Congenital Achilles Tendon Contracture

Congenital Achilles tendon contracture is an autosomal dominant disease which is relatively rare. The disease manifests itself as 'toe walking'. Since the clinical condition is relatively benign, it is easy to be overlooked by the clinicians. To the patients, it presents problems of ambulation and activities of daily living. We present a case of 23 year old man who has been walking on his toes. The patient had a difficulty in squatting and tieing shoes and performed poorly gym activities. The patient's father and brother also walked on toes, which made the patient become indifferent to his condition. Upon physical examination, plantarflexion contractures of both ankle joints were 10 degree and the knee were 5 degree. We could not find any abnormal findings in motor or sensory function tests of both lower limbs. Deep tendon reflexes on patella and ankle were within normal range. There were no abnormalities in ankle X-ray, electromyography, blood sample test including muscle enzymes. Gait analysis showed increased ankle plantarflexion moment during entire gait cycle, increased knee flexion during terminal stance, and decreased both knee flexion during initial swing.

Gait Analysis for Prosthetic Ambulation of Hip Disarticulation: A case report

There have been a many reports of observational analysis on hip disarticulation prosthetic ambulation, but not a scientific analysis by a computerized motion analyzer. We present to share with our professional colleague our invaluable experience gained from the study on the gait analysis of a left hip disarticulation prosthetic gait. Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed in a left hip disarticulation patient fitted with a left Canadian type hip disarticulation prosthesis. In linear parameters, the cadence showed 79 steps/min, the gait speed was 0.68 m/sec, and the double support phase was 25.27% of a total gait cycle. In kinematics, the maximal pelvic tilt angle showed 29.92o at pre-swing phase, and significantly increased as compared with normal person. Hip motion change remained flexed, and maximal knee flexion angle disclosed 22.07o at the terminal stage of initial swing phase. In kinetics, the hip extension moment on initial contact stage was 0.089 NM/kg, which was impaired being compared with normal person. In conclusion, the increased pelvic tilt which implies that initiation of a prosthetic gait for hip disarticulation comes from a forward swing of the pelvis on the affected side, and an overall decrease of gait parameters accounts for the degree of disability of hip disarticulation amputee.

Comparison of Gait Analysis Using High-heeled Shoes and High-forefoot Shoes

Previous studies proved that, the high-heeled shoes caused postural changes, a loss of foot function, and deformities of foot. However the lumbar lordosis in gait is rarely measured. The purposes of this study were to compare kinematics and kinetics between high-heeled and high-forefoot gait by skin markers, and to find the influence of heel height to lumbar vertebral alignment. We used the Vicon 370 three-dimension Gait Analysis System. In the present study, the lower extremity biomechanics in high-heeled and high-forefoot shoes were examined in 20 Korean female subjects. Results showed that the double support phase increased in high-forefoot gait in linear parameters. In sagittal plane kinematics, the lumbar lordosis slightly increased in high-forefoot gait, but that did not increase in high-heeled gait. The knee flexion and ankle plantarflexion increased in high-heeled gait, but ankle pantar flexion reduced in high-forefoot gait. Clinically the change of ankle motion was not significantly influenced to the lumbar lordosis. However, high-heeled shoe users with low back pain are probably influenced by the overstress of paraspinal muscles and vertebral ligments. Further studies are required for more precise analysis of high-heeled and high-forefoot gaits.