| 1. |
- Alnemo, John, et al.
(författare)
-
Are the left and right limbs unequally affected by diabetic foot complications?
- 2019
-
Ingår i: 8th International symposium on diabetic foot. ; , s. 140-140
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: There is some debate about laterality for diabetic foot complications, that is, whether the right and left limbs are unequally affected. Coxon and Gallen (1) found that more amputations were performed on the right limb and Evans et al. (2) interpreted this in the context of foot dominance: they found that most foot ulcers occured on the dominant limb (which for most people is the right one) and speculated that the dominant limb may be more exposed to mechanical stresses and injuries. However, Demetriou et al. (3) did not find any laterality in foot ulcer location. The aim was to investigate laterality for foot ulcers and amputations. Methods: A questionnaire was posted to 1245 people who had diabetes, experience of using therapeutic shoes, and who had attended one of two prosthetics and orthotics clinics during a 12 months’ period. The number of ulcers or amputations on the right and left limb were compared with a two-sided chi-square test. Results: 469 (37.7%) questionnaires were returned. 118 (25.2%) participants reported unilateral foot ulcers, 54 (11.5%) reported unilateral minor amputation, and 21 (4.5%) reported unilateral major amputation. There was no statistically significant right-left difference in foot ulcers, minor amputations or major amputations (Table 1, p-values 0.713-1.000). Conclusions: Our results do not support the hypothesis about laterality for foot ulcers and amputations.
|
|
| 2. |
|
|
| 3. |
- Alnemo, John, et al.
(författare)
-
Attitudes and attributes of women and men using therapeutic shoes for diabetic foot complications
- 2019
-
Ingår i: 8th International symposium on diabetic foot. ; , s. 117-117
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Therapeutic shoes can prevent diabetic foot reulcerations but their use is complicated by the fact that shoes have psychological and social meanings, which is believed to put a larger burden on women than men. The aim was to compare attitudes and attributes of women and men using therapeutic shoes for diabetic foot complications.Methods: A questionnaire was posted to 1230 people with diabetes who had been fitted with therapeutic shoes. Women's and men's answers were compared using t-tests, Mann-Whitney U tests and chi-square tests with Fischer's exact tests. P-values < 0.05 were considered statistically significant.Results: Questionnaires from 443 (36.0%) respondents (294 men, 149 women, mean age 69.2 years) were analyzed. More men than women (p < 0.05) had paid employment (20.4% vs 9.4%), had someone who reminded them to wear their therapeutic shoes (27.6% vs 10.0%), and had a history of foot ulcers (62.9% vs 46.3%) or minor amputation (17.7% vs 6.7%). More women than men received disability pension (18.8% vs 10.2%). Women reported worse general health, lower internal locus of control regarding ulcer prevention, and more negative attitudes to the appearance and price of therapeutic shoes and how they felt about wearing them in public. Other comparisons were non-significant: other shoe attributes, education, diabetes type, current foot ulcers, major amputations, satisfaction with shoe services, understanding of neuropathy as a risk factor, locus of control regarding ulcer healing, belief in the shoes' efficacy to prevent and heal ulcers, worries about ulcer healing and new ulcerations, self-efficacy, depression, shoe use/adherence, paying a fee for therapeutic shoes, and social support.Conclusions: Men had worse foot complications. Women had worse general health, lower internal locus of control regarding ulcer prevention, and more negative attitudes toward therapeutic shoes. Clinicians should pay more attention to their female patients' concerns. Future research and development should focus on improving the weight and appearance of therapeutic shoes, particularly for women. Research is also needed on how to facilitate the adaption and reevaluation process where patients change from viewing shoes purely as items of clothing to also viewing them as medical interventions
|
|
| 4. |
- Armannsdottir, A., et al.
(författare)
-
Frontal plane pelvis and hip kinematics of transfemoral amputee gait. Effect of a prosthetic foot with active ankle dorsiflexion and individualized training - a case study
- 2018
-
Ingår i: Disability and Rehabilitation-Assistive Technology. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 13:4, s. 388-393
-
Tidskriftsartikel (refereegranskat)abstract
- Following a transfemoral amputation (TFA), numerous changes in movement patterns during gait can occur. Frontal plane hip and pelvis compensatory strategies are recognized among individuals with a TFA, some thought to aid in safe foot clearance during the swing phase of gait. The aim of this case study was to evaluate the effect of an active ankle dorsiflexion provided by a microprocessor-controlled prosthetic foot, as well as the effect of individualized training on these parameters. In this case study, a 42-year-old male underwent 3D gait analysis. Data were captured for two conditions; with a microprocessor-controlled prosthetic foot with active/inactive ankle dorsiflexion, during two sessions; before and after 6 weeks of individualized training. The main outcomes analyzed were frontal plane pelvis and hip kinematics. Prior to training, pelvic lift decreased slightly, coupled with an increase in hip abduction, during gait with the active ankle dorsiflexion of a prosthetic foot, compared to inactive dorsiflexion. After the training period, the pelvic lift was further decreased and an increase in hip adduction was concurrently seen. The results of this case study indicate a positive effect of the active dorsiflexion of the prosthetic foot but highlight the need for specific training after prescription of a microprocessor prosthetic foot.
|
|
| 5. |
- Augustsson, Jesper, 1964, et al.
(författare)
-
Single-leg hop testing following fatiguing exercise: reliability and biomechanical analysis
- 2006
-
Ingår i: Scand J Med Sci Sports. - : Wiley. - 0905-7188. ; 16:2, s. 111-20
-
Tidskriftsartikel (refereegranskat)abstract
- A fatiguing exercise protocol was combined with single-leg hop testing to improve the possibilities of evaluating the effects of training or rehabilitation interventions. In the first test-retest experiment, 11 healthy male subjects performed two trials of single-leg hops under three different test conditions: non-fatigued and following fatiguing exercise, which consisted of unilateral weight machine knee extensions at 80% and 50%, respectively, of 1 repetition maximum (1 RM) strength. Intraclass correlation coefficients ranged from 0.75 to 0.98 for different hop test conditions, indicating that all tests were reliable. For the second experiment, eight healthy male subjects performed the fatiguing exercise protocol to investigate how fatigue influences lower-extremity joint kinematics and kinetics during single-leg hops. Hip, knee and ankle joint angles, moments and powers, as well as ground-reaction forces were recorded with a six-camera, motion-capture system and a force platform. Recovery of hop performance following the fatiguing exercise was also measured. During the take-off for the single-leg hops, hip and knee flexion angles, generated powers for the knee and ankle joints, and ground-reaction forces decreased for the fatigued hop conditions compared with the non-fatigued condition (P<0.05). Compared with landing during the non-fatigued condition, hip moments and ground-reaction forces were lower for the fatigued hop conditions (P<0.05). The negative joint power was two to three times greater for the knee than for the hip and five to 10 times greater for the knee than for the ankle during landing for all test conditions (P<0.05). Most measured variables had recovered three minutes post-exercise. It is concluded that the fatiguing exercise protocol combined with single-leg hop testing was a reliable method for investigating functional performance under fatigued test conditions. Further, subjects utilized an adapted hop strategy, which employed less hip and knee flexion and generated powers for the knee and ankle joints during take-off, and less hip joint moments during landing under fatigued conditions. The large negative power values observed at the knee joint during the landing phase of the single-leg hop, during which the quadriceps muscle activates eccentrically, indicate that not only hop distance but also the ability to perform successful landings should be investigated when assessing dynamic knee function.
|
|
| 6. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Heel-Rise Height Deficit 1 Year After Achilles Tendon Rupture Relates to Changes in Ankle Biomechanics 6 Years After Injury
- 2017
-
Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 45:13, s. 3060-3068
-
Tidskriftsartikel (refereegranskat)abstract
- Background: It is unknown whether the height of a heel-rise performed in the single-leg standing heel-rise test 1 year after an Achilles tendon rupture (ATR) correlates with ankle biomechanics during walking, jogging, and jumping in the long-term. Purpose: To explore the differences in ankle biomechanics, tendon length, calf muscle recovery, and patient-reported outcomes at a mean of 6 years after ATR between 2 groups that, at 1-year follow-up, had less than 15% versus greater than 30% differences in heel-rise height. Methods: Seventeen patients with less than 15% (<15% group) and 17 patients with greater than 30% (>30% group) side-toside difference in heel-rise height at 1 year after ATR were evaluated at a mean (SD) 6.1 (2.0) years after their ATR. Ankle kinematics and kinetics were sampled via standard motion capture procedures during walking, jogging, and jumping. Patientreported outcome was evaluated with Achilles tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and Foot and Ankle Outcome Score (FAOS). Tendon length was evaluated by ultrasonography. The Limb Symmetry Index (LSI = [Injured Side divided by Healthy Side x 3 100) was calculated for side differences. Results: The.30% group had significantly more deficits in ankle kinetics during all activities compared with patients in the <15% group at a mean of 6 years after ATR (LSI, 70%-149% and 84%-106%, respectively; P =.010-.024). The.30% group, compared with the <5% group, also had significantly lower values in heel-rise height (LSI, 72% and 95%, respectively; P<. 001) and heel-rise work (LSI, 58% and 91%, respectively; P<. 001) and significantly larger side-to-side difference in tendon length (114% and 106%, respectively; P =.012). Achilles tendon length correlated with ankle kinematic variables (r = 0.38-0.44; P =.015-.027) whereas heel-rise work correlated with kinetic variables (r = 20.57 to 0.56; P =.001-.047). LSI tendon length correlated negatively with LSI heel-rise height (r = 20.41; P =.018). No differences were found between groups in patient-reported outcome (P =.143-.852). Conclusion: Height obtained during the single-leg standing heel-rise test performed 1 year after ATR related to the long-term ability to regain normal ankle biomechanics. Minimizing tendon elongation and regaining heel-rise height may be important for the long-term recovery of ankle biomechanics, particularly during more demanding activities such as jumping.
|
|
| 7. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
The injured limb presents lower values in foot structure measurements 6 years after an achilles tendon rupture
- 2021
-
Ingår i: Muscles, Ligaments and Tendons Journal. - : Edra SpA. - 2240-4554. ; 11:4, s. 694-703
-
Tidskriftsartikel (refereegranskat)abstract
- Background. It is not known if foot structure may change after an Achilles tendon rupture and if a possible change may have an impact on lower limb function. The primary aim of the study was to explore the difference in foot structure between injured and healthy limb and between two treatment groups, at mean 6 years after an Achilles tendon rupture. A secondary aim was to explore if the differences in foot structure correlated with functional and clinical outcome. Methods. Ninety patients (15 women) with the mean (SD) age of 49 (9) years were evaluated. They had all been randomized to be treated with (n = 45) or without (n = 45) surgery. Foot structure was evaluated with Navicular Drop (Ndrop) and Drift (Ndrift), Longitudinal Arch Angle (LAA) and standing Dorsiflexion with knee straight and bent (DFstraight) and (DFbent). Calf muscle performance was evaluated with Single-leg standing heel-rise test and tendon length with ultrasound. For Patient-reported outcome measurements, Achilles tendon Total Rupture Score (ATRS) and Physical Activity Scale (PAS) were used. Both limbs were evaluated and the limb symmetry index (LSI (%) = injured/healthy × 100) was calculated. Results. In all patients, the injured limb demonstrated lower values (injured/healthy) in Ndrift (6.0/6.7 mm, p = 0.034), Ndrop (6.6/7.4 mm, p = 0.32) and DFbent (44/46°, p < 0.001). In the group treated with surgery, there was significant difference between limbs in DFbent (44/46°, p = 0.002). In the non-surgically treated group, the injured limb demonstrated significantly lower values in Ndrift (6.0/7.4 mm, p = 0.005), Ndrop (6.9/8.2 mm, p = 0.005) and DFbent (44/46°, p = 0.008). There was no difference between treatment groups in LSI-values. Conclusions. An Achilles tendon rupture seems to have an impact on foot structure long time after the injury. There is a need to clarify if the injury influences both feet and if there is a difference between treatment groups.
|
|
| 8. |
- Eek, Meta Nyström, et al.
(författare)
-
Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole
- 2017
-
Ingår i: Gait and Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 55, s. 150-156
-
Tidskriftsartikel (refereegranskat)abstract
- The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP. Results: Ten children with spastic CP, able to walk without aids, and 10 typically developing (TD) children aged between seven and 14 years were assessed with 3D gait analysis: 1) barefoot, 2) with shoes and 3) with an extra sole beneath the shoe for the shorter leg. All children with CP had a leg length discrepancy of more than or equal to 1.0 cm. In the barefoot condition, the velocity was slower and the stride length was shorter, in children with CP compared with TD. The stride length and gait velocity increased in children with CP with shoes and shoe + sole and the stance time became more symmetrical. Among children with CP, there was more flexion in the longer leg relative to the short leg during barefoot walking. Differences in the kinematic pattern between the long and the short leg decreased with the extra sole.
|
|
| 9. |
- Eek, Meta Nyström, et al.
(författare)
-
Muscle strength and kinetic gait pattern in children with bilateral spastic CP.
- 2011
-
Ingår i: Gait & posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 33:3, s. 333-7
-
Tidskriftsartikel (refereegranskat)abstract
- Cerebral palsy is often associated with an abnormal gait pattern. This study put focus on relation between muscle strength and kinetic gait pattern in children with bilateral spastic cerebral palsy and compares them with a reference group. In total 20 children with CP and 20 typically developing children participated. They were all assessed with measurement of muscle strength in eight muscle groups in the legs and a 3-dimensional gait analysis including force data. It was found that children with CP were not only significantly weaker in all muscle groups but also walked with slower velocity and shorter stride length when compared with the reference group. Gait moments differed at the ankle level with significantly lower moments in children with CP. Gait moments were closer to the maximal muscle strength in the group of children with CP. Furthermore a correlation between plantarflexing gait moment and muscle strength was observed in six of the eight muscle groups in children with CP, a relation not found in the reference group. A similar pattern was seen between muscle strength and generating ankle power with a rho=0.582-0.766. The results of this study state the importance of the relationship of the overall muscle strength pattern in the lower extremity, not only the plantarflexors.
|
|
| 10. |
- Eek, Meta Nyström, et al.
(författare)
-
Muscle strength training to improve gait function in children with cerebral palsy.
- 2008
-
Ingår i: Developmental medicine and child neurology. - : Wiley. - 1469-8749 .- 0012-1622. ; 50:10, s. 759-64
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate the influence of muscle strength training on gait outcomes in children with cerebral palsy. Sixteen children (two females, 14 males, Gross Motor Function Classification System levels I-II, mean age 12y 6mo, range 9y 4mo-15y 4mo) underwent muscle strength measurement using a handheld device, Gross Motor Function Measure (GMFM) assessment, three-dimensional gait analysis, joint range of motion assessment, and grading of spasticity before and after 8 weeks of training. All participants had a diagnosis of spastic diplegia and could walk without aids. Training consisted of exercises for lower extremity muscles with free weights, rubber bands, and body weight for resistance, three times a week. Values for muscle strength below normal were identified in all children; this was most pronounced at the ankle, followed by the hip muscles. After training, muscle strength and GMFM scores increased, velocity was unchanged, stride length increased, and cadence was reduced. There was an increase in hip extensor moment and power generated at push off. Eight weeks of muscle strength training can increase muscle strength and improve gait function.
|
|
