Toe-in Gait, Associated Complications, and Available Conservative Treatments: A Systematic Review of Literature / 대한족부족관절학회지

Purpose@#Toe-in gait is defined as a style of walking in which the foot turns inward. It may be caused by an increase in femoral bone anteversion, tibia torsion, and metatarsus adductus. There are some conservative treatment approaches used to correct this condition. This review aimed to determine the effects of the toe-in gait on joint loading, kinematics, and kinetic parameters while walking. Moreover, it sought to determine the efficiency of various conservative treatments used to correct the condition. @*Materials and Methods@#A literature search was conducted in the following databases: PubMed, Institute for Scientific Information (ISI), Web of Science database, EBSCO, and Embase, using the following keywords in toe, toe-in, toeing, in-toe, pigeon toe, and conservative treatment published between 1950 and 2021. The quality of the studies was evaluated using the Down and Black tool. @*Results@#A total of 13 papers on the impact of toe-in gait on joint contact force, kinematics, kinetic parameters, and conservative approaches to management were found. The quality of the studies varied between a score of 11 and 22. The toe-in gait influences the joint contact forces and kinematics of the joints, especially the hip and pelvis. The effects of conservative treatment on the toe-in gait appear to be controversial. @*Conclusion@#As the toe-in gait influences the joint contact force, it may increase the incidence of degenerative joint diseases. Therefore, treatment is recommended. However, there is no strong evidence on the efficacy of conservative treatments, and there are no recommendations for the use of these treatments in subjects with toe-in gait.

Investigation of the range of motion of the shoulder joint in subjects with rotator cuff arthropathy while performing daily activities

Background@#Patients who have rotator cuff arthropathy experience a limited range of motion (ROM) of the shoulder joint and experience problems in performing their daily activities; however, no evidence is available to suggest the exact ROM of the shoulder joint in this population. Therefore, this study sought to determine the degree of motion of the shoulder joint in three planes during different activities. @*Methods@#Five subjects with rotator cuff injuries participated in this study. The motion of the shoulder joints on both the involved and normal sides was assessed by a motion analysis system while performing forward abduction (task 1), flexion (task 2), and forward flexion (task 3). The OpenSIM software program was used to determine the ROM of the shoulder joints on both sides. The difference between the ranges of motion was determined using a two-sample t-test. @*Results@#The ROMs of the shoulder joint in task 1 were 35°±16.5°, 72.1°±2.6°, and 103.9°±28.7° degrees for flexion, abduction, and rotation, respectively, on the normal side and 28°±19.8°, 31°±31.56°, and 48°±33.5° on the involved side (p<0.05). There was no significant difference between the flexion/extension and rotation movements of the shoulder joint when performing task 1. However, the difference between flexion and rotation movements of the shoulder joints for the second task was significant (p˃0.05). @*Conclusions@#Those with rotator cuff arthropathy have functional limitations due to muscle weakness and paralysis, especially during the vertical reaching task. However, although these individuals have decreased ROM for transverse reaching tasks, the reduction was not significant.

Investigation of the range of motion of the shoulder joint in subjects with rotator cuff arthropathy while performing daily activities

Background@#Patients who have rotator cuff arthropathy experience a limited range of motion (ROM) of the shoulder joint and experience problems in performing their daily activities; however, no evidence is available to suggest the exact ROM of the shoulder joint in this population. Therefore, this study sought to determine the degree of motion of the shoulder joint in three planes during different activities. @*Methods@#Five subjects with rotator cuff injuries participated in this study. The motion of the shoulder joints on both the involved and normal sides was assessed by a motion analysis system while performing forward abduction (task 1), flexion (task 2), and forward flexion (task 3). The OpenSIM software program was used to determine the ROM of the shoulder joints on both sides. The difference between the ranges of motion was determined using a two-sample t-test. @*Results@#The ROMs of the shoulder joint in task 1 were 35°±16.5°, 72.1°±2.6°, and 103.9°±28.7° degrees for flexion, abduction, and rotation, respectively, on the normal side and 28°±19.8°, 31°±31.56°, and 48°±33.5° on the involved side (p<0.05). There was no significant difference between the flexion/extension and rotation movements of the shoulder joint when performing task 1. However, the difference between flexion and rotation movements of the shoulder joints for the second task was significant (p˃0.05). @*Conclusions@#Those with rotator cuff arthropathy have functional limitations due to muscle weakness and paralysis, especially during the vertical reaching task. However, although these individuals have decreased ROM for transverse reaching tasks, the reduction was not significant.

Analysis of dynamic balance during walking in patients with Parkinson's disease and able-bodied elderly people

Purpose: Walking pattern in patients with Parkinson's disease [PD] is abnormal, and dynamic balance of these patients is not clear yet. The objective of this study was to analyze the dynamic balance of patients with PD during walking and comparing it with normal elderly individuals

Methods: This is an Ex-post - facto research study design. Twelve male patients with PD [mean age: 64.0 +/- 7.8 y; mean height: 165.0 +/- 7.0 cm; mean mass: 65.3 +/- 10.3 kg; and mean BMI: 24.1 +/- 3.6 kg/m2] and 12 healthy male subjects as the peer group with matched age, height, weight, and BMI participated in this study. All subjects were chosen using convenience sampling method. Vicon motion analysis system was used to analyze temporal variables and center of mass [COM] displacement of the subjects during walking. Data were analyzed in SPSS-19 using independent t test with P<0.05

Results: Stride length and walking speed was significantly smaller in patients with PD than that in peer group [P<0.05]. Mediolateral displacement of COM was not different between the two groups [P>0.05]. However, posterioanterior and vertical displacements of COM were significantly smaller in patients with PD

Conclusion: Stride length, walking speed, as well as the posterioanterior and vertical displacement of COM in patients with PD were lower than those variables in normal subjects. These changes might be considered as a compensatory response of neuromuscular system to the affected dynamic postural control in these patients

Evaluation of the association between physical health and religion: a literature review

Physical health is influenced by various factors including religion. There are many questions regarding the impact of religious activities on physical health. Therefore, the aim of this study was to find the correlation between physical health and religion. Various databases including PubMed, Ovid, and Medline were investigated. Considering the inclusion criteria, 50 studies were found using the keyword-based information retrieval; though, only 12 papers were approved for the final analysis. Based on the literature review, there is no consensus regarding the impacts of religious practices on physical health; it is not clear whether religious activities result in better physical health and less severe musculoskeletal disorders, or are inversely related to physical health. There are various limitations observed in the available studies; therefore, reaching a firm conclusion might be no easy task. It is recommended that cross-sectional studies be carried out in various regions to find the association between religion and physical health

What are the next steps in designing an orthosis for paraplegic subjects?

Over the years, various types of orthoses have been designed to assist subjects with spinal cord injury [SCI] to stand and walk. However, the functional performance of the orthoses has not been adequate, that is, patients experience stability problems, consume excessive energy during ambulation, and generally require assistance in donning and doffing the devices. This research is aimed at categorizing the available orthoses designed specifically for SCI patients and to compare the available orthoses according to the energy consumption, stability analysis, and gait parameters. An electronic search was done in PubMed, Embase, and ISI Web of Knowledge databases to extract data related to 1960-2010. The available orthoses were characterized based on the level of stabilization they provided and the source of power used. The orthoses were compared based on the stability, energy consumption, and gait performance parameters, according to the results of various studies collected from the literature review. Among various orthoses designed for paraplegic subjects, the mechanical orthoses seemed to have a better performance. Moreover, donning and doffing of the mechanical orthosis was easier for the subjects. Although the HGO has better functional performance than other available orthoses, the subjects are more willing to use the RGO. The new design of orthoses must allow easy donning and doffing by the users, have enough stability during walking and standing, and enable the patients to change the alignment of the orthosis to suit their needs