ABSTRACT
BACKGROUND: Metatarsal fractures are managed using different types of forefoot offloading orthosis. Theaim of this prospective study was to evaluate the clinical and pedographic results of a vacuum shoe system in comparison to a forefoot unloading shoe. METHOD: 20 patients (14 women/6 men--age: 36.4 +/- 14.1 years) were prospectively included in the study. The patients were followed up at four different time points. Detailed clinical and radiological examinations were carried out, functional scores were measured and a pedographic assessment was performed. RESULTS: Between the study groups no differences were seen in functional scoring. A complete bony healing was achieved within the 3 months of followup in all patients. The heelstrike to heelstrike time was without significant differences in the pedographic analysis. Adequate forefoot unloading was achieved with both orthosis. The load sharing between fore-, mid- and hindfoot showed no significant differences in the pedographic analysis. Patients' satisfaction was rated with higher values for the vacuum shoe system, but without significance. CONCLUSION: Both shoe systems show an adequate unloading of the forefoot. Therefore both orthosis may be used for the treatment of metatarsal fractures.
Subject(s)
Foot Orthoses , Fractures, Bone/therapy , Metatarsal Bones/injuries , Shoes , Weight-Bearing , Adolescent , Adult , Female , Follow-Up Studies , Fracture Healing/physiology , Gait , Humans , Male , Middle Aged , Pain Measurement , Patient Satisfaction , Prospective Studies , Vacuum , Young AdultABSTRACT
AIM: The aim of this study is the determination of physical activity in everyday life of handicapped persons due to cerebral palsy using standardised testing procedures. METHOD: The subjects were examined according to the Conconi test on a treadmill at increasing speeds for their fitness. We used a continuous heart rate monitoring, 3-axis acceleration sensors, lactate measurements and pedography. RESULTS: Three groups of subjects could be differentiated. In one group, a rapid rise in heart rate even at lower walking speed was observed. In a second group of persons with poor motor coordination, the maximum walking speed was limited. Single subjects were not limited neither in their physical performance nor in their condition. CONCLUSION: In the physical therapy for patients with cerebral palsy one should not lose sight of possible cardiovascular limitations additional to the physical disabilities.
Subject(s)
Actigraphy/methods , Activities of Daily Living , Cerebral Palsy/diagnosis , Cerebral Palsy/physiopathology , Monitoring, Ambulatory/methods , Motor Activity , Physical Fitness , Adult , Exercise Test/methods , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
PURPOSE: The aim of this study was the development of a simple procedure to calculate functional kinetic parameters from the plantar pressure distribution measurement which is used in many orthopaedic practices and clinics as a standard measurement device. The special purpose is the comparison of functional parameters between datasets taken before and after a surgical operation, for example the correction of a hallux valgus. METHOD: In the gait laboratory, pressure distribution measurements were recorded from healthy test subjects and patients with different foot diseases. The test subjects walked barefoot over the measurement plate which is integrated in a gangway. The device records a "movie" of the pressure distribution in the unrolling of the foot. It takes 72 pressure distribution pictures per second. By integrating the pressure over all segmental areas, i. e., pressure distribution picture for pressure distribution picture, the temporal progress of the total ground force can be calculated. By integration of the pressure only over a certain part of the foot, the ground force on that certain anatomic structure can be calculated, for example, the ground reaction force upon then hallux. By integration of the pressure over the same segmental areas considering their lever distance to the axes of the ankle joint, the external joint moment can be calculated. For this, the musculature of the lower leg must generate an internal moment, which exactly compensates the external moment. RESULTS: In the case of a correction of a hallux valgus, the percentage of the total external moment with regard to the upper ankle joint can be measured which is taken on by the hallux and metatarsal I. This allows us to verify a functional improvement through the operative treatment. With patients after one-sided injuries of the foot and ankle joints, the functional success of a treatment can be quantified by means of a comparison of sides, for example, after a fracture of the calcaneus. CONCLUSION: The determination of muscular ankle joint moments from the pressure distribution measurement improves the objectivity when reviewing the functional success of a therapy in different orthopaedic or surgical interventions at the foot and ankle joint.
Subject(s)
Algorithms , Ankle Injuries/diagnosis , Ankle Injuries/physiopathology , Diagnosis, Computer-Assisted/methods , Foot/physiopathology , Gait , Models, Biological , Physical Examination/methods , Computer Simulation , Humans , Kinetics , PressureABSTRACT
The aim of this study was to consider whether changes occur in the foot area while under repeated physical stress and if they are age related. In addition it interests what consequences this might have in regard to proper shoe wear. The subjects for this study consisted of 15 children and youths aged between 4 and 16 years. The plantar pressure distribution and vertical ground reaction forces were measured before and after physical exercise. The subjects first ran a given distance wearing sport shoes, had a rest and then ran the same distance barefoot. The results showed marked age related differences after exercise. The pressure values were increased in all of the youths in the middle foot region. In comparison young children always exhibited an unbound gait pattern without any dynamic foot roll during heel strike or toe-off. The forefoot had ground contact from the beginning of the stance phase. To compensate for the lack of dynamic foot roll it is recommended that children wear a shoe with a soft sole and with sufficient space for toe movement. The sports shoe for youths should grip the heel and support the longitudinal arch to prevent an incorrect weight distribution.
Subject(s)
Foot/growth & development , Sports/physiology , Weight-Bearing/physiology , Adolescent , Adult , Age Factors , Child , Child, Preschool , Exercise Test , Gait/physiology , Humans , Male , Reference Values , Running/physiology , Shoes , Signal Processing, Computer-Assisted , Walking/physiologyABSTRACT
AIM OF THE STUDY: We point out multiple applications of a gait laboratory in solving different problems in the children's orthopaedic field. With typical examples we show how biometrical data of the gait laboratory can be helpful to solve problems in orthopaedic examinations. MATERIAL AND METHOD: The range of questions to be solved in the gait laboratory differs from individual diagnostic examinations of a patient up to the control of devices in the functional use at the patient. As a typical example for the individual examination we show the gait analysis in a 14-year-old girl with idiopathic chondrolysis of the hip joint. The functional use of orthopaedic devices will be shown in youths with neuroorthopaedic diseases. As a very special question to the gait lab we describe the supply of children and youths with optimal sport shoes for running. RESULTS: The biometrical measurement techniques generate exact data to solve individual diagnostic and therapeutic questions. Orthopaedic devices can be tested in their functional efficiency and quality. Special questions can be answered very flexible. CONCLUSION: Diagnosis and therapy in orthopaedics and children's orthopaedics rely on exact data. However, details of the dynamics during movement are neither visible to the most experienced orthopaedic surgeon nor can they be documented by conventional diagnostic imaging procedures. The present technical potential of biometric assessment methods allow to precise and correct some empirical knowledge, they open a wide field of new applications in diagnostic and therapeutic examinations.
Subject(s)
Biomechanical Phenomena , Cartilage Diseases/diagnosis , Cerebral Palsy/diagnosis , Electromyography , Gait Apraxia/diagnosis , Gait/physiology , Hemiplegia/diagnosis , Hip Joint , Orthotic Devices , Signal Processing, Computer-Assisted , Spinal Dysraphism/diagnosis , Video Recording , Adolescent , Ankle Joint/physiopathology , Cartilage Diseases/physiopathology , Cartilage Diseases/rehabilitation , Cerebral Palsy/physiopathology , Cerebral Palsy/rehabilitation , Child , Child, Preschool , Clubfoot/diagnosis , Clubfoot/physiopathology , Clubfoot/rehabilitation , Female , Gait Apraxia/etiology , Gait Apraxia/rehabilitation , Hemiplegia/physiopathology , Hemiplegia/rehabilitation , Hip Joint/physiopathology , Humans , Knee Joint/physiopathology , Male , Reference Values , Sensitivity and Specificity , Shoes , Spinal Dysraphism/physiopathology , Spinal Dysraphism/rehabilitation , Sports/physiology , Weight-Bearing/physiologyABSTRACT
PURPOSE: The following study aims to demonstrate the bending stress on a hallux valgus during normal gait. The bending axis was related to the position of an open wedge osteotomy. The moments were calculated from plantar pressure measurements. METHOD: In the gait analysis laboratory plantar pressure distribution measurement was done with healthy adult volunteers during barefoot gait. From the plantar pressure distribution the vertical forces were derived just for the region hallux metatarsal I. The following calculation of the bending stress regarding to the hypothetic region of the osteotomy was done by integrating the pressure distribution multiplicated with the distance to the osteotomy. The measurements are compared with theoretical values derived from the anatomy of the foot under some plausible assumptions. RESULTS: The results of the mean values of the bending stress were 15.8 +/- 4.8 Nm for the female subjects and 21.6 +/- 5.6 Nm for the male subjects. The amount of the bending moments depended with low significance on the weight. More important is the individual type of gait. CONCLUSION: The measurements show the size of bending stress the plate stabilizing the osteosynthesis has to resist under unfavorable circumstances (for example if the plantar foot muscles are not adequately activated) and if no external stabilization (for example, cast) is used.
