Associations Between Static and Functional Measures of Joint Function in the Foot and Ankle

2004 ◽  
Vol 94 (6) ◽  
pp. 535-541 ◽  
Author(s):  
James S. Wrobel ◽  
John E. Connolly ◽  
Michael L. Beach
Keyword(s):  
Sagittal Plane ◽  
Smoking Status ◽  
Glycosylated Hemoglobin ◽  
Metatarsophalangeal Joint ◽  
Joint Function ◽  
Gait Patterns ◽  
First Metatarsophalangeal Joint ◽  
Gait Parameters ◽  
Ankle Joints ◽  
Functional Gait

Clinicians have traditionally assessed range of motion of the first metatarsophalangeal and ankle joints in a static position. It is unclear, however, if these measurements accurately reflect functional sagittal plane limitations of these joints during gait. For 50 patients (100 feet), we assessed available dorsiflexion at the first metatarsophalangeal and ankle joints, as well as the presence of pinch callus. We then compared these findings with 11 functional gait parameters, as measured using a pressure sensor system. After adjusting for age, weight, smoking status, glycosylated hemoglobin, and insensitivity to monofilament, we found that patients with pinch callus demonstrated statistically significant compensatory gait patterns in 7 of 11 measures. Hallux limitus and equinus patients demonstrated six and three statistically significant associations, respectively. Pinch callus seems to be as predictive of functional gait alterations as static first metatarsophalangeal joint and ankle dorsiflexion. (J Am Podiatr Med Assoc 94(6): 535–541, 2004)

scholarly journals Functional Measures of Grip Strength and Gait Remain Altered Long-Term in a Rat Model of Post-Traumatic Elbow Contracture

2019 ◽  
Vol 141 (7) ◽  
Author(s):  
Alex J. Reiter ◽  
Griffin J. Kivitz ◽  
Ryan M. Castile ◽  
Paul C. Cannon ◽  
Emily H. Lakes ◽  
...  
Keyword(s):  
Grip Strength ◽  
Joint Mechanics ◽  
Joint Function ◽  
Gait Patterns ◽  
Gait Parameters ◽  
Quantitative Understanding ◽  
Post Traumatic ◽  
Analysis System

Post-traumatic joint contracture (PTJC) is a debilitating condition, particularly in the elbow. Previously, we established an animal model of elbow PTJC quantifying passive postmortem joint mechanics and histological changes temporally. These results showed persistent motion loss similar to what is experienced in humans. Functional assessment of PTJC in our model was not previously considered; however, these measures would provide a clinically relevant measure and would further validate our model by demonstrating persistently altered joint function. To this end, a custom bilateral grip strength device was developed, and a recently established open-source gait analysis system was used to quantify forelimb function in our unilateral injury model. In vivo joint function was shown to be altered long-term and never fully recover. Specifically, forelimb strength in the injured limbs showed persistent deficits at all time points; additionally, gait patterns remained imbalanced and asymmetric throughout the study (although a few gait parameters did return to near normal levels). A quantitative understanding of these longitudinal, functional disabilities further strengthens the clinical relevance of our rat PTJC model enabling assessment of the effectiveness of future interventions aimed at reducing or preventing PTJC.

scholarly journals Sensitivity and Specificity of the Functional Hallux Limitus Test to Predict Foot Function

2002 ◽  
Vol 92 (5) ◽  
pp. 269-271 ◽  
Author(s):  
Craig Payne ◽  
Vivienne Chuter ◽  
Kathryn Miller
Keyword(s):  
Sensitivity And Specificity ◽  
Metatarsophalangeal Joint ◽  
Clinical Test ◽  
Joint Function ◽  
Compensatory Mechanisms ◽  
First Metatarsophalangeal Joint ◽  
Hallux Limitus ◽  
First Ray ◽  
Foot Function ◽  
Midtarsal Joint

Functional hallux limitus is an underrecognized entity that generally does not produce symptoms but can result in a variety of compensatory mechanisms that can produce symptoms. Clinically, hallux limitus can be determined by assessing the range of motion available at the first metatarsophalangeal joint while the first ray is prevented from plantarflexing. The aim of this study was to determine the sensitivity and specificity of this clinical test to predict abnormal excessive midtarsal joint function during gait. A total of 86 feet were examined for functional hallux limitus and abnormal pronation of the midtarsal joint during late midstance. The test had a sensitivity of 0.72 and a specificity of 0.66, suggesting that clinicians should consider functional hallux limitus when there is late midstance pronation of the midtarsal joint during gait. (J Am Podiatr Med Assoc 92(5): 269-271, 2002)

Gait style as an etiology to chronic postural pain. Part II. Postural compensatory process

1993 ◽  
Vol 83 (11) ◽  
pp. 615-624 ◽  
Author(s):  
HJ Dananberg
Keyword(s):  
Kinetic Energy ◽  
Sagittal Plane ◽  
Center Of Mass ◽  
Metatarsophalangeal Joint ◽  
Specific Pattern ◽  
The Body ◽  
First Metatarsophalangeal Joint ◽  
The Past ◽  
Compensatory Process ◽  
Methods Of Treatment

The body is designed to pull the center of mass over a single pivotal site formed by dorsiflexion of the first metatarsophalangeal joint. If this response dorsiflexion motion is blocked by functional hallux limitus, then the kinetic energy, which is created for this motion, must somehow be dissipated. The process by which this dissipation occurs creates a specific pattern of compensations which, in the past, has been seen as primary motions unrelated to sagittal plane blockade. These compensatory motions are described along with a brief section concerning the methods of treatment.

Clinical, Quantitative Assessment of First Tarsometatarsal Mobility in the Sagittal Plane and Its Relation to Hallux Valgus Deformity

1994 ◽  
Vol 15 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Kaj Klaue ◽  
Sigvard T. Hansen ◽  
Alain C. Masquelet
Keyword(s):  
Hallux Valgus ◽  
Sagittal Plane ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Valgus Deformity ◽  
Main Concern ◽  
First Metatarsophalangeal Joint ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
First Ray

Today, bunion surgery is still controversial. Considering that a bunion deformity in fact may be a result of multiple causes, the rationale of the currently applied techniques of surgical treatment has not been conclusively demonstrated. In view of the known hypermobility syndrome of the first ray that results in insufficient weightbearing beneath the first metatarsal head, the relationship between this syndrome and hallux valgus deformity has been investigated. The results suggest a direct relationship between painful hallux valgus deformity and hypermobility in extension of the first tarsometatarsal joint. A pathological mechanism of symptomatic hallux valgus is proposed that relates this pathology with primary weightbearing disturbances in the forefoot where angulation of the first metatarsophalangeal joint is one of the consequences. The alignment of the metatarsal heads within the sagittal plane seems to be a main concern in many hallux valgus deformities. As a consequence, treatment includes reestablishing stable sagittal alignment in addition to the horizontal reposition of the metatarsal over the sesamoid complex. As an example, first tarsometatarsal reorientation arthrodesis regulates the elasticity of the multiarticular first ray within the sagittal plane and may be the treatment of choice in many hallux valgus deformities.

The Plantar Plate of the First Metatarsophalangeal Joint

2014 ◽  
Vol 7 (2) ◽  
pp. 108-112 ◽  
Author(s):  
Douglas E. Lucas ◽  
Terrence Philbin ◽  
Safet Hatic
Keyword(s):  
Sagittal Plane ◽  
Average Distance ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Cadaver Study ◽  
Joint Line ◽  
Level Of Evidence ◽  
First Metatarsophalangeal Joint ◽  
Plantar Plate

The plantar plate of the first metatarsophalangeal (MP) joint is a critical structure of the forefoot that has been identified as a major stabilizer within the capsuloligamentous complex. Many studies have clarified and documented the anatomy of the lesser toe MP plantar plates, but few have looked closely at the anatomy of the first MP joint. Ten cadaveric specimens were examined to identify and document the objective anatomic relationship of the plantar plate, tibial sesamoid, and surrounding osseus structures. The average distance of the plantar plate distal insertion from the joint line into the proximal phalanx was 0.33 mm. The plantar plate was inserted into the metatarsal head on average 17.29 mm proximal from the joint line. The proximal aspect of the sesamoid was 18.55 mm proximal to the distal attachment of the plantar plate to the phalanx. The distal aspect of the sesamoid averaged 4.69 mm away from the distal attachment into the proximal phalanx. The footprint of the distal plate insertion was on average 6.33 mm in length in the sagittal plane. The authors hope that these objective data measures can aid in the understanding and subsequent surgical repair of this important forefoot structure. Level of Evidence: Level V: Cadaver study

scholarly journals First metatarsophalangeal joint range of motion is associated with lower limb kinematics in individuals with first metatarsophalangeal joint osteoarthritis

2020 ◽  
Author(s):  
Jamie J Allan ◽  
Jodie A McClelland ◽  
Shannon E Munteanu ◽  
Andrew K Buldt ◽  
Karl B Landorf ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Sagittal Plane ◽  
Metatarsophalangeal Joint ◽  
Hip Joints ◽  
First Metatarsophalangeal Joint ◽  
Clinical Measurement ◽  
Joint Range Of Motion ◽  
Level Walking ◽  
Dynamic Function ◽  
Joint Range

Abstract Background Osteoarthritis of the first metatarsophalangeal joint (1st MTP joint OA) is a common and disabling condition that results in pain and limited joint range of motion. There is inconsistent evidence regarding the relationship between clinical measurement of 1st MTP joint maximum dorsiflexion and dynamic function of the joint during level walking. Therefore, the aim of this study was to examine the association between passive non-weightbearing (NWB) 1st MTP joint maximum dorsiflexion and sagittal plane kinematics in individuals with radiographically confirmed 1st MTP joint OA. Methods Forty-eight individuals with radiographically confirmed 1st MTP joint OA (24 males and 24 females; mean age 57.8 years, standard deviation 10.5) underwent clinical measurement of passive NWB 1st MTP joint maximum dorsiflexion and gait analysis during level walking using a 10-camera infrared Vicon motion analysis system. Sagittal plane kinematics of the 1st MTP, ankle, knee, and hip joints were calculated. Associations between passive NWB 1st MTP joint maximum dorsiflexion and kinematic variables were explored using Pearson’s r correlation coefficients. Results Passive NWB 1st MTP joint maximum dorsiflexion was significantly associated with maximum 1st MTPJ dorsiflexion (r=0.486, p<0.001), ankle joint maximum plantarflexion (r=0.383, p=0.007), and ankle joint excursion (r=0.399, p=0.005) during gait. There were no significant associations between passive NWB 1st MTP joint maximum dorsiflexion and sagittal plane kinematics of the knee or hip joints. Conclusions Passive NWB 1st MTP joint maximum dorsiflexion is associated with sagittal plane kinematics of the 1st MTP and ankle joints during level walking in individuals with 1st MTP joint OA. These findings suggest that clinical measurement of 1st MTP joint maximum dorsiflexion provides useful insights into the dynamic function of the foot and ankle during the propulsive phase of gait in this population.

scholarly journals First metatarsophalangeal joint range of motion is associated with lower limb kinematics in individuals with first metatarsophalangeal joint osteoarthritis

2020 ◽  
Author(s):  
Jamie J Allan ◽  
Jodie A McClelland ◽  
Shannon E Munteanu ◽  
Andrew K Buldt ◽  
Karl B Landorf ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Sagittal Plane ◽  
Metatarsophalangeal Joint ◽  
Hip Joints ◽  
First Metatarsophalangeal Joint ◽  
Clinical Measurement ◽  
Joint Range Of Motion ◽  
Dynamic Function ◽  
Joint Range

Abstract Background Osteoarthritis of the first metatarsophalangeal joint (1st MTP joint OA) is a common and disabling condition that results in pain and limited joint range of motion. There is inconsistent evidence regarding the relationship between clinical measurement of 1st MTP joint maximum dorsiflexion and dynamic function of the joint during level walking. Therefore, the aim of this study was to examine the association between passive non-weightbearing (NWB) 1st MTP joint maximum dorsiflexion and sagittal plane kinematics in individuals with radiographically confirmed 1st MTP joint OA. Methods Forty-eight individuals with radiographically confirmed 1st MTP joint OA (24 males and 24 females; mean age 57.8 years, standard deviation 10.5) underwent clinical measurement of passive NWB 1st MTP joint maximum dorsiflexion and gait analysis during level walking using a 10-camera infrared Vicon motion analysis system. Sagittal plane kinematics of the 1st MTP, ankle, knee, and hip joints were calculated. Associations between passive NWB 1st MTP joint maximum dorsiflexion and kinematic variables were explored using Pearson’s r correlation coefficients. Results Passive NWB 1st MTP joint maximum dorsiflexion was significantly associated with maximum 1st MTPJ dorsiflexion (r=0.486, p<0.001), ankle joint maximum plantarflexion (r=0.383, p=0.007), and ankle joint excursion (r=0.399, p=0.005) during gait. There were no significant associations between passive NWB 1st MTP joint maximum dorsiflexion and sagittal plane kinematics of the knee or hip joints. Conclusions These findings suggest that clinical measurement of 1st MTP joint maximum dorsiflexion provides useful insights into the dynamic function of the foot and ankle during the propulsive phase of gait in this population.

scholarly journals First metatarsophalangeal joint chondroplasty using the autologous matrix-induced chondrogenesis in treatment of patients with hallux rigidus. Analysis of immediate and medium-term results

2020 ◽  
Vol 27 (3) ◽  
pp. 32-41
Author(s):  
Maxim R. Nurmukhametov ◽  
Maxim A. Makarov ◽  
Evgeny I. Bialik ◽  
Sergey A. Makarov ◽  
Yaroslav B. Khrennikov
Keyword(s):  
Surgical Treatment ◽  
Metatarsophalangeal Joint ◽  
Collagen Matrix ◽  
Hallux Rigidus ◽  
Medium Term ◽  
First Metatarsophalangeal Joint ◽  
Relieve Pain ◽  
Ankle Joints ◽  
Foot Function ◽  
And Function

Introduction. To date, there is no single approach to the surgical treatment of hallux rigidus. In turn, it is known that in the presence of bone-cartilaginous defects in knee, hip and ankle joints, the autologous matrix-induced chondrogenesis is quite successfully used. In this regard, we have proposed to use this technique in patients with hallux rigidus. The aim of the study was to evaluate the clinical efficacy of the 1st MTP joint chondroplasty using the induced chondrogenesis technique in patients with HR, to analyze the immediate and medium-term results of the operations in terms of pain and function. Materials and methods. The 1st MTP joint chondroplasty has been performed in 21 patients with hallux rigidus. Before the surgery the range of motion (ROM) in 1st MTP joint was measured; the foot condition was evaluated using such scales as VAS of pain, AOFAS, VAS FA. The 1st MTP joint chondroplasty was performed using the technique of the induced chondrogenesis with collagen matrix. The results of surgical treatment were evaluated within 3, 6 and 12 months after surgery. Results: 3 months after the operation, a significant decrease in pain, an increase in ROM in 1st MTP joint and an improvement in the foot function were observed. Subsequently, a moderate positive dynamic was observed. Conclusion: the results of the operations showed that the 1st MTP joint chondroplasty can be an effective method of surgical treatment, which allows to relieve pain and significantly improve the quality of life of patients with hallux rigidus, both young and elderly. Also, this technique can be used in the treatment of patients with rheumatic diseases of the low activity or remission.

scholarly journals Application of the technique of autologous matrix-induced chondrogenesis in the treatment of patients with osteoarthritis of the first metatarsophalangeal joint

2021 ◽  
Vol 27 (2) ◽  
pp. 220-226
Author(s):  
M.R. Nurmukhametov ◽  
◽  
M.A. Makarov ◽  
E.I. Byalik ◽  
Ya.B. Khrennikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Metatarsophalangeal Joint ◽  
Collagen Matrix ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint ◽  
Ankle Joints ◽  
Mid Term Results

(OA of the first MTP joint). On the other hand, it is known that the technique of autologous matrix-induced chondrogenesis has been successfully used for osteochondral defects in the hip, knee and ankle joints. Therefore, we have proposed to use this technique in the treatment of patients with OA of the first MTP joint. Purpose To study the possibility of surgical treatment of patients with OA of the first MTP joint with the use of chondroplasty utilizing the technique of autologous matrix-induced chondrogenesis, to demonstrate the immediate and mid-term results of such operations. Materials and methods Chondroplasty was performed in 15 patients (16 feet) with OA of the first MTP joint. The examination determined the range of motion in of the first MTP joint; the condition was assessed according to such scales as VAS for pain, AOFAS, FFI. Chondroplasty in of the first MTP joint was performed with the technique of induced chondrogenesis using a collagen matrix. The results of the operations were evaluated after 3, 6 and 12 months. Results As early as 3 months after the operation, there was a marked significant increase in the range of motion and a decrease in pain of the first MTP joint. Moderate positive dynamics were observed after 6 and 12 months. Conclusion The results of the operations showed that chondroplasty of the first MTP joint is an effective method of surgical treatment that provides pain relief and significantly improves the quality of life of patients with OA of the first MTP joint. However, it is necessary to study long-term results.

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