was greater in the CAI group compared to in the healthy and coper groups regardless of muscle type. NMA of the TA was less than the PL and MG regardless of the group in the EO. The CAI group demonstrated greater NMAs of the PL and MG than the healthy and coper groups in the EC. The CAI group demonstrated greater NMA of the PL and MG by compensating their ankle muscles in the EO and EC. BESS suggests that the coper group may have coping mechanisms to stabilize static postural control compared to the CAI group. The EC may be better to detect static postural instability in the CAI or coper group.

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