Sample records for ankle inversion velocity

  1. Using Ankle Bracing and Taping to Decrease Range of Motion and Velocity During Inversion Perturbation While Walking.

    PubMed

    Hall, Emily A; Simon, Janet E; Docherty, Carrie L

    2016-04-01

    Prophylactic ankle supports are commonly used. However, the effectiveness of external supports in preventing an inversion stress has been debated. To evaluate how ankle bracing and taping affect inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability compared with a control condition during a dynamic inversion perturbation while walking. Crossover study. Research laboratory. A total of 42 physically active participants (16 men, 26 women; age = 21.2 ± 3.3 years, height = 168.9 ± 8.9 cm, mass = 66.1 ± 11.4 kg) volunteered. Participants walked on a custom-built walkway that suddenly inverted their ankles to 30° in 3 conditions: brace, tape, and control (no external support). We used an ASO ankle brace for the brace condition and a closed basketweave technique for the tape condition. Three trials were completed for each condition. Main Outcome Measure(s) Maximum inversion (degrees), time to maximum inversion (milliseconds), and inversion velocity (degrees per second) were measured using an electrogoniometer, and perceived stability (centimeters) was measured using a visual analog scale. Maximum inversion decreased more in the brace condition (20.1°) than in the control (25.3°) or tape (22.3°) conditions (both P values = .001), and the tape condition restricted inversion more than the control condition (P = .001). Time to maximum inversion was greater in the brace condition (143.5 milliseconds) than in the control (123.7 milliseconds; P = .001) or tape (130.7 milliseconds; P = .009) conditions and greater in the tape than in the control condition (P = .02). Inversion velocity was slower in the brace condition (142.6°/s) than in the control (209.1°/s) or tape (174.3°/s) conditions (both P values = .001) and slower in the tape than in the control condition (P = .001). Both the brace and tape conditions provided more perceived stability (0.98 cm and 0.94 cm, respectively) than the control condition (2.38 cm; both P

  2. Using Ankle Bracing and Taping to Decrease Range of Motion and Velocity During Inversion Perturbation While Walking

    PubMed Central

    Hall, Emily A.; Simon, Janet E.; Docherty, Carrie L.

    2016-01-01

    Context:  Prophylactic ankle supports are commonly used. However, the effectiveness of external supports in preventing an inversion stress has been debated. Objective:  To evaluate how ankle bracing and taping affect inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability compared with a control condition during a dynamic inversion perturbation while walking. Design:  Crossover study. Setting:  Research laboratory. Patients or Other Participants:  A total of 42 physically active participants (16 men, 26 women; age = 21.2 ± 3.3 years, height = 168.9 ± 8.9 cm, mass = 66.1 ± 11.4 kg) volunteered. Intervention(s):  Participants walked on a custom-built walkway that suddenly inverted their ankles to 30° in 3 conditions: brace, tape, and control (no external support). We used an ASO ankle brace for the brace condition and a closed basketweave technique for the tape condition. Three trials were completed for each condition. Main Outcome Measure(s):  Maximum inversion (degrees), time to maximum inversion (milliseconds), and inversion velocity (degrees per second) were measured using an electrogoniometer, and perceived stability (centimeters) was measured using a visual analog scale. Results:  Maximum inversion decreased more in the brace condition (20.1°) than in the control (25.3°) or tape (22.3°) conditions (both P values = .001), and the tape condition restricted inversion more than the control condition (P = .001). Time to maximum inversion was greater in the brace condition (143.5 milliseconds) than in the control (123.7 milliseconds; P = .001) or tape (130.7 milliseconds; P = .009) conditions and greater in the tape than in the control condition (P = .02). Inversion velocity was slower in the brace condition (142.6°/s) than in the control (209.1°/s) or tape (174.3°/s) conditions (both P values = .001) and slower in the tape than in the control condition (P = .001). Both the brace and tape

  3. Impaired control of weight bearing ankle inversion in subjects with chronic ankle instability.

    PubMed

    Terrier, R; Rose-Dulcina, K; Toschi, B; Forestier, N

    2014-04-01

    Previous studies have proposed that evertor muscle weakness represents an important factor affecting chronic ankle instability. For research purposes, ankle evertor strength is assessed by means of isokinetic evaluations. However, this methodology is constraining for daily clinical use. The present study proposes to assess ankle evertor muscle weakness using a new procedure, one that is easily accessible for rehabilitation specialists. To do so, we compared weight bearing ankle inversion control between patients suffering from chronic ankle instability and healthy subjects. 12 healthy subjects and 11 patients suffering from chronic ankle instability conducted repetitions of one leg weight bearing ankle inversion on a specific ankle destabilization device equipped with a gyroscope. Ankle inversion control was performed by means of an eccentric recruitment of evertor muscles. Instructions were to perform, as slow as possible, the ankle inversion while resisting against full body weight applied on the tested ankle. Data clearly showed higher angular inversion velocity peaks in patients suffering from chronic ankle instability. This illustrates an impaired control of weight bearing ankle inversion and, by extension, an eccentric weakness of evertor muscles. The present study supports the hypothesis of a link between the decrease of ankle joint stability and evertor muscle weakness. Moreover, it appears that the new parameter is of use in a clinical setting. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Unanticipated ankle inversions are significantly different from anticipated ankle inversions during drop landings: overcoming anticipation bias.

    PubMed

    Dicus, Jeremy R; Seegmiller, Jeff G

    2012-05-01

    Few ankle inversion studies have taken anticipation bias into account or collected data with an experimental design that mimics actual injury mechanisms. Twenty-three participants performed randomized single-leg vertical drop landings from 20 cm. Subjects were blinded to the landing surface (a flat force plate or 30° inversion wedge on the force plate). After each trial, participants reported whether they anticipated the landing surface. Participant responses were validated with EMG data. The protocol was repeated until four anticipated and four unanticipated landings onto the inversion wedge were recorded. Results revealed a significant main effect for landing condition. Normalized vertical ground reaction force (% body weights), maximum ankle inversion (degrees), inversion velocity (degrees/second), and time from contact to peak muscle activation (seconds) were significantly greater in unanticipated landings, and the time from peak muscle activation to maximum VGRF (second) was shorter. Unanticipated landings presented different muscle activation patterns than landings onto anticipated surfaces, which calls into question the usefulness of clinical studies that have not controlled for anticipation bias.

  5. Efficacy of an ankle brace with a subtalar locking system in inversion control in dynamic movements.

    PubMed

    Zhang, Songning; Wortley, Michael; Chen, Qingjian; Freedman, Julia

    2009-12-01

    Controlled laboratory study. To examine effectiveness of an ankle brace with a subtalar locking system in restricting ankle inversion during passive and dynamic movements. Semirigid ankle braces are considered more effective in restricting ankle inversion than other types of brace, but a semirigid brace with a subtalar locking system may be even more effective. Nineteen healthy subjects with no history of major lower extremity injuries were included in the study. Participants performed 5 trials of an ankle inversion drop test and a lateral-cutting movement without wearing a brace and while wearing either the Element (with the subtalar locking system), a Functional ankle brace, or an ASO ankle brace. A 2-way repeated-measures analysis of variance (ANOVA) was used to assess brace differences (P?.05). All 3 braces significantly reduced total passive ankle frontal plane range of motion (ROM), with the Element ankle brace being the most effective. For the inversion drop the results showed significant reductions in peak ankle inversion angle and inversion ROM for all 3 braces compared to the no brace condition; and the peak inversion velocity was also reduced for the Element brace and the Functional brace. In the lateral-cutting movement, a small but significant reduction of the peak inversion angle in early foot contact and the peak eversion velocity at push-off were seen when wearing the Element and the Functional ankle braces compared to the no brace condition. Peak vertical ground reaction force was reduced for the Element brace compared to the ASO brace and the no brace conditions. These results suggest that the tested ankle braces, especially the Element brace, provided effective restriction of ankle inversion during both passive and dynamic movements.

  6. Does Talocrural Joint-Thrust Manipulation Improve Outcomes After Inversion Ankle Sprain?

    PubMed

    Krueger, Brett; Becker, Laura; Leemkuil, Greta; Durall, Christopher

    2015-08-01

    Clinical Scenario: Ankle sprains account for roughly 10% of sport-related injuries in the active population. The majority of these injuries occur from excessive ankle inversion, leading to lateral ligamentous injury. In addition to pain and swelling, limitations in ankle range of motion (ROM) and self-reported function are common findings. These limitations are thought to be due in part to loss of mobility in the talocrural joint. Accordingly, some investigators have reported using high-velocity, low-amplitude thrust-manipulation techniques directed at the talocrural joint to address deficits in dorsiflexion (DF) ROM and function. This review was conducted to ascertain the impact of talocrural joint-thrust manipulation (TJM) on DF ROM, self-reported function, and pain in patients with a history of ankle sprain. Focused Clinical Question: In patients with a history of inversion ankle sprain, does TJM improve outcomes in DF ROM, self-reported function, and/or pain?

  7. Test-retest reliability of sudden ankle inversion measurements in subjects with healthy ankle joints.

    PubMed

    Eechaute, Christophe; Vaes, Peter; Duquet, William; Van Gheluwe, Bart

    2007-01-01

    Sudden ankle inversion tests have been used to investigate whether the onset of peroneal muscle activity is delayed in patients with chronically unstable ankle joints. Before interpreting test results of latency times in patients with chronic ankle instability and healthy subjects, the reliability of these measures must be first demonstrated. To investigate the test-retest reliability of variables measured during a sudden ankle inversion movement in standing subjects with healthy ankle joints. Validation study. Research laboratory. 15 subjects with healthy ankle joints (30 ankles). Subjects stood on an ankle inversion platform with both feet tightly fixed to independently moveable trapdoors. An unexpected sudden ankle inversion of 50 degrees was imposed. We measured latency and motor response times and electromechanical delay of the peroneus longus muscle, along with the time and angular position of the first and second decelerating moments, the mean and maximum inversion speed, and the total inversion time. Correlation coefficients and standard error of measurements were calculated. Intraclass correlation coefficients ranged from 0.17 for the electromechanical delay of the peroneus longus muscle (standard error of measurement = 2.7 milliseconds) to 0.89 for the maximum inversion speed (standard error of measurement = 34.8 milliseconds). The reliability of the latency and motor response times of the peroneus longus muscle, the time of the first and second decelerating moments, and the mean and maximum inversion speed was acceptable in subjects with healthy ankle joints and supports the investigation of the reliability of these measures in subjects with chronic ankle instability. The lower reliability of the electromechanical delay of the peroneus longus muscle and the angular positions of both decelerating moments calls the use of these variables into question.

  8. Preparatory co-activation of the ankle muscles may prevent ankle inversion injuries

    PubMed Central

    DeMers, Matthew S.; Hicks, Jennifer L.; Delp, Scott L.

    2018-01-01

    Ankle inversion sprains are the most frequent acute musculoskeletal injuries occurring in physical activity. Interventions that retrain muscle coordination have helped rehabilitate injured ankles, but it is unclear which muscle coordination strategies, if any, can prevent ankle sprains. The purpose of this study was to determine whether coordinated activity of the ankle muscles could prevent excessive ankle inversion during a simulated landing on a 30-degree incline. We used a set of musculoskeletal simulations to evaluate the efficacy of two strategies for coordinating the ankle evertor and invertor muscles during simulated landing scenarios: planned co-activation and stretch reflex activation with physiologic latency (60-millisecond delay). A full-body musculoskeletal model of landing was used to generate simulations of a subject dropping onto an inclined surface with each coordination condition. Within each condition, the intensity of evertor and invertor co-activity or stretch reflexes were varied systematically. The simulations revealed that strong preparatory co-activation of the ankle evertors and invertors prior to ground contact prevented ankle inversion from exceeding injury thresholds by rapidly generating eversion moments after initial contact. Conversely, stretch reflexes were too slow to generate eversion moments before the simulations reached the threshold for inversion injury. These results suggest that training interventions to protect the ankle should focus on stiffening the ankle with muscle co-activation prior to landing. The musculoskeletal models, controllers, software, and simulation results are freely available online at http://simtk.org/home/ankle-sprains, enabling others to reproduce the results and explore new injury scenarios and interventions. PMID:28057351

  9. Relationship between viscosity of the ankle joint complex and functional ankle instability for inversion ankle sprain patients.

    PubMed

    Lin, Che-Yu; Kang, Jiunn-Horng; Wang, Chung-Li; Shau, Yio-Wha

    2015-03-01

    Measurement of viscosity of the ankle joint complex is a novel method to assess mechanical ankle instability. In order to further investigate the clinical significance of the method, this study intended to investigate the relationship between ankle viscosity and severity of functional ankle instability. Cross-sectional study. 15 participants with unilateral inversion ankle sprain and 15 controls were recruited. Their ankles were further classified into stable and unstable ankles. Ankle viscosity was measured by an instrumental anterior drawer test. Severity of functional ankle instability was measured by the Cumberland Ankle Instability Tool. Unstable ankles were compared with stable ankles. Injured ankles were compared with uninjured ankles of both groups. The spearman's rank correlation coefficient was applied to determine the relationship between ankle viscosity and severity of functional ankle instability in unstable ankles. There was a moderate relationship between ankle viscosity and severity of functional ankle instability (r=-0.64, p<0.0001). Unstable ankles exhibited significantly lower viscosity (p<0.005) and more severe functional ankle instability (p<0.0001) than stable ankles. Injured ankles exhibited significantly lower viscosity and more severe functional ankle instability than uninjured ankles (p<0.0001). There was a moderate relationship between ankle viscosity and severity of functional ankle instability. This finding suggested that, severity of functional ankle instability may be partially attributed to mechanical insufficiencies such as the degenerative changes in ankle viscosity following the inversion ankle sprain. In clinical application, measurement of ankle viscosity could be a useful tool to evaluate severity of chronic ankle instability. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. Changes in active ankle dorsiflexion range of motion after acute inversion ankle sprain.

    PubMed

    Youdas, James W; McLean, Timothy J; Krause, David A; Hollman, John H

    2009-08-01

    Posterior calf stretching is believed to improve active ankle dorsiflexion range of motion (AADFROM) after acute ankle-inversion sprain. To describe AADFROM at baseline (postinjury) and at 2-wk time periods for 6 wk after acute inversion sprain. Randomized trial. Sports clinic. 11 men and 11 women (age range 11-54 y) with acute inversion sprain. Standardized home exercise program for acute inversion sprain. AADFROM with the knee extended. Time main effect on AADFROM was significant (F3,57 = 108, P < .001). At baseline, mean active sagittal-plane motion of the ankle was 6 degrees of plantar flexion, whereas at 2, 4, and 6 wk AADFROM was 7 degrees, 11 degrees, and 11 degrees, respectively. AADFROM increased significantly from baseline to week 2 and from week 2 to week 4. Normal AADFROM was restored within 4 wk after acute inversion sprain.

  11. Expecting ankle tilts and wearing an ankle brace influence joint control in an imitated ankle sprain mechanism during walking.

    PubMed

    Gehring, Dominic; Wissler, Sabrina; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    A thorough understanding of the functional aspects of ankle joint control is essential to developing effective injury prevention. It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking. Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24° inversion and 15° plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace. Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (-7%) and velocity (-4%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (-14%) and velocity (-11%) as well as reactive neuromuscular responses. The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing. Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Reliability and discriminative validity of sudden ankle inversion measurements in patients with chronic ankle instability.

    PubMed

    Eechaute, Christophe; Vaes, Peter; Duquet, William; Van Gheluwe, Bart

    2009-07-01

    Studies investigating peroneal muscle reaction times in chronically unstable ankle joints present conflicting results. The degree of reliability and accuracy of these measurements is unknown in patients with chronic ankle instability (CAI). 40 patients with CAI and 30 healthy subjects were tested using a sudden ankle inversion of 50 degrees while standing on a trapdoor device. Sudden ankle inversion measurements were registered using electromyography, accelerometry and electrogoniometry. For reliability testing, intra-class coefficients (ICCs; model 3,1) and standard errors of measurements of the latency time, motor response time and electromechanical delay of the peroneus longus muscle, the time and angular position of onset of decelerations, the mean and maximum inversion speed and the total inversion time were calculated in 15 patients with CAI. To assess between-group differences, t-tests for independent samples (p<.05) were used. ICCs ranged from .20 (angular position of onset of the second deceleration) to .98 (electromechanical delay of the peroneus longus muscle). Significant between-group differences were observed in only 2 of the 12 variables (for the electromechanical delay of the peroneus longus muscle, p=.001; time of onset of the second deceleration, p=.040). The latency time and motor response time of the peroneus longus muscle, the total inversion time and the mean inversion speed demonstrate acceptable reliability in healthy subjects and patients. The latency time and motor response time of the peroneus longus muscle are not delayed in patients with CAI. Ankle inversion measurements are not discriminative for CAI.

  13. Medial compressible forefoot sole elements reduce ankle inversion in lateral SSC jumps.

    PubMed

    Fleischmann, Jana; Mornieux, Guillaume; Gehring, Dominic; Gollhofer, Albert

    2013-06-01

    Sideward movements are associated with high incidences of lateral ankle sprains. Special shoe constructions might be able to reduce these injuries during lateral movements. The purpose of this study was to investigate whether medial compressible forefoot sole elements can reduce ankle inversion in a reactive lateral movement, and to evaluate those elements' influence on neuromuscular and mechanical adjustments in lower extremities. Foot placement and frontal plane ankle joint kinematics and kinetics were analyzed by 3-dimensional motion analysis. Electromyographic data of triceps surae, peroneus longus, and tibialis anterior were collected. This modified shoe reduced ankle inversion in comparison with a shoe with a standard sole construction. No differences in ankle inversion moments were found. With the modified shoe, foot placement occurred more internally rotated, and muscle activity of the lateral shank muscles was reduced. Hence, lateral ankle joint stability during reactive sideward movements can be improved by these compressible elements, and therefore lower lateral shank muscle activity is required. As those elements limit inversion, the strategy to control inversion angles via a high external foot rotation does not need to be used.

  14. [Influence of Ankle Braces on the Prevalence of Ankle Inversion Injuries in the Swiss Volleyball National League A].

    PubMed

    Jaggi, J; Kneubühler, S; Rogan, S

    2016-06-01

    Ankle inversion is a common injury among volleyball players. The injury rate during a game is 2.1 times higher than during training. As a result, the preventive use of ankle braces is frequently observed in Swiss volleyball leagues. Studies have shown that ankle braces have a preventive effect on the prevalence of ankle inversion. In Switzerland there has been no investigation into the preventive use of braces and their influence on prevalence. For this reason, the goals of this study are 1) to determine when, why and by whom ankle braces are worn and 2) to evaluate the injury rate of users and non-users of ankle braces. A modified questionnaire was sent to 18 men's and women's teams of the Swiss National League A. The questionnaire included questions about injury rates and the circumstances of ankle inversion injuries. The data were statistically analysed with Microsoft Excel 2012 and SPSS Version 20. The overall response rate was 61 %, allowing data from 181 players to be analysed. 33 % (59 of 181) of the players used an ankle brace. There was a statistically significant difference in the prevalence of ankle inversion between users (12 injured) and non-users (8 injured) (p = 0.006). Wearing an ankle brace during training or during a game made no difference in the prevention of injuries (p = 0.356). More athletes were injured during training (n = 13) than during a game (n = 7). The results of the present study indicate that volleyball players preferably wear ankle braces to prevent injury. More than one third of the players in the study wore an ankle brace, 60 % for primary prevention and 40 % for secondary prevention due to a previous injury. The study shows that significantly more users than non-users of ankle braces were injured. This is contrary to literature. Furthermore it was shown that more injuries occur during training than during a game. This finding results from the fact that ankle braces were rarely worn during training. It is

  15. Cold water immersion of the ankle decreases neuromuscular response of lower limb after inversion movement.

    PubMed

    Macedo, Christiane S G; Alonso, Carolina S; Liporaci, Rogério F; Vieira, Fernando; Guirro, Rinaldo R J

    2014-01-01

    Cryotherapy has been associated with a significant decrease in nerve conduction velocity and muscle contraction with possible effects on exercise and physical training. To quantify the electromyographic response of the lateral gastrocnemius, tibialis anterior, fibularis longus, rectus femoris and gluteus medius to ankle inversion following cold water immersion. The peak values of the root mean square (RMS) were obtained from 35 healthy and active university subjects after the use of a tilt platform to force the ankle into 30° of inversion before, immediately after, and 10, 20, and 30 minutes after water immersion at 4±2°C, for 20 minutes. The Shapiro-Wilk test, repeated measures analysis, Bonferroni's post-hoc, and linear regression analysis provided the results. Peak RMS was significantly lower at all times after cold water immersion, with residual effect of up to 30 minutes, when compared to pre-immersion for all muscles, except for immediate post-immersion for the gluteus medius. After cold water immersion of the ankle, special care should be taken in activities that require greater neuromuscular control.

  16. Aftermath of Ankle Inversion Injuries: Spectrum of MR Imaging Findings.

    PubMed

    Meehan, Timothy M; Martinez-Salazar, Edgar Leonardo; Torriani, Martin

    2017-02-01

    Acute and chronic ankle inversion injuries are a common source of pain and a diagnostic challenge. Several studies have shown a variety of injury patterns after inversion injury both in acute and chronic settings. Although traditional assessment with clinical examination and radiographs is generally accepted for inversion injuries, MR imaging is a useful tool to detect occult injuries and in patients with chronic symptoms. This article examines a range of MR imaging findings that may be present in patients with lateral ankle pain following an acute or chronic inversion injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The effect of high-top and low-top shoes on ankle inversion kinematics and muscle activation in landing on a tilted surface.

    PubMed

    Fu, Weijie; Fang, Ying; Liu, Yu; Hou, Jianfu

    2014-02-18

    There is still uncertainty concerning the beneficial effects of shoe collar height for ankle sprain prevention and very few data are available in the literature regarding the effect of high-top and low-top shoes on muscle responses during landing. The purpose of this study was to quantify the effect of high-top and low-top shoes on ankle inversion kinematics and pre-landing EMG activation of ankle evertor muscles during landing on a tilted surface. Thirteen physical education students landed on four types of surfaces wearing either high-top shoes (HS) or low-top shoes (LS). The four conditions were 15° inversion, 30° inversion, combined 25° inversion + 10° plantar flexion, and combined 25° inversion + 20° plantar flexion. Ankle inversion kinematics and EMG data of the tibialis anterior (TA), peroneus longus (PL), and peroneus brevis (PB) muscles were measured simultaneously. A 2 × 4 (shoe × surface) repeated measures ANOVA was performed to examine the effect of shoe and landing surfaces on ankle inversion and EMG responses. No significant differences were observed between the various types of shoes in the maximum ankle inversion angle, the ankle inversion range of motion, and the maximum ankle inversion angular velocity after foot contact for all conditions. However, the onset time of TA and PB muscles was significantly later wearing HS compared to LS for the 15° inversion condition. Meanwhile, the mean amplitude of the integrated EMG from the 50 ms prior to contact (aEMGpre) of TA was significantly lower with HS compared to LS for the 15° inversion condition and the combined 25° inversion + 20° plantarflexion condition. Similarly, the aEMGpre when wearing HS compared to LS also showed a 37.2% decrease in PL and a 31.0% decrease in PB for the combined 25° inversion + 20° plantarflexion condition and the 15° inversion condition, respectively. These findings provide preliminary evidence suggesting that wearing high-top shoes

  18. Kinematics analysis of ankle inversion ligamentous sprain injuries in sports: five cases from televised tennis competitions.

    PubMed

    Fong, Daniel Tik-Pui; Ha, Sophia Chui-Wai; Mok, Kam-Ming; Chan, Christie Wing-Long; Chan, Kai-Ming

    2012-11-01

    Ankle ligamentous sprain is common in sports. The most direct way to study the mechanism quantitatively is to study real injury cases; however, it is unethical and impractical to produce an injury in the laboratory. A recently developed, model-based image-matching motion analysis technique allows quantitative analysis of real injury incidents captured in televised events and gives important knowledge for the development of injury prevention protocols and equipment. To date, there have been only 4 reported cases, and there is a need to conduct more studies for a better understanding of the mechanism of ankle ligamentous sprain injury. This study presents 5 cases in tennis and a comparison with 4 previous cases for a better understanding of the mechanism of ankle ligamentous sprain injury. Case series; level of evidence, 4. Five sets of videos showing ankle sprain injuries in televised tennis competition with 2 camera views were collected. The videos were transformed, synchronized, and rendered to a 3-dimensional animation software. The dimensions of the tennis court in each case were obtained to build a virtual environment, and a skeleton model scaled to the injured athlete's height was used for the skeleton matching. Foot strike was determined visually, and the profiles of the ankle joint kinematics were individually presented. There was a pattern of sudden inversion and internal rotation at the ankle joint, with the peak values ranging from 48°-126° and 35°-99°, respectively. In the sagittal plane, the ankle joint fluctuated between plantar flexion and dorsiflexion within the first 0.50 seconds after foot strike. The peak inversion velocity ranged from 509 to 1488 deg/sec. Internal rotation at the ankle joint could be one of the causes of ankle inversion sprain injury, with a slightly inverted ankle joint orientation at landing as the inciting event. To prevent the foot from rolling over the edge to cause a sprain injury, tennis players who do lots of sideward

  19. Common peroneal nerve palsy after grade I inversion ankle sprain.

    PubMed

    Mitsiokapa, Evanthia A; Mavrogenis, Andreas F; Antonopoulos, Dimitris; Tzanos, George; Papagelopoulos, Panayiotis J

    2012-01-01

    This case report presents a 28-year-old man with foot drop 48 hours after a grade I inversion ankle sprain. Clinical examination and electrodiagnostic studies showed common peroneal nerve palsy. The patient was managed with conservative treatment and rehabilitation and recovered completely 4 months after the injury. Physicians should be aware of the possibility of delayed peroneal nerve injury after grade I ankle sprain. Function of the peroneal nerve should be evaluated in all patients with inversion ankle sprain as part of initial and follow-up evaluations. Early electrodiagnostic studies are helpful to localize and provide indications of the severity of the injury.

  20. Slower nerve conduction velocity in individuals with functional ankle instability.

    PubMed

    Simon, J; Docherty, C

    2014-08-01

    The purpose of this study is to quantify nerve conduction velocity differences in individuals with functional ankle instability compared to a "healthy" population. 38 participants ages 18-30 were recruited from a large university with approximately 43,000 students. 19 subjects (9 men and 10 women; age=21.0±1.4 years; height=172.0±9.3 cm; mass=74.4±1 2.4 kg) with symptoms of functional ankle instability were in the functional ankle instability group. 19 subjects (10 men, 9 women; age=22.0±2.6 years; height=169.8±9.1 cm; mass=69.0±14.8 kg) with "healthy" ankles were in the control group. Nerve conduction velocity was conducted using one trial at 2 different sites: posterior to the fibular head (fibular), and 10 cm superior/posterior of the first site (popliteal). Nerve conduction velocity (m/sec) was assessed using a SierraWave II system (Cadwell Laboratories; Kennewick, WA). A MANCOVA was performed on the two dependent variables (fibular and popliteal). Covariates included surface temperature of the leg, body mass index, and age. The independent variable was group (functional ankle instability and control). The effect of group was significantly related to nerve conduction velocity at the fibular site (F(1, 27) =16.49, p=0.01) and popliteal site (F(1, 27)=4.51, p=0.01), with responses significantly faster for individuals in the control group than the functional ankle instability group. These results indicate that patients with functional ankle instability might have damage to the peroneal nerve which results in slower peroneal nerve conduction velocity. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Analysis of the Effects of Normal Walking on Ankle Joint Contact Characteristics After Acute Inversion Ankle Sprain.

    PubMed

    Bae, Ji Yong; Park, Kyung Soon; Seon, Jong Keun; Jeon, Insu

    2015-12-01

    To show the causal relationship between normal walking after various lateral ankle ligament (LAL) injuries caused by acute inversion ankle sprains and alterations in ankle joint contact characteristics, finite element simulations of normal walking were carried out using an intact ankle joint model and LAL injury models. A walking experiment using a volunteer with a normal ankle joint was performed to obtain the boundary conditions for the simulations and to support the appropriateness of the simulation results. Contact pressure and strain on the talus articular cartilage and anteroposterior and mediolateral translations of the talus were calculated. Ankles with ruptured anterior talofibular ligaments (ATFLs) had a higher likelihood of experiencing increased ankle joint contact pressures, strains and translations than ATFL-deficient ankles. In particular, ankles with ruptured ATFL + calcaneofibular ligaments and all ruptured ankles had a similar likelihood as the ATFL-ruptured ankles. The push off stance phase was the most likely situation for increased ankle joint contact pressures, strains and translations in LAL-injured ankles.

  2. Step-to-Step Ankle Inversion/Eversion Torque Modulation Can Reduce Effort Associated with Balance.

    PubMed

    Kim, Myunghee; Collins, Steven H

    2017-01-01

    Below-knee amputation is associated with higher energy expenditure during walking, partially due to difficulty maintaining balance. We previously found that once-per-step push-off work control can reduce balance-related effort, both in simulation and in experiments with human participants. Simulations also suggested that changing ankle inversion/eversion torque on each step, in response to changes in body state, could assist with balance. In this study, we investigated the effects of ankle inversion/eversion torque modulation on balance-related effort among amputees ( N = 5) using a multi-actuated ankle-foot prosthesis emulator. In stabilizing conditions, changes in ankle inversion/eversion torque were applied so as to counteract deviations in side-to-side center-of-mass acceleration at the moment of intact-limb toe off; higher acceleration toward the prosthetic limb resulted in a corrective ankle inversion torque during the ensuing stance phase. Destabilizing controllers had the opposite effect, and a zero gain controller made no changes to the nominal inversion/eversion torque. To separate the balance-related effects of step-to-step control from the potential effects of changes in average mechanics, average ankle inversion/eversion torque and prosthesis work were held constant across conditions. High-gain stabilizing control lowered metabolic cost by 13% compared to the zero gain controller ( p = 0.05). We then investigated individual responses to subject-specific stabilizing controllers following an enforced exploration period. Four of five participants experienced reduced metabolic rate compared to the zero gain controller (-15, -14, -11, -6, and +4%) an average reduction of 9% ( p = 0.05). Average prosthesis mechanics were unchanged across all conditions, suggesting that improvements in energy economy might have come from changes in step-to-step corrections related to balance. Step-to-step modulation of inversion/eversion torque could be used in new, active

  3. Association of Brachial-Ankle Pulse Wave Velocity with Asymptomatic Intracranial Arterial Stenosis in Hypertension Patients.

    PubMed

    Wang, Yan; Zhang, Jin; Qain, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

    2016-08-01

    Intracranial arterial stenosis is a common cause of ischemic stroke in Asians. We therefore sought to explore the relationship of brachial-ankle pulse wave velocity and intracranial arterial stenosis in 834 stroke-free hypertensive patients. Intracranial arterial stenosis was evaluated through computerized tomographic angiography. Brachial-ankle pulse wave velocity was measured by an automated cuff device. The top decile of brachial-ankle pulse wave velocity was significantly associated with intracranial arterial stenosis (P = .027, odds ratio = 1.82; 95% confidence interval: 1.07-3.10). The patients with the top decile of brachial-ankle pulse wave velocity showed 56% higher risk for the presence of intracranial arterial stenosis to the whole population, which was more significant in patients younger than 65 years old. We also found that brachial-ankle pulse wave velocity related to both intracranial arterial stenosis and homocysteine. Our study showed the association of brachial-ankle pulse wave velocity with asymptomatic intracranial arterial stenosis in hypertension patients, especially in relative younger subjects. Brachial-ankle pulse wave velocity might be a relatively simple and repeatable measurement to detect hypertension patients in high risk of intracranial arterial stenosis. Copyright © 2016. Published by Elsevier Inc.

  4. Development of a fulcrum methodology to replicate the lateral ankle sprain mechanism and measure dynamic inversion speed.

    PubMed

    Knight, Adam C; Weimar, Wendi H

    2012-09-01

    When the ankle is forced into inversion, the speed at which this movement occurs may affect the extent of injury. The purpose of this investigation was to develop a fulcrum device to mimic the mechanism of a lateral ankle sprain and to determine the reliability and validity of the temporal variables produced by this device. Additionally, this device was used to determine if a single previous lateral ankle sprain or ankle taping effected the time to maximum inversion and/or mean inversion speed. Twenty-six participants (13 with history of a single lateral ankle sprain and 13 with no history of injury) completed the testing. The participants completed testing on three separate days, performing 10 trials with the fulcrum per leg on each testing day, and tape was applied to both ankles on one testing day. No significant interactions or main effects were found for either previous injury or ankle taping, but good reliability was found for time to maximum inversion (ICC = .81) and mean inversion speed (ICC = .79). The findings suggest that although neither variable was influenced by the history of a single previous lateral ankle sprain or ankle taping, both variables demonstrated good reliability and construct validity, but not discriminative validity.

  5. A Study of H-Reflexes in Subjects with Acute Ankle Inversion Injuries

    DTIC Science & Technology

    1996-12-09

    stress to the injured ankle at heel- strike .(57) Any increased inversion stress by way of joint loading in the presence of compromised joint...the present study, may play a role in decreasing the degree of calcaneal inversion just prior to heel- strike and minimize the stress on the lateral...Presentation: * Significant edema/ecchymosis on lateral and medial aspects of ankle. * Possible pitting edema on forefoot (several days post- injury

  6. Preparation time influences ankle and knee joint control during dynamic change of direction movements.

    PubMed

    Fuerst, Patrick; Gollhofer, Albert; Gehring, Dominic

    2017-04-01

    The influence of preparation time on ankle joint biomechanics during highly dynamic movements is largely unknown. The aim of this study was to evaluate the impact of limited preparation time on ankle joint loading during highly dynamic run-and-cut movements. Thirteen male basketball players performed 45°-sidestep-cutting and 180°-turning manoeuvres in reaction to light signals which appeared during the approach run. Both movements were executed under (1) an easy condition, in which the light signal appeared very early, (2) a medium condition and (3) a hard condition with very little time to prepare the movements. Maximum ankle inversion angles, moments and velocities during ground contact, as well as EMG signals of three lower extremity muscles, were analysed. In 180°-turning movements, reduced preparation time led to significantly increased maximum ankle inversion velocities. Muscular activation levels, however, did not change. Increased inversion velocities, without accompanying changes in muscular activation, may have the potential to destabilise the ankle joint when less preparation time is available. This may result in a higher injury risk during turning movements and should therefore be considered in ankle injury research and the aetiology of ankle sprains.

  7. Foot and ankle muscle strength in people with gout: A two-arm cross-sectional study.

    PubMed

    Stewart, Sarah; Mawston, Grant; Davidtz, Lisa; Dalbeth, Nicola; Vandal, Alain C; Carroll, Matthew; Morpeth, Trish; Otter, Simon; Rome, Keith

    2016-02-01

    Foot and ankle structures are the most commonly affected in people with gout. However, the effect of gout on foot and ankle muscle strength is not well understood. The primary aim of this study was to determine whether differences exist in foot and ankle muscle strength for plantarflexion, dorsiflexion, inversion and eversion between people with gout and age- and sex-matched controls. The secondary aim was to determine whether foot and ankle muscle strength was correlated with foot pain and disability. Peak isokinetic concentric muscle torque was measured for ankle plantarflexion, dorsiflexion, eversion and inversion in 20 participants with gout and 20 matched controls at two testing velocities (30°/s and 120°/s) using a Biodex dynamometer. Foot pain and disability was measured using the Manchester Foot Pain and Disability Index (MFPDI). Participants with gout demonstrated reduced muscle strength at both the 30°/s and 120°/s testing velocities for plantarflexion, inversion and eversion (P<0.05). People with gout also displayed a reduced plantarflexion-to-dorsiflexion strength ratio at both 30°/s and 120°/s (P<0.05). Foot pain and disability was higher in people with gout (P<0.0001) and MFPDI scores were inversely correlated with plantarflexion and inversion muscle strength at the 30°/s testing velocity, and plantarflexion, inversion and eversion muscle strength at the 120°/s testing velocity (all P<0.05). People with gout have reduced foot and ankle muscle strength and experience greater foot pain and disability compared to controls. Foot and ankle strength reductions are strongly associated with increased foot pain and disability in people with gout. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Test-retest reliability of biodex system 4 pro for isometric ankle-eversion and -inversion measurement.

    PubMed

    Tankevicius, Gediminas; Lankaite, Doanata; Krisciunas, Aleksandras

    2013-08-01

    The lack of knowledge about isometric ankle testing indicates the need for research in this area. to assess test-retest reliability and to determine the optimal position for isometric ankle-eversion and -inversion testing. Test-retest reliability study. Isometric ankle eversion and inversion were assessed in 3 different dynamometer foot-plate positions: 0°, 7°, and 14° of inversion. Two maximal repetitions were performed at each angle. Both limbs were tested (40 ankles in total). The test was performed 2 times with a period of 7 d between the tests. University hospital. The study was carried out on 20 healthy athletes with no history of ankle sprains. Reliability was assessed using intraclass correlation coefficient (ICC2,1); minimal detectable change (MDC) was calculated using a 95% confidence interval. Paired t test was used to measure statistically significant changes, and P <.05 was considered statistically significant. Eversion and inversion peak torques showed high ICCs in all 3 angles (ICC values .87-.96, MDC values 3.09-6.81 Nm). Eversion peak torque was the smallest when testing at the 0° angle and gradually increased, reaching maximum values at 14° angle. The increase of eversion peak torque was statistically significant at 7 ° and 14° of inversion. Inversion peak torque showed an opposite pattern-it was the smallest when measured at the 14° angle and increased at the other 2 angles; statistically significant changes were seen only between measures taken at 0° and 14°. Isometric eversion and inversion testing using the Biodex 4 Pro system is a reliable method. The authors suggest that the angle of 7° of inversion is the best for isometric eversion and inversion testing.

  9. Correlation of ankle eversion to inversion strength ratio and static balance in dominant and non-dominant limbs of basketball players.

    PubMed

    Dabadghav, Rachana

    2016-04-01

    To compare ankle eversion to inversion strength ratio (E/I R) and static balance control between the dominant and non-dominant limbs of basketball players and to correlate ankle E/I R and static balance control in the dominant and non-dominant limbs of basketball players. Twenty-one healthy basketball players in the age-group of 18-25 years participated in this study. Isokinetic ankle eversion and inversion muscle strength was assessed at 30°/s and 120°/s in both dominant and non-dominant limbs using the Biodex isokinetic dynamometer. Similarly balance was assessed on a force platform with eyes open and eyes closed in both dominant and non-dominant limbs. Repeated measure ANOVA for strength measurement, found that there was significant main effect of speed, P=0.001 (P<0.05). However, there was no significant main effect in the sides P=0.099 (P<0.05).There was significant main effect of sides with respect to balance. Balance was affected more in non-dominant limb P=0.000 as compared to dominant limb. However, there was not much of a significant difference with eyes open and eyes closed position. The E/I ratio was >1.0 at the angular velocity of 120°/s increasing the chances of ankle injuries in basketball players. There was no correlation between ankle strength and balance in both dominant and non-dominant limbs.

  10. The Impact of Chiropractic Manipulative Therapy on Chronic Recurrent Lateral Ankle Sprain Syndrome in Two Young Athletes

    PubMed Central

    Gillman, Scott F.

    2004-01-01

    Abstract Objective To describe two cases of abrupt resolution of chronic, recurrent, inversion sprain to ankles in young recreational athletes. Clinical Features A 13-year-old, female, avid recreational soccer player with ankles that would spontaneously invert during various inconsistent points in the weight bearing gait cycle, sometimes with acute pain or sprain to the ankle. No intervention was attempted prior to her entry to the chiropractic office. A 17-year-old male avid skate- boarder and snowboarder whose left ankle routinely “gave out” into inversion upon mundane weight bearing activity, usually with pain and with dependence on wearing an ankle support when skateboarding to lessen ankle pain. The patient had used an ankle support prior to seeking chiropractic care. Intervention and Outcome High velocity, low amplitude chiropractic manipulative therapy applied to the spine, pelvis and extremity joints was the primary intervention in both cases, with particular focus on the ankle. Other procedures used included taping and orthotics, but not before the manipulation effect was noted. Conclusion High velocity, low amplitude chiropractic manipulative therapy to the spine, pelvis, and extremities, particularly at the ankle, should be considered when managing young recreational athletes with functional chronic, recurrent, ankle inversion sprains. PMID:19674638

  11. Unusual exostosis formation of the subtalar joint following an inversion ankle injury.

    PubMed

    Cisco, R W; Shaffer, M; Kuchler, L

    1993-01-01

    Exostosis formation following trauma isnot uncommon to the joints of the foot and ankle. The etiology and treatment of these boney lesions is well-documented in the literature. The following is a report of an unusual exostosis of the subtalar joint following inversion ankle injury. This case is unusual in respect to the formation of an adventitious articulation, the size of the lesion, and the pathology.

  12. The Effect of Flow Velocity on Waveform Inversion

    NASA Astrophysics Data System (ADS)

    Lee, D.; Shin, S.; Chung, W.; Ha, J.; Lim, Y.; Kim, S.

    2017-12-01

    The waveform inversion is a velocity modeling technique that reconstructs accurate subsurface physical properties. Therefore, using the model in its final, updated version, we generated data identical to modeled data. Flow velocity, like several other factors, affects observed data in seismic exploration. Despite this, there is insufficient research on its relationship with waveform inversion. In this study, the generated synthetic data considering flow velocity was factored in waveform inversion and the influence of flow velocity in waveform inversion was analyzed. Measuring the flow velocity generally requires additional equipment. However, for situations where only seismic data was available, flow velocity was calculated by fixed-point iteration method using direct wave in observed data. Further, a new waveform inversion was proposed, which can be applied to the calculated flow velocity. We used a wave equation, which can work with the flow velocities used in the study by Käser and Dumbser. Further, we enhanced the efficiency of computation by applying the back-propagation method. To verify the proposed algorithm, six different data sets were generated using the Marmousi2 model; each of these data sets used different flow velocities in the range 0-50, i.e., 0, 2, 5, 10, 25, and 50. Thereafter, the inversion results from these data sets along with the results without the use of flow velocity were compared and analyzed. In this study, we analyzed the results of waveform inversion after flow velocity has been factored in. It was demonstrated that the waveform inversion is not affected significantly when the flow velocity is of smaller value. However, when the flow velocity has a large value, factoring it in the waveform inversion produces superior results. This research was supported by the Basic Research Project(17-3312, 17-3313) of the Korea Institute of Geoscience and Mineral Resources(KIGAM) funded by the Ministry of Science, ICT and Future Planning of Korea.

  13. Mechanical instability destabilises the ankle joint directly in the ankle-sprain mechanism.

    PubMed

    Gehring, Dominic; Faschian, Katrin; Lauber, Benedikt; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain. Thus, the purpose of this study was to evaluate whether individuals with MAI have deficits in stabilising their ankle joint in a close-to-injury situation compared with those with FAI and healthy controls. Ankle-joint control was assessed by means of three-dimensional motion analysis and electromyography in participants with FAI and MAI (n=19), in participants with pure FAI (n=9) and in healthy controls (n=18). Close-to-injury situations were simulated during standing, walking and jumping by means of a custom-made tilt platform. Individuals with FAI and MAI displayed significantly greater maximum ankle inversion angles (+5°) and inversion velocities (+50°/s) in the walking and jumping conditions compared to those with pure FAI and controls. Furthermore, individuals in the FAI and MAI group showed a significantly decreased pre-activation of the peroneus longus muscle during jumping compared to those with FAI. No differences between groups were found for plantar flexion and internal rotation, or for muscle activities following tilting of the platform. The present study demonstrates that MAI is characterised by impairments of ankle-joint control in close-to-injury situations. This could make these individuals more prone to recurrent ankle sprains, and suggests the need for additional mechanical support such as braces or even surgery. In addition, the study highlights the fact that dynamic experimental test conditions in the acting participant are needed to further unravel the mystery of chronic ankle instability.

  14. Delayed latency of peroneal reflex to sudden inversion with ankle taping or bracing.

    PubMed

    Shima, N; Maeda, A; Hirohashi, K

    2005-01-01

    The purpose of the present study was to examine the effects of ankle taping and bracing based on the peroneal reflex in the hypermobile and normal ankle joints with and without history of ankle injury. Thirty-six ankle joints of 18 collegiate American football athletes with and without previous history of injury were studied. The angle of talar tilt (TT) was measured by stress radiograph for classifying normal (TT5 degrees ) ankles. They were tested with taping, bracing, and without any supports as a control. The latency of peroneus longus muscle was measured by a sudden inversion of 25 degrees using surface EMG signals. The results of the present study show no significant three-way Group (hypermobile or normal ankles) by History (previously injured or uninjured ankles) by Condition (control, taping, or bracing) interaction, while Condition main effect was significant (p<0.05). There were significant differences between control (80.8 ms) and taping (83.8 ms, p<0.01), between control and bracing (83.0 ms, p<0.05), but not between taping and bracing (p>0.05). In conclusion, ankle taping and bracing delayed the peroneal reflex latency not only for hypermobile ankles and/or injured ankle joints but also for intact ankle joints.

  15. Influence of ankle joint plantarflexion and dorsiflexion on lateral ankle sprain: A computational study.

    PubMed

    Purevsuren, Tserenchimed; Kim, Kyungsoo; Batbaatar, Myagmarbayar; Lee, SuKyoung; Kim, Yoon Hyuk

    2018-05-01

    Understanding the mechanism of injury involved in lateral ankle sprain is essential to prevent injury, to establish surgical repair and reconstruction, and to plan reliable rehabilitation protocols. Most studies for lateral ankle sprain posit that ankle inversion, internal rotation, and plantarflexion are involved in the mechanism of injury. However, recent studies indicated that ankle dorsiflexion also plays an important role in the lateral ankle sprain mechanism. In this study, the contributions of ankle plantarflexion and dorsiflexion on the ankle joint were evaluated under complex combinations of internal and inversion moments. A multibody ankle joint model including 24 ligaments was developed and validated against two experimental cadaveric studies. The effects of ankle plantarflexion (up to 60°) and dorsiflexion (up to 30°) on the lateral ankle sprain mechanism under ankle inversion moment coupled with internal rotational moment were investigated using the validated model. Lateral ankle sprain injuries can occur during ankle dorsiflexion, in which the calcaneofibular ligament and anterior talofibular ligament tears may occur associated with excessive inversion and internal rotational moment, respectively. Various combinations of inversion and internal moment may lead to anterior talofibular ligament injuries at early ankle plantarflexion, while the inversion moment acts as a primary factor to tear the anterior talofibular ligament in early plantarflexion. It is better to consider inversion and internal rotation as primary factors of the lateral ankle sprain mechanism, while plantarflexion or dorsiflexion can be secondary factor. This information will help to clarify the lateral ankle sprain mechanism of injury.

  16. Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability.

    PubMed

    Kim, Ki-Jong; Jun, Hyun-Ju; Heo, Myoung

    2015-11-01

    [Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost.

  17. Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability

    PubMed Central

    Kim, Ki-Jong; Jun, Hyun-Ju; Heo, Myoung

    2015-01-01

    [Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost. PMID:26696703

  18. Collar height and heel counter-stiffness for ankle stability and athletic performance in basketball.

    PubMed

    Liu, Hui; Wu, Zitian; Lam, Wing-Kai

    2017-01-01

    This study examined the effects of collar height and heel counter-stiffness of basketball shoes on ankle stability during sidestep cutting and athletic performance. 15 university basketball players wore customized shoes with different collar heights (high and low) and heel counter-stiffness (regular, stiffer and stiffest) for this study. Ankle stability was evaluated in sidestep cutting while athletic performance evaluated in jumping and agility tasks. All variables were analysed using two-way repeated ANOVA. Results showed shorter time to peak ankle inversion for both high collar and stiff heel counter conditions (P < 0.05), while smaller initial ankle inversion angle, peak inversion velocity and total range of inversion for wearing high collar shoes (P < 0.05). No shoe differences were found for performance variables. These findings imply that the collar height might play a larger role in lateral stability than heel counter-stiffness, while both collar height and counter-stiffness have no effect on athletic performance.

  19. Ankle taping can reduce external ankle joint moments during drop landings on a tilted surface.

    PubMed

    Sato, Nahoko; Nunome, Hiroyuki; Hopper, Luke S; Ikegami, Yasuo

    2017-09-20

    Ankle taping is commonly used to prevent ankle sprains. However, kinematic assessments investigating the biomechanical effects of ankle taping have provided inconclusive results. This study aimed to determine the effect of ankle taping on the external ankle joint moments during a drop landing on a tilted surface at 25°. Twenty-five participants performed landings on a tilted force platform that caused ankle inversion with and without ankle taping. Landing kinematics were captured using a motion capture system. External ankle inversion moment, the angular impulse due to the medio-lateral and vertical components of ground reaction force (GRF) and their moment arm lengths about the ankle joint were analysed. The foot plantar inclination relative to the ground was assessed. In the taping condition, the foot plantar inclination and ankle inversion angular impulse were reduced significantly compared to that of the control. The only component of the external inversion moment to change significantly in the taped condition was a shortened medio-lateral GRF moment arm length. It can be assumed that the ankle taping altered the foot plantar inclination relative to the ground, thereby shortening the moment arm of medio-lateral GRF that resulted in the reduced ankle inversion angular impulse.

  20. Myoelectric stimulation on peroneal muscles resists simulated ankle sprain motion.

    PubMed

    Fong, Daniel Tik-Pui; Chu, Vikki Wing-Shan; Chan, Kai-Ming

    2012-07-26

    The inadequate reaction time of the peroneal muscles in response to an incorrect foot contact event has been proposed as one of the etiological factors contributing to ankle joint inversion injury. Thus, the current study aimed to investigate the efficacy of a myoelectric stimulation applied to the peroneal muscles in the prevention of a simulated ankle inversion trauma. Ten healthy male subjects performed simulated inversion and supination tests on a pair of mechanical sprain simulators. An electrical signal was delivered to the peroneal muscles of the subjects through a pair of electrode pads. The start of the stimulus was synchronized with the drop of the sprain simulator's platform. In order to determine the maximum delay time which the stimulus could still resist the simulated ankle sprain motion, different delay time were test (0, 5, 10, and 15ms). Together with the control trial (no stimulus), there were 5 testing conditions for both simulated inversion and supination test. The effect was quantified by the drop in maximum ankle tilting angle and angular velocity, as determined by a motion analysis system with a standard laboratory procedure. Results showed that the myoelectric stimulation was effective in all conditions except the one with myoelectric stimulus delayed for 15ms in simulated supination test. It is concluded that myoelectric stimulation on peroneal muscles could resist an ankle spraining motion. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. [Influence of Restricting the Ankle Joint Complex Motions on Gait Stability of Human Body].

    PubMed

    Li, Yang; Zhang, Junxia; Su, Hailong; Wang, Xinting; Zhang, Yan

    2016-10-01

    The purpose of this study is to determine how restricting inversion-eversion and pronation-supination motions of the ankle joint complex influences the stability of human gait.The experiment was carried out on a slippery level ground walkway.Spatiotemporal gait parameter,kinematics and kinetics data as well as utilized coefficient of friction(UCOF)were compared between two conditions,i.e.with restriction of the ankle joint complex inversion-eversion and pronation-supination motions(FIXED)and without restriction(FREE).The results showed that FIXED could lead to a significant increase in velocity and stride length and an obvious decrease in double support time.Furthermore,FIXED might affect the motion angle range of knee joint and ankle joint in the sagittal plane.In FIXED condition,UCOF was significantly increased,which could lead to an increase of slip probability and a decrease of gait stability.Hence,in the design of a walker,bipedal robot or prosthetic,the structure design which is used to achieve the ankle joint complex inversion-eversion and pronation-supination motions should be implemented.

  2. Acute inversion injury of the ankle: magnetic resonance imaging and clinical outcomes.

    PubMed

    Tochigi, Y; Yoshinaga, K; Wada, Y; Moriya, H

    1998-11-01

    This study was undertaken to compare the clinical and magnetic resonance imaging results of 24 patients who had sustained ligament injuries after acute inversion injury of the ankle. On magnetic resonance imaging, the following lesions were detected: anterior talofibular ligament tear in 23 patients, calcaneofibular ligament lesion in 15, posterior talofibular ligament lesion in 11, interosseous talocalcaneal ligament lesion in 13, cervical ligament lesion in 12, and deltoid ligament lesion in 8. Compared with the clinical outcome at the follow-up study, there was a statistically significant relationship between interosseous talocalcaneal ligament lesion and each of giving way, pain, and limitation of ankle motion; between cervical ligament lesion and both giving way and pain; and between deltoid ligament lesion and giving way (P < 0.05).

  3. Comparison of custom-moulded ankle orthosis with hinged joints and off-the-shelf ankle braces in preventing ankle sprain in lateral cutting movements.

    PubMed

    Lee, Winson C C; Kobayashi, Toshiki; Choy, Barton T S; Leung, Aaron K L

    2012-06-01

    A custom moulded ankle orthosis with hinged joints potentially offers a better control over the subtalar joint and the ankle joint during lateral cutting movements, due to total contact design and increase in material strength. To test the above hypothesis by comparing it to three other available orthoses. Repeated measures. Eight subjects with a history of ankle sprains (Grade 2), and 11 subjects without such history performed lateral cutting movements in four test conditions: 1) non-orthotic, 2) custom-moulded ankle orthosis with hinges, 3) Sport-Stirrup, and 4) elastic ankle sleeve with plastic support. A VICON motion analysis system was used to study the motions at the ankle and subtalar joints. The custom-moulded ankle orthosis significantly lowered the inversion angle at initial contact (p = 0.006) and the peak inversion angle (p = 0.000) during lateral cutting movements in comparison to non-orthotic condition, while the other two orthoses did not. The three orthoses did not affect the plantarflexion motions, which had been suggested by previous studies to be important in shock wave attenuation. The custom-moulded ankle orthosis with hinges could better control inversion and thus expected to better prevent ankle sprain in lateral cutting movements. Custom-moulded ankle orthoses are not commonly used in preventing ankle sprains. This study raises the awareness of the use of custom-moulded ankle orthoses which are expected to better prevent ankle sprains.

  4. Reducing uncertainties in the velocities determined by inversion of phase velocity dispersion curves using synthetic seismograms

    NASA Astrophysics Data System (ADS)

    Hosseini, Seyed Mehrdad

    Characterizing the near-surface shear-wave velocity structure using Rayleigh-wave phase velocity dispersion curves is widespread in the context of reservoir characterization, exploration seismology, earthquake engineering, and geotechnical engineering. This surface seismic approach provides a feasible and low-cost alternative to the borehole measurements. Phase velocity dispersion curves from Rayleigh surface waves are inverted to yield the vertical shear-wave velocity profile. A significant problem with the surface wave inversion is its intrinsic non-uniqueness, and although this problem is widely recognized, there have not been systematic efforts to develop approaches to reduce the pervasive uncertainty that affects the velocity profiles determined by the inversion. Non-uniqueness cannot be easily studied in a nonlinear inverse problem such as Rayleigh-wave inversion and the only way to understand its nature is by numerical investigation which can get computationally expensive and inevitably time consuming. Regarding the variety of the parameters affecting the surface wave inversion and possible non-uniqueness induced by them, a technique should be established which is not controlled by the non-uniqueness that is already affecting the surface wave inversion. An efficient and repeatable technique is proposed and tested to overcome the non-uniqueness problem; multiple inverted shear-wave velocity profiles are used in a wavenumber integration technique to generate synthetic time series resembling the geophone recordings. The similarity between synthetic and observed time series is used as an additional tool along with the similarity between the theoretical and experimental dispersion curves. The proposed method is proven to be effective through synthetic and real world examples. In these examples, the nature of the non-uniqueness is discussed and its existence is shown. Using the proposed technique, inverted velocity profiles are estimated and effectiveness of this

  5. Altered neuromuscular control and ankle joint kinematics during walking in subjects with functional instability of the ankle joint.

    PubMed

    Delahunt, Eamonn; Monaghan, Kenneth; Caulfield, Brian

    2006-12-01

    The ankle joint requires very precise neuromuscular control during the transition from terminal swing to the early stance phase of the gait cycle. Altered ankle joint arthrokinematics and muscular activity have been cited as potential factors that may lead to an inversion sprain during the aforementioned time periods. However, to date, no study has investigated patterns of muscle activity and 3D joint kinematics simultaneously in a group of subjects with functional instability compared with a noninjured control group during these phases of the gait cycle. To compare the patterns of lower limb 3D joint kinematics and electromyographic activity during treadmill walking in a group of subjects with functional instability with those observed in a control group. Controlled laboratory study. Three-dimensional angular velocities and displacements of the hip, knee, and ankle joints, as well as surface electromyography of the rectus femoris, peroneus longus, tibialis anterior, and soleus muscles, were recorded simultaneously while subjects walked on a treadmill at a velocity of 4 km/h. Before heel strike, subjects with functional instability exhibited a decrease in vertical foot-floor clearance (12.62 vs 22.84 mm; P < .05), as well as exhibiting a more inverted position of the ankle joint before, at, and immediately after heel strike (1.69 degrees , 2.10 degrees , and -0.09 degrees vs -1.43 degrees , -1.43 degrees , and -2.78 degrees , respectively [minus value = eversion]; P < .05) compared with controls. Subjects with functional instability were also observed to have an increase in peroneus longus integral electromyography during the post-heel strike time period (107.91%.millisecond vs 64.53%.millisecond; P < .01). The altered kinematics observed in this study could explain the reason subjects with functional instability experience repeated episodes of ankle inversion injury in situations with only slight or no external provocation. It is hypothesized that the observed

  6. Football boot insoles and sensitivity to extent of ankle inversion movement.

    PubMed

    Waddington, G; Adams, R

    2003-04-01

    The capacity of the plantar sole of the foot to convey information about foot position is reduced by conventional smooth boot insoles, compared with barefoot surface contact. To test the hypothesis that movement discrimination may be restored by inserting textured replacement insoles, achieved by changing footwear conditions and measuring the accuracy of judgments of the extent of ankle inversion movement. An automated testing device, the ankle movement extent discrimination apparatus (AMEDA), developed to assess active ankle function in weight bearing without a balance demand, was used to test the effects of sole inserts in soccer boots. Seventeen elite soccer players, the members of the 2000 Australian Women's soccer squad (34 ankles), took part in the study. Subjects were randomly allocated to start testing in: bare feet, their own football boots, own football boot and replacement insole, and on the left or right side. Subjects underwent six 50 trial blocks, in which they completed all footwear conditions. The sole inserts were cut to size for each foot from textured rubber "finger profile" sheeting. Movement discrimination scores were significantly worse when subjects wore their football boots and socks, compared with barefoot data collected at the same time. The substitution of textured insoles for conventional smooth insoles in the football boots was found to restore movement discrimination to barefoot levels. The lower active movement discrimination scores of athletes when wearing football boots with smooth insoles suggest that the insole is one aspect of football boot and sport shoe design that could be modified to provide the sensory feedback needed for accurate foot positioning.

  7. Lower limb joint kinetics and ankle joint stiffness in the sprint start push-off.

    PubMed

    Charalambous, Laura; Irwin, Gareth; Bezodis, Ian N; Kerwin, David

    2012-01-01

    Sprint push-off technique is fundamental to sprint performance and joint stiffness has been identified as a performance-related variable during dynamic movements. However, joint stiffness for the push-off and its relationship with performance (times and velocities) has not been reported. The aim of this study was to quantify and explain lower limb net joint moments and mechanical powers, and ankle stiffness during the first stance phase of the push-off. One elite sprinter performed 10 maximal sprint starts. An automatic motion analysis system (CODA, 200 Hz) with synchronized force plates (Kistler, 1000 Hz) collected kinematic profiles at the hip, knee, and ankle and ground reaction forces, providing input for inverse dynamics analyses. The lower-limb joints predominately extended and revealed a proximal-to-distal sequential pattern of maximal extensor angular velocity and positive power production. Pearson correlations revealed relationships (P < 0.05) between ankle stiffness (5.93 ± 0.75 N x m x deg(-1)) and selected performance variables. Relationships between negative power phase ankle stiffness and horizontal (r = -0.79) and vertical (r = 0.74) centre of mass velocities were opposite in direction to the positive power phase ankle stiffness (horizontal: r = 0.85; vertical: r = -0.54). Thus ankle stiffness may affect the goals of the sprint push-off in different ways, depending on the phase of stance considered.

  8. Four Weeks of Balance Training does not Affect Ankle Joint Stiffness in Subjects with Unilateral Chronic Ankle Instability

    PubMed Central

    Jain, Tarang Kumar; Wauneka, Clayton N.; Liu, Wen

    2016-01-01

    Background Balance training has been shown to be effective in preventing ankle sprain recurrences in subjects with chronic ankle instability (CAI) but the biomechanical pathways underlying the clinical outcomes are still unknown. This study was conducted to determine if a 4-week balance training intervention can alter the mechanical characteristics in ankles with CAI. Methods Twenty-two recreationally active subjects with unilateral CAI were randomized to either a control (n = 11, 35.1 ± 9.3 years) or intervention (n = 11, 33.5 ± 6.6 years) group. Subjects in the intervention group were trained on the affected limb with static and dynamic components using a Biodex balance stability system for 4-weeks. The ankle joint stiffness and neutral zone in inversion and eversion directions on the involved and uninvolved limbs was measured at baseline and post-intervention using a dynamometer. Results At baseline, the mean values of the inversion stiffness (0.69 ± 0.37 Nm/degree) in the involved ankle was significantly lower (p < 0.011, 95% CI [0.563, 0.544]) than that of uninvolved contralateral ankle (0.99 ± 0.41 Nm/degree). With the available sample size, the eversion stiffness, inversion neutral zone, and eversion neutral zone were not found to be significantly different between the involved and uninvolved contralateral ankles. The 4-week balance training intervention failed to show any significant effect on the passive ankle stiffness and neutral zones in inversion and eversion. Conclusion Decreased inversion stiffness in the involved chronic unstable ankle was found that of uninvolved contralateral ankle. The 4-week balance training program intervention was ineffective in altering the mechanical characteristics of ankles with CAI. Level of evidence Randomized controlled clinical trial; Level of evidence, 1. PMID:27642647

  9. Joint stability characteristics of the ankle complex in female athletes with histories of lateral ankle sprain, part II: clinical experience using arthrometric measurement.

    PubMed

    Kovaleski, John E; Heitman, Robert J; Gurchiek, Larry R; Hollis, J M; Liu, Wei; Pearsall, Albert W

    2014-01-01

    This is part II of a 2-part series discussing stability characteristics of the ankle complex. In part I, we used a cadaver model to examine the effects of sectioning the lateral ankle ligaments on anterior and inversion motion and stiffness of the ankle complex. In part II, we wanted to build on and apply these findings to the clinical assessment of ankle-complex motion and stiffness in a group of athletes with a history of unilateral ankle sprain. To examine ankle-complex motion and stiffness in a group of athletes with reported history of lateral ankle sprain. Cross-sectional study. University research laboratory. Twenty-five female college athletes (age = 19.4 ± 1.4 years, height = 170.2 ± 7.4 cm, mass = 67.3 ± 10.0 kg) with histories of unilateral ankle sprain. All ankles underwent loading with an ankle arthrometer. Ankles were tested bilaterally. The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness. Anterior displacement of the ankle complex did not differ between the uninjured and sprained ankles (P = .37), whereas ankle-complex rotation was greater for the sprained ankles (P = .03). The sprained ankles had less anterior and inversion end-range stiffness than the uninjured ankles (P < .01). Changes in ankle-complex laxity and end-range stiffness were detected in ankles with histories of sprain. These results indicate the presence of altered mechanical characteristics in the soft tissues of the sprained ankles.

  10. Medial joint line bone bruising at MRI complicating acute ankle inversion injury: what is its clinical significance?

    PubMed

    Chan, V O; Moran, D E; Shine, S; Eustace, S J

    2013-10-01

    To assess the incidence and clinical significance of medial joint line bone bruising following acute ankle inversion injury. Forty-five patients who underwent ankle magnetic resonance imaging (MRI) within 2 weeks of acute ankle inversion injury were included in this prospective study. Integrity of the lateral collateral ligament complex, presence of medial joint line bone bruising, tibio-talar joint effusion, and soft-tissue swelling were documented. Clinical follow-up at 6 months was carried out to determine the impact of injury on length of time out of work, delay in return to normal walking, delay in return to sports activity, and persistence of medial joint line pain. Thirty-seven patients had tears of the anterior talofibular ligament (ATFL). Twenty-six patients had medial joint line bone bruising with altered marrow signal at the medial aspect of the talus and congruent surface of the medial malleolus. A complete ATFL tear was seen in 92% of the patients with medial joint line bone bruising (p = 0.05). Patients with an ATFL tear and medial joint line bone bruising had a longer delay in return to normal walking (p = 0.0002), longer delay in return to sports activity (p = 0.0001), and persistent medial joint line pain (p = 0.0003). There was no statistically significant difference in outcome for the eight patients without ATFL tears. Medial joint line bone bruising following an acute ankle inversion injury was significantly associated with a complete ATFL tear, longer delay in the return to normal walking and sports activity, as well as persistent medial joint line pain. Its presence should prompt detailed assessment of the lateral collateral ligament complex, particularly the ATFL. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  11. The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications

    PubMed Central

    Golanó, Pau; Sierevelt, Inger N.; van Dijk, C. Niek

    2010-01-01

    Despite the fact that the superficial peroneal nerve is the only nerve in the human body that can be made visible; iatrogenic damage to this nerve is the most frequently reported complication in anterior ankle arthroscopy. One of the methods to visualize the nerve is combined ankle plantar flexion and inversion. In the majority of cases, the superficial peroneal nerve can be made visible. The portals for anterior ankle arthroscopy are however created with the ankle in the neutral or slightly dorsiflexed position and not in combined plantar flexion and inversion. The purpose of this study was to undertake an anatomical study to the course of the superficial peroneal nerve in different positions of the foot and ankle. We hypothesize that the anatomical localization of the superficial peroneal nerve changes with different foot and ankle positions. In ten fresh frozen ankle specimens, a window, only affecting the skin, was made at the level of the anterolateral portal for anterior ankle arthroscopy in order to directly visualize the superficial peroneal nerve, or if divided, its terminal branches. Nerve movement was assessed from combined 10° plantar flexion and inversion to 5° dorsiflexion, standardized by the Telos stress device. Also for the 4th toe flexion, flexion of all the toes and for skin tensioning possible nerve movement was determined. The mean superficial peroneal nerve movement was 2.4 mm to the lateral side when the ankle was moved from 10° plantar flexion and inversion to the neutral ankle position and 3.6 mm to the lateral side from 10° plantar flexion and inversion to 5° dorsiflexion. Both displacements were significant (P < 0.01). The nerve consistently moves lateral when the ankle is manoeuvred from combined plantar flexion and inversion to the neutral or dorsiflexed position. If visible, it is therefore advised to create the anterolateral portal medial from the preoperative marking, in order to prevent iatrogenic damage to the superficial

  12. Joint Stability Characteristics of the Ankle Complex in Female Athletes With Histories of Lateral Ankle Sprain, Part II: Clinical Experience Using Arthrometric Measurement

    PubMed Central

    Kovaleski, John E.; Heitman, Robert J.; Gurchiek, Larry R.; Hollis, J. M.; Liu, Wei; IV, Albert W. Pearsall

    2014-01-01

    Context: This is part II of a 2-part series discussing stability characteristics of the ankle complex. In part I, we used a cadaver model to examine the effects of sectioning the lateral ankle ligaments on anterior and inversion motion and stiffness of the ankle complex. In part II, we wanted to build on and apply these findings to the clinical assessment of ankle-complex motion and stiffness in a group of athletes with a history of unilateral ankle sprain. Objective: To examine ankle-complex motion and stiffness in a group of athletes with reported history of lateral ankle sprain. Design: Cross-sectional study. Setting: University research laboratory. Patients or Other Participants: Twenty-five female college athletes (age = 19.4 ± 1.4 years, height = 170.2 ± 7.4 cm, mass = 67.3 ± 10.0 kg) with histories of unilateral ankle sprain. Intervention(s): All ankles underwent loading with an ankle arthrometer. Ankles were tested bilaterally. Main Outcome Measure(s): The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness. Results: Anterior displacement of the ankle complex did not differ between the uninjured and sprained ankles (P = .37), whereas ankle-complex rotation was greater for the sprained ankles (P = .03). The sprained ankles had less anterior and inversion end-range stiffness than the uninjured ankles (P < .01). Conclusions: Changes in ankle-complex laxity and end-range stiffness were detected in ankles with histories of sprain. These results indicate the presence of altered mechanical characteristics in the soft tissues of the sprained ankles. PMID:24568223

  13. Perturbational and nonperturbational inversion of Rayleigh-wave velocities

    USGS Publications Warehouse

    Haney, Matt; Tsai, Victor C.

    2017-01-01

    The inversion of Rayleigh-wave dispersion curves is a classic geophysical inverse problem. We have developed a set of MATLAB codes that performs forward modeling and inversion of Rayleigh-wave phase or group velocity measurements. We describe two different methods of inversion: a perturbational method based on finite elements and a nonperturbational method based on the recently developed Dix-type relation for Rayleigh waves. In practice, the nonperturbational method can be used to provide a good starting model that can be iteratively improved with the perturbational method. Although the perturbational method is well-known, we solve the forward problem using an eigenvalue/eigenvector solver instead of the conventional approach of root finding. Features of the codes include the ability to handle any mix of phase or group velocity measurements, combinations of modes of any order, the presence of a surface water layer, computation of partial derivatives due to changes in material properties and layer boundaries, and the implementation of an automatic grid of layers that is optimally suited for the depth sensitivity of Rayleigh waves.

  14. Talofibular interval changes after acute ankle sprain: a stress ultrasonography study of ankle laxity.

    PubMed

    Croy, Theodore; Saliba, Susan; Saliba, Ethan; Anderson, Mark W; Hertel, Jay

    2013-11-01

    Quantifying talocrural joint laxity after ankle sprain is problematic. Stress ultrasonography (US) can image the lateral talocrural joint and allow the measurement of the talofibular interval, which may suggest injury to the anterior talofibular ligament (ATFL). The acute talofibular interval changes after lateral ankle sprain are unknown. Twenty-five participants (9 male, 16 female; age 21.8 ± 3.2 y, height 167.8 ± 34.1 cm, mass 72.7 ± 13.8 kg) with 27 acute, lateral ankle injuries underwent bilateral stress US imaging at baseline (<7 d) and on the affected ankle at 3 wk and 6 wk from injury in 3 ankle conditions: neutral, anterior drawer, and inversion. Talofibular interval (mm) was measured using imaging software and self-reported function (activities of daily living [ADL] and sports) by the Foot and Ankle Ability Measure (FAAM). The talofibular interval increased with anterior-drawer stress in the involved ankle (22.65 ± 3.75 mm; P = .017) over the uninvolved ankle (19.45 ± 2.35 mm; limb × position F1,26 = 4.9, P = .035) at baseline. Inversion stress also resulted in greater interval changes (23.41 ± 2.81 mm) than in the uninvolved ankles (21.13 ± 2.08 mm). A main effect for time was observed for inversion (F2,52 = 4.3, P = .019, 21.93 ± 2.24 mm) but not for anterior drawer (F2,52 = 3.1, P = .055, 21.18 ± 2.34 mm). A significant reduction in the talofibular interval took place between baseline and week 3 inversion measurements only (F1,26 = 5.6, P = .026). FAAM-ADL and sports results increased significantly from baseline to wk 3 (21.9 ± 16.2, P < .0001 and 23.8 ± 16.9, P < .0001) and from wk 3 to wk 6 (2.5 ± 4.4, P = .009 and 10.5 ± 13.2, P = .001). Stress US methods identified increased talofibular interval changes suggestive of talocrural laxity and ATFL injury using anterior drawer and inversion stress that, despite significant improvements in self-reported function, only marginally improved during the 6 wk after ankle sprain. Stress US

  15. Do ankle orthoses improve ankle proprioceptive thresholds or unipedal balance in older persons with peripheral neuropathy?

    PubMed

    Son, Jaebum; Ashton-Miller, James A; Richardson, James K

    2010-05-01

    To determine whether ankle orthoses that provide medial and lateral support, and have been found to decrease gait variability in older persons with peripheral neuropathy, decrease (improve) frontal plane ankle proprioceptive thresholds or increase unipedal stance time in that same population. Observational study in which unipedal stance time was determined with a stopwatch, and frontal plane ankle (inversion and eversion) proprioceptive thresholds were quantified during bipedal stance using a foot cradle system and a series of 100 rotational stimuli, in 11 older neuropathic subjects (8 men; age 72 +/- 7.1 yr) with and without ankle orthoses. The subjects demonstrated no change in combined frontal plane (inversion + eversion) proprioceptive thresholds or unipedal stance time with vs. without the orthoses (1.06 +/- 0.56 vs. 1.13 +/- 0.39 degrees, respectively; P = 0.955 and 6.1 +/- 6.5 vs. 6.2 +/- 5.4 secs, respectively; P = 0.922). Ankle orthoses that provide medial-lateral support do not seem to change ankle inversion/eversion proprioceptive thresholds or unipedal stance time in older persons with diabetic peripheral neuropathy. Previously identified improvements in gait variability using orthoses in this population are therefore likely related to an orthotically induced stiffening of the ankle rather than a change in ankle afferent function.

  16. Shear velocity structure of central Eurasia from inversion of surface wave velocities

    NASA Astrophysics Data System (ADS)

    Villaseñor, A.; Ritzwoller, M. H.; Levshin, A. L.; Barmin, M. P.; Engdahl, E. R.; Spakman, W.; Trampert, J.

    2001-04-01

    We present a shear velocity model of the crust and upper mantle beneath central Eurasia by simultaneous inversion of broadband group and phase velocity maps of fundamental-mode Love and Rayleigh waves. The model is parameterized in terms of velocity depth profiles on a discrete 2°×2° grid. The model is isotropic for the crust and for the upper mantle below 220 km but, to fit simultaneously long period Love and Rayleigh waves, the model is transversely isotropic in the uppermost mantle, from the Moho discontinuity to 220 km depth. We have used newly available a priori models for the crust and sedimentary cover as starting models for the inversion. Therefore, the crustal part of the estimated model shows good correlation with known surface features such as sedimentary basins and mountain ranges. The velocity anomalies in the upper mantle are related to differences between tectonic and stable regions. Old, stable regions such as the East European, Siberian, and Indian cratons are characterized by high upper-mantle shear velocities. Other large high velocity anomalies occur beneath the Persian Gulf and the Tarim block. Slow shear velocity anomalies are related to regions of current extension (Red Sea and Andaman ridges) and are also found beneath the Tibetan and Turkish-Iranian Plateaus, structures originated by continent-continent collision. A large low velocity anomaly beneath western Mongolia corresponds to the location of a hypothesized mantle plume. A clear low velocity zone in vSH between Moho and 220 km exists across most of Eurasia, but is absent for vSV. The character and magnitude of anisotropy in the model is on average similar to PREM, with the most prominent anisotropic region occurring beneath the Tibetan Plateau.

  17. Restriction of foot supination by ankle braces in sudden fall situations.

    PubMed

    Podzielny, S; Hennig, E M

    1997-06-01

    OBJECTIVE: To investigate the restriction of foot supination in different shoe orthotic combinations for unexpected ankle turns. DESIGN: A supination platform was used to experimentally induce sudden ankle turns. BACKGROUND: This study expanded on previous investigations of the effectiveness of different ankle braces and the influence of shoe material on foot supination. METHODS: For 21 male subjects pressure distribution data, achilles tendon angle, and supination velocity were collected. A comparison between a shoe with cut upper material and an intact shoe was done to show the influence of upper material on supination. The effectiveness of four different orthotics inside of an intact shoe were tested in comparison to the same shoe without ankle brace. Additionally, subjects rated their perceived supination movement of the foot. RESULTS: Between experimental conditions no large differences for the pressure distribution patterns were found. Three of the ankle braces reduced foot supination as well as supination velocities. More than two times lower supination values were measured for a footwear condition in which the upper material was cut away. Already during the free-fall most ankle braces caused a substantial reduction of foot inversion. CONCLUSION: The experiments demonstrated the influence of the upper material of a shoe and different orthotics on foot supination. Biomechanical measurements are necessary because of limited capabilities of subjects in detecting subtalar angular motions. RELEVANCE: This study investigated the effectiveness of different shoe conditions and ankle braces under experimental conditions that simulated unexpected ankle turns, the most frequent causes of sport injuries. The results of the study provide insights into which factors influence the amount of foot supination during unexpected ankle turns.

  18. A multi-frequency receiver function inversion approach for crustal velocity structure

    NASA Astrophysics Data System (ADS)

    Li, Xuelei; Li, Zhiwei; Hao, Tianyao; Wang, Sheng; Xing, Jian

    2017-05-01

    In order to constrain the crustal velocity structures better, we developed a new nonlinear inversion approach based on multi-frequency receiver function waveforms. With the global optimizing algorithm of Differential Evolution (DE), low-frequency receiver function waveforms can primarily constrain large-scale velocity structures, while high-frequency receiver function waveforms show the advantages in recovering small-scale velocity structures. Based on the synthetic tests with multi-frequency receiver function waveforms, the proposed approach can constrain both long- and short-wavelength characteristics of the crustal velocity structures simultaneously. Inversions with real data are also conducted for the seismic stations of KMNB in southeast China and HYB in Indian continent, where crustal structures have been well studied by former researchers. Comparisons of inverted velocity models from previous and our studies suggest good consistency, but better waveform fitness with fewer model parameters are achieved by our proposed approach. Comprehensive tests with synthetic and real data suggest that the proposed inversion approach with multi-frequency receiver function is effective and robust in inverting the crustal velocity structures.

  19. Total-variation based velocity inversion with Bregmanized operator splitting algorithm

    NASA Astrophysics Data System (ADS)

    Zand, Toktam; Gholami, Ali

    2018-04-01

    Many problems in applied geophysics can be formulated as a linear inverse problem. The associated problems, however, are large-scale and ill-conditioned. Therefore, regularization techniques are needed to be employed for solving them and generating a stable and acceptable solution. We consider numerical methods for solving such problems in this paper. In order to tackle the ill-conditioning of the problem we use blockiness as a prior information of the subsurface parameters and formulate the problem as a constrained total variation (TV) regularization. The Bregmanized operator splitting (BOS) algorithm as a combination of the Bregman iteration and the proximal forward backward operator splitting method is developed to solve the arranged problem. Two main advantages of this new algorithm are that no matrix inversion is required and that a discrepancy stopping criterion is used to stop the iterations, which allow efficient solution of large-scale problems. The high performance of the proposed TV regularization method is demonstrated using two different experiments: 1) velocity inversion from (synthetic) seismic data which is based on Born approximation, 2) computing interval velocities from RMS velocities via Dix formula. Numerical examples are presented to verify the feasibility of the proposed method for high-resolution velocity inversion.

  20. Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial.

    PubMed

    Cleland, Joshua A; Mintken, Paul E; McDevitt, Amy; Bieniek, Melanie L; Carpenter, Kristin J; Kulp, Katherine; Whitman, Julie M

    2013-01-01

    Randomized clinical trial. To compare the effectiveness of manual therapy and exercise (MTEX) to a home exercise program (HEP) in the management of individuals with an inversion ankle sprain. An in-clinic exercise program has been found to yield similar outcomes as an HEP for individuals with an inversion ankle sprain. However, no studies have compared an MTEX approach to an HEP. Patients with an inversion ankle sprain completed the Foot and Ankle Ability Measure (FAAM) activities of daily living subscale, the FAAM sports subscale, the Lower Extremity Functional Scale, and the numeric pain rating scale. Patients were randomly assigned to either an MTEX or an HEP treatment group. Outcomes were collected at baseline, 4 weeks, and 6 months. The primary aim (effects of treatment on pain and disability) was examined with a mixed-model analysis of variance. The hypothesis of interest was the 2-way interaction (group by time). Seventy-four patients (mean ± SD age, 35.1 ± 11.0 years; 48.6% female) were randomized into the MTEX group (n = 37) or the HEP group (n = 37). The overall group-by-time interaction for the mixed-model analysis of variance was statistically significant for the FAAM activities of daily living subscale (P<.001), FAAM sports subscale (P<.001), Lower Extremity Functional Scale (P<.001), and pain (P ≤.001). Improvements in all functional outcome measures and pain were significantly greater at both the 4-week and 6-month follow-up periods in favor of the MTEX group. The results suggest that an MTEX approach is superior to an HEP in the treatment of inversion ankle sprains. Registered at clinicaltrials.gov (NCT00797368). Therapy, level 1b-.

  1. Ipsilateral hip abductor weakness after inversion ankle sprain.

    PubMed

    Friel, Karen; McLean, Nancy; Myers, Christine; Caceres, Maria

    2006-01-01

    Hip stability and strength are important for proper gait mechanics and foot position during heel strike. To determine the relationships between hip muscle strength and chronic ankle sprains and hip muscle strength and ankle range of motion. Ex post facto design with the uninvolved limb serving as the control. Laboratory. A total of 23 subjects with unilateral chronic ankle sprain were recruited. Subjects had at least 2 ipsilateral ankle sprains and were bearing full weight, with the most recent injury occurring at least 3 months earlier. They were not undergoing formal or informal rehabilitation at the time of the study. We obtained goniometric measurements for all planes of motion at the ankle. Handheld dynamometry was used to assess the strength of the hip abductor and hip extensor muscles in both limbs. Hip abductor muscle strength and plantar flexion were significantly less on the involved side than the uninvolved side (P < .001 in each case). Strength of the involved hip abductor and hip extensor muscles was significantly correlated (r = 0.539, P < .01). No significant difference was noted in hip extensor muscle strength between sides (P = .19). Our subjects with unilateral chronic ankle sprains had weaker hip abduction strength and less plantar-flexion range of motion on the involved sides. Clinicians should consider exercises to increase hip abduction strength when developing rehabilitation programs for patients with ankle sprains.

  2. Do Ankle Orthoses Improve Ankle Proprioceptive Thresholds or Unipedal Balance in Older Persons with Peripheral Neuropathy?

    PubMed Central

    Son, Jaebum; Ashton-Miller, James A.; Richardson, James K.

    2010-01-01

    Objective To determine whether ankle orthoses that provide medial and lateral support, and have been found to decrease gait variability in older persons with peripheral neuropathy, decrease (improve) frontal plane ankle proprioceptive thresholds or increase unipedal stance time in that same population. Design Observational study in which unipedal stance time was determined with a stopwatch, and frontal plane ankle (inversion and eversion) proprioceptive thresholds were quantified during bipedal stance with and without the ankle orthoses, in 11 older diabetic subjects with peripheral neuropathy (8 men; age 72 ± 7.1 years) using a foot cradle system which presented a series of 100 rotational stimuli. Results The subjects demonstrated no change in combined frontal plane (inversion + eversion) proprioceptive thresholds or unipedal stance time with versus without the orthoses (1.06 ± 0.56 versus 1.13 ± 0.39 degrees, respectively; p = 0.955 and 6.1 ± 6.5 versus 6.2 ± 5.4 seconds, respectively; p = 0.922). Conclusion Ankle orthoses which provide medial-lateral support do not appear to change ankle inversion/eversion proprioceptive thresholds or unipedal stance time in older persons with diabetic peripheral neuropathy. Previously identified improvements in gait variability using orthoses in this population are therefore likely related to an orthotically-induced stiffening of the ankle rather than a change in ankle afferent function. PMID:20407302

  3. Ankle mechanics during sidestep cutting implicates need for 2-degrees of freedom powered ankle-foot prostheses.

    PubMed

    Ficanha, Evandro M; Rastgaar, Mohammad; Kaufman, Kenton R

    2015-01-01

    The ankle joint of currently available powered prostheses is capable of controlling one degree of freedom (DOF), focusing on improved mobility in the sagittal plane. To increase agility, the requirements of turning in prosthesis design need to be considered. Ankle kinematics and kinetics were studied during sidestep cutting and straight walking. There were no significant differences between the ankle sagittal plane mechanics when comparing sidestep cutting and straight walking; however, significant differences were observed in ankle frontal plane mechanics. During straight walking, the inversion-eversion (IE) angles were smaller than with sidestep cutting. The ankle that initiated the sidestep cutting showed progressively increasing inversion from 2 to 13 degrees while the following contralateral step showed progressively decreasing inversion from 8 to -4 degrees during normal walking speed. The changes in IE kinematics were the most significant during sidestep cutting compared with straight walking. The IE moments of the step that initiated the sidestep cutting were always in eversion, acting as a braking moment opposing the inverting motion. This suggests that an ankle-foot prosthesis with active DOFs in the sagittal and frontal planes will increase the agility of gait for patients with limb loss.

  4. Recovering Long-wavelength Velocity Models using Spectrogram Inversion with Single- and Multi-frequency Components

    NASA Astrophysics Data System (ADS)

    Ha, J.; Chung, W.; Shin, S.

    2015-12-01

    Many waveform inversion algorithms have been proposed in order to construct subsurface velocity structures from seismic data sets. These algorithms have suffered from computational burden, local minima problems, and the lack of low-frequency components. Computational efficiency can be improved by the application of back-propagation techniques and advances in computing hardware. In addition, waveform inversion algorithms, for obtaining long-wavelength velocity models, could avoid both the local minima problem and the effect of the lack of low-frequency components in seismic data. In this study, we proposed spectrogram inversion as a technique for recovering long-wavelength velocity models. In spectrogram inversion, decomposed frequency components from spectrograms of traces, in the observed and calculated data, are utilized to generate traces with reproduced low-frequency components. Moreover, since each decomposed component can reveal the different characteristics of a subsurface structure, several frequency components were utilized to analyze the velocity features in the subsurface. We performed the spectrogram inversion using a modified SEG/SEGE salt A-A' line. Numerical results demonstrate that spectrogram inversion could also recover the long-wavelength velocity features. However, inversion results varied according to the frequency components utilized. Based on the results of inversion using a decomposed single-frequency component, we noticed that robust inversion results are obtained when a dominant frequency component of the spectrogram was utilized. In addition, detailed information on recovered long-wavelength velocity models was obtained using a multi-frequency component combined with single-frequency components. Numerical examples indicate that various detailed analyses of long-wavelength velocity models can be carried out utilizing several frequency components.

  5. Ipsilateral Hip Abductor Weakness After Inversion Ankle Sprain

    PubMed Central

    Friel, Karen; McLean, Nancy; Myers, Christine; Caceres, Maria

    2006-01-01

    Context: Hip stability and strength are important for proper gait mechanics and foot position during heel strike. Objective: To determine the relationships between hip muscle strength and chronic ankle sprains and hip muscle strength and ankle range of motion. Design: Ex post facto design with the uninvolved limb serving as the control. Setting: Laboratory. Patients or Other Participants: A total of 23 subjects with unilateral chronic ankle sprain were recruited. Subjects had at least 2 ipsilateral ankle sprains and were bearing full weight, with the most recent injury occurring at least 3 months earlier. They were not undergoing formal or informal rehabilitation at the time of the study. Main Outcome Measure(s): We obtained goniometric measurements for all planes of motion at the ankle. Handheld dynamometry was used to assess the strength of the hip abductor and hip extensor muscles in both limbs. Results: Hip abductor muscle strength and plantar flexion were significantly less on the involved side than the uninvolved side (P < .001 in each case). Strength of the involved hip abductor and hip extensor muscles was significantly correlated (r = 0.539, P < .01). No significant difference was noted in hip extensor muscle strength between sides (P = .19). Conclusions: Our subjects with unilateral chronic ankle sprains had weaker hip abduction strength and less plantar-flexion range of motion on the involved sides. Clinicians should consider exercises to increase hip abduction strength when developing rehabilitation programs for patients with ankle sprains. PMID:16619098

  6. Chronic ankle instability and common fibular nerve injury.

    PubMed

    Benchortane, Michaël; Collado, Hervé; Coudreuse, Jean-Marie; Desnuelle, Claude; Viton, Jean-Michel; Delarque, Alain

    2011-03-01

    The lateral collateral ligaments of the ankle are often damaged in ankle inversion injuries. Ankle inversion may also cause injury to other structures located around the ankle or further away, such as the common fibular nerve. Few descriptions exist of common fibular nerve injury associated with ankle sprains and chronic ankle instability. We describe the case of a patient who sustained common fibular nerve injury during each of two ankle sprain recurrences involving the lateral collateral ligaments. Our objectives are to illustrate the links between common fibular nerve and lateral collateral ligament injuries and to emphasize the importance of the neurological evaluation in patients seen for ankle sprains or chronic ankle instability. Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  7. ANKLE JOINT CONTROL DURING SINGLE-LEGGED BALANCE USING COMMON BALANCE TRAINING DEVICES – IMPLICATIONS FOR REHABILITATION STRATEGIES

    PubMed Central

    Strøm, Mark; Thorborg, Kristian; Bandholm, Thomas; Tang, Lars; Zebis, Mette; Nielsen, Kristian

    2016-01-01

    ABSTRACT Background A lateral ankle sprain is the most prevalent musculoskeletal injury in sports. Exercises that aim to improve balance are a standard part of the ankle rehabilitation process. In an optimal progression model for ankle rehabilitation and prevention of future ankle sprains, it is important to characterize different balance exercises based on level of difficulty and sensori-motor training stimulus. Purpose The purpose of this study was to investigate frontal-plane ankle kinematics and associated peroneal muscle activity during single-legged balance on stable surface (floor) and three commonly used balance devices (Airex®, BOSU® Ball and wobble board). Design Descriptive exploratory laboratory study. Methods Nineteen healthy subjects performed single-legged balance with eyes open on an Airex® mat, BOSU® Ball, wobble board, and floor (reference condition). Ankle kinematics were measured using reflective markers and 3-dimensional recordings and expressed as inversion-eversion range of motion variability, peak velocity of inversion and number of inversion-eversion direction changes. Peroneus longus EMG activity was averaged and normalized to maximal activity during maximum voluntary contraction (MVC), and in addition amplitude probability distribution function (APDF) between 90 and 10% was calculated as a measure of muscle activation variability. Results Balancing on BOSU® Ball and wobble board generally resulted in increased ankle kinematic and muscle activity variables, compared to the other surfaces. BOSU® Ball was the most challenging in terms of inversion-eversion variability while wobble board was associated with a higher number of inversion-eversion direction changes. No differences in average muscle activation level were found between these two surfaces, but the BOSU® Ball did show a more variable activation pattern in terms of APDF. Conclusion The results showed large kinematic variability among different balance training devices and

  8. Clinical examination results in individuals with functional ankle instability and ankle-sprain copers.

    PubMed

    Wright, Cynthia J; Arnold, Brent L; Ross, Scott E; Ketchum, Jessica; Ericksen, Jeffrey; Pidcoe, Peter

    2013-01-01

    Why some individuals with ankle sprains develop functional ankle instability and others do not (ie, copers) is unknown. Current understanding of the clinical profile of copers is limited. To contrast individuals with functional ankle instability (FAI), copers, and uninjured individuals on both self-reported variables and clinical examination findings. Cross-sectional study. Sports medicine research laboratory. Participants consisted of 23 individuals with a history of 1 or more ankle sprains and at least 2 episodes of giving way in the past year (FAI: Cumberland Ankle Instability Tool [CAIT] score = 20.52 ± 2.94, episodes of giving way = 5.8 ± 8.4 per month), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers: CAIT score = 27.74 ± 1.69), and 23 individuals with no history of ankle sprain and no instability (uninjured: CAIT score = 28.78 ± 1.78). Self-reported disability was recorded using the CAIT and Foot and Ankle Ability Measure for Activities of Daily Living and for Sports. On clinical examination, ligamentous laxity and tenderness, range of motion (ROM), and pain at end ROM were recorded. Questionnaire scores for the CAIT, Foot and Ankle Ability Measure for Activities of Daily Living and for Sports, ankle inversion and anterior drawer laxity scores, pain with palpation of the lateral ligaments, ankle ROM, and pain at end ROM. Individuals with FAI had greater self-reported disability for all measures (P < .05). On clinical examination, individuals with FAI were more likely to have greater talar tilt laxity, pain with inversion, and limited sagittal-plane ROM than copers (P < .05). Differences in both self-reported disability and clinical examination variables distinguished individuals with FAI from copers at least 1 year after injury. Whether the deficits could be detected immediately postinjury to prospectively identify potential copers is unknown.

  9. Estimation of near-surface shear-wave velocity by inversion of Rayleigh waves

    USGS Publications Warehouse

    Xia, J.; Miller, R.D.; Park, C.B.

    1999-01-01

    The shear-wave (S-wave) velocity of near-surface materials (soil, rocks, pavement) and its effect on seismic-wave propagation are of fundamental interest in many groundwater, engineering, and environmental studies. Rayleigh-wave phase velocity of a layered-earth model is a function of frequency and four groups of earth properties: P-wave velocity, S-wave velocity, density, and thickness of layers. Analysis of the Jacobian matrix provides a measure of dispersion-curve sensitivity to earth properties. S-wave velocities are the dominant influence on a dispersion curve in a high-frequency range (>5 Hz) followed by layer thickness. An iterative solution technique to the weighted equation proved very effective in the high-frequency range when using the Levenberg-Marquardt and singular-value decomposition techniques. Convergence of the weighted solution is guaranteed through selection of the damping factor using the Levenberg-Marquardt method. Synthetic examples demonstrated calculation efficiency and stability of inverse procedures. We verify our method using borehole S-wave velocity measurements.Iterative solutions to the weighted equation by the Levenberg-Marquardt and singular-value decomposition techniques are derived to estimate near-surface shear-wave velocity. Synthetic and real examples demonstrate the calculation efficiency and stability of the inverse procedure. The inverse results of the real example are verified by borehole S-wave velocity measurements.

  10. Quantification of the Interrelationship between Brachial-Ankle and Carotid-Femoral Pulse Wave Velocity in a Workplace Population.

    PubMed

    Cheng, Yi-Bang; Li, Yan; Sheng, Chang-Sheng; Huang, Qi-Fang; Wang, Ji-Guang

    2016-04-01

    Brachial-ankle pulse wave velocity (PWV) is increasingly used for the measurement of arterial stiffness. In the present study, we quantified the interrelationship between brachial-ankle and carotid-femoral PWV in a workplace population, and investigated the associations with cardiovascular risk factors and carotid intima-media thickness (IMT). Brachial-ankle and carotid-femoral PWV were measured using the Omron-Colin VP1000 and SphygmoCor devices, respectively. We investigated the interrelationship by the Pearson's correlation analysis and Bland-Altman plot, and performed sensitivity and specificity analyses. The 954 participants (mean ± standard deviation age 42.6 ± 14.2 years) included 630 (66.0%) men and 203 (21.3%) hypertensive patients. Brachial-ankle (13.4 ± 2.7 m/s) and carotid-femoral PWV (7.3 ± 1.6 m/s) were significantly correlated in all subjects (r = 0.75) as well as in men (r = 0.72) and women (r = 0.80) separately. For arterial stiffness defined as a carotid-femoral PWV of 10 m/s or higher, the sensitivity and specificity of brachial-ankle PWV of 16.7 m/s or higher were 72 and 94%, respectively. The area under the receiver operating characteristic curve was 0.953. In multiple stepwise regression, brachial-ankle and carotid-femoral PWV were significantly (p < 0.001) associated with age (partial r = 0.33 and 0.34, respectively) and systolic blood pressure (partial r = 0.71 and 0.66, respectively). In addition, brachial-ankle and carotid-femoral PWV were significantly (p < 0.001) associated with carotid IMT (r = 0.57 and 0.55, respectively) in unadjusted analysis, but not in analysis adjusted for cardiovascular risk factors (p ≥ 0.08). Brachial-ankle and carotid-femoral PWV were closely correlated, and had similar determinants. Brachial-ankle PWV can behave as an ease-of-use alternative measure of arterial stiffness for assessing cardiovascular risk.

  11. All-inside, anatomical lateral ankle stabilization for revision and complex primary lateral ankle stabilization: a technique guide.

    PubMed

    Prissel, Mark A; Roukis, Thomas S

    2014-12-01

    Lateral ankle instability is a common mechanical problem that often requires surgical management when conservative efforts fail. Historically, myriad open surgical approaches have been proposed. Recently, consideration for arthroscopic management of lateral ankle instability has become popular, with promising results. Unfortunately, recurrent inversion ankle injury following lateral ankle stabilization can occur and require revision surgery. To date, arthroscopic management for revision lateral ankle stabilization has not been described. We present a novel arthroscopic technique combining an arthroscopic lateral ankle stabilization kit with a suture anchor ligament augmentation system for revision as well as complex primary lateral ankle stabilization. © 2014 The Author(s).

  12. Understanding acute ankle ligamentous sprain injury in sports

    PubMed Central

    Fong, Daniel TP; Chan, Yue-Yan; Mok, Kam-Ming; Yung, Patrick SH; Chan, Kai-Ming

    2009-01-01

    This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms). The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not

  13. Feasibility of waveform inversion of Rayleigh waves for shallow shear-wave velocity using a genetic algorithm

    USGS Publications Warehouse

    Zeng, C.; Xia, J.; Miller, R.D.; Tsoflias, G.P.

    2011-01-01

    Conventional surface wave inversion for shallow shear (S)-wave velocity relies on the generation of dispersion curves of Rayleigh waves. This constrains the method to only laterally homogeneous (or very smooth laterally heterogeneous) earth models. Waveform inversion directly fits waveforms on seismograms, hence, does not have such a limitation. Waveforms of Rayleigh waves are highly related to S-wave velocities. By inverting the waveforms of Rayleigh waves on a near-surface seismogram, shallow S-wave velocities can be estimated for earth models with strong lateral heterogeneity. We employ genetic algorithm (GA) to perform waveform inversion of Rayleigh waves for S-wave velocities. The forward problem is solved by finite-difference modeling in the time domain. The model space is updated by generating offspring models using GA. Final solutions can be found through an iterative waveform-fitting scheme. Inversions based on synthetic records show that the S-wave velocities can be recovered successfully with errors no more than 10% for several typical near-surface earth models. For layered earth models, the proposed method can generate one-dimensional S-wave velocity profiles without the knowledge of initial models. For earth models containing lateral heterogeneity in which case conventional dispersion-curve-based inversion methods are challenging, it is feasible to produce high-resolution S-wave velocity sections by GA waveform inversion with appropriate priori information. The synthetic tests indicate that the GA waveform inversion of Rayleigh waves has the great potential for shallow S-wave velocity imaging with the existence of strong lateral heterogeneity. ?? 2011 Elsevier B.V.

  14. Velocity structure of a bottom simulating reflector offshore Peru: Results from full waveform inversion

    USGS Publications Warehouse

    Pecher, I.A.; Minshull, T.A.; Singh, S.C.; von Huene, Roland E.

    1996-01-01

    Much of our knowledge of the worldwide distribution of submarine gas hydrates comes from seismic observations of Bottom Simulating Reflectors (BSRs). Full waveform inversion has proven to be a reliable technique for studying the fine structure of BSRs using the compressional wave velocity. We applied a non-linear full waveform inversion technique to a BSR at a location offshore Peru. We first determined the large-scale features of seismic velocity variations using a statistical inversion technique to maximise coherent energy along travel-time curves. These velocities were used for a starting velocity model for the full waveform inversion, which yielded a detailed velocity/depth model in the vicinity of the BSR. We found that the data are best fit by a model in which the BSR consists of a thin, low-velocity layer. The compressional wave velocity drops from 2.15 km/s down to an average of 1.70 km/s in an 18m thick interval, with a minimum velocity of 1.62 km/s in a 6 m interval. The resulting compressional wave velocity was used to estimate gas content in the sediments. Our results suggest that the low velocity layer is a 6-18 m thick zone containing a few percent of free gas in the pore space. The presence of the BSR coincides with a region of vertical uplift. Therefore, we suggest that gas at this BSR is formed by a dissociation of hydrates at the base of the hydrate stability zone due to uplift and subsequently a decrease in pressure.

  15. Peeling linear inversion of upper mantle velocity structure with receiver functions

    NASA Astrophysics Data System (ADS)

    Shen, Xuzhang; Zhou, Huilan

    2012-02-01

    A peeling linear inversion method is presented to study the upper mantle (from Moho to 800 km depth) velocity structures with receiver functions. The influences of the crustal and upper mantle velocity ratio error on the inversion results are analyzed, and three valid measures are taken for its reduction. This method is tested with the IASP91 and the PREM models, and the upper mantle structures beneath the stations GTA, LZH, and AXX in northwestern China are then inverted. The results indicate that this inversion method is feasible to quantify upper mantle discontinuities, besides the discontinuities between 3 h M ( h M denotes the depth of Moho) and 5 h M due to the interference of multiples from Moho. Smoothing is used to overcome possible false discontinuities from the multiples and ensure the stability of the inversion results, but the detailed information on the depth range between 3 h M and 5 h M is sacrificed.

  16. EFFECT OF ATHLETIC TAPING AND KINESIOTAPING® ON MEASUREMENTS OF FUNCTIONAL PERFORMANCE IN BASKETBALL PLAYERS WITH CHRONIC INVERSION ANKLE SPRAINS

    PubMed Central

    Karatas, Nihan; Baltaci, Gul

    2012-01-01

    Background: Chronic inversion ankle sprains are common in basketball players. The effect of taping on functional performance is disputed in the literature. Kinesiotaping® (KT®) is a new method that is being used as both a therapeutic and performance enhancement tool. To date, it appears that no study has investigated the effect of ankle KT® on functional performance. Purpose: To investigate the effects of different types of taping (KT® using Kinesio Tex®, athletic taping) on functional performance in athletes with chronic inversion sprains of the ankle. Study Design: Crossover Study Design Methods: Fifteen male basketball players with chronic inversion ankle sprains between the ages of 18 and 22 participated in this study. Functional performance tests (Hopping test by Amanda et al, Single Limb Hurdle Test, Standing Heel Rise test, Vertical Jump Test, The Star Excursion Balance Test [SEBT] and Kinesthetic Ability Trainer [KAT] Test) were used to quantify agility, endurance, balance, and coordination. These tests were conducted four times at one week intervals using varied conditions: placebo tape, without tape, standard athletic tape, and KT®. One-way ANOVA tests were used to examine difference in measurements between conditions. Bonferroni correction was applied to correct for repeated testing. Results: There were no significant differences among the results obtained using the four conditions for SEBT (anterior p=0.0699; anteromedial p=0.126; medial p=0.550; posteromedial p=0.587; posterior p=0.754; posterolateral p=0.907; lateral p=0.124; anterolateral p=0.963) and the KAT dynamic measurement (p=0.388). Faster performance times were measured with KT® and athletic tape in single limb hurdle test when compared to placebo and non-taped conditions (Athletic taping- placebo taping: p=0.03; athletic taping- non tape p=0.016;KT®- Placebo taping p=0.042; KT®-Non tape p=0.016). In standing heel rise test and vertical jump test, athletic taping led to decreased

  17. Clinical Examination Results in Individuals With Functional Ankle Instability and Ankle-Sprain Copers

    PubMed Central

    Wright, Cynthia J.; Arnold, Brent L.; Ross, Scott E.; Ketchum, Jessica; Ericksen, Jeffrey; Pidcoe, Peter

    2013-01-01

    Context: Why some individuals with ankle sprains develop functional ankle instability and others do not (ie, copers) is unknown. Current understanding of the clinical profile of copers is limited. Objective: To contrast individuals with functional ankle instability (FAI), copers, and uninjured individuals on both self-reported variables and clinical examination findings. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Participants consisted of 23 individuals with a history of 1 or more ankle sprains and at least 2 episodes of giving way in the past year (FAI: Cumberland Ankle Instability Tool [CAIT] score = 20.52 ± 2.94, episodes of giving way = 5.8 ± 8.4 per month), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers: CAIT score = 27.74 ± 1.69), and 23 individuals with no history of ankle sprain and no instability (uninjured: CAIT score = 28.78 ± 1.78). Intervention(s): Self-reported disability was recorded using the CAIT and Foot and Ankle Ability Measure for Activities of Daily Living and for Sports. On clinical examination, ligamentous laxity and tenderness, range of motion (ROM), and pain at end ROM were recorded. Main Outcome Measure(s): Questionnaire scores for the CAIT, Foot and Ankle Ability Measure for Activities of Daily Living and for Sports, ankle inversion and anterior drawer laxity scores, pain with palpation of the lateral ligaments, ankle ROM, and pain at end ROM. Results: Individuals with FAI had greater self-reported disability for all measures (P < .05). On clinical examination, individuals with FAI were more likely to have greater talar tilt laxity, pain with inversion, and limited sagittal-plane ROM than copers (P < .05). Conclusions: Differences in both self-reported disability and clinical examination variables distinguished individuals with FAI from copers at least 1 year after injury. Whether the deficits could be detected

  18. The deficit of joint position sense in the chronic unstable ankle as measured by inversion angle replication error.

    PubMed

    Nakasa, Tomoyuki; Fukuhara, Kohei; Adachi, Nobuo; Ochi, Mitsuo

    2008-05-01

    Functional instability is defined as a repeated ankle inversion sprain and a giving way sensation. Previous studies have described the damage of sensori-motor control in ankle sprain as being a possible cause of functional instability. The aim of this study was to evaluate the inversion angle replication errors in patients with functional instability after ankle sprain. The difference between the index angle and replication angle was measured in 12 subjects with functional instability, with the aim of evaluating the replication error. As a control group, the replication errors of 17 healthy volunteers were investigated. The side-to-side differences of the replication errors were compared between both the groups, and the relationship between the side-to-side differences of the replication errors and the mechanical instability were statistically analyzed in the unstable group. The side-to-side difference of the replication errors was 1.0 +/- 0.7 degrees in the unstable group and 0.2 +/- 0.7 degrees in the control group. There was a statistically significant difference between both the groups. The side-to-side differences of the replication errors in the unstable group did not statistically correlate to the anterior talar translation and talar tilt. The patients with functional instability had the deficit of joint position sense in comparison with healthy volunteers. The replication error did not correlate to the mechanical instability. The patients with functional instability should be treated appropriately in spite of having less mechanical instability.

  19. Quantification of the Interrelationship between Brachial-Ankle and Carotid-Femoral Pulse Wave Velocity in a Workplace Population

    PubMed Central

    Cheng, Yi-Bang; Li, Yan; Sheng, Chang-Sheng; Huang, Qi-Fang; Wang, Ji-Guang

    2016-01-01

    Background Brachial-ankle pulse wave velocity (PWV) is increasingly used for the measurement of arterial stiffness. In the present study, we quantified the interrelationship between brachial-ankle and carotid-femoral PWV in a workplace population, and investigated the associations with cardiovascular risk factors and carotid intima-media thickness (IMT). Methods Brachial-ankle and carotid-femoral PWV were measured using the Omron-Colin VP1000 and SphygmoCor devices, respectively. We investigated the interrelationship by the Pearson's correlation analysis and Bland-Altman plot, and performed sensitivity and specificity analyses. Results The 954 participants (mean ± standard deviation age 42.6 ± 14.2 years) included 630 (66.0%) men and 203 (21.3%) hypertensive patients. Brachial-ankle (13.4 ± 2.7 m/s) and carotid-femoral PWV (7.3 ± 1.6 m/s) were significantly correlated in all subjects (r = 0.75) as well as in men (r = 0.72) and women (r = 0.80) separately. For arterial stiffness defined as a carotid-femoral PWV of 10 m/s or higher, the sensitivity and specificity of brachial-ankle PWV of 16.7 m/s or higher were 72 and 94%, respectively. The area under the receiver operating characteristic curve was 0.953. In multiple stepwise regression, brachial-ankle and carotid-femoral PWV were significantly (p < 0.001) associated with age (partial r = 0.33 and 0.34, respectively) and systolic blood pressure (partial r = 0.71 and 0.66, respectively). In addition, brachial-ankle and carotid-femoral PWV were significantly (p < 0.001) associated with carotid IMT (r = 0.57 and 0.55, respectively) in unadjusted analysis, but not in analysis adjusted for cardiovascular risk factors (p ≥ 0.08). Conclusions Brachial-ankle and carotid-femoral PWV were closely correlated, and had similar determinants. Brachial-ankle PWV can behave as an ease-of-use alternative measure of arterial stiffness for assessing cardiovascular risk. PMID:27195246

  20. Differences in lateral ankle laxity measured via stress ultrasonography in individuals with chronic ankle instability, ankle sprain copers, and healthy individuals.

    PubMed

    Croy, Theodore; Saliba, Susan A; Saliba, Ethan; Anderson, Mark W; Hertel, Jay

    2012-07-01

    Cross-sectional. To use stress ultrasonography to measure the change in anterior talofibular ligament length during the simulated anterior drawer and ankle inversion stress tests. In approximately 30% of individuals, ankle sprains may eventually develop into chronic ankle instability (CAI) with recurrent symptoms. Individuals with CAI and those who have a history of ankle sprain (greater than 1 year prior) without chronic instability (copers) may or may not have mechanical laxity. Sixty subjects (n=60 ankles) were divided into 3 groups: 1) Control subjects without ankle injury history (n=20; mean ± SD age; 24.8 ± 4.8 years; height, 173.7 ± 9.4 cm; weight, 77.2 ± 19.5 kg), ankle sprain copers (n=20; 22.3 ± 2.9 years; 172.8 ± 11.3 cm; 72.4 ± 14.3 kg), and subjects with CAI (n=20; 23.5 ± 4.2 years; 174.6 ± 9.6 cm; 74.8 ± 17.3 kg). Ligament length change with the anterior drawer and end range ankle inversion was calculated from ultrasound images. The Foot and Ankle Ability Measure (FAAM) was used to quantify self-reported function on activities-of-daily living (ADL) and sports. The anterior drawer test resulted in length changes that were greater (F₂,₅₇=6.2, P=.004) in the CAI (mean ± SD length change, 15.6 ± 15.1%, P=.006) and the coper groups (14.0 ± 15.9%, P=.016) compared to the control group (1.3 ± 10.7%); however the length change for the CAI and coper groups were not different (P=.93). Ankle inversion similarly resulted in greater ligament length change (F₂,₅₇=6.5, P=.003) in the CAI (25.3 ± 15.5%, P=.003) and coper groups (20.2 ± 19.6%, P=.039) compared to the control group (7.4 ± 12.9%); with no difference in length change between the copers and CAI groups (P=.59). The CAI group had a lower score on the FAAM-ADL (87.4 ± 13.4%) and FAAM-Sports (74.2 ± 17.8%) when compared to the control (98.8 ± 2.9% and 98.9 ± 3.1%, P<.0001) and coper groups (99.4 ± 1.8% and 94.6 ± 8.8%, P<.0001). Stress ultrasonography identified greater

  1. Simultaneous inversion of seismic velocity and moment tensor using elastic-waveform inversion of microseismic data: Application to the Aneth CO2-EOR field

    NASA Astrophysics Data System (ADS)

    Chen, Y.; Huang, L.

    2017-12-01

    Moment tensors are key parameters for characterizing CO2-injection-induced microseismic events. Elastic-waveform inversion has the potential to providing accurate results of moment tensors. Microseismic waveforms contains information of source moment tensors and the wave propagation velocity along the wavepaths. We develop an elastic-waveform inversion method to jointly invert the seismic velocity model and moment tensor. We first use our adaptive moment-tensor joint inversion method to estimate moment tensors of microseismic events. Our adaptive moment-tensor inversion method jointly inverts multiple microseismic events with similar waveforms within a cluster to reduce inversion uncertainty for microseismic data recorded using a single borehole geophone array. We use this inversion result as the initial model for our elastic-waveform inversion to minimize the cross-correlated-based data misfit between observed data and synthetic data. We verify our method using synthetic microseismic data and obtain improved results of both moment tensors and seismic velocity model. We apply our new inversion method to microseismic data acquired at a CO2-enhanced oil recovery field in Aneth, Utah, using a single borehole geophone array. The results demonstrate that our new inversion method significantly reduces the data misfit compared to the conventional ray-theory-based moment-tensor inversion.

  2. Inverse Dynamics Model for the Ankle Joint with Applications in Tibia Malleolus Fracture

    NASA Astrophysics Data System (ADS)

    Budescu, E.; Merticaru, E.; Chirazi, M.

    The paper presents a biomechanical model of the ankle joint, in order to determine the force and the torque of reaction into the articulation, through inverse dynamic analysis, in various stages of the gait. Thus, knowing the acceleration of the foot and the reaction force between foot and ground during the gait, determined by experimental measurement, there was calculated, for five different positions of the foot, the joint reaction forces, on the basis of dynamic balance equations. The values numerically determined were compared with the admissible forces appearing in the technical systems of osteosynthesis of tibia malleolus fracture, in order to emphasize the motion restrictions during bone healing.

  3. Contributing factors to chronic ankle instability.

    PubMed

    Hubbard, Tricia J; Kramer, Lauren C; Denegar, Craig R; Hertel, Jay

    2007-03-01

    The development of repetitive ankle sprains and persistent symptoms after initial ankle sprain has been termed chronic ankle instability (CAI). There is no clear indication of which measures are most important in discriminating between individuals with and without CAI. Thirty subjects with unilateral CAI and controls had measures of ankle laxity and hypomobility, static and dynamic balance, ankle and hip strength, lower extremity alignments, and flexibility taken on both limbs. Based on comparisons of CAI ankles and side-matched limbs in controls, the measures significantly predictive of CAI were increased inversion laxity (r(2) change = 0.203), increased anterior laxity (r(2) change = 0.11), more missed balance trials (r(2) change = 0.094), and lower plantarflexion to dorsiflexion peak torque (r(2) change = 0.052). Symmetry indices comparing the side-to-side differences of each measure also were calculated for each dependent variable and compared between groups. The measures significantly predictive of CAI were decreased anterior reach (r(2) change = 0.185), decreased plantarflexion peak torque (r(2) change = 0.099), decreased posterior medial reach (r(2) change = 0.094), and increased inversion laxity (r(2) change = 0.041). The results of this study elucidate the specific measures that best discriminate between individuals with and without CAI. Both mechanical (anterior and inversion laxity) and functional (strength, dynamic balance) insufficiencies significantly contribute to the etiology of CAI. Prevention of CAI may be possible with proper initial management of the acute injury with rehabilitation aimed at those factors that best discriminate between individuals with and without CAI.

  4. The Hemi-Castaing ligamentoplasty for chronic lateral ankle instability does not modify proprioceptive, muscular and posturographic parameters.

    PubMed

    Baray, Anne-Laure; Philippot, Rémi; Neri, Thomas; Farizon, Frédéric; Edouard, Pascal

    2016-04-01

    The Hemi-Castaing ligamentoplasty uses a powerful dynamic stabilizer of the ankle which is the peroneus brevis tendon. To our knowledge, there is no study available evaluating the effects of this type of surgery on proprioceptive, muscular and posturographic parameters. This case-control study included 39 subjects divided into two groups: the operated (n = 24) and the control group (n = 15). All subjects underwent a clinical, proprioceptive and isokinetic assessment using a CON-TREX dynamometer, and a postural evaluation using the Win-Posturo force platform. At a mean period of 23 (SD 5.4) post-operative months, the Karlsson ankle functional score was 84.2 (SD 23.8) and the AOFAS score was 88.1 (SD 16.2). The mean ankle joint position error for operated ankles was from 1.9° (SD 0.9) at 10° of inversion range of motion to 2.5° (SD 1.7) at 20°. It was similar to that achieved in the control group ranging from 2.2° (SD 1) at 10° to 2.3° (SD 1.3) at 20°. No significant loss of ankle eversion strength could be observed after ligamentoplasty. Ankle eversion/inversion ratio when tested under all velocities and contraction modes failed to reveal any statistical difference between the operated and healthy ankles in the patient group, neither between the patient and control groups. This surgical technique achieved excellent functional outcomes. It did not impair the agonist/antagonist balance of ankle muscles, and use of half the peroneus brevis tendon did not lessen the eversion strength. Case-control study, Level III.

  5. Immediate Effects of Ankle Balance Taping with Kinesiology Tape for Amateur Soccer Players with Lateral Ankle Sprain: A Randomized Cross-Over Design

    PubMed Central

    Kim, Myoung Kwon; Shin, Young Jun

    2017-01-01

    Background The objective of this study was to investigate the immediate effect on gait function when ankle balance taping is applied to amateur soccer players with lateral ankle sprain. Material/Methods A cross-over randomized design was used. Twenty-two soccer players with an ankle sprain underwent 3 interventions in a random order. Subjects were randomly assigned to ankle balance taping, placebo taping, and no taping groups. The assessment was performed using the GAITRite portable walkway system, which records the location and timing of each footfall during ambulation. Results Significant differences were found in the velocity, step length, stride length, and H-H base support among the 3 different taping methods (p<0.05). The ankle balance taping group showed significantly greater velocity, step length, and stride length in comparison to the placebo and no taping group. The ankle balance taping group showed a statistically significant decrease (p<0.05) in the H-H base support compared to the placebo and no taping groups, and the placebo group showed significantly greater velocity in comparison to the no taping group (p<0.05). Conclusions We conclude that ankle balance taping that uses kinesiology tape instantly increased the walking ability of amateur soccer players with lateral ankle sprain. Therefore, ankle balance taping is a useful alternative to prevent and treat ankle sprain of soccer players. PMID:29158472

  6. Clinical tests of ankle plantarflexor strength do not predict ankle power generation during walking.

    PubMed

    Kahn, Michelle; Williams, Gavin

    2015-02-01

    The aim of this study was to investigate the relationship between a clinical test of ankle plantarflexor strength and ankle power generation (APG) at push-off during walking. This is a prospective cross-sectional study of 102 patients with traumatic brain injury. Handheld dynamometry was used to measure ankle plantarflexor strength. Three-dimensional gait analysis was performed to quantify ankle power generation at push-off during walking. Ankle plantarflexor strength was only moderately correlated with ankle power generation at push-off (r = 0.43, P < 0.001; 95% confidence interval, 0.26-0.58). There was also a moderate correlation between ankle plantarflexor strength and self-selected walking velocity (r = 0.32, P = 0.002; 95% confidence interval, 0.13-0.48). Handheld dynamometry measures of ankle plantarflexor strength are only moderately correlated with ankle power generation during walking. This clinical test of ankle plantarflexor strength is a poor predictor of calf muscle function during gait in people with traumatic brain injury.

  7. Inverting ion images without Abel inversion: maximum entropy reconstruction of velocity maps.

    PubMed

    Dick, Bernhard

    2014-01-14

    A new method for the reconstruction of velocity maps from ion images is presented, which is based on the maximum entropy concept. In contrast to other methods used for Abel inversion the new method never applies an inversion or smoothing to the data. Instead, it iteratively finds the map which is the most likely cause for the observed data, using the correct likelihood criterion for data sampled from a Poissonian distribution. The entropy criterion minimizes the information content in this map, which hence contains no information for which there is no evidence in the data. Two implementations are proposed, and their performance is demonstrated with simulated and experimental data: Maximum Entropy Velocity Image Reconstruction (MEVIR) obtains a two-dimensional slice through the velocity distribution and can be compared directly to Abel inversion. Maximum Entropy Velocity Legendre Reconstruction (MEVELER) finds one-dimensional distribution functions Q(l)(v) in an expansion of the velocity distribution in Legendre polynomials P((cos θ) for the angular dependence. Both MEVIR and MEVELER can be used for the analysis of ion images with intensities as low as 0.01 counts per pixel, with MEVELER performing significantly better than MEVIR for images with low intensity. Both methods perform better than pBASEX, in particular for images with less than one average count per pixel.

  8. Using seismically constrained magnetotelluric inversion to recover velocity structure in the shallow lithosphere

    NASA Astrophysics Data System (ADS)

    Moorkamp, M.; Fishwick, S.; Jones, A. G.

    2015-12-01

    Typical surface wave tomography can recover well the velocity structure of the upper mantle in the depth range between 70-200km. For a successful inversion, we have to constrain the crustal structure and assess the impact on the resulting models. In addition,we often observe potentially interesting features in the uppermost lithosphere which are poorly resolved and thus their interpretationhas to be approached with great care.We are currently developing a seismically constrained magnetotelluric (MT) inversion approach with the aim of better recovering the lithospheric properties (and thus seismic velocities) in these problematic areas. We perform a 3D MT inversion constrained by a fixed seismic velocity model from surface wave tomography. In order to avoid strong bias, we only utilize information on structural boundaries to combine these two methods. Within the region that is well resolved by both methods, we can then extract a velocity-conductivity relationship. By translating the conductivitiesretrieved from MT into velocities in areas where the velocity model is poorly resolved, we can generate an updated velocity model and test what impactthe updated velocities have on the predicted data.We test this new approach using a MT dataset acquired in central Botswana over the Okwa terrane and the adjacent Kaapvaal and Zimbabwe Cratons togetherwith a tomographic models for the region. Here, both datasets have previously been used to constrain lithospheric structure and show some similarities.We carefully asses the validity of our results by comparing with observations and petrophysical predictions for the conductivity-velocity relationship.

  9. Effect of isokinetic training on strength, functionality and proprioception in athletes with functional ankle instability.

    PubMed

    Sekir, Ufuk; Yildiz, Yavuz; Hazneci, Bulent; Ors, Fatih; Aydin, Taner

    2007-05-01

    The purpose of this study was to investigate the effects of isokinetic exercise on strength, joint position sense and functionality in recreational athletes with functional ankle instability (FAI). Strength, proprioception and balance of 24 recreational athletes with unilateral FAI were evaluated by using isokinetic muscle strength measurement, ankle joint position sense and one leg standing test. The functional ability was evaluated using five different tests. These were; single limb hopping course (SLHC), one legged and triple legged hop for distance (OLHD-TLHD), and six and cross six meter hop for time (SMHT-CSMHT). Isokinetic peak torque of the ankle invertor and evertor muscles were assessed eccentrically and concentrically at test speeds of 120 degrees /s. Isokinetic exercise protocol was carried out at an angular velocity of 120 degrees /s. The exercise session was repeated three times a week and lasted after 6 weeks. At baseline, concentric invertor strength was found to be significantly lower in the functionally unstable ankles compared to the opposite healthy ankles (p < 0.001). This difference was not present after executing the 6 weeks exercise sessions (p > 0.05). Ankle joint position sense in the injured ankles declined significantly from 2.35 +/- 1.16 to 1.33 +/- 0.62 degrees for 10 degrees of inversion angle (p < 0.001) and from 3.10 +/- 2.16 to 2.19 +/- 0.98 degrees for 20 degrees of inversion angle (p < 0.05) following the isokinetic exercise. One leg standing test score decreased significantly from 15.17 +/- 8.50 to 11.79 +/- 7.81 in the injured ankles (p < 0.001). Following the isokinetic exercise protocol, all of the worsened functional test scores in the injured ankles as compared to the opposite healthy ankles displayed a significant improvement (p < 0.01 for OLHD and CSMHT, p < 0.001 for SLHC, TLHD, and SMHT). These results substantiate the deficits of strength, proprioception, balance and functionality in recreational athletes with FAI. The

  10. Effect of athletic taping and kinesiotaping® on measurements of functional performance in basketball players with chronic inversion ankle sprains.

    PubMed

    Bicici, Seda; Karatas, Nihan; Baltaci, Gul

    2012-04-01

    Chronic inversion ankle sprains are common in basketball players. The effect of taping on functional performance is disputed in the literature. Kinesiotaping® (KT®) is a new method that is being used as both a therapeutic and performance enhancement tool. To date, it appears that no study has investigated the effect of ankle KT® on functional performance. To investigate the effects of different types of taping (KT® using Kinesio Tex®, athletic taping) on functional performance in athletes with chronic inversion sprains of the ankle. Crossover Study Design Fifteen male basketball players with chronic inversion ankle sprains between the ages of 18 and 22 participated in this study. Functional performance tests (Hopping test by Amanda et al, Single Limb Hurdle Test, Standing Heel Rise test, Vertical Jump Test, The Star Excursion Balance Test [SEBT] and Kinesthetic Ability Trainer [KAT] Test) were used to quantify agility, endurance, balance, and coordination. These tests were conducted four times at one week intervals using varied conditions: placebo tape, without tape, standard athletic tape, and KT®. One-way ANOVA tests were used to examine difference in measurements between conditions. Bonferroni correction was applied to correct for repeated testing. There were no significant differences among the results obtained using the four conditions for SEBT (anterior p=0.0699; anteromedial p=0.126; medial p=0.550; posteromedial p=0.587; posterior p=0.754; posterolateral p=0.907; lateral p=0.124; anterolateral p=0.963) and the KAT dynamic measurement (p=0.388). Faster performance times were measured with KT® and athletic tape in single limb hurdle test when compared to placebo and non-taped conditions (Athletic taping- placebo taping: p=0.03; athletic taping- non tape p=0.016;KT®- Placebo taping p=0.042; KT®-Non tape p=0.016). In standing heel rise test and vertical jump test, athletic taping led to decreased performance. (Standing heel rise test: Athletic taping

  11. Efficacy of thrust and nonthrust manipulation and exercise with or without the addition of myofascial therapy for the management of acute inversion ankle sprain: a randomized clinical trial.

    PubMed

    Truyols-Domí Nguez, Sebastián; Salom-Moreno, Jaime; Abian-Vicen, Javier; Cleland, Joshua A; Fernández-de-Las-Peñas, César

    2013-05-01

    Randomized clinical trial. To compare the effects of thrust and nonthrust manipulation and exercises with and without the addition of myofascial therapy for the treatment of acute inversion ankle sprain. Studies have reported that thrust and nonthrust manipulations of the ankle joint are effective for the management of patients post-ankle sprain. However, it is not known whether the inclusion of soft tissue myofascial therapy could further improve clinical and functional outcomes. Fifty patients (37 men and 13 women; mean ± SD age, 33 ± 10 years) post-acute inversion ankle sprain were randomly assigned to 2 groups: a comparison group that received a thrust and nonthrust manipulation and exercise intervention, and an experimental group that received the same protocol and myofascial therapy. The primary outcomes were ankle pain at rest and functional ability. Additionally, ankle mobility and pressure pain threshold over the ankle were assessed by a clinician who was blinded to the treatment allocation. Outcomes of interest were captured at baseline, immediately after the treatment period, and at a 1-month follow-up. The primary analysis was the group-by-time interaction. The 2-by-3 mixed-model analyses of variance revealed a significant group-by-time interaction for ankle pain (P<.001) and functional score (P = .002), with the patients who received the combination of nonthrust and thrust manipulation and myofascial intervention experiencing a greater improvement in pain and function than those who received the nonthrust and thrust manipulation intervention alone. Significant group-by-time interactions were also observed for ankle mobility (P<.001) and pressure pain thresholds (all, P<.01), with those in the experimental group experiencing greater increases in ankle mobility and pressure pain thresholds. Between-group effect sizes were large (d>0.85) for all outcomes. This study provides evidence that, in the treatment of individuals post-inversion ankle sprain, the

  12. Extremal inversion of lunar travel time data. [seismic velocity structure

    NASA Technical Reports Server (NTRS)

    Burkhard, N.; Jackson, D. D.

    1975-01-01

    The tau method, developed by Bessonova et al. (1974), of inversion of travel times is applied to lunar P-wave travel time data to find limits on the velocity structure of the moon. Tau is the singular solution to the Clairaut equation. Models with low-velocity zones, with low-velocity zones at differing depths, and without low-velocity zones, were found to be consistent with data and within the determined limits. Models with and without a discontinuity at about 25-km depth have been found which agree with all travel time data to within two standard deviations. In other words, the existence of the discontinuity and its size and location have not been uniquely resolved. Models with low-velocity channels are also possible.

  13. Relationship between mechanical ankle joint laxity and subjective function.

    PubMed

    Hubbard-Turner, Tricia

    2012-10-01

    An increase in ankle joint laxity has been reported in patients with chronic ankle instability (CAI). However, it is not known if this increase in joint laxity is responsible for the subjective level of functional deficits also reported in these patients. One hundred twenty subjects with unilateral CAI (55 males, 65 females; age, 20.6 ± 1.5 years; mass, 74.5 ± 13.6 kg; height, 174.2 ± 9.7 cm) participated in the study. Mechanical joint stability was measured with an instrumented ankle arthrometer. The arthrometer measured ankle joint motion for anterior/posterior translation and inversion/eversion angular displacement. Subjective level of function was assessed with the foot and ankle disability index (FADI) and foot and ankle disability index sport (FADIS). Bivariate correlations using Pearson Product Moments were made between all dependent variables taken on the unstable ankles. The strongest relationship was between anterior laxity and the FADIS (r = -0.88, p < 0.0001). As scores on the FADIS decreased, anterior laxity increased. Similar significant results were reported for anterior laxity and the FADI (r = -0.65, p = 0.013), as well as inversion laxity and the FADI (r = -0.53, p = 0.017) and FADIS (r = -0.45, p = 0.013). These data demonstrate that there appears to be a relationship between anterior and inversion ankle laxity and subjective function in those with CAI. Although numerous insufficiencies develop after an ankle sprain, increased laxity may cause some of the subjective functional deficits reported in those with CAI. Strategies to prevent increased laxity following ankle sprain may improve the patient's subjective level of function.

  14. Shank Muscle Strength Training Changes Foot Behaviour during a Sudden Ankle Supination

    PubMed Central

    Hagen, Marco; Lescher, Stephanie; Gerhardt, Andreas; Lahner, Matthias; Felber, Stephan; Hennig, Ewald M.

    2015-01-01

    Background The peroneal muscles are the most effective lateral stabilisers whose tension braces the ankle joint complex against excessive supination. The purpose of this study was to identify the morphological and biomechanical effects of two machine-based shank muscle training methods. Methods Twenty-two healthy male recreationally active sports students performed ten weeks of single-set high resistance strength training with 3 training sessions per week. The subjects conducted subtalar pronator/supinator muscle training (ST) with the right leg by using a custom-made apparatus; the left foot muscles were exercised with machine-based talocrural plantar and dorsiflexor training (TT). Muscle strength (MVIC), muscle volume and foot biomechanics (rearfoot motion, ground reaction forces, muscle reaction times) during a sudden ankle supination were recorded before and after the intervention. Results Compared to TT, ST resulted in significantly higher pronator (14% vs. 8%, P<0.01) and supinator MVIC (25% vs. 12%, P<0.01). During sudden foot inversions, both ST and TT resulted in reduced supination velocity (-12%; P<0.01). The muscle reaction onset time was faster after the training in peroneus longus (PL) (P<0.01). Muscle volume of PL (P<0.01) and TA (P<0.01) increased significantly after both ST and TT. Conclusion After both ST and TT, the ankle joint complex is mechanically more stabilised against sudden supinations due to the muscle volume increase of PL and TA. As the reduced supination velocities indicate, the strength training effects are already present during free-fall. According to a sudden ankle supination in standing position, both machine-based dorsiflexor and pronator strength training is recommended for enhancing the mechanical stability of the ankle. PMID:26110847

  15. Full Waveform Inversion for Seismic Velocity And Anelastic Losses in Heterogeneous Structures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Askan, A.; /Carnegie Mellon U.; Akcelik, V.

    2009-04-30

    We present a least-squares optimization method for solving the nonlinear full waveform inverse problem of determining the crustal velocity and intrinsic attenuation properties of sedimentary valleys in earthquake-prone regions. Given a known earthquake source and a set of seismograms generated by the source, the inverse problem is to reconstruct the anelastic properties of a heterogeneous medium with possibly discontinuous wave velocities. The inverse problem is formulated as a constrained optimization problem, where the constraints are the partial and ordinary differential equations governing the anelastic wave propagation from the source to the receivers in the time domain. This leads to amore » variational formulation in terms of the material model plus the state variables and their adjoints. We employ a wave propagation model in which the intrinsic energy-dissipating nature of the soil medium is modeled by a set of standard linear solids. The least-squares optimization approach to inverse wave propagation presents the well-known difficulties of ill posedness and multiple minima. To overcome ill posedness, we include a total variation regularization functional in the objective function, which annihilates highly oscillatory material property components while preserving discontinuities in the medium. To treat multiple minima, we use a multilevel algorithm that solves a sequence of subproblems on increasingly finer grids with increasingly higher frequency source components to remain within the basin of attraction of the global minimum. We illustrate the methodology with high-resolution inversions for two-dimensional sedimentary models of the San Fernando Valley, under SH-wave excitation. We perform inversions for both the seismic velocity and the intrinsic attenuation using synthetic waveforms at the observer locations as pseudoobserved data.« less

  16. Crustal velocity structure of central Gansu Province from regional seismic waveform inversion using firework algorithm

    NASA Astrophysics Data System (ADS)

    Chen, Yanyang; Wang, Yanbin; Zhang, Yuansheng

    2017-04-01

    The firework algorithm (FWA) is a novel swarm intelligence-based method recently proposed for the optimization of multi-parameter, nonlinear functions. Numerical waveform inversion experiments using a synthetic model show that the FWA performs well in both solution quality and efficiency. We apply the FWA in this study to crustal velocity structure inversion using regional seismic waveform data of central Gansu on the northeastern margin of the Qinghai-Tibet plateau. Seismograms recorded from the moment magnitude ( M W) 5.4 Minxian earthquake enable obtaining an average crustal velocity model for this region. We initially carried out a series of FWA robustness tests in regional waveform inversion at the same earthquake and station positions across the study region, inverting two velocity structure models, with and without a low-velocity crustal layer; the accuracy of our average inversion results and their standard deviations reveal the advantages of the FWA for the inversion of regional seismic waveforms. We applied the FWA across our study area using three component waveform data recorded by nine broadband permanent seismic stations with epicentral distances ranging between 146 and 437 km. These inversion results show that the average thickness of the crust in this region is 46.75 km, while thicknesses of the sedimentary layer, and the upper, middle, and lower crust are 3.15, 15.69, 13.08, and 14.83 km, respectively. Results also show that the P-wave velocities of these layers and the upper mantle are 4.47, 6.07, 6.12, 6.87, and 8.18 km/s, respectively.

  17. Inversion of Surface-wave Dispersion Curves due to Low-velocity-layer Models

    NASA Astrophysics Data System (ADS)

    Shen, C.; Xia, J.; Mi, B.

    2016-12-01

    A successful inversion relies on exact forward modeling methods. It is a key step to accurately calculate multi-mode dispersion curves of a given model in high-frequency surface-wave (Rayleigh wave and Love wave) methods. For normal models (shear (S)-wave velocity increasing with depth), their theoretical dispersion curves completely match the dispersion spectrum that is generated based on wave equation. For models containing a low-velocity-layer, however, phase velocities calculated by existing forward-modeling algorithms (e.g. Thomson-Haskell algorithm, Knopoff algorithm, fast vector-transfer algorithm and so on) fail to be consistent with the dispersion spectrum at a high frequency range. They will approach a value that close to the surface-wave velocity of the low-velocity-layer under the surface layer, rather than that of the surface layer when their corresponding wavelengths are short enough. This phenomenon conflicts with the characteristics of surface waves, which results in an erroneous inverted model. By comparing the theoretical dispersion curves with simulated dispersion energy, we proposed a direct and essential solution to accurately compute surface-wave phase velocities due to low-velocity-layer models. Based on the proposed forward modeling technique, we can achieve correct inversion for these types of models. Several synthetic data proved the effectiveness of our method.

  18. Analysis of muscle activity and ankle joint movement during the side-hop test.

    PubMed

    Yoshida, Masahiro; Taniguchi, Keigo; Katayose, Masaki

    2011-08-01

    Functional performance tests (FPTs) that consist of movements, such as hopping, landing, and cutting, provide useful measurements. Although some tests have been established for kinematic studies of the knee joint, very few tests have been established for the ankle joint. To use the FPT as a test battery for patients with an ankle sprain, it is necessary to document typical patterns of muscle activation and range of motion (ROM) of the ankle joint during FPTs. Therefore, the purpose of this study was to investigate the pattern of the ROM of the ankle inversion/eversion and the muscle activity of the peroneus longus muscle (PL) and the tibial anterior muscle (TA) in normal subjects during the side-hop test. To emphasize the characteristics of ROM and electromyography (EMG) at each phase, the side-hop tests were divided into 4 phases: lateral-hop contact phase (LC), lateral-hop flight phase (LF), medial hop contact phase (MC), and medial hop flight phase (MF), and the ROM of ankle inversion/eversion, a peak angle of ankle inversion, and Integral EMG (IEMG) of PL and TA compared among 4 phases. Fifteen male subjects with no symptoms of ankle joint problems participated in this research. The ROM of ankle inversion/eversion during the side-hop test was 27 ± 3.8° (mean ± SD), and there was a significant difference in the ROM of ankle inversion/eversion among 4 phases (p < 0.05). The phase in which the widest ROM was presented was the MF. A peak angle of the ankle inversion at MC was significantly greater than at LC and MF (p <0.05). A peak angle of the ankle inversion at LF was significantly greater than at LC and MF. The PL remained contracting with 50-160% of maximal voluntary contraction (MVC). The IEMGs of PL in both the contact phases were significantly greater than in both the flight phases (p < 0.05). In addition, the PL activity at LC was significantly greater than at MC. The TA remained contracting at 50-80% of MVC through the side-hop test. The IEMG of TA at

  19. Effect of External Ankle Support on Ankle and Knee Biomechanics During the Cutting Maneuver in Basketball Players.

    PubMed

    Klem, Nardia-Rose; Wild, Catherine Y; Williams, Sian A; Ng, Leo

    2017-03-01

    Despite the high prevalence of lower extremity injuries in female basketball players as well as a high proportion of athletes who wear ankle braces, there is a paucity of research pertaining to the effects of ankle bracing on ankle and knee biomechanics during basketball-specific tasks. To compare the effects of a lace-up brace (ASO), a hinged brace (Active T2), and no ankle bracing (control) on ankle and knee joint kinematics and joint reaction forces in female basketball athletes during a cutting maneuver. Controlled laboratory study. Twenty healthy, semi-elite female basketball players performed a cutting task under both ankle brace conditions (lace-up ankle brace and hinged ankle brace) and a no-brace condition. The 3-dimensional kinematics of the ankle and knee during the cutting maneuver were measured with an 18-camera motion analysis system (250 Hz), and ground-reaction force data were collected by use of a multichannel force plate (2000 Hz) to quantify ankle and knee joint reaction forces. Conditions were randomized using a block randomization method. Compared with the control condition, the hinged ankle brace significantly restricted peak ankle inversion (mean difference, 1.7°; P = .023). No significant difference was found between the lace-up brace and the control condition ( P = .865). Compared with the lace-up brace, the hinged brace significantly reduced ankle and knee joint compressive forces at the time of peak ankle dorsiflexion (mean difference, 1.5 N/kg [ P = .018] and 1.4 N/kg [ P = .013], respectively). Additionally, the hinged ankle brace significantly reduced knee anterior shear forces compared with the lace-up brace both during the deceleration phase and at peak ankle dorsiflexion (mean difference, 0.8 N/kg [ P = .018] and 0.9 N/kg [ P = .011], respectively). The hinged ankle brace significantly reduced ankle inversion compared with the no-brace condition and reduced ankle and knee joint forces compared with the lace-up brace in a female

  20. Peroneal electromechanical delay and fatigue in patients with chronic ankle instability.

    PubMed

    Flevas, Dimitrios A; Bernard, Manfred; Ristanis, Stavros; Moraiti, Constantina; Georgoulis, Anastasios D; Pappas, Evangelos

    2017-06-01

    The purpose of this study was to investigate the effect of chronic ankle instability (CAI) on electromechanical delay times (EMD) before and after fatigue. Understanding the mechanisms that contribute to CAI is essential for the development of effective rehabilitation programmes. It was hypothesized that patients with CAI will demonstrate prolonged EMD times compared to healthy subjects and that fatigue will cause greater increases in EMD times in the CAI group. Twenty-one male volunteers participated in the study providing data on 16 ankles with CAI and 26 with no history of ankle injury. EMD was measured on an isokinetic dynamometer. Measurements were taken with the ankle in neutral (0°) and at 30° of inversion. All subjects followed an isokinetic fatigue protocol until eversion torque fell below 50 % of initial torque for three consecutive repetitions. A 2 × 2 × 2 ANOVA was used to calculate the effect of ankle status (CAI vs. healthy), fatigue, angle (0° vs. 30°) and their interactions on EMD. Fatigue caused a significant increase on EMD [non-fatigued: 122(29)ms vs. fatigue 155(54)ms; p < 0.001]. EMD times were shorter at 30° of inversion compared to neutral [neutral: 145(39)ms vs. 30° of inversion: 132(40)ms, p = 0.015]. An interaction effect for ankle status and angle was found (p = 0.026) with CAI ankles demonstrating longer EMD [CAI: 156(45)ms vs. healthy: 133(40)ms] in neutral but not at 30° of inversion [CAI: 133(46)ms vs. 132(33)ms]. Patients with CAI had longer EMD times in neutral, but not when the ankle was placed in inversion. This suggests that rehabilitation programmes may be more effective when retraining occurs with the ankle in neutral position. It is likely that low EMD times prevent ankle acceleration at the beginning of the mechanism of injury, but they are less important when the ankle has already inverted at 30°. Both CAI and healthy subjects demonstrated longer EMD after fatigue, emphasizing the importance of proper

  1. Ankle muscle coactivation and its relationship with ankle joint kinematics and kinetics during gait in hemiplegic patients after stroke.

    PubMed

    Kitatani, Ryosuke; Ohata, Koji; Sato, Shuhei; Watanabe, Aki; Hashiguchi, Yu; Yamakami, Natsuki; Sakuma, Kaoru; Yamada, Shigehito

    2016-06-01

    Increased ankle muscle coactivation during gait is a compensation strategy for enhancing postural stability in patients after stroke. However, no previous studies have demonstrated that increased ankle muscle coactivation influenced ankle joint movements during gait in patients after stroke. To investigate the relationship between ankle muscle coactivation and ankle joint movements in hemiplegic patients after stroke. Seventeen patients after stroke participated. The coactivation index (CoI) at the ankle joint was calculated separately for the first and second double support (DS1 and DS2, respectively) and single support (SS) phases on the paretic and non-paretic sides during gait using surface electromyography. Simultaneously, three-dimensional motion analysis was performed to measure the peak values of the ankle joint angle, moment, and power in the sagittal plane. Ground reaction forces (GRFs) of the anterior and posterior components and centers of pressure (COPs) trajectory ranges and velocities were also measured. The CoI during the SS phase on the paretic side was negatively related to ankle dorsiflexion angle, ankle plantarflexion moment, ankle joint power generation, and COP velocity on the paretic side. Furthermore, the CoI during the DS2 phase on both sides was negatively related to anterior GRF amplitude on each side. Increased ankle muscle coactivation is related to decreased ankle joint movement during the SS phase on the paretic side to enhance joint stiffness and compensate for stance limb instability, which may be useful for patients who have paretic instability during the stance phase after stroke.

  2. Ankle Ranges of Motion During Extended Activity Periods While Taped and Braced

    PubMed Central

    Paris, David L.; Kokkaliaris, Jimmy; Vardaxis, Vassilios

    1995-01-01

    Tape has traditionally been used to support the ankle during activity. More recently, commercial ankle braces have been worn as an alternative. The cumulative information on the effects of taped versus braced ankle support or interbrace comparisons is inconclusive. With few exceptions, ankle brace studies have collected data soon after support conditions were administered. Plantar-dorsiflexion and inversion-eversion ranges of motion (ROM) of 30 subjects were compared under conditions of unsupported, nonelastic adhesivetaped, and Swede-O and Sub Talar Support-braced ankles. We recorded measurements before activity and after periods of 15, 30, 45, and 60 minutes of selected activity on a motorized treadmill. All support conditions significantly reduced preactivity ROM in all directions compared to unsupported ankles. Results showed that the ankle significantly increased in plantarflexion ROM 15 minutes after the initiation of activity with tape or the SubTalar Support-brace, and after 30 minutes with the Swede-O brace. Tape showed further significant increases in plantarflexion ROM after 15-minute intervals of 30, 45, and 60 minutes of activity. All three support conditions had increased significantly in inversion ROM by 15 minutes of activity. The SubTalar Support brace showed a further significant inversion ROM increase between 15 and 30 minutes postactivity. We conclude that the Swede-O and SubTalar Support braces and tape offer significant preactivity ankle support in all four directions of movement. We also conclude that both braces offer longer postactivity support than tape. In inversion ROM and plantarflexion ROM, actions prevalent in ankle sprains, the Swede-O brace retained support longer than the SubTalar Support brace. ImagesFig 1.Fig 2.Fig 3. PMID:16558340

  3. Chronic Ankle Instability: Evolution of the Model

    PubMed Central

    Hiller, Claire E.; Kilbreath, Sharon L.; Refshauge, Kathryn M.

    2011-01-01

    Abstract Context: The Hertel model of chronic ankle instability (CAI) is commonly used in research but may not be sufficiently comprehensive. Mechanical instability and functional instability are considered part of a continuum, and recurrent sprain occurs when both conditions are present. A modification of the Hertel model is proposed whereby these 3 components can exist independently or in combination. Objective: To examine the fit of data from people with CAI to 2 CAI models and to explore whether the different subgroups display impairments when compared with a control group. Design: Cross-sectional study. Patients or Other Participants: Community-dwelling adults and adolescent dancers were recruited: 137 ankles with ankle sprain for objective 1 and 81 with CAI and 43 controls for objective 2. Intervention(s): Two balance tasks and time to recover from an inversion perturbation were assessed to determine if the subgroups demonstrated impairments when compared with a control group (objective 2). Main Outcome Measure(s): For objective 1 (fit to the 2 models), outcomes were Cumberland Ankle Instability Tool score, anterior drawer test results, and number of sprains. For objective 2, outcomes were 2 balance tasks (number of foot lifts in 30 seconds, ability to balance on the ball of the foot) and time to recover from an inversion perturbation. The Cohen d was calculated to compare each subgroup with the control group. Results: A total of 56.5% of ankles (n = 61) fit the Hertel model, whereas all ankles (n = 108) fit the proposed model. In the proposed model, 42.6% of ankles were classified as perceived instability, 30.5% as recurrent sprain and perceived instability, and 26.9% as among the remaining groups. All CAI subgroups performed more poorly on the balance and inversion-perturbation tasks than the control group. Subgroups with perceived instability had greater impairment in single-leg stance, whereas participants with recurrent sprain performed more poorly than

  4. Ankle sprain complications: MRI evaluation.

    PubMed

    Martin, Barney

    2008-04-01

    Sprains are disruptions of the ligamentous anatomy about a joint. The ankle sprain is one of the most common injuries seen in podiatric and orthopedic practice. It usually is incurred from an inversion force on the ankle, but eversion forces also can traumatize the ankle. Many times, this injury is taken for granted because of the frequency of its presentation. The patient usually is given appropriate initial care, but the patient can experience continued or residual pain. Podiatrists have found this problem is common and have come to recognize that secondary or accessory injuries occur that slow the natural recovery of this injury.

  5. Preventive lateral ligament tester (PLLT): a novel method to evaluate mechanical properties of lateral ankle joint ligaments in the intact ankle.

    PubMed

    Best, Raymond; Böhle, Caroline; Mauch, Frieder; Brüggemann, Peter G

    2016-04-01

    To construct and evaluate an ankle arthrometer that registers inversion joint deflection at standardized inversion loads and that, moreover, allows conclusions about the mechanical strain of intact ankle joint ligaments at these loads. Twelve healthy ankles and 12 lower limb cadaver specimens were tested in a self-developed measuring device monitoring passive ankle inversion movement (Inv-ROM) at standardized application of inversion loads of 5, 10 and 15 N. To adjust in vivo and in vitro conditions, the muscular inactivity of the evertor muscles was assured by EMG in vivo. Preliminary, test-retest and trial-to-trial reliabilities were tested in vivo. To detect lateral ligament strain, the cadaveric calcaneofibular ligament was instrumented with a buckle transducer. After post-test harvesting of the ligament with its bony attachments, previously obtained resistance strain gauge results were then transferred to tensile loads, mounting the specimens with their buckle transducers into a hydraulic material testing machine. ICC reliability considering the Inv-ROM and torsional stiffness varied between 0.80 and 0.90. Inv-ROM ranged from 15.3° (±7.3°) at 5 N to 28.3° (±7.6) at 15 N. The different tests revealed a CFL tensile load of 31.9 (±14.0) N at 5 N, 51.0 (±15.8) at 10 N and 75.4 (±21.3) N at 15 N inversion load. A highly reliable arthrometer was constructed allowing not only the accurate detection of passive joint deflections at standardized inversion loads but also reveals some objective conclusions of the intact CFL properties in correlation with the individual inversion deflections. The detection of individual joint deflections at predefined loads in correlation with the knowledge of tensile ligament loads in the future could enable more individual preventive measures, e.g., in high-level athletes.

  6. Seismic velocity structure of the forearc in northern Cascadia from Bayesian inversion of teleseismic data

    NASA Astrophysics Data System (ADS)

    Gosselin, J.; Audet, P.; Schaeffer, A. J.

    2017-12-01

    The seismic velocity structure in the forearc of subduction zones provides important constraints on material properties, with implications for seismogenesis. In Cascadia, previous studies have imaged a downgoing low-velocity zone (LVZ) characterized by an elevated P-to-S velocity ratio (Vp/Vs) down to 45 km depth, near the intersection with the mantle wedge corner, beyond which the signature of the LVZ disappears. These results, combined with the absence of a "normal" continental Moho, indicate that the down-going oceanic crust likely carries large amounts of overpressured free fluids that are released downdip at the onset of crustal eclogitization, and are further stored in the mantle wedge as serpentinite. These overpressured free fluids affect the stability of the plate interface and facilitate slow slip. These results are based on the inversion and migration of scattered teleseismic data for individual layer properties; a methodology which suffers from regularization and smoothing, non-uniqueness, and does not consider model uncertainty. This study instead applies trans-dimensional Bayesian inversion of teleseismic data collected in the forearc of northern Cascadia (the CAFÉ experiment in northern Washington) to provide rigorous, quantitative estimates of local velocity structure, and associated uncertainties (particularly Vp/Vs structure and depth to the plate interface). Trans-dimensional inversion is a generalization of fixed-dimensional inversion that includes the number (and type) of parameters required to describe the velocity model (or data error model) as unknown in the problem. This allows model complexity to be inherently determined by data information content, not by subjective regularization. The inversion is implemented here using the reversible-jump Markov chain Monte Carlo algorithm. The result is an ensemble set of candidate velocity-structure models which approximate the posterior probability density (PPD) of the model parameters. The solution

  7. Seismic velocity and crustal thickness inversions: Moon and Mars

    NASA Astrophysics Data System (ADS)

    Drilleau, Melanie; Blanchette-Guertin, Jean-François; Kawamura, Taichi; Lognonné, Philippe; Wieczorek, Mark

    2017-04-01

    We present results from new inversions of seismic data arrival times acquired by the Apollo active and passive experiments. Markov chain Monte Carlo inversions are used to constrain (i) 1-D lunar crustal and upper mantle velocity models and (ii) 3-D lateral crustal thickness models under the Apollo stations and the artificial and natural impact sites. A full 3-D model of the lunar crustal thickness is then obtained using the GRAIL gravimetric data, anchored by the crustal thicknesses under each Apollo station and impact site. To avoid the use of any seismic reference model, a Bayesian inversion technique is implemented. The advantage of such an approach is to obtain robust probability density functions of interior structure parameters governed by uncertainties on the seismic data arrival times. 1-D seismic velocities are parameterized using C1-Bézier curves, which allow the exploration of both smoothly varying models and first-order discontinuities. The parameters of the inversion include the seismic velocities of P and S waves as a function of depth, the thickness of the crust under each Apollo station and impact epicentre. The forward problem consists in a ray tracing method enabling both the relocation of the natural impact epicenters, and the computation of time corrections associated to the surface topography and the crustal thickness variations under the stations and impact sites. The results show geology-related differences between the different sites, which are due to contrasts in megaregolith thickness and to shallow subsurface composition and structure. Some of the finer structural elements might be difficult to constrain and might fall within the uncertainties of the dataset. However, we use the more precise LROC-located epicentral locations for the lunar modules and Saturn-IV upper stage artificial impacts, reducing some of the uncertainties observed in past studies. In the framework of the NASA InSight/SEIS mission to Mars, the method developed in

  8. Joint stability characteristics of the ankle complex after lateral ligamentous injury, part I: a laboratory comparison using arthrometric measurement.

    PubMed

    Kovaleski, John E; Heitman, Robert J; Gurchiek, Larry R; Hollis, J M; Liu, Wei; Pearsall, Albert W

    2014-01-01

    The mechanical property of stiffness may be important to investigating how lateral ankle ligament injury affects the behavior of the viscoelastic properties of the ankle complex. A better understanding of injury effects on tissue elastic characteristics in relation to joint laxity could be obtained from cadaveric study. To biomechanically determine the laxity and stiffness characteristics of the cadaver ankle complex before and after simulated injury to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) during anterior drawer and inversion loading. Cross-sectional study. University research laboratory. Seven fresh-frozen cadaver ankle specimens. All ankles underwent loading before and after simulated lateral ankle injury using an ankle arthrometer. The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness. Isolated ATFL and combined ATFL and CFL sectioning resulted in increased anterior displacement but not end-range stiffness when compared with the intact ankle. With inversion loading, combined ATFL and CFL sectioning resulted in increased range of motion and decreased end-range stiffness when compared with the intact and ATFL-sectioned ankles. The absence of change in anterior end-range stiffness between the intact and ligament-deficient ankles indicated bony and other soft tissues functioned to maintain stiffness after pathologic joint displacement, whereas inversion loading of the CFL-deficient ankle after pathologic joint displacement indicated the ankle complex was less stiff when supported only by the secondary joint structures.

  9. Cryotherapy does not affect peroneal reaction following sudden inversion.

    PubMed

    Berg, Christine L; Hart, Joseph M; Palmieri-Smith, Riann; Cross, Kevin M; Ingersoll, Christopher D

    2007-11-01

    If ankle joint cryotherapy impairs the ability of the ankle musculature to counteract potentially injurious forces, the ankle is left vulnerable to injury. To compare peroneal reaction to sudden inversion following ankle joint cryotherapy. Repeated measures design with independent variables, treatment (cryotherapy and control), and time (baseline, immediately post treatment, 15 minutes post treatment, and 30 minutes post treatment). University research laboratory. Twenty-seven healthy volunteers. An ice bag was secured to the lateral ankle joint for 20 minutes. The onset and average root mean square amplitude of EMG activity in the peroneal muscles was calculated following the release of a trap door mechanism causing inversion. There was no statistically significant change from baseline for peroneal reaction time or average peroneal muscle activity at any post treatment time. Cryotherapy does not affect peroneal muscle reaction following sudden inversion perturbation.

  10. Differences in kinematic control of ankle joint motions in people with chronic ankle instability.

    PubMed

    Kipp, Kristof; Palmieri-Smith, Riann M

    2013-06-01

    People with chronic ankle instability display different ankle joint motions compared to healthy people. The purpose of this study was to investigate the strategies used to control ankle joint motions between a group of people with chronic ankle instability and a group of healthy, matched controls. Kinematic data were collected from 11 people with chronic ankle instability and 11 matched control subjects as they performed a single-leg land-and-cut maneuver. Three-dimensional ankle joint angles were calculated from 100 ms before, to 200 ms after landing. Kinematic control of the three rotational ankle joint degrees of freedom was investigated by simultaneously examining the three-dimensional co-variation of plantarflexion/dorsiflexion, toe-in/toe-out rotation, and inversion/eversion motions with principal component analysis. Group differences in the variance proportions of the first two principal components indicated that the angular co-variation between ankle joint motions was more linear in the control group, but more planar in the chronic ankle instability group. Frontal and transverse plane motions, in particular, contributed to the group differences in the linearity and planarity of angular co-variation. People with chronic ankle instability use a different kinematic control strategy to coordinate ankle joint motions during a single-leg landing task. Compared to the healthy group, the chronic ankle instability group's control strategy appeared to be more complex and involved joint-specific contributions that would tend to predispose this group to recurring episodes of instability. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Acoustic radiation force impulse tissue characterization of the anterior talofibular ligament: A promising non-invasive approach in ankle imaging.

    PubMed

    Hotfiel, Thilo; Heiss, Rafael; Janka, Rolf; Forst, Raimund; Raithel, Martine; Lutter, Christoph; Gelse, Kolja; Pachowsky, Milena; Golditz, Tobias

    2018-06-09

    The anterior talofibular ligament (ATFL) is the most frequently injured ligament during inversion strains of the ankle. The purpose of this study was to evaluate the feasibility of acoustic radiation force impulse (ARFI) elastography and to determine the in vivo mechanical properties of the ATFL in healthy athletes. Fifty-one healthy athletes (32 female, 28 male; 29 ±2 years) were recruited from the medical and sports faculty. ARFI values, represented as shear wave velocities (SWV) as well as conventional ultrasound were obtained for the ATFL in neutral ankle position. A clinical assessment was performed in which the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score and the functional ankle ability measure (FAAM) were collected. Interobserver and intraobserver reliability (repeated sessions and repeated days) were assessed using an intra class correlation coefficient (ICC) and typical error (TE) calculation in absolute (TE) and relative units as coefficient of the variation (CV). SWV values of the ATFL had an average velocity of 1.79±0.34 m/s for all participants, with an average of 1.72±0.36 m/s for females and 1.85±0.31 m/s for males. The interobserver and intraobserver reliability revealed an ICC of 0.902 and 0.933 (TE of 0.67 (CV: 5.2 % and 0.51 m/s (CV: 3.83 %), respectively. FAAM and AOFAS revealed the best possible scores. ARFI seems to be a valuable diagnostic modality and represents a promising imaging marker for the assessment and monitoring of ankle ligaments in the context of acute and chronic ankle instabilities; ARFI could also be used to investigate loading or sport dependent adaptions.

  12. Microseismic Image-domain Velocity Inversion: Case Study From The Marcellus Shale

    NASA Astrophysics Data System (ADS)

    Shragge, J.; Witten, B.

    2017-12-01

    Seismic monitoring at injection wells relies on generating accurate location estimates of detected (micro-)seismicity. Event location estimates assist in optimizing well and stage spacings, assessing potential hazards, and establishing causation of larger events. The largest impediment to generating accurate location estimates is an accurate velocity model. For surface-based monitoring the model should capture 3D velocity variation, yet, rarely is the laterally heterogeneous nature of the velocity field captured. Another complication for surface monitoring is that the data often suffer from low signal-to-noise levels, making velocity updating with established techniques difficult due to uncertainties in the arrival picks. We use surface-monitored field data to demonstrate that a new method requiring no arrival picking can improve microseismic locations by jointly locating events and updating 3D P- and S-wave velocity models through image-domain adjoint-state tomography. This approach creates a complementary set of images for each chosen event through wave-equation propagation and correlating combinations of P- and S-wavefield energy. The method updates the velocity models to optimize the focal consistency of the images through adjoint-state inversions. We demonstrate the functionality of the method using a surface array of 192 three-component geophones over a hydraulic stimulation in the Marcellus Shale. Applying the proposed joint location and velocity-inversion approach significantly improves the estimated locations. To assess event location accuracy, we propose a new measure of inconsistency derived from the complementary images. By this measure the location inconsistency decreases by 75%. The method has implications for improving the reliability of microseismic interpretation with low signal-to-noise data, which may increase hydrocarbon extraction efficiency and improve risk assessment from injection related seismicity.

  13. Dance floor force reduction influences ankle loads in dancers during drop landings.

    PubMed

    Hopper, Luke S; Alderson, Jacqueline A; Elliott, Bruce C; Ackland, Timothy R

    2015-07-01

    Dance floor mechanical properties have the potential to influence the high frequency of ankle injuries in dancers. However, biomechanical risk factors for injury during human movement on hard, low force reduction floors have not been established. The aim of this study was to examine the ankle joint mechanics of dancers performing drop landings on dance floors with varied levels of force reduction. Repeated measures cross sectional study. Fourteen dancers performed drop landings on five custom built dance floors. Ankle joint mechanics were calculated using a three dimensional kinematic model and inverse dynamics approach. Ankle joint kinematic (dorsiflexion; range of motion, peak angular velocity and acceleration) and kinetic (plantar flexion; peak joint moments and power) variables significantly increased with a decrease in floor force reduction. Many of the observed changes occurred within a latency of <0.1s post-contact with the floor and were associated with increased vertical ground reaction forces and decreased floor vertical deformation. The observed mechanical changes are interpreted as an increase in the load experienced by the energy absorbing structures that cross the ankle. The short latency of the changes represents a high intensity movement at the ankle during a period of limited cognitive neuromuscular control. It is suggested that these observations may have injury risk implications for dancers that are related to joint stabilization. These findings may be of benefit for further investigation of dance injury prevention and support the notion that bespoke force reduction standards for dance floors are necessary. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Spatially-resolved velocities of thermally-produced spray droplets using a velocity-divided Abel inversion of photographed streaks

    NASA Astrophysics Data System (ADS)

    Kawaguchi, Y.; Kobayashi, N.; Yamagata, Y.; Miyazaki, F.; Yamasaki, M.; Muraoka, K.

    2017-10-01

    Droplet velocities of thermal spray are known to have profound effects on important coating qualities, such as adhesive strength, porosity, and hardness, for various applications. For obtaining the droplet velocities, therefore, the TOF (time-of-flight) technique has been widely used, which relies on observations of emitted radiation from the droplets, where all droplets along the line-of-sight contribute to signals. Because droplets at and near the flow axis mostly contribute coating layers, it has been hoped to get spatially resolved velocities. For this purpose, a velocity-divided Abel inversion was devised from CMOS photographic data. From this result, it has turned out that the central velocity is about 25% higher than that obtained from the TOF technique for the case studied (at the position 150 mm downstream of the plasma spray gun, where substrates for spray coatings are usually placed). Further implications of the obtained results are discussed.

  15. [Anterolateral ankle pain: differential diagnosis and approach. A case report].

    PubMed

    García-Renedo, R J; Pérez-Carro, L; Fernández-Torres, J J; Carranza-Bencano, A; Gómez-del Alamo, G

    2011-01-01

    The ankle soft tissue pathology represents a very painful disorder for patients who, often times, are not precisely diagnosed. Anterolateral ankle impingement is a condition that occurs in young people and athletes due to a plantar flexion-inversion mechanism. We report a case of anterolateral ankle impingement describing the arthroscopic technique and making the differential diagnosis considering other conditions.

  16. Posterior impingement syndromes of the ankle.

    PubMed

    Lee, Justin C; Calder, James D F; Healy, Jeremiah C

    2008-06-01

    Acute, or repetitive, compression of the posterior structures of the ankle may lead to posterior ankle impingement (PAI) syndrome, posteromedial ankle impingement (PoMI) syndrome, or Haglund's syndrome. The etiology of each of these conditions is quite different. Variations in posterior ankle osseous and soft tissue anatomy contribute to the etiology of PAI and Haglund's syndromes. The presence of an os trigonum or Stieda process is classically associated with PAI syndrome, whereas a prominent posterosuperior tubercle of the os calcis or Haglund's deformity is the osseous predisposing factor in Haglund's syndrome. PoMI has no defined predisposing anatomical variants but typically follows an inversion-supination injury of the ankle joint. This article discusses the biomechanics, clinical features, imaging, and management of each of these conditions. Magnetic resonance imaging (MRI) provides the optimal tool in posterior ankle assessment, and this review focuses on the MRI findings of each of the conditions just listed.

  17. Estimations of relative effort during sit-to-stand increase when accounting for variations in maximum voluntary torque with joint angle and angular velocity.

    PubMed

    Bieryla, Kathleen A; Anderson, Dennis E; Madigan, Michael L

    2009-02-01

    The main purpose of this study was to compare three methods of determining relative effort during sit-to-stand (STS). Fourteen young (mean 19.6+/-SD 1.2 years old) and 17 older (61.7+/-5.5 years old) adults completed six STS trials at three speeds: slow, normal, and fast. Sagittal plane joint torques at the hip, knee, and ankle were calculated through inverse dynamics. Isometric and isokinetic maximum voluntary contractions (MVC) for the hip, knee, and ankle were collected and used for model parameters to predict the participant-specific maximum voluntary joint torque. Three different measures of relative effort were determined by normalizing STS joint torques to three different estimates of maximum voluntary torque. Relative effort at the hip, knee, and ankle were higher when accounting for variations in maximum voluntary torque with joint angle and angular velocity (hip=26.3+/-13.5%, knee=78.4+/-32.2%, ankle=27.9+/-14.1%) compared to methods which do not account for these variations (hip=23.5+/-11.7%, knee=51.7+/-15.0%, ankle=20.7+/-10.4%). At higher velocities, the difference in calculating relative effort with respect to isometric MVC or incorporating joint angle and angular velocity became more evident. Estimates of relative effort that account for the variations in maximum voluntary torque with joint angle and angular velocity may provide higher levels of accuracy compared to methods based on measurements of maximal isometric torques.

  18. The ZH ratio method for long-period seismic data: inversion for S-wave velocity structure

    NASA Astrophysics Data System (ADS)

    Yano, Tomoko; Tanimoto, T.; Rivera, L.

    2009-10-01

    The particle motion of surface waves, in addition to phase and group velocities, can provide useful information for S-wave velocity structure in the crust and upper mantle. In this study, we applied a new method to retrieve velocity structure using the ZH ratio, the ratio between vertical and horizontal surface amplitudes of Rayleigh waves. Analysing data from the GEOSCOPE network, we measured the ZH ratios for frequencies between 0.004 and 0.05 Hz (period between 20 and 250s) and inverted them for S-wave velocity structure beneath each station. Our analysis showed that the resolving power of the ZH ratio is limited and final solutions display dependence on starting models; in particular, the depth of the Moho in the starting model is important in order to get reliable results. Thus, initial models for the inversion need to be carefully constructed. We chose PREM and CRUST2.0 in this study as a starting model for all but one station (ECH). The eigenvalue analysis of the least-squares problem that arises for each step of the iterative process shows a few dominant eigenvalues which explains the cause of the inversion's initial-model dependence. However, the ZH ratio is unique in having high sensitivity to near-surface structure and thus provides complementary information to phase and group velocities. Application of this method to GEOSCOPE data suggest that low velocity zones may exist beneath some stations near hotspots. Our tests with different starting models show that the models with low-velocity anomalies fit better to the ZH ratio data. Such low velocity zones are seen near Hawaii (station KIP), Crozet Island (CRZF) and Djibuti (ATD) but not near Reunion Island (RER). It is also found near Echery (ECH) which is in a geothermal area. However, this method has a tendency to produce spurious low velocity zones and resolution of the low velocity zones requires further careful study. We also performed simultaneous inversions for volumetric perturbation and

  19. Anisotropic S-wave velocity structure from joint inversion of surface wave group velocity dispersion: A case study from India

    NASA Astrophysics Data System (ADS)

    Mitra, S.; Dey, S.; Siddartha, G.; Bhattacharya, S.

    2016-12-01

    We estimate 1-dimensional path average fundamental mode group velocity dispersion curves from regional Rayleigh and Love waves sampling the Indian subcontinent. The path average measurements are combined through a tomographic inversion to obtain 2-dimensional group velocity variation maps between periods of 10 and 80 s. The region of study is parametrised as triangular grids with 1° sides for the tomographic inversion. Rayleigh and Love wave dispersion curves from each node point is subsequently extracted and jointly inverted to obtain a radially anisotropic shear wave velocity model through global optimisation using Genetic Algorithm. The parametrization of the model space is done using three crustal layers and four mantle layers over a half-space with varying VpH , VsV and VsH. The anisotropic parameter (η) is calculated from empirical relations and the density of the layers are taken from PREM. Misfit for the model is calculated as a sum of error-weighted average dispersion curves. The 1-dimensional anisotropic shear wave velocity at each node point is combined using linear interpolation to obtain 3-dimensional structure beneath the region. Synthetic tests are performed to estimate the resolution of the tomographic maps which will be presented with our results. We envision to extend this to a larger dataset in near future to obtain high resolution anisotrpic shear wave velocity structure beneath India, Himalaya and Tibet.

  20. Multivariable dynamic ankle mechanical impedance with relaxed muscles.

    PubMed

    Lee, Hyunglae; Krebs, Hermano Igo; Hogan, Neville

    2014-11-01

    Neurological or biomechanical disorders may distort ankle mechanical impedance and thereby impair locomotor function. This paper presents a quantitative characterization of multivariable ankle mechanical impedance of young healthy subjects when their muscles were relaxed, to serve as a baseline to compare with pathophysiological ankle properties of biomechanically and/or neurologically impaired patients. Measurements using a highly backdrivable wearable ankle robot combined with multi-input multi-output stochastic system identification methods enabled reliable characterization of ankle mechanical impedance in two degrees-of-freedom (DOFs) simultaneously, the sagittal and frontal planes. The characterization included important ankle properties unavailable from single DOF studies: coupling between DOFs and anisotropy as a function of frequency. Ankle impedance in joint coordinates showed responses largely consistent with a second-order system consisting of inertia, viscosity, and stiffness in both seated (knee flexed) and standing (knee straightened) postures. Stiffness in the sagittal plane was greater than in the frontal plane and furthermore, was greater when standing than when seated, most likely due to the stretch of bi-articular muscles (medial and lateral gastrocnemius). Very low off-diagonal partial coherences implied negligible coupling between dorsiflexion-plantarflexion and inversion-eversion. The directions of principal axes were tilted slightly counterclockwise from the original joint coordinates. The directional variation (anisotropy) of ankle impedance in the 2-D space formed by rotations in the sagittal and frontal planes exhibited a characteristic "peanut" shape, weak in inversion-eversion over a wide range of frequencies from the stiffness dominated region up to the inertia dominated region. Implications for the assessment of neurological and biomechanical impairments are discussed.

  1. Measurement of the passive stiffness of ankle joint in 3 DOF using stewart platform type ankle foot device.

    PubMed

    Nomura, Kenta; Yonezawa, Teru; Mizoguchi, Hiroshi; Takemura, Hiroshi

    2016-08-01

    This paper presents a method to measure the passive stiffness of an ankle joint in three degrees of freedom (DOF) under two motion speeds (1 Hz and 5 degree/s) using a developed Stewart platform-type device. The developed device can reproduce input motions of the foot in 6 DOF by controlling six pneumatic linear motion actuators. We used the device to measure the passive stiffness of an ankle joint undergoing three kinds of motion, namely dorsi-plantar flexion, inversion-eversion, and adduction-abduction. The measured values of the passive stiffness of the ankle joint in dorsiflexion that we obtained agreed well with that obtained in a previous study, indicating that the developed device is useful for measuring the passive stiffness of ankle joint. In addition, the developed device can be used to measure the stiffness in inversion-eversion and adduction-abduction motions as well, parameters that have never been measured. The results we obtained demonstrated certain interesting features as we varied both the direction and pace of motion (e.g., there were significant differences in the stiffness not only between adduction and abduction during the faster pace, but also between these and the other motions).

  2. Full Waveform Inversion of Diving & Reflected Waves based on Scale Separation for Velocity and Impedance Imaging

    NASA Astrophysics Data System (ADS)

    Brossier, Romain; Zhou, Wei; Operto, Stéphane; Virieux, Jean

    2015-04-01

    Full Waveform Inversion (FWI) is an appealing method for quantitative high-resolution subsurface imaging (Virieux et al., 2009). For crustal-scales exploration from surface seismic, FWI generally succeeds in recovering a broadband of wavenumbers in the shallow part of the targeted medium taking advantage of the broad scattering-angle provided by both reflected and diving waves. In contrast, deeper targets are often only illuminated by short-spread reflections, which favor the reconstruction of the short wavelengths at the expense of the longer ones, leading to a possible notch in the intermediate part of the wavenumber spectrum. To update the velocity macromodel from reflection data, image-domain strategies (e.g., Symes & Carazzone, 1991) aim to maximize a semblance criterion in the migrated domain. Alternatively, recent data-domain strategies (e.g., Xu et al., 2012, Ma & Hale, 2013, Brossier et al., 2014), called Reflection FWI (RFWI), inspired by Chavent et al. (1994), rely on a scale separation between the velocity macromodel and prior knowledge of the reflectivity to emphasize the transmission regime in the sensitivity kernel of the inversion. However, all these strategies focus on reflected waves only, discarding the low-wavenumber information carried out by diving waves. With the current development of very long-offset and wide-azimuth acquisitions, a significant part of the recorded energy is provided by diving waves and subcritical reflections, and high-resolution tomographic methods should take advantage of all types of waves. In this presentation, we will first review the issues of classical FWI when applied to reflected waves and how RFWI is able to retrieve the long wavelength of the model. We then propose a unified formulation of FWI (Zhou et al., 2014) to update the low wavenumbers of the velocity model by the joint inversion of diving and reflected arrivals, while the impedance model is updated thanks to reflected wave only. An alternate inversion of

  3. Peroneal nerve palsy after ankle sprain: an update.

    PubMed

    Mitsiokapa, Evanthia; Mavrogenis, Andreas F; Drakopoulos, Dionysis; Mauffrey, Cyril; Scarlat, Marius

    2017-01-01

    Ankle sprains are extremely common in the general population and the most common injuries in athletes. Although rare, peroneal nerve palsy may occur simultaneously with ankle sprain. The exact incidence of nerve injury after ankle sprain is not known; few cases of peroneal nerve palsy associated with ankle sprains have been reported in the literature. The function of the peroneal nerve should be evaluated in all patients with a history of inversion ankle sprain as part of the initial and follow-up evaluation, even if the initial neurological status is normal, because delayed peroneal nerve palsy is possible. This article discusses the incidence, pathophysiology, evaluation, diagnosis and differential diagnosis, and management of the patients with peroneal nerve palsy after ankle sprain aiming to increase the awareness of the treating physicians for this nerve injury.

  4. Biomechanical Comparison of 3 Ankle Braces With and Without Free Rotation in the Sagittal Plane

    PubMed Central

    Alfuth, Martin; Klein, Dieter; Koch, Raphael; Rosenbaum, Dieter

    2014-01-01

    Context: Various designs of braces including hinged and nonhinged models are used to provide external support of the ankle. Hinged ankle braces supposedly allow almost free dorsiflexion and plantar flexion of the foot in the sagittal plane. It is unclear, however, whether this additional degree of freedom affects the stabilizing effect of the brace in the other planes of motion. Objective: To investigate the dynamic and passive stabilizing effects of 3 ankle braces, 2 hinged models that provide free plantar flexion–dorsiflexion in the sagittal plane and 1 ankle brace without a hinge. Design: Crossover study. Setting: University Movement Analysis Laboratory. Patients or Other Participants: Seventeen healthy volunteers (5 women, 12 men; age = 25.4 ± 4.8 years; height = 180.3 ± 6.5 cm; body mass = 75.5 ± 10.4 kg). Intervention(s): We dynamically induced foot inversion on a tilting platform and passively induced foot movements in 6 directions via a custom-built apparatus in 3 brace conditions and a control condition (no brace). Main Outcome Measure(s): Maximum inversion was determined dynamically using an in-shoe electrogoniometer. Passively induced maximal joint angles were measured using a torque and angle sensor. We analyzed differences among the 4 ankle-brace conditions (3 braces, 1 control) for each of the dependent variables with Friedman and post hoc tests (P < .05). Results: Each ankle brace restricted dynamic foot-inversion movements on the tilting platform as compared with the control condition, whereas only the 2 hinged ankle braces differed from each other, with greater movement restriction caused by the Ankle X model. Passive foot inversion was reduced with all ankle braces. Passive plantar flexion was greater in the hinged models as compared with the nonhinged brace. Conclusions: All ankle braces showed stabilizing effects against dynamic and passive foot inversion. Differences between the hinged braces and the nonhinged brace did not appear to be

  5. Acute and chronic lateral ankle instability in the athlete.

    PubMed

    Chan, Keith W; Ding, Bryan C; Mroczek, Kenneth J

    2011-01-01

    Ankle sprain injuries are the most common injury sustained during sporting activities. Three-quarters of ankle injuries involve the lateral ligamentous complex, comprised of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The most common mechanism of injury in lateral ankle sprains occurs with forced plantar flexion and inversion of the ankle as the body's center of gravity rolls over the ankle. The ATFL followed by the CFL are the most commonly injured ligaments. Eighty percent of acute ankle sprains make a full recovery with conservative management, while 20% of acute ankle sprains develop mechanical or functional instability, resulting in chronic ankle instability. Treatment of acute ankle sprains generally can be successfully managed with a short period of immobilization that is followed by functional rehabilitation. Patients with chronic ankle instability who fail functional rehabilitation are best treated with a Brostrom-Gould anatomic repair or, in those patients with poor tissue quality or undergoing revision surgery, an anatomic reconstruction.

  6. Ankle instability effects on joint position sense when stepping across the active movement extent discrimination apparatus.

    PubMed

    Witchalls, Jeremy; Waddington, Gordon; Blanch, Peter; Adams, Roger

    2012-01-01

    Individuals with and without functional ankle instability have been tested for deficits in lower limb proprioception with varied results. To determine whether a new protocol for testing participants' joint position sense during stepping is reliable and can detect differences between participants with unstable and stable ankles. Descriptive laboratory study. University clinical laboratory. Sample of convenience involving 21 young adult university students and staff. Ankle stability was categorized by score on the Cumberland Ankle Instability Tool; 13 had functional ankle instability, 8 had healthy ankles. Test-retest of ankle joint position sense when stepping onto and across the Active Movement Extent Discrimination Apparatus twice, separated by an interim test, standing still on the apparatus and moving only 1 ankle into inversion. Difference in scores between groups with stable and unstable ankles and between test repeats. Participants with unstable ankles were worse at differentiating between inversion angles underfoot in both testing protocols. On repeated testing with the stepping protocol, performance of the group with unstable ankles was improved (Cohen d = 1.06, P = .006), whereas scores in the stable ankle group did not change in the second test (Cohen d = 0.04, P = .899). Despite this improvement, the unstable group remained worse at differentiating inversion angles on the stepping retest (Cohen d = 0.99, P = .020). The deficits on proprioceptive tests shown by individuals with functional ankle instability improved with repeated exposure to the test situation. The learning effect may be the result of systematic exposure to ankle-angle variation that led to movement-specific learning or increased confidence when stepping across the apparatus.

  7. The in situ force in the calcaneofibular ligament and the contribution of this ligament to ankle joint stability.

    PubMed

    Kobayashi, Takuma; Yamakawa, Satoshi; Watanabe, Kota; Kimura, Kei; Suzuki, Daisuke; Otsubo, Hidenori; Teramoto, Atsushi; Fujimiya, Mineko; Fujie, Hiromichi; Yamashita, Toshihiko

    2016-12-01

    Numerous biomechanical studies of the lateral ankle ligaments have been reported; however, the isolated function of the calcaneofibular ligament has not been clarified. We hypothesize that the calcaneofibular ligament would stabilize the ankle joint complex under multidirectional loading, and that the in situ force in the calcaneofibular ligament would change in each flexed position. Using seven fresh frozen cadaveric lower extremities, the motions and forces of the intact ankle under multidirectional loading were recorded using a 6-degree-of-freedom robotic system. On repeating these intact ankle joint complex motions after the calcaneofibular ligament transection, the in situ force in the calcaneofibular ligament and the contribution of the calcaneofibular ligament to ankle joint complex stability were calculated. Finally, the motions of the calcaneofibular ligament-transected ankle joint complex were recorded. Under an inversion load, significant increases of inversion angle were observed in all the flexed positions following calcaneofibular ligament transection, and the calcaneofibular ligament accounted for 50%-70% of ankle joint complex stability during inversion. The in situ forces in the calcaneofibular ligament under an anterior force, inversion moment, and external rotation moment were larger in the dorsiflexed position than in the plantarflexed position. The calcaneofibular ligament plays a role in stabilizing the ankle joint complex to multidirectional loads and the role differs with load directions. The in situ force of the calcaneofibular ligament is larger at the dorsiflexed position. This ligament provides the primary restraint to the inversion ankle stability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Multivariable Dynamic Ankle Mechanical Impedance With Relaxed Muscles

    PubMed Central

    Lee, Hyunglae; Krebs, Hermano Igo; Hogan, Neville

    2015-01-01

    Neurological or biomechanical disorders may distort ankle mechanical impedance and thereby impair locomotor function. This paper presents a quantitative characterization of multivariable ankle mechanical impedance of young healthy subjects when their muscles were relaxed, to serve as a baseline to compare with pathophysiological ankle properties of biomechanically and/or neurologically impaired patients. Measurements using a highly backdrivable wearable ankle robot combined with multi-input multi-output stochastic system identification methods enabled reliable characterization of ankle mechanical impedance in two degrees-of-freedom (DOFs) simultaneously, the sagittal and frontal planes. The characterization included important ankle properties unavailable from single DOF studies: coupling between DOFs and anisotropy as a function of frequency. Ankle impedance in joint coordinates showed responses largely consistent with a second-order system consisting of inertia, viscosity, and stiffness in both seated (knee flexed) and standing (knee straightened) postures. Stiffness in the sagittal plane was greater than in the frontal plane and furthermore, was greater when standing than when seated, most likely due to the stretch of bi-articular muscles (medial and lateral gastrocnemius). Very low off-diagonal partial coherences implied negligible coupling between dorsiflexion-plantarflexion and inversion-eversion. The directions of principal axes were tilted slightly counterclockwise from the original joint coordinates. The directional variation (anisotropy) of ankle impedance in the 2-D space formed by rotations in the sagittal and frontal planes exhibited a characteristic “peanut” shape, weak in inversion-eversion over a wide range of frequencies from the stiffness dominated region up to the inertia dominated region. Implications for the assessment of neurological and biomechanical impairments are discussed. PMID:24686292

  9. Frontal plane ankle proprioceptive thresholds and unipedal balance

    PubMed Central

    Son, Jaebum; Ashton-Miller, James A.; Richardson, James K.

    2012-01-01

    Reliable unipedal balance is fundamental to safe ambulation. Accordingly, older persons with peripheral neuropathy (PN), who are at increased risk for falls, demonstrate impaired unipedal balance. To explore the relationship between afferent function and unipedal balance, frontal plane proprioceptive thresholds at the ankle were quantified in 22 subjects (72.5 ± 6.3 years; 11 with PN and 11 matched controls) while they were standing using a foot cradle system and a staircase series of 100 rotational stimuli. PN subjects, as compared to controls, demonstrated shorter median unipedal balance times (3.4 ± 2.7 versus 14.3 ± 8.9 seconds; p = 0.0017) and greater (less precise) combined ankle inversion/eversion proprioceptive thresholds (1.17 ± 0.36 versus 0.65 ± 0.37 degrees; p = 0.0055). Combined ankle inversion/eversion proprioceptive thresholds explained approximately half the variance in unipedal balance time (R2 = 0.5138; p = 0.0004). Given prior work demonstrating a similarly strong relationship between ankle torque generation and unipedal balance, neuropathy-associated impairments in ankle frontal plane afferent and efferent function appear to be equally responsible for the inability of older persons with PN to reliably balance on one foot. They therefore provide distinct targets for intervention. PMID:19145650

  10. Shear wave velocity structure in North America from large-scale waveform inversions of surface waves

    USGS Publications Warehouse

    Alsina, D.; Woodward, R.L.; Snieder, R.K.

    1996-01-01

    A two-step nonlinear and linear inversion is carried out to map the lateral heterogeneity beneath North America using surface wave data. The lateral resolution for most areas of the model is of the order of several hundred kilometers. The most obvious feature in the tomographic images is the rapid transition between low velocities in the technically active region west of the Rocky Mountains and high velocities in the stable central and eastern shield of North America. The model also reveals smaller-scale heterogeneous velocity structures. A high-velocity anomaly is imaged beneath the state of Washington that could be explained as the subducting Juan de Fuca plate beneath the Cascades. A large low-velocity structure extends along the coast from the Mendocino to the Rivera triple junction and to the continental interior across the southwestern United States and northwestern Mexico. Its shape changes notably with depth. This anomaly largely coincides with the part of the margin where no lithosphere is consumed since the subduction has been replaced by a transform fault. Evidence for a discontinuous subduction of the Cocos plate along the Middle American Trench is found. In central Mexico a transition is visible from low velocities across the Trans-Mexican Volcanic Belt (TMVB) to high velocities beneath the Yucatan Peninsula. Two elongated low-velocity anomalies beneath the Yellowstone Plateau and the eastern Snake River Plain volcanic system and beneath central Mexico and the TMVB seem to be associated with magmatism and partial melting. Another low-velocity feature is seen at depths of approximately 200 km beneath Florida and the Atlantic Coastal Plain. The inversion technique used is based on a linear surface wave scattering theory, which gives tomographic images of the relative phase velocity perturbations in four period bands ranging from 40 to 150 s. In order to find a smooth reference model a nonlinear inversion based on ray theory is first performed. After

  11. The feasibility of measuring joint angular velocity with a gyro-sensor.

    PubMed

    Arai, Takeshi; Obuchi, Shuichi; Shiba, Yoshitaka; Omuro, Kazuya; Nakano, Chika; Higashi, Takuya

    2008-01-01

    To determine the reliability of an assessment of joint angular velocity using a gyro-sensor and to examine the relationship between ankle angular velocity and physical functions. Cross-sectional. Kinesiology laboratory. Twenty healthy young adults (mean age, 22.5 y) and 113 community-dwelling older adults (mean age, 75.1 y). Not applicable. Maximal ankle joint velocity was measured using a gyro-sensor during heel-rising and jumping with knee extended. The intraclass correlation coefficient (ICC) was used to determine the intertester and intratester reliability. The Pearson correlation coefficient was used to examine the relationships between maximal ankle joint velocity and isometric muscle strength and isokinetic muscle power in young adults and also to examine the relationships between maximal ankle joint velocity and functional performance measurements such as walking time in older adults. High reliability was found for intertester (ICC=.96) and intratester reliability (ICC=.96). The data from the gyro-sensor highly correlated with muscle strength (r range, .62-.68; P<.01) and muscle power (r range, .45-.79; P range, .01-.05). In older subjects, mobility functions significantly correlated with the angular velocity of ankle plantarflexion. Measurement of ankle angular velocity using a gyro-sensor is both reliable and feasible, with the results representing a significant correlation to muscle power and performance measurements.

  12. Reliability of a functional test battery evaluating functionality, proprioception, and strength in recreational athletes with functional ankle instability.

    PubMed

    Sekir, U; Yildiz, Y; Hazneci, B; Ors, F; Saka, T; Aydin, T

    2008-12-01

    In contrast to the single evaluation methods used in the past, the combination of multiple tests allows one to obtain a global assessment of the ankle joint. The aim of this study was to determine the reliability of the different tests in a functional test battery. Twenty-four male recreational athletes with unilateral functional ankle instability (FAI) were recruited for this study. One component of the test battery included five different functional ability tests. These tests included a single limb hopping course, single-legged and triple-legged hop for distance, and six and cross six meter hop for time. The ankle joint position sense and one leg standing test were used for evaluation of proprioception and sensorimotor control. The isokinetic strengths of the ankle invertor and evertor muscles were evaluated at a velocity of 120 degrees /s. The reliability of the test battery was assessed by calculating the intraclass correlation coefficient (ICC). Each subject was tested two times, with an interval of 3-5 days between the test sessions. The ICCs for ankle functional and proprioceptive ability showed high reliability (ICCs ranging from 0.94 to 0.98). Additionally, isokinetic ankle joint inversion and eversion strength measurements represented good to high reliability (ICCs between 0.82 and 0.98). The functional test battery investigated in this study proved to be a reliable tool for the assessment of athletes with functional ankle instability. Therefore, clinicians may obtain reliable information from the functional test battery during the assessment of ankle joint performance in patients with functional ankle instability.

  13. The role of military footwear and workload on ground reaction forces during a simulated lateral ankle sprain mechanism.

    PubMed

    Simpson, Jeffrey D; DeBusk, Hunter; Hill, Christopher; Knight, Adam; Chander, Harish

    2018-03-01

    Ankle sprains are a common orthopedic injury in military populations, which may be attributed to occupational demands and footwear. Minimalist military boots have become popular, but their influence on ground reaction force (GRF) attenuation capabilities during an ankle inversion perturbation are unknown. Therefore, the purpose of this study was to examine potential differences in GRFs during an ankle inversion perturbation in a standard issue (STN) and minimalist military boot (MIN) before and after a simulated military workload. Twenty-one healthy adult males completed an ankle inversion perturbation protocol in each footwear condition before and after an incremental treadmill exercise protocol to volitional exhaustion while wearing a 16kg rucksack. The ankle inversion perturbation protocol consisted of stepping down from a 27cm box onto a force platform with a fulcrum (FUL), which created 25° of inversion upon landing, or flat (FLT) outer sole attached to the plantar aspect of the participants' footwear in random order. Peak vertical, anterior/posterior, and medial/lateral components of the GRF during FUL and FLT conditions were assessed, normalized to multiples of body weight in each footwear. Dependent variables were then analyzed using separate 2 (footwear)×2 (time) repeated measures ANOVA (p<0.05). The MIN footwear demonstrated significantly greater vertical GRF and significantly less medial GRF during the FUL condition. These results indicate that various mechanical and design characteristics of military footwear may influence GRF attenuation capabilities and ankle joint loading when the foot/ankle complex is forced into inversion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Gastrocnemius operating length with ankle foot orthoses in cerebral palsy.

    PubMed

    Choi, Hwan; Wren, Tishya Anne Leong; Steele, Katherine Muterspaugh

    2017-06-01

    Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation. This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy. Case series, within subject comparison of gastrocnemius operating length while walking barefoot and with two types of ankle foot orthoses. We performed gait analyses for 11 children with cerebral palsy. Each child was fit with two types of orthoses: a dynamic ankle foot orthosis (Cascade dynamic ankle foot orthosis) and an adjustable dynamic response ankle foot orthosis (Ultraflex ankle foot orthosis). Musculoskeletal modeling was used to quantify gastrocnemius musculotendon operating length and velocity with each orthosis. Walking with ankle foot orthoses could stretch the gastrocnemius more than barefoot walking for some individuals; however, there was significant variability between participants and orthoses. At least one type of orthosis stretched the gastrocnemius during walking for 4/6 and 3/5 of the Gross Motor Functional Classification System Level I and III participants, respectively. AFOs also reduced peak gastrocnemius lengthening velocity compared to barefoot walking for some participants, with greater reductions among the Gross Motor Functional Classification System Level III participants. Changes in gastrocnemius operating length and lengthening velocity were related to changes in ankle and knee kinematics during gait. Ankle foot orthoses impact gastrocnemius operating length during walking and, with proper design, may assist with stretching tight muscles in daily life. Clinical relevance Determining whether ankle foot orthoses stretch tight muscles can

  15. The effects of a semi-rigid ankle brace on a simulated isolated subtalar joint instability.

    PubMed

    Choisne, Julie; Hoch, Matthew C; Bawab, Sebastian; Alexander, Ian; Ringleb, Stacie I

    2013-12-01

    Subtalar joint instability is hypothesized to occur after injuries to the calcaneofibular ligament (CFL) in isolation or in combination with the cervical and the talocalcaneal interosseous ligaments. A common treatment for hindfoot instability is the application of an ankle brace. However, the ability of an ankle brace to promote subtalar joint stability is not well established. We assessed the kinematics of the subtalar joint, ankle, and hindfoot in the presence of isolated subtalar instability, investigated the effect of bracing in a CFL deficient foot and with a total rupture of the intrinsic ligaments, and evaluated how maximum inversion range of motion is affected by the position of the ankle in the sagittal plane. Kinematics from nine cadaveric feet were collected with the foot placed in neutral, dorsiflexion, and plantar flexion. Motion was applied with and without a brace on an intact foot and after sequentially sectioning the CFL and the intrinsic ligaments. Isolated CFL sectioning increased ankle joint inversion, while sectioning the CFL and intrinsic ligaments affected subtalar joint stability. The brace limited inversion at the subtalar and ankle joints. Additionally, examining the foot in dorsiflexion reduced ankle and subtalar joint motion. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  16. Inversion of azimuthally dependent NMO velocity in transversely isotropic media with a tilted axis of symmetry

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Grechka, V.; Tsvankin, I.

    2000-02-01

    Just as the transversely isotropic model with a vertical symmetry axis (VTI media) is typical for describing horizontally layered sediments, transverse isotropy with a tilted symmetry axis (TTI) describes dipping TI layers (such as tilted shale beds near salt domes) or crack systems. P-wave kinematic signatures in TTI media are controlled by the velocity V{sub PO} in the symmetry direction, Thomsen's anisotropic coefficients {xi} and {delta}, and the orientation (tilt {nu} and azimuth {beta}) of the symmetry axis. Here, the authors show that all five parameters can be obtained from azimuthally varying P-wave NMO velocities measured for two reflectors withmore » different dips and/or azimuths (one of the reflectors can be horizontal). The shear-wave velocity V{sub SO} in the symmetry direction, which has negligible influence on P-wave kinematic signatures, can be found only from the moveout of shear waves. Using the exact NMO equation, the authors examine the propagation of errors in observed moveout velocities into estimated values of the anisotropic parameters and establish the necessary conditions for a stable inversion procedure. Since the azimuthal variation of the NMO velocity is elliptical, each reflection event provides them with up to three constraints on the model parameters. Generally, the five parameters responsible for P-wave velocity can be obtained from two P-wave ellipses, but the feasibility of the moveout inversion strongly depends on the tilt {nu}. While most of the analysis is carried out for a single layer, the authors also extend the inversion algorithm to vertically heterogeneous TTI media above a dipping reflector using the generalized Dix equation. A synthetic example for a strongly anisotropic, stratified TTI medium demonstrates a high accuracy of the inversion.« less

  17. Nonlinear inversion of borehole-radar tomography data to reconstruct velocity and attenuation distribution in earth materials

    USGS Publications Warehouse

    Zhou, C.; Liu, L.; Lane, J.W.

    2001-01-01

    A nonlinear tomographic inversion method that uses first-arrival travel-time and amplitude-spectra information from cross-hole radar measurements was developed to simultaneously reconstruct electromagnetic velocity and attenuation distribution in earth materials. Inversion methods were developed to analyze single cross-hole tomography surveys and differential tomography surveys. Assuming the earth behaves as a linear system, the inversion methods do not require estimation of source radiation pattern, receiver coupling, or geometrical spreading. The data analysis and tomographic inversion algorithm were applied to synthetic test data and to cross-hole radar field data provided by the US Geological Survey (USGS). The cross-hole radar field data were acquired at the USGS fractured-rock field research site at Mirror Lake near Thornton, New Hampshire, before and after injection of a saline tracer, to monitor the transport of electrically conductive fluids in the image plane. Results from the synthetic data test demonstrate the algorithm computational efficiency and indicate that the method robustly can reconstruct electromagnetic (EM) wave velocity and attenuation distribution in earth materials. The field test results outline zones of velocity and attenuation anomalies consistent with the finding of previous investigators; however, the tomograms appear to be quite smooth. Further work is needed to effectively find the optimal smoothness criterion in applying the Tikhonov regularization in the nonlinear inversion algorithms for cross-hole radar tomography. ?? 2001 Elsevier Science B.V. All rights reserved.

  18. Ankle Instability Effects on Joint Position Sense When Stepping Across the Active Movement Extent Discrimination Apparatus

    PubMed Central

    Witchalls, Jeremy; Waddington, Gordon; Blanch, Peter; Adams, Roger

    2012-01-01

    Context Individuals with and without functional ankle instability have been tested for deficits in lower limb proprioception with varied results. Objective To determine whether a new protocol for testing participants' joint position sense during stepping is reliable and can detect differences between participants with unstable and stable ankles. Design Descriptive laboratory study. Setting University clinical laboratory. Patients or Other Participants Sample of convenience involving 21 young adult university students and staff. Ankle stability was categorized by score on the Cumberland Ankle Instability Tool; 13 had functional ankle instability, 8 had healthy ankles. Intervention(s) Test-retest of ankle joint position sense when stepping onto and across the Active Movement Extent Discrimination Apparatus twice, separated by an interim test, standing still on the apparatus and moving only 1 ankle into inversion. Main Outcome Measure(s) Difference in scores between groups with stable and unstable ankles and between test repeats. Results Participants with unstable ankles were worse at differentiating between inversion angles underfoot in both testing protocols. On repeated testing with the stepping protocol, performance of the group with unstable ankles was improved (Cohen d = 1.06, P = .006), whereas scores in the stable ankle group did not change in the second test (Cohen d = 0.04, P = .899). Despite this improvement, the unstable group remained worse at differentiating inversion angles on the stepping retest (Cohen d = 0.99, P = .020). Conclusions The deficits on proprioceptive tests shown by individuals with functional ankle instability improved with repeated exposure to the test situation. The learning effect may be the result of systematic exposure to ankle-angle variation that led to movement-specific learning or increased confidence when stepping across the apparatus. PMID:23182010

  19. Responses of spinal dorsal horn neurons to foot movements in rats with a sprained ankle

    PubMed Central

    Kim, Jae Hyo; Kim, Hee Young; Chung, Kyungsoon

    2011-01-01

    Acute ankle injuries are common problems and often lead to persistent pain. To investigate the underlying mechanism of ankle sprain pain, the response properties of spinal dorsal horn neurons were examined after ankle sprain. Acute ankle sprain was induced manually by overextending the ankle of a rat hindlimb in a direction of plantarflexion and inversion. The weight-bearing ratio (WBR) of the affected foot was used as an indicator of pain. Single unit activities of dorsal horn neurons in response to plantarflexion and inversion of the foot or ankle compression were recorded from the medial part of the deep dorsal horn, laminae IV-VI, in normal and ankle-sprained rats. One day after ankle sprain, rats showed significantly reduced WBRs on the affected foot, and this reduction was partially restored by systemic morphine. The majority of deep dorsal horn neurons responded to a single ankle stimulus modality. After ankle sprain, the mean evoked response rates were significantly increased, and afterdischarges were developed in recorded dorsal horn neurons. The ankle sprain-induced enhanced evoked responses were significantly reduced by morphine, which was reversed by naltrexone. The data indicate that movement-specific dorsal horn neuron responses were enhanced after ankle sprain in a morphine-dependent manner, thus suggesting that hyperactivity of dorsal horn neurons is an underlying mechanism of pain after ankle sprain. PMID:21389306

  20. The effect of talocrural joint manipulation on range of motion at the ankle.

    PubMed

    Fryer, Gary A; Mudge, Jacob M; McLaughlin, Patrick A

    2002-01-01

    To determine whether a single high-velocity, low-amplitude thrust manipulation to the talocrural joint altered ankle range of motion. A randomized, controlled and blinded study. Asymptomatic male and female volunteers (N = 41). Subjects were randomly assigned into either an experimental group (n = 20) or a control group (n = 21). Both ankles of subjects in the experimental group were manipulated by using a single high-velocity, low-amplitude thrust to the talocrural joint. Pretest and posttest measurements of passive dorsiflexion range of motion were taken. No significant changes in dorsiflexion range of motion were detected between manipulated ankles and those of control subjects. A significantly greater pretest dorsiflexion range of motion existed in those ankles in which manipulation produced an audible cavitation. Manipulation of the ankle does not increase dorsiflexion range of motion in asymptomatic subjects. Ankles that displayed a greater pretest range of dorsiflexion were more likely to cavitate, raising the possibility that ligament laxity may be associated with the tendency for ankles to cavitate.

  1. Sensitivity analyses of acoustic impedance inversion with full-waveform inversion

    NASA Astrophysics Data System (ADS)

    Yao, Gang; da Silva, Nuno V.; Wu, Di

    2018-04-01

    Acoustic impedance estimation has a significant importance to seismic exploration. In this paper, we use full-waveform inversion to recover the impedance from seismic data, and analyze the sensitivity of the acoustic impedance with respect to the source-receiver offset of seismic data and to the initial velocity model. We parameterize the acoustic wave equation with velocity and impedance, and demonstrate three key aspects of acoustic impedance inversion. First, short-offset data are most suitable for acoustic impedance inversion. Second, acoustic impedance inversion is more compatible with the data generated by density contrasts than velocity contrasts. Finally, acoustic impedance inversion requires the starting velocity model to be very accurate for achieving a high-quality inversion. Based upon these observations, we propose a workflow for acoustic impedance inversion as: (1) building a background velocity model with travel-time tomography or reflection waveform inversion; (2) recovering the intermediate wavelength components of the velocity model with full-waveform inversion constrained by Gardner’s relation; (3) inverting the high-resolution acoustic impedance model with short-offset data through full-waveform inversion. We verify this workflow by the synthetic tests based on the Marmousi model.

  2. Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

    PubMed Central

    Forrester, Larry W.; Roy, Anindo; Krebs, Hermano Igo; Macko, Richard F.

    2013-01-01

    Background Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking. Objectives To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke. Methods This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function. Results Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased. Conclusions Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies. PMID:21115945

  3. Ankle Fusion Combined With Calcaneal Sliding Osteotomy for Severe Arthritic Ball and Socket Ankle Deformity.

    PubMed

    Cho, Byung-Ki; Park, Kyoung-Jin; Choi, Seung-Myung; Kang, Sang-Woo; Lee, Hyung-Ki

    2016-12-01

    Although a ball and socket ankle deformity is usually congenital and asymptomatic, abnormal inversion and eversion mobility can result in recurrent ankle sprain and osteoarthritis. This retrospective study was performed to evaluate the clinical and radiologic outcomes of ankle fusion combined with calcaneal sliding osteotomy for severe arthritic ball and socket ankle deformity. Fourteen patients with severe arthritic ball and socket ankle deformity were followed for more than 3 years after operation. The clinical evaluation consisted of American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS) for pain, and subjective satisfaction score. The period to fusion and union of osteotomy, the change of hindfoot alignment angle, and complications were evaluated radiologically. AOFAS and FAAM scores were significantly improved from an average of 37.4 and 34.5 points to 74.6 and 78.5 points, respectively. VAS for pain with walking over 20 minutes was significantly improved from an average of 8.4 points to 1.9 points. The average satisfaction score of patients was 88.9 points. The difference in heel alignment angle (compared to contralateral side) was significantly improved from an average of 34.8 to 5.4 degrees. There were 2 cases of progressive arthritis in an adjacent joint and 1 case of failed fusion. Ankle fusion combined with calcaneal sliding osteotomy can be an effective operative option for ball and socket ankle deformity with advanced arthritis. In spite of increased complication rate, reliable pain relief, and restoration of gait ability through correcting hindfoot malalignment could improve the quality of life. Level IV, retrospective case series. © The Author(s) 2016.

  4. Treatment of cuboid syndrome secondary to lateral ankle sprains: a case series.

    PubMed

    Jennings, Jason; Davies, George J

    2005-07-01

    Case series. Plantar flexion/inversion ankle sprains are one of the most frequently occurring sports injuries. Cuboid syndrome, which is difficult to diagnose, may result from a plantar flexion/ inversion ankle injury and could become the source of lateral ankle/midfoot pain. The objective of this case series is to describe the examination, evaluation, and treatment of the cuboid syndrome following a lateral ankle sprain. Seven patients were seen in our clinic 1 to 8 weeks following a lateral ankle sprain with a chief complaint of lateral ankle/midfoot pain. In these 7 patients, the presence of cuboid syndrome was identified independently by 2 examiners. Treatment consisted of a cuboid manipulation. All 7 patients returned to sports activities following 1 to 2 treatments consisting of the "cuboid whip" manipulation. No recurrence of symptoms was reported upon immediate return to competition or during the remainder of the season (mean follow-up, 5.7 months; range, 2 to 8 months). Based on those 7 patients, our results suggest that patients who are properly diagnosed with cuboid syndrome and receive the cuboid manipulation can return to competitive activity within 1 or 2 visits without injury recurrence.

  5. The ANKLE TRIAL (ANKLE treatment after injuries of the ankle ligaments): what is the benefit of external support devices in the functional treatment of acute ankle sprain? : a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Acute lateral ankle ligament injuries are very common problems in present health care. Still there is no hard evidence about which treatment strategy is superior. Current evidence supports the view that a functional treatment strategy is preferable, but insufficient data are present to prove the benefit of external support devices in these types of treatment. The hypothesis of our study is that external ankle support devices will not result in better outcome in the treatment of acute ankle sprains, compared to a purely functional treatment strategy. Overall objective is to compare the results of three different strategies of functional treatment for acute ankle sprain, especially to determine the advantages of external support devices in addition to functional treatment strategy, based on balance and coordination exercises. Methods/design This study is designed as a randomised controlled multi-centre trial with one-year follow-up. Adult and healthy patients (N = 180) with acute, single sided and first inversion trauma of the lateral ankle ligaments will be included. They will all follow the same schedule of balancing exercises and will be divided into 3 treatment groups, 1. pressure bandage and tape, 2. pressure bandage and brace and 3. no external support. Primary outcome measure is the Karlsson scoring scale; secondary outcomes are FAOS (subscales), number of recurrent ankle injuries, Visual Analogue Scales of pain and satisfaction and adverse events. They will be measured after one week, 6 weeks, 6 months and 1 year. Discussion The ANKLE TRIAL is a randomized controlled trial in which a purely functional treated control group, without any external support is investigated. Results of this study could lead to other opinions about usefulness of external support devices in the treatment of acute ankle sprain. Trial registration Netherlands Trial Register (NTR): NTR2151 PMID:22340371

  6. Does ankle joint power reflect type of muscle action of soleus and gastrocnemius during walking in cats and humans?

    PubMed

    Cronin, Neil J; Prilutsky, Boris I; Lichtwark, Glen A; Maas, Huub

    2013-04-26

    The main objective of this paper is to highlight the difficulties of identifying shortening and lengthening contractions based on analysis of power produced by resultant joint moments. For that purpose, we present net ankle joint powers and muscle fascicle/muscle-tendon unit (MTU) velocities for medial gastrocnemius (MG) and soleus (SO) muscles during walking in species of different size (humans and cats). For the cat, patterns of ankle joint power and MTU velocity of MG and SO during stance were similar: negative power (ankle moment×angular velocity<0), indicating absorption of mechanical energy, was associated with MTU lengthening, and positive power (generation of mechanical energy) was found during MTU shortening. This was also found for the general fascicle velocity pattern in SO. In contrast, substantial differences between ankle joint power and fascicle velocity patterns were observed for MG muscle. In humans, like cats, the patterns of ankle joint power and MTU velocity of SO and MG were similar. Unlike the cat, there were substantial differences between patterns of fascicle velocity and ankle joint power during stance in both muscles. These results indicate that during walking, only a small fraction of mechanical work of the ankle moment is either generated or absorbed by the muscle fascicles, thus confirming the contribution of in-series elastic structures and/or energy transfer via two-joint muscles. We conclude that ankle joint negative power does not necessarily indicate eccentric action of muscle fibers and that positive power cannot be exclusively attributed to muscle concentric action, especially in humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Finite-Source Inversion for the 2004 Parkfield Earthquake using 3D Velocity Model Green's Functions

    NASA Astrophysics Data System (ADS)

    Kim, A.; Dreger, D.; Larsen, S.

    2008-12-01

    We determine finite fault models of the 2004 Parkfield earthquake using 3D Green's functions. Because of the dense station coverage and detailed 3D velocity structure model in this region, this earthquake provides an excellent opportunity to examine how the 3D velocity structure affects the finite fault inverse solutions. Various studies (e.g. Michaels and Eberhart-Phillips, 1991; Thurber et al., 2006) indicate that there is a pronounced velocity contrast across the San Andreas Fault along the Parkfield segment. Also the fault zone at Parkfield is wide as evidenced by mapped surface faults and where surface slip and creep occurred in the 1966 and the 2004 Parkfield earthquakes. For high resolution images of the rupture process"Ait is necessary to include the accurate 3D velocity structure for the finite source inversion. Liu and Aurchuleta (2004) performed finite fault inversions using both 1D and 3D Green's functions for 1989 Loma Prieta earthquake using the same source paramerization and data but different Green's functions and found that the models were quite different. This indicates that the choice of the velocity model significantly affects the waveform modeling at near-fault stations. In this study, we used the P-wave velocity model developed by Thurber et al (2006) to construct the 3D Green's functions. P-wave speeds are converted to S-wave speeds and density using by the empirical relationships of Brocher (2005). Using a finite difference method, E3D (Larsen and Schultz, 1995), we computed the 3D Green's functions numerically by inserting body forces at each station. Using reciprocity, these Green's functions are recombined to represent the ground motion at each station due to the slip on the fault plane. First we modeled the waveforms of small earthquakes to validate the 3D velocity model and the reciprocity of the Green"fs function. In the numerical tests we found that the 3D velocity model predicted the individual phases well at frequencies lower than 0

  8. Shear wave velocity variation across the Taupo Volcanic Zone, New Zealand, from receiver function inversion

    USGS Publications Warehouse

    Bannister, S.; Bryan, C.J.; Bibby, H.M.

    2004-01-01

    The Taupo Volcanic Zone (TVZ), New Zealand is a region characterized by very high magma eruption rates and extremely high heat flow, which is manifest in high-temperature geothermal waters. The shear wave velocity structure across the region is inferred using non-linear inversion of receiver functions, which were derived from teleseismic earthquake data. Results from the non-linear inversion, and from forward synthetic modelling, indicate low S velocities at ???6- 16 km depth near the Rotorua and Reporoa calderas. We infer these low-velocity layers to represent the presence of high-level bodies of partial melt associated with the volcanism. Receiver functions at other stations are complicated by reverberations associated with near-surface sedimentary layers. The receiver function data also indicate that the Moho lies between 25 and 30 km, deeper than the 15 ?? 2 km depth previously inferred for the crust-mantle boundary beneath the TVZ. ?? 2004 RAS.

  9. Multi-segment foot kinematics after total ankle replacement and ankle arthrodesis during relatively long-distance gait.

    PubMed

    Rouhani, H; Favre, J; Aminian, K; Crevoisier, X

    2012-07-01

    This study aimed to investigate the influence of ankle osteoarthritis (AOA) treatments, i.e., ankle arthrodesis (AA) and total ankle replacement (TAR), on the kinematics of multi-segment foot and ankle complex during relatively long-distance gait. Forty-five subjects in four groups (AOA, AA, TAR, and control) were equipped with a wearable system consisting of inertial sensors installed on the tibia, calcaneus, and medial metatarsals. The subjects walked 50-m twice while the system measured the kinematic parameters of their multi-segment foot: the range of motion of joints between tibia, calcaneus, and medial metatarsals in three anatomical planes, and the peaks of angular velocity of these segments in the sagittal plane. These parameters were then compared among the four groups. It was observed that the range of motion and peak of angular velocities generally improved after TAR and were similar to the control subjects. However, unlike AOA and TAR, AA imposed impairments in the range of motion in the coronal plane for both the tibia-calcaneus and tibia-metatarsals joints. In general, the kinematic parameters showed significant correlation with established clinical scales (FFI and AOFAS), which shows their convergent validity. Based on the kinematic parameters of multi-segment foot during 50-m gait, this study showed significant improvements in foot mobility after TAR, but several significant impairments remained after AA. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Effects of circumferential ankle pressure on ankle proprioception, stiffness, and postural stability: a preliminary investigation.

    PubMed

    You, Sung H; Granata, Kevin P; Bunker, Linda K

    2004-08-01

    Cross-sectional repeated-measures design. Determine the effects of circumferential ankle pressure (CAP) intervention on proprioceptive acuity, ankle stiffness, and postural stability. The application of CAP using braces, taping, and adaptive shoes or military boots is widely used to address chronic ankle instability (CAI). An underlying assumption is that the CAP intervention might improve ankle stability through increased proprioceptive acuity and stiffness in the ankle. METHOD AND MEASURES: A convenience sample of 10 subjects was recruited from the local university community and categorized according to proprioceptive acuity (high, low) and ankle stability (normal, CAI). Proprioceptive acuity was measured when blindfolded subjects were asked to accurately reproduce a self-selected target ankle position before and after the application of CAP. Proprioceptive acuity was determined in 5 different ankle joint position sense tests: neutral, inversion, eversion, plantar flexion, and dorsiflexion. Joint position angles were recorded electromechanically using a potentiometer. Passive ankle stiffness was computed from the ratio of applied static moment versus angular displacement. Active ankle stiffness was determined from biomechanical analyses of ankle motion following a mediolateral perturbation. Postural stability was quantified from the center of pressure displacement in the mediolateral and the anteroposterior directions in unipedal stance. All measurements were recorded with and without CAP applied by a pediatric blood pressure cuff. Data were analyzed using a separate mixed-model analysis of variance (ANOVA) for each dependent variable. Post hoc comparison using Tukey's honestly significant difference (HSD) test was performed if significant interactions were obtained. Significance level was set at P<.05 for all analyses. Significant group (high versus low proprioceptive acuity) x CAP interactions were identified for postural stability. Passive ankle stiffness was

  11. Detailed Velocity and Density models of the Cascadia Subduction Zone from Prestack Full-Waveform Inversion

    NASA Astrophysics Data System (ADS)

    Fortin, W.; Holbrook, W. S.; Mallick, S.; Everson, E. D.; Tobin, H. J.; Keranen, K. M.

    2014-12-01

    Understanding the geologic composition of the Cascadia Subduction Zone (CSZ) is critically important in assessing seismic hazards in the Pacific Northwest. Despite being a potential earthquake and tsunami threat to millions of people, key details of the structure and fault mechanisms remain poorly understood in the CSZ. In particular, the position and character of the subduction interface remains elusive due to its relative aseismicity and low seismic reflectivity, making imaging difficult for both passive and active source methods. Modern active-source reflection seismic data acquired as part of the COAST project in 2012 provide an opportunity to study the transition from the Cascadia basin, across the deformation front, and into the accretionary prism. Coupled with advances in seismic inversion methods, this new data allow us to produce detailed velocity models of the CSZ and accurate pre-stack depth migrations for studying geologic structure. While still computationally expensive, current computing clusters can perform seismic inversions at resolutions that match that of the seismic image itself. Here we present pre-stack full waveform inversions of the central seismic line of the COAST survey offshore Washington state. The resultant velocity model is produced by inversion at every CMP location, 6.25 m laterally, with vertical resolution of 0.2 times the dominant seismic frequency. We report a good average correlation value above 0.8 across the entire seismic line, determined by comparing synthetic gathers to the real pre-stack gathers. These detailed velocity models, both Vp and Vs, along with the density model, are a necessary step toward a detailed porosity cross section to be used to determine the role of fluids in the CSZ. Additionally, the P-velocity model is used to produce a pre-stack depth migration image of the CSZ.

  12. CLINICAL COMMENTARY ON MIDFOOT AND FOREFOOT INVOLVEMENT IN LATERAL ANKLE SPRAINS AND CHRONIC ANKLE INSTABILITY. PART 2: CLINICAL CONSIDERATIONS

    PubMed Central

    Feger, Mark A.; Hertel, Jay

    2016-01-01

    Lateral ankle sprains (LAS) and chronic ankle instability (CAI) are common musculoskeletal injuries that are a result of inversion injury during sport. The midfoot and forefoot is frequently injured during a LAS, is often overlooked during clinical examination, and maybe contributory to the development of CAI. The purpose of part two of this clinical commentary and current concept review is to increase clinician's awareness of the contribution of midfoot and forefoot impairment to functional limitation and disability of individuals who experience LAS and CAI and to facilitate future research in this area. The importance of multisegmented foot and ankle assessment from a clinical and research perspective is stressed. Select physical assessment and manual therapeutic techniques are presented to assist the clinician in examination and treatment of the ankle-foot complex in patients with LAS and CAI. PMID:27999731

  13. Reduced effects of tendon vibration with increased task demand during active, cyclical ankle movements

    PubMed Central

    Floyd, Lisa M.; Holmes, Taylor C.; Dean, Jesse C.

    2013-01-01

    Tendon vibration can alter proprioceptive feedback, one source of sensory information which humans can use to produce accurate movements. However, the effects of tendon vibration during functional movement vary depending on the task. For example, ankle tendon vibration has considerably smaller effects during walking than standing posture. The purpose of this study was to test whether the effects of ankle tendon vibration are predictably influenced by the mechanical demands of a task, as quantified by peak velocity. Twelve participants performed symmetric, cyclical ankle plantarflexion/dorsiflexion movements while lying prone with their ankle motion unconstrained. The prescribed movement period (1s, 3s) and peak-to-peak amplitude (10°, 15°, 20°) were varied across trials; shorter movement periods or larger amplitudes increased the peak velocity. In some trials, vibration was continuously and simultaneously applied to the right ankle plantarflexor and dorsiflexor tendons, while the left ankle tendons were never vibrated. The vibration frequency (40, 80, 120, 160 Hz) was varied across trials. During trials without vibration, participants accurately matched the movement of their ankles. The application of 80 Hz vibration to the right ankle tendons significantly reduced the amplitude of right ankle movement. However, the effect of vibration was smaller during more mechanically demanding (i.e. higher peak velocity) movements. Higher vibration frequencies had larger effects on movement accuracy, possibly due to parallel increases in vibration amplitude. These results demonstrate that the effects of ankle tendon vibration are dependent on the mechanical demand of the task being performed, but cannot definitively identify the underlying physiological mechanism. PMID:24136344

  14. Improving the accurate assessment of a layered shear-wave velocity model using joint inversion of the effective Rayleigh wave and Love wave dispersion curves

    NASA Astrophysics Data System (ADS)

    Yin, X.; Xia, J.; Xu, H.

    2016-12-01

    Rayleigh and Love waves are two types of surface waves that travel along a free surface.Based on the assumption of horizontal layered homogenous media, Rayleigh-wave phase velocity can be defined as a function of frequency and four groups of earth parameters: P-wave velocity, SV-wave velocity, density and thickness of each layer. Unlike Rayleigh waves, Love-wave phase velocities of a layered homogenous earth model could be calculated using frequency and three groups of earth properties: SH-wave velocity, density, and thickness of each layer. Because the dispersion of Love waves is independent of P-wave velocities, Love-wave dispersion curves are much simpler than Rayleigh wave. The research of joint inversion methods of Rayleigh and Love dispersion curves is necessary. (1) This dissertation adopts the combinations of theoretical analysis and practical applications. In both lateral homogenous media and radial anisotropic media, joint inversion approaches of Rayleigh and Love waves are proposed to improve the accuracy of S-wave velocities.A 10% random white noise and a 20% random white noise are added to the synthetic dispersion curves to check out anti-noise ability of the proposed joint inversion method.Considering the influences of the anomalous layer, Rayleigh and Love waves are insensitive to those layers beneath the high-velocity layer or low-velocity layer and the high-velocity layer itself. Low sensitivities will give rise to high degree of uncertainties of the inverted S-wave velocities of these layers. Considering that sensitivity peaks of Rayleigh and Love waves separate at different frequency ranges, the theoretical analyses have demonstrated that joint inversion of these two types of waves would probably ameliorate the inverted model.The lack of surface-wave (Rayleigh or Love waves) dispersion data may lead to inaccuracy S-wave velocities through the single inversion of Rayleigh or Love waves, so this dissertation presents the joint inversion method of

  15. 3D strength surfaces for ankle plantar- and dorsi-flexion in healthy adults: an isometric and isokinetic dynamometry study.

    PubMed

    Hussain, Sara J; Frey-Law, Laura

    2016-01-01

    The ankle is an important component of the human kinetic chain, and deficits in ankle strength can negatively impact functional tasks such as balance and gait. While peak torque is influenced by joint angle and movement velocity, ankle strength is typically reported for a single angle or movement speed. To better identify deficits and track recovery of ankle strength after injury or surgical intervention, ankle strength across a range of movement velocities and joint angles in healthy adults is needed. Thus, the primary goals of this study were to generate a database of strength values and 3-dimensional strength surface models for plantarflexion (PF) and dorsiflexion (DF) ankle strength in healthy men and women. Secondary goals were to develop a means to estimate ankle strength percentiles as well as examine predictors of maximal ankle strength in healthy adults. Using an isokinetic dynamometer, we tested PF and DF peak torques at five joint angles (-10° [DF], 0° [neutral], 10° [PF], 20° [PF] and 30° [PF]) and six velocities (0°/s, 30°/s, 60°/s, 90°/s, 120°/s and 180°/s) in 53 healthy adults. These data were used to generate 3D plots, or "strength surfaces", for males and females for each direction; surfaces were fit using a logistic equation. We also tested predictors of ankle strength, including height, weight, sex, and self-reported physical activity levels. Torque-velocity and torque-angle relationships at the ankle interact, indicating that these relationships are interdependent and best modeled using 3D surfaces. Sex was the strongest predictor of ankle strength over height, weight, and self-reported physical activity levels. 79 to 97 % of the variance in mean peak torque was explained by joint angle and movement velocity using logistic equations, for men and women and PF and DF directions separately. The 3D strength data and surface models provide a more comprehensive dataset of ankle strength in healthy adults than previously reported. These

  16. [Concomitant injuries after upper ankle joint dislocations].

    PubMed

    Dann, K; Wahler, G; Neubauer, N; Steiner, R; Titze, W; Wagner, M

    1996-09-01

    Functional treatment with the Air Stirrup Ankle Brace recommended by C. N. Stover in 1979 can reduce pathological inversion of the ankle joint. In our retrospective study of 109 patients treated by this kind of ankle brace we found 96 patients (88%) with excellent results. Only 13 patients (12%) reported moderate to good results. To detect and characterize their painful conditions of ankles we did a clinical, radiological and MRI-Investigation. In only 2 cases we found a moderate instability after clinical investigation, anterior stress roentgenogram and talar tilt. By using the MRI-investigation 1.0 Tesla with a 512 x 360 Matrix we could find 10 cases with osteochondral lesions of the ankle. In 7 cases there was separated ossicle in the fibulotalar joint, in 1 case we detected a fracture of the processus anterior tali, in another case we could see a posttraumatic lesion of the talus and calcaneus with bone bruise and at least one osteochondral fracture of the distal tibia. The capability of the MRI to detect particularly osteo-chondral lesions of the talus and the tibiofibular joint was shown in 10 of 13 cases. Therefore we recommend to do an MRI-investigation on all patients after ankle sprain if there are painful conditions within the ankle after conservative treatment.

  17. Ankle joint function during walking in tophaceous gout: A biomechanical gait analysis study.

    PubMed

    Carroll, Matthew; Boocock, Mark; Dalbeth, Nicola; Stewart, Sarah; Frampton, Christopher; Rome, Keith

    2018-04-17

    The foot and ankle are frequently affected in tophaceous gout, yet kinematic and kinetic changes in this region during gait are unknown. The aim of the study was to evaluate ankle biomechanical characteristics in people with tophaceous gout using three-dimensional gait analysis. Twenty-four participants with tophaceous gout were compared with 24 age-and sex-matched control participants. A 9-camera motion analysis system and two floor-mounted force plates were used to calculate kinematic and kinetic parameters. Peak ankle joint angular velocity was significantly decreased in participants with gout (P < 0.01). No differences were found for ankle ROM in either the sagittal (P = 0.43) or frontal planes (P = 0.08). No differences were observed between groups for peak ankle joint power (P = 0.41), peak ankle joint force (P = 0.25), peak ankle joint moment (P = 0.16), timing for peak ankle joint force (P = 0.81), or timing for peak ankle joint moment (P = 0.16). Three dimensional gait analysis demonstrated that ankle joint function does not change in people with gout. People with gout demonstrated a reduced peak ankle joint angular velocity which may reflect gait-limiting factors and adaptations from the high levels of foot pain, impairment and disability experienced by this population. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Velocity Inversion In Cylindrical Couette Gas Flows

    NASA Astrophysics Data System (ADS)

    Dongari, Nishanth; Barber, Robert W.; Emerson, David R.; Zhang, Yonghao; Reese, Jason M.

    2012-05-01

    We investigate a power-law probability distribution function to describe the mean free path of rarefied gas molecules in non-planar geometries. A new curvature-dependent model is derived by taking into account the boundary-limiting effects on the molecular mean free path for surfaces with both convex and concave curvatures. In comparison to a planar wall, we find that the mean free path for a convex surface is higher at the wall and exhibits a sharper gradient within the Knudsen layer. In contrast, a concave wall exhibits a lower mean free path near the surface and the gradients in the Knudsen layer are shallower. The Navier-Stokes constitutive relations and velocity-slip boundary conditions are modified based on a power-law scaling to describe the mean free path, in accordance with the kinetic theory of gases, i.e. transport properties can be described in terms of the mean free path. Velocity profiles for isothermal cylindrical Couette flow are obtained using the power-law model. We demonstrate that our model is more accurate than the classical slip solution, especially in the transition regime, and we are able to capture important non-linear trends associated with the non-equilibrium physics of the Knudsen layer. In addition, we establish a new criterion for the critical accommodation coefficient that leads to the non-intuitive phenomena of velocity-inversion. Our results are compared with conventional hydrodynamic models and direct simulation Monte Carlo data. The power-law model predicts that the critical accommodation coefficient is significantly lower than that calculated using the classical slip solution and is in good agreement with available DSMC data. Our proposed constitutive scaling for non-planar surfaces is based on simple physical arguments and can be readily implemented in conventional fluid dynamics codes for arbitrary geometric configurations.

  19. Comparative evaluation between anatomic and non-anatomic lateral ligament reconstruction techniques in the ankle joint: A computational study.

    PubMed

    Purevsuren, Tserenchimed; Batbaatar, Myagmarbayar; Khuyagbaatar, Batbayar; Kim, Kyungsoo; Kim, Yoon Hyuk

    2018-03-12

    Biomechanical studies have indicated that the conventional non-anatomic reconstruction techniques for lateral ankle sprain (LAS) tend to restrict subtalar joint motion compared to intact ankle joints. Excessive restriction in subtalar motion may lead to chronic pain, functional difficulties, and development of osteoarthritis. Therefore, various anatomic surgical techniques to reconstruct both the anterior talofibular and calcaneofibular ligaments have been introduced. In this study, ankle joint stability was evaluated using multibody computational ankle joint model to assess two new anatomic reconstruction and three popular non-anatomic reconstruction techniques. An LAS injury, three popular non-anatomic reconstruction models (Watson-Jones, Evans, and Chrisman-Snook), and two common types of anatomic reconstruction models were developed based on the intact ankle model. The stability of ankle in both talocrural and subtalar joint were evaluated under anterior drawer test (150 N anterior force), inversion test (3 Nm inversion moment), internal rotational test (3 Nm internal rotation moment), and the combined loading test (9 Nm inversion and internal moment as well as 1800 N compressive force). Our overall results show that the two anatomic reconstruction techniques were superior to the non-anatomic reconstruction techniques in stabilizing both talocrural and subtalar joints. Restricted subtalar joint motion, which mainly observed in Watson-Jones and Chrisman-Snook techniques, was not shown in the anatomical reconstructions. Evans technique was beneficial for subtalar joint as it does not restrict subtalar motion, though Evans technique was insufficient for restoring talocrural joint inversion. The anatomical reconstruction techniques best recovered ankle stability.

  20. Effects of focal ankle joint cooling on unipedal static balance in individuals with and without chronic ankle instability.

    PubMed

    Kim, Kyung-Min; Hart, Joseph M; Saliba, Susan A; Hertel, Jay

    2015-01-01

    Application of cryotherapy over an injured joint has been shown to improve muscle function, yet it is unknown how ankle cryotherapy affects postural control. Our purpose was to determine the effects of a 20-min focal ankle joint cooling on unipedal static stance in individuals with and without chronic ankle instability (CAI). Fifteen young subjects with CAI (9 males, 6 females) and 15 healthy gender-matched controls participated. All subjects underwent two intervention sessions on different days in which they had a 1.5L plastic bag filled with either crushed ice (active treatment) or candy corn (sham) applied to the ankle. Unipedal stance with eyes closed for 10s were assessed with a forceplate before and after each intervention. Center of pressure (COP) data were used to compute 10 specific dependent measures including velocity, area, standard deviation (SD), and percent range of COP excursions, and mean and SD of time-to-boundary (TTB) minima in the anterior-posterior (AP) and mediolateral directions. For each measure a three-way (Group-Intervention-Time) repeated ANOVAs found no significant interactions and main effects involving intervention (all Ps > 0.05). There were group main effects found for mean velocity (F(1,28) = 6.46, P = .017), area (F(1,28) = 12.83, P = .001), and mean of TTB minima in the AP direction (F(1,28) = 5.19, P = .031) indicating that the CAI group demonstrated greater postural instability compared to the healthy group. Postural control of unipedal stance was not significantly altered following focal ankle joint cooling in groups both with and without CAI. Ankle joint cryotherapy was neither beneficial nor harmful to single leg balance. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Influence of different shortening velocities preceding stretch on human triceps surae moment generation in vivo.

    PubMed

    De Monte, Gianpiero; Arampatzis, Adamantios

    2008-07-19

    The purpose of this study was to examine the influence of different shortening velocities preceding the stretch on moment generation of the triceps surae muscles and architecture of the m. gastrocnemius medialis after shortening-stretch cycles of equal magnitude in vivo. Eleven male subjects (31.6+/-5.8 years, 178.4+/-7.3cm, 80.6+/-9.6kg) performed a series of electro-stimulated (85Hz) shortening-stretch plantar flexion contractions. The shortening-stretch cycles were performed at three constant angular velocities (25, 50, 100 degrees /s) in the plantar flexion direction (shortening) and at 50 degrees /s in the dorsiflexion direction (stretching). The resultant ankle joint moments were calculated through inverse dynamics. Pennation angle and fascicle length of the m. gastrocnemius medialis at rest and during contractions were measured using ultrasonography. The corresponding ankle moments, kinematics and changes in muscle architecture were analysed at seven time intervals. An analysis of variance for repeated measurements and post hoc test with Bonferroni correction was used to check the velocity-related effects on moment enhancement (alpha=0.05). The results show an increase in pennation angles and a decrease in fascicle lengths after the shortening-stretch cycle. The ankle joint moment ratio (post to pre) was higher (p<0.01) than 1.0 indicating a moment enhancement after the shortening-stretch cycle. The found ankle joint moment enhancement was 2-5% after the shortening-stretch cycle and was independed of the shortening velocity. Furthermore, the decrease in fascicle length after the shortening-stretch cycle indicates that the moment enhancement found in the present study is underestimated at least by 1-3%. Considering that the experiments have been done at the ascending limb of the force-length curve and that force enhancement is higher at the descending and the plateau region of the force-length curve, we conclude that the moment enhancement after shortening

  2. Lateral ankle injury. Literature review and report of two cases.

    PubMed

    Pollard, Henry; Sim, Patrick; McHardy, Andrew

    2002-07-01

    Injury to the ankle joint is the most common peripheral joint injury. The sports that most commonly produce high ankle injury rates in their participating athletes include: basketball, netball, and the various codes of football. To provide an up to date understanding of manual therapy relevant to lateral ligament injury of the ankle. A discussion of the types of ligament injury and common complicating factors that present with lateral ankle pain is presented along with a review of relevant anatomy, assessment and treatment. Also included is a discussion of the efficacy of manual therapy in the treatment of ankle sprain. A detailed knowledge of the anatomy of the ankle as well as the early recognition of factors that may delay the rate of healing are important considerations when developing a management plan for inversion sprains of the ankle. This area appears to be under-researched however it was found that movement therapy and its various forms appear to be the most efficient and most effective method of treating uncomplicated ankle injury. Future investigations should involve a study to determine the effect chiropractic treatment (manipulation) may have on the injured ankle.

  3. Prophylactic Ankle Braces and the Kinematics and Kinetics of Half-Squat Parachute Landing.

    PubMed

    Wu, Di; Zheng, Chao; Wu, Ji; Hu, Tan; Huang, Rongrong; Wang, Lizhen; Fan, Yubo

    2018-02-01

    The objective of the study was to investigate the effects of dropping heights and prophylactic ankle braces on ankle joint biomechanics during half-squat parachute landing from two different heights. There were 30 male elite paratroopers with formal parachute landing training and more than 2 yr of parachute jumping experience who were recruited for this study. The subjects tested three different ankle brace conditions (no-brace, elastic brace, semirigid brace). Each subject was instructed to jump off a platform from two different heights of 0.4 m and 0.8 m, and land on a force plate in a half-squat posture. The Vicon 3D motion capture system and force plate were used to record and calculate kinematic and kinetic data. Dropping height had a significant effect on peak vertical ground reaction force (vGRF), maximum ankle angular displacement, and time to vGRF. As compared with the no-brace group, use of an elastic ankle brace significantly reduced peak vGRF by 18.57% and both braces significantly reduced the maximal angular displacements of dorsiflexion. The semirigid brace provided greater restriction against maximal angular displacement of inversion. The elastic and semirigid ankle braces both effectively restricted motion stability of the ankle joint in the sagittal plane, and the semirigid ankle brace prevented excessive inversion, although the comfort of this device should be improved overall.Wu D, Zheng C, Wu J, Hu T, Huang R, Wang L, Fan Y. Prophylactic ankle braces and the kinematics and kinetics of half-squat parachute landing. Aerosp Med Hum Perform. 2018; 89(2):141-146.

  4. Evaluating Postural Control and Ankle Laxity Between Taping and High-Top Cleats in High School Football Players.

    PubMed

    Pizac, Douglas A; Swanik, Charles B; Glutting, Joseph J; Kaminski, Thomas W

    2018-03-01

    Lateral ankle sprains are the most common injuries in high school sports. While ankle taping is a preferred method of external prophylactic support, its restrictive properties decline during exercise. The Under Armour ® Highlight cleat is marketed on the premise that it provides added support without the need for additional ankle taping. To determine if differences in ankle joint laxity and postural control exist between football players wearing the Under Armour ® Highlight cleat (Under Armour Inc, Baltimore, MD) as compared to a low/mid-top cleat with ankle tape. Crossover trial. Athletic training room and football practice field sideline. 32 interscholastic football players (15.8 ± 1.0 y; 178.9 ± 7.4 cm; 87.1 ± 21.4 kg). Ankle laxity was assessed using an instrumented ankle arthrometer (Blue Bay Research Inc, Milton, FL), while postural control testing was performed on the Tekscan MobileMat™ Balanced Error Scoring System (BESS; South Boston, MA). The 2 treatments included Under Armour ® Highlight cleats and a low/mid-top cleat with ankle tape applied to the nondominant ankle only. Measurements were taken before and immediately after practice. The independent variable was treatment (Highlight vs low/mid-top cleat with ankle tape). Dependent variables included ankle arthrometry measures of anterior displacement (mm), inversion/eversion rotation (deg), and the modified BESS error scores. A linear mixed-effects model was used for analysis. The low/mid-top cleat with tape condition had significantly higher inversion range-of-motion (ROM) and inversion/eversion rotation postexercise when compared to the Highlight cleat (P < 0.05). The results of this study provide some evidence that the Under Armour ® Highlight cleat restricts ankle ROM following a training session better than the taped low/mid-top cleat. Further study is warranted to determine if this high-top style of football cleat can reduce the incidence of ankle sprains and how it

  5. Viscoelastic response of the lateral side of the ankle to cyclic inversion: a time course analysis.

    PubMed

    Malmir, K; Olyaei, G R; Talebian, S; Jamshidi, A A

    2014-12-01

    Although important, viscoelastic behavior of the ankle's lateral side has rarely been studied. The present study assesses the viscoelastic behavior during cyclic inversions. Eighteen recreationally active healthy males underwent 40 passive cyclic inversions using a Biodex dynamometer at 5 °/s through 80% of maximum range of motion. Energy absorption and restitution and dissipation coefficient were calculated for each repetition. Changes in the mean of the dependent variables for repetitions 1 (R1 ), R5 , R10 , R15 , R20 , R25 , R30 , R35 and R40 were compared by three one-way analyses of variance with repeated measures. There was a significant difference between the means of energy absorption for the selected repetitions from R1 to R20 (P < 0.01), but there was no significant difference between them from R20 to R40 (P > 0.05). There was no significant difference between the means of energy restitution for the selected repetitions (P > 0.05). Whereas there was no significant difference consecutively between the means of dissipative coefficient for the selected repetitions (P > 0.05), there was a significant difference between the means of R30 or R40 relative to the baseline (P < 0.005). The decrease in the energy absorbed and the dissipation coefficient following repeated inversions may be due to the slippage of collagen fibers. The decrease in the shock absorbing ability of the tissues may expose them to injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The Effect of Lateral Ankle Ligament Repair in Muscle Reaction Time in Patients with Mechanical Ankle Instability.

    PubMed

    Li, H-Y; Zheng, J-J; Zhang, J; Hua, Y-H; Chen, S-Y

    2015-11-01

    Studies have shown that functional ankle instability can result in prolonged muscle reaction time. However, the deficit in muscle reaction time in patients with mechanical ankle instability (MAI) and the effect of lateral ankle ligament repair on muscle reaction time are unclear. The purpose of this study was to identify the deficit in muscle reaction time, and to evaluate the role of lateral ligament repair in improving muscle reaction time in MAI patients. Sixteen MAI patients diagnosed with lateral ankle ligament tears by ultrasonography and magnetic resonance imaging underwent arthroscopic debridement and open lateral ankle ligament repair with a modified Broström procedure. One day before the operation, reaction times of the tibialis anterior and peroneus longus muscles were recorded following sudden inversion perturbation while walking on a custom walkway, and anterior drawer test (ADT) and American Orthopaedic Foot and Ankle Society (AOFAS) scale score were evaluated. Six months postoperatively, muscle reaction time, ADT and AOFAS scale score were reevaluated, and muscle reaction times in 15 healthy controls were also recorded. Preoperatively, the affected ankles in the MAI group had significantly delayed tibialis anterior and peroneus longus muscles reaction times compared with controls. Six months after the operation, median AOFAS scale scores were significantly greater than preoperatively, and ADT was negative in the MAI group. However, the affected ankles in the MAI group showed no difference in muscle reaction time compared with preoperative values. MAI patients had prolonged muscle reaction time. The modified Broström procedure produced satisfactory clinical outcomes in MAI patients, but did not shorten reaction times of the tibialis anterior and peroneus longus muscles. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Validity of an ankle joint motion and position sense measurement system and its application in healthy subjects and patients with ankle sprain.

    PubMed

    Lin, Chueh-Ho; Chiang, Shang-Lin; Lu, Liang-Hsuan; Wei, Shun-Hwa; Sung, Wen-Hsu

    2016-07-01

    Ankle motion and proprioception in multiple axis movements are crucial for daily activities. However, few studies have developed and used a multiple axis system for measuring ankle motion and proprioception. This study was designed to validate a novel ankle haptic interface system that measures the ankle range of motion (ROM) and joint position sense in multiple plane movements, investigating the proprioception deficits during joint position sense tasks for patients with ankle instability. Eleven healthy adults (mean ± standard deviation; age, 24.7 ± 1.9 years) and thirteen patients with ankle instability were recruited in this study. All subjects were asked to perform tests to evaluate the validity of the ankle ROM measurements and underwent tests for validating the joint position sense measurements conducted during multiple axis movements of the ankle joint. Pearson correlation was used for validating the angular position measurements obtained using the developed system; the independent t test was used to investigate the differences in joint position sense task performance for people with or without ankle instability. The ROM measurements of the device were linearly correlated with the criterion standards (r = 0.99). The ankle instability and healthy groups were significantly different in direction, absolute, and variable errors of plantar flexion, dorsiflexion, inversion, and eversion (p < 0.05). The results demonstrate that the novel ankle joint motion and position sense measurement system is valid and can be used for measuring the ankle ROM and joint position sense in multiple planes and indicate proprioception deficits for people with ankle instability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. How to sprain your ankle - a biomechanical case report of an inversion trauma.

    PubMed

    Gehring, D; Wissler, S; Mornieux, G; Gollhofer, A

    2013-01-04

    In order to develop preventive measures against lateral ankle sprains, it is essential to have a detailed understanding of the injury mechanism. Under laboratory experimental conditions the examination of the joint load has to be restricted with clear margins of safety. However, in the present case one athlete sprained his ankle while performing a run-and-cut movement during a biomechanical research experiment. 3D kinematics, kinetics, and muscle activity of the lower limb were recorded and compared to 16 previously performed trials. Motion patterns of global pelvis orientation, hip flexion, and knee flexion in the sprain trail deviated from the reference trials already early in the preparatory phase before ground contact. During ground contact, the ankle was rapidly plantar flexed (up to 1240°/s), inverted (up to 1290°/s) and internally rotated (up to 580°/s) reaching its maximum displacement within the first 150 ms after heel strike. Rapid neuromuscular activation bursts of the m. tibialis anterior and the m. peroneus longus started 40-45 ms after ground contact and overshot the activation profile of the reference trials with peak activation at 62 ms and 74 ms respectively. Therefore, it may be suggested that neuromuscular reflexes played an important role in joint control during the critical phase of excessive ankle displacement. The results of this case report clearly indicate that (a) upper leg mechanics, (b) pre-landing adjustments, and (c) neuromuscular contribution have to be considered in the mechanism of lateral ankle sprains. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. S-velocity structure in Cimandiri fault zone derived from neighbourhood inversion of teleseismic receiver functions

    NASA Astrophysics Data System (ADS)

    Syuhada; Anggono, T.; Febriani, F.; Ramdhan, M.

    2018-03-01

    The availability information about realistic velocity earth model in the fault zone is crucial in order to quantify seismic hazard analysis, such as ground motion modelling, determination of earthquake locations and focal mechanism. In this report, we use teleseismic receiver function to invert the S-velocity model beneath a seismic station located in the Cimandiri fault zone using neighbourhood algorithm inversion method. The result suggests the crustal thickness beneath the station is about 32-38 km. Furthermore, low velocity layers with high Vp/Vs exists in the lower crust, which may indicate the presence of hot material ascending from the subducted slab.

  10. Lateral Ligament Repair and Reconstruction Restore Neither Contact Mechanics of the Ankle Joint nor Motion Patterns of the Hindfoot

    PubMed Central

    Prisk, Victor R.; Imhauser, Carl W.; O'Loughlin, Padhraig F.; Kennedy, John G.

    2010-01-01

    Background: Ankle sprains may damage both the lateral ligaments of the hindfoot and the osteochondral tissue of the ankle joint. When nonoperative treatment fails, operative approaches are indicated to restore both native motion patterns at the hindfoot and ankle joint contact mechanics. The goal of the present study was to determine the effect of lateral ligament injury, repair, and reconstruction on ankle joint contact mechanics and hindfoot motion patterns. Methods: Eight cadaveric specimens were tested with use of robotic technology to apply combined compressive (200-N) and inversion (4.5-Nm) loads to the hindfoot at 0° and 20° of plantar flexion. Contact mechanics at the ankle joint were simultaneously measured. A repeated-measures experiment was designed with use of the intact condition as control, with the other conditions including sectioned anterior talofibular and calcaneofibular ligaments, the Broström and Broström-Gould repairs, and graft reconstruction. Results: Ligament sectioning decreased contact area and caused a medial and anterior shift in the center of pressure with inversion loads relative to those with the intact condition. There were no significant differences in inversion or coupled axial rotation with inversion between the Broström repair and the intact condition; however, medial translation of the center of pressure remained elevated after the Broström repair relative to the intact condition. The Gould modification of the Broström procedure provided additional support to the hindfoot relative to the Broström repair, reducing inversion and axial rotation with inversion beyond that of intact ligaments. There were no significant differences in center-of-pressure excursion patterns between the Broström-Gould repair and the intact ligament condition, but this repair increased contact area beyond that with the ligaments intact. Graft reconstruction more closely restored inversion motion than did the Broström-Gould repair at 20° of

  11. Estimation of ligament strains and joint moments in the ankle during a supination sprain injury.

    PubMed

    Wei, Feng; Fong, Daniel Tik-Pui; Chan, Kai-Ming; Haut, Roger C

    2015-01-01

    This study presents the ankle ligament strains and ankle joint moments during an accidental injury event diagnosed as a grade I anterior talofibular ligament (ATaFL) sprain. A male athlete accidentally sprained his ankle while performing a cutting motion in a laboratory setting. The kinematic data were input to a three-dimensional rigid-body foot model for simulation analyses. Maximum strains in 20 ligaments were evaluated in simulations that investigated various combinations of the reported ankle joint motions. Temporal strains in the ATaFL and the calcaneofibular ligament (CaFL) were then compared and the three-dimensional ankle joint moments were evaluated from the model. The ATaFL and CaFL were highly strained when the inversion motion was simulated (10% for ATaFL and 12% for CaFL). These ligament strains were increased significantly when either or both plantarflexion and internal rotation motions were added in a temporal fashion (up to 20% for ATaFL and 16% for CaFL). Interestingly, at the time strain peaked in the ATaFL, the plantarflexion angle was not large but apparently important. This computational simulation study suggested that an inversion moment of approximately 23 N m plus an internal rotation moment of approximately 11 N m and a small plantarflexion moment may have generated a strain of 15-20% in the ATaFL to produce a grade I ligament injury in the athlete's ankle. This injury simulation study exhibited the potentially important roles of plantarflexion and internal rotation, when combined with a large inversion motion, to produce a grade I ATaFL injury in the ankle of this athlete.

  12. Lateral ligament repair and reconstruction restore neither contact mechanics of the ankle joint nor motion patterns of the hindfoot.

    PubMed

    Prisk, Victor R; Imhauser, Carl W; O'Loughlin, Padhraig F; Kennedy, John G

    2010-10-20

    Ankle sprains may damage both the lateral ligaments of the hindfoot and the osteochondral tissue of the ankle joint. When nonoperative treatment fails, operative approaches are indicated to restore both native motion patterns at the hindfoot and ankle joint contact mechanics. The goal of the present study was to determine the effect of lateral ligament injury, repair, and reconstruction on ankle joint contact mechanics and hindfoot motion patterns. Eight cadaveric specimens were tested with use of robotic technology to apply combined compressive (200-N) and inversion (4.5-Nm) loads to the hindfoot at 0° and 20° of plantar flexion. Contact mechanics at the ankle joint were simultaneously measured. A repeated-measures experiment was designed with use of the intact condition as control, with the other conditions including sectioned anterior talofibular and calcaneofibular ligaments, the Broström and Broström-Gould repairs, and graft reconstruction. Ligament sectioning decreased contact area and caused a medial and anterior shift in the center of pressure with inversion loads relative to those with the intact condition. There were no significant differences in inversion or coupled axial rotation with inversion between the Broström repair and the intact condition; however, medial translation of the center of pressure remained elevated after the Broström repair relative to the intact condition. The Gould modification of the Broström procedure provided additional support to the hindfoot relative to the Broström repair, reducing inversion and axial rotation with inversion beyond that of intact ligaments. There were no significant differences in center-of-pressure excursion patterns between the Broström-Gould repair and the intact ligament condition, but this repair increased contact area beyond that with the ligaments intact. Graft reconstruction more closely restored inversion motion than did the Broström-Gould repair at 20° of plantar flexion but limited

  13. Airflow obstruction was associated with elevation of brachial-ankle pulse wave velocity but not ankle-brachial index in aged patients with chronic obstructive pulmonary disease.

    PubMed

    Chen, Rui; He, Wanbing; Zhang, Kun; Zheng, Houzhen; Lin, Lin; Nie, Ruqiong; Wang, Jingfeng; Huang, Hui

    2015-09-01

    Both brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) are important predictors for cardiovascular disease (CVD). Patients with chronic obstructive pulmonary disease (COPD) are at high risk of CVD. But the association between airflow obstruction and baPWV or ABI was still unclear. The study was aimed to investigate the influencing factors on arterial stiffness in aged COPD patients. 67 aged patients with COPD and 67 age- and sex-matched controls without COPD were enrolled in this study. COPD patients were grouped into four groups according to the Global Initiative for Chronic Obstructive Lung Disease Guidelines (GOLD). Both baPWV and ABI were evaluated. Spirometry indices, blood pressure, smoking history and related laboratory parameters were also collected. Comparing with controls, all COPD patients had significantly higher baPWV (1933 ± 355 cm/s versus 1515 ± 256 cm/s, P < 0.001) but not ABI (P = 0.196). And baPWV values were significantly highest at GOLD stage 4. Forced expiratory volume in 1 s (FEV1) was the most significant factor influencing baPWV, after adjusting for age, systolic blood pressure and other traditional cardiovascular risk factors (β = -0.463, P = 0.014). Arterial stiffness was serious in aged patients with COPD. Spirometry index FEV1 was a possible important predictor for the severity of arterial stiffness of COPD patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. The effects of load carriage on joint work at different running velocities.

    PubMed

    Liew, Bernard X W; Morris, Susan; Netto, Kevin

    2016-10-03

    Running with load carriage has become increasingly prevalent in sport, as well as many field-based occupations. However, the "sources" of mechanical work during load carriage running are not yet completely understood. The purpose of this study was to determine the influence of load magnitudes on the mechanical joint work during running, across different velocities. Thirty-one participants performed overground running at three load magnitudes (0%, 10%, 20% body weight), and at three velocities (3, 4, 5m/s). Three dimensional motion capture was performed, with synchronised force plate data captured. Inverse dynamics was used to quantify joint work in the stance phase of running. Joint work was normalized to a unit proportion of body weight and leg length (one dimensionless work unit=532.45J). Load significantly increased total joint work and total positive work and this effect was greater at faster velocities. Load carriage increased ankle positive work (β coefficient=rate of 6.95×10 -4 unit work per 1% BW carried), and knee positive (β=1.12×10 -3 unit) and negative work (β=-2.47×10 -4 unit), and hip negative work (β=-7.79×10 -4 unit). Load carriage reduced hip positive work and this effect was smaller at faster velocities. Inter-joint redistribution did not contribute significantly to altered mechanical work within the spectrum of load and velocity investigated. Hence, the ankle joint contributed to the greatest extent in work production, whilst that of the knee contributed to the greatest extent to work absorption when running with load. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Predictors of chronic ankle instability: Analysis of peroneal reaction time, dynamic balance and isokinetic strength.

    PubMed

    Sierra-Guzmán, Rafael; Jiménez, Fernando; Abián-Vicén, Javier

    2018-05-01

    Previous studies have reported the factors contributing to chronic ankle instability, which could lead to more effective treatments. However, factors such as the reflex response and ankle muscle strength have not been taken into account in previous investigations. Fifty recreational athletes with chronic ankle instability and 55 healthy controls were recruited. Peroneal reaction time in response to sudden inversion, isokinetic evertor muscle strength and dynamic balance with the Star Excursion Balance Test and the Biodex Stability System were measured. The relationship between the Cumberland Ankle Instability Tool score and performance on each test was assessed and a backward multiple linear regression analysis was conducted. Participants with chronic ankle instability showed prolonged peroneal reaction time, poor performance in the Biodex Stability System and decreased reach distance in the Star Excursion Balance Test. No significant differences were found in eversion and inversion peak torque. Moderate correlations were found between the Cumberland Ankle Instability Tool score and the peroneal reaction time and performance on the Star Excursion Balance Test. Peroneus brevis reaction time and the posteromedial and lateral directions of the Star Excursion Balance Test accounted for 36% of the variance in the Cumberland Ankle Instability Tool. Dynamic balance deficits and delayed peroneal reaction time are present in participants with chronic ankle instability. Peroneus brevis reaction time and the posteromedial and lateral directions of the Star Excursion Balance Test were the main contributing factors to the Cumberland Ankle Instability Tool score. No clear strength impairments were reported in unstable ankles. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Mechanical stability of the subtalar joint after lateral ligament sectioning and ankle brace application: a biomechanical experimental study.

    PubMed

    Kamiya, Tomoaki; Kura, Hideji; Suzuki, Daisuke; Uchiyama, Eiichi; Fujimiya, Mineko; Yamashita, Toshihiko

    2009-12-01

    The roles of each ligament supporting the subtalar joint have not been clarified despite several biomechanical studies. The effects of ankle braces on subtalar instability have not been shown. The ankle brace has a partial effect on restricting excessive motion of the subtalar joint. Controlled laboratory study. Ten normal fresh-frozen cadaveric specimens were used. The angular motions of the talus were measured via a magnetic tracking system. The specimens were tested while inversion and eversion forces, as well as internal and external rotation torques, were applied. The calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament were sectioned sequentially, and the roles of each ligament, as well as the stabilizing effects of the ankle brace, were examined. Complete sectioning of the ligaments increased the angle between the talus and calcaneus in the frontal plane to 51.7 degrees + or - 11.8 degrees compared with 35.7 degrees + or - 6.0 degrees in the intact state when inversion force was applied. There was a statistically significant difference in the angles between complete sectioning of the ligaments and after application of the brace (34.1 degrees + or - 7.3 degrees ) when inversion force was applied. On the other hand, significant differences in subtalar rotation were not found between complete sectioning of the ligaments and application of the brace when internal and external rotational torques were applied. The ankle brace limited inversion of the subtalar joint, but it did not restrict motion after application of internal or external rotational torques. In cases of severe ankle sprains involving the calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament injuries, application of an ankle brace might be less effective in limiting internal-external rotational instabilities than in cases of inversion instabilities in the subtalar joint. An improvement in the design of the brace is needed to restore

  17. Giant Cells Osseous Tumor in the Tarsal Canal after Lateral Ankle Sprain

    PubMed Central

    Lughi, Marcello

    2018-01-01

    Ankle sprain can cause injuries to the anatomic structures surrounding the tibiotarsal joint. A possible extra-articular pathology is to be hypothesized and diagnosed as early as possible. The subtalar joint, for anatomical and functional reasons, is one of the most damaged joints following an ankle sprain. In spite of this, its involvement is often underestimated. The clinical case presented in the present article is referred to a giant cells osseous tumor in the tarsal canal that was diagnosed 2 months after an inversion ankle sprain. PMID:29675509

  18. A mechanical jig for measuring ankle supination and pronation torque in vitro and in vivo.

    PubMed

    Fong, Daniel Tik-Pui; Chung, Mandy Man-Ling; Chan, Yue-Yan; Chan, Kai-Ming

    2012-07-01

    This study presents the design of a mechanical jig for evaluating the ankle joint torque on both cadaver and human ankles. Previous study showed that ankle sprain motion was a combination of plantarflexion and inversion. The device allows measurement of ankle supination and pronation torque with one simple axis in a single step motion. More importantly, the ankle orientation allows rotation starting from an anatomical position. Six cadaveric specimens and six human subjects were tested with simulated and voluntary rotation respectively. The presented mechanical jig makes possible the determination of supination torque for studying ankle sprain injury and the estimation of pronation torque for examining peroneal muscle response. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  19. Study protocol: the effect of whole body vibration on acute unilateral unstable lateral ankle sprain- a biphasic randomized controlled trial.

    PubMed

    Baumbach, Sebastian Felix; Fasser, Mariette; Polzer, Hans; Sieb, Michael; Regauer, Markus; Mutschler, Wolf; Schieker, Matthias; Blauth, Michael

    2013-01-14

    Ankle sprains often result in ankle instability, which is most likely caused by damage to passive structures and neuromuscular impairment. Whole body vibration (WBV) is a neuromuscular training method improving those impaired neurologic parameters. The aim of this study is to compare the current gold standard functional treatment to functional treatment plus WBV in patients with acute unilateral unstable inversion ankle sprains. 60 patients, aged 18-40 years, presenting with an isolated, unilateral, acute unstable inversion ankle sprain will be included in this bicentric, biphasic, randomized controlled trial. Samples will be randomized by envelope drawing. All patients will be allowed early mobilization and pain-dependent weight bearing, limited functional immobilization by orthosis, PRICE, NSARDs as well as home and supervised physiotherapy. Supervised physical therapy will take place twice a week, for 30 minutes for a period of 6 weeks, following a standardized intervention protocol. During supervised physical therapy, the intervention group will perform exercises similar to those of the control group, on a side-alternating sinusoidal vibration platform. Two time-dependent primary outcome parameters will be assessed: short-term outcome after six weeks will be postural control quantified by the sway index; mid-term outcome after one year will be assessed by subjective instability, defined by the presence of giving-way attacks. Secondary outcome parameters include: return to pre-injury level of activities, residual pain, recurrence, objective instability, energy/coordination, Foot and Ankle Disability Index and EQ 5D. This is the first trial investigating the effects of WBV in patients with acute soft tissue injury. Inversion ankle sprains often result in ankle instability, which is most likely due to damage of neurological structures. Due to its unique, frequency dependent, influence on various neuromuscular parameters, WBV is a promising treatment method for

  20. Study protocol: the effect of whole body vibration on acute unilateral unstable lateral ankle sprain- a biphasic randomized controlled trial

    PubMed Central

    2013-01-01

    Background Ankle sprains often result in ankle instability, which is most likely caused by damage to passive structures and neuromuscular impairment. Whole body vibration (WBV) is a neuromuscular training method improving those impaired neurologic parameters. The aim of this study is to compare the current gold standard functional treatment to functional treatment plus WBV in patients with acute unilateral unstable inversion ankle sprains. Methods/Design 60 patients, aged 18–40 years, presenting with an isolated, unilateral, acute unstable inversion ankle sprain will be included in this bicentric, biphasic, randomized controlled trial. Samples will be randomized by envelope drawing. All patients will be allowed early mobilization and pain-dependent weight bearing, limited functional immobilization by orthosis, PRICE, NSARDs as well as home and supervised physiotherapy. Supervised physical therapy will take place twice a week, for 30 minutes for a period of 6 weeks, following a standardized intervention protocol. During supervised physical therapy, the intervention group will perform exercises similar to those of the control group, on a side-alternating sinusoidal vibration platform. Two time-dependent primary outcome parameters will be assessed: short-term outcome after six weeks will be postural control quantified by the sway index; mid-term outcome after one year will be assessed by subjective instability, defined by the presence of giving-way attacks. Secondary outcome parameters include: return to pre-injury level of activities, residual pain, recurrence, objective instability, energy/coordination, Foot and Ankle Disability Index and EQ 5D. Discussion This is the first trial investigating the effects of WBV in patients with acute soft tissue injury. Inversion ankle sprains often result in ankle instability, which is most likely due to damage of neurological structures. Due to its unique, frequency dependent, influence on various neuromuscular parameters, WBV

  1. The effect of dual tasking on foot kinematics in people with functional ankle instability.

    PubMed

    Tavakoli, Sanam; Forghany, Saeed; Nester, Christopher

    2016-09-01

    Some cases of repeated inversion ankle sprains are thought to have a neurological basis and are termed functional ankle instability (FAI). In addition to factors local to the ankle, such as loss of proprioception, cognitive demands have the ability to influence motor control and may increase the risk of repetitive lateral sprains. The purpose of this study was to investigate the effect of cognitive demand on foot kinematics in physically active people with functional ankle instability. 21 physically active participants with FAI and 19 matched healthy controls completed trials of normal walking (single task) and normal walking while performing a cognitive task (dual task). Foot motion relative to the shank was recorded. Cognitive performance, ankle kinematics and movement variability in single and dual task conditions was characterized. During normal walking, the ankle joint was significantly more inverted in FAI compared to the control group pre and post initial contact. Under dual task conditions, there was a statistically significant increase in frontal plane foot movement variability during the period 200ms pre and post initial contact in people with FAI compared to the control group (p<0.05). Dual task also significantly increased plantar flexion and inversion during the period 200ms pre and post initial contact in the FAI group (p<0.05). participants with FAI demonstrated different ankle movement patterns and increased movement variability during a dual task condition. Cognitive load may increase risk of ankle instability in these people. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Postural stability and ankle sprain history in athletes compared to uninjured controls.

    PubMed

    Huurnink, Arnold; Fransz, Duncan P; Kingma, Idsart; Verhagen, Evert A L M; van Dieën, Jaap H

    2014-02-01

    Diminished postural stability is a risk factor for ankle sprain occurrence and ankle sprains result in impaired postural stability. To date, ankle sprain history has not been taken into account as a determinant of postural stability, while it could possibly specify subgroups of interest. Postural stability was compared between 18 field hockey athletes who had recovered from an ankle sprain (mean (SD); 3.6 (1.5) months post-injury), and 16 uninjured controls. Force plate and kinematics parameters were calculated during single-leg standing: mean center of pressure speed, mean absolute horizontal ground reaction force, mean absolute ankle angular velocity, and mean absolute hip angular velocity. Additionally, cluster analysis was applied to the 'injured' participants, and the cluster with diminished postural stability was compared to the other participants with respect to ankle sprain history. MANCOVA showed no significant difference between groups in postural stability (P = 0.68). A self-reported history of an (partial) ankle ligament rupture was typically present in the cluster with diminished postural stability. Subsequently, a 'preceding rupture' was added as a factor in the MANCOVA, which showed a significant association between diminished postural stability and a 'preceding rupture' (P = 0.01), for all four individual parameters (P: 0.001-0.029; Cohen's d: 0.96-2.23). Diminished postural stability is not apparent in all previously injured athletes. However, our analysis suggests that an (mild) ankle sprain with a preceding severe ankle sprain is associated with impaired balance ability. Therefore, sensorimotor training may be emphasized in this particular group and caution is warranted in return to play decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Delayed reconstruction of lateral complex structures of the ankle

    PubMed Central

    Slater, Gordon L; Pino, Alejandro E; O’Malley, Martin

    2011-01-01

    Lateral ankle instability is one of the most common and well-recognized conditions presenting to foot and ankle surgeons. It may exist as an isolated entity or in conjunction with other concomitant pathology, making it important to appropriately diagnose and identify other conditions that may need to be addressed as part of treatment. These associated conditions may be a source of chronic pain, even when the instability has been appropriately treated, or may lead to failure of treatment by predisposing the patient to ankle inversion injuries. The primary goal of this editorial is to provide a brief summary of the common techniques used in the delayed reconstruction of lateral ankle ligamentous injuries and present a method we have successfully employed for over 15 years. We will also briefly discuss the diagnosis and treatment of the more common associated conditions, which are important to identify to achieve satisfactory results for the patient. We present the outcomes of 250 consecutive reconstructions performed over the last 10 years and describe our operative technique for addressing lateral ankle ligamentous injuries. PMID:22474633

  4. Inferring Muscle-Tendon Unit Power from Ankle Joint Power during the Push-Off Phase of Human Walking: Insights from a Multiarticular EMG-Driven Model.

    PubMed

    Honert, Eric C; Zelik, Karl E

    2016-01-01

    Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs). However, such interpretations are confounded by multiarticular (multi-joint) musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions. The objective of this study was to investigate the degree to which ankle joint power overestimates net plantarflexor MTU power during the Push-off phase of walking, due to the behavior of the flexor digitorum and hallucis longus (FDHL)-multiarticular MTUs crossing the ankle and metatarsophalangeal (toe) joints. We performed a gait analysis study on six healthy participants, recording ground reaction forces, kinematics, and electromyography (EMG). Empirical data were input into an EMG-driven musculoskeletal model to estimate ankle power. This model enabled us to parse contributions from mono- and multi-articular MTUs, and required only one scaling and one time delay factor for each subject and speed, which were solved for based on empirical data. Net plantarflexing MTU power was computed by the model and quantitatively compared to inverse dynamics ankle power. The EMG-driven model was able to reproduce inverse dynamics ankle power across a range of gait speeds (R2 ≥ 0.97), while also providing MTU-specific power estimates. We found that FDHL dynamics caused ankle power to slightly overestimate net plantarflexor MTU power, but only by ~2-7%. During Push-off, FDHL MTU dynamics do not substantially confound the inference of net plantarflexor MTU power from inverse dynamics ankle power. However, other methodological limitations may cause inverse dynamics to overestimate net MTU power; for instance, due to rigid-body foot assumptions. Moving forward, the EMG-driven modeling approach presented

  5. A 4-week neuromuscular training program and gait patterns at the ankle joint.

    PubMed

    Coughlan, Garrett; Caulfield, Brian

    2007-01-01

    Previous research into the rehabilitation of ankle sprains has primarily focused on outcome measures that do not replicate functional activities, thus making it difficult to extrapolate the results relative to the weight-bearing conditions under which most ankle sprains occur. To measure the effects of a training program on gait during walking and running in an active athletic population. Matched-pairs, controlled trial. University motion analysis laboratory. Ten subjects from an athletic population (7 healthy, 3 with functional ankle instability: age = 25.8 +/- 3.9 years, height = 177.6 +/- 6.1 cm, mass = 66.8 +/- 7.4 kg) and 10 controls matched for age, sex, activity, and ankle instability (7 healthy, 3 with functional ankle instability: age = 27.4 +/- 5.8 years, height = 178.7 +/- 10.8 cm, mass = 71.6 +/- 10.0 kg). A 4-week neuromuscular training program undertaken by the treatment group. We measured ankle position and velocity in the frontal (x) and sagittal (y) planes in all subjects during treadmill walking and running for the periods 100 milliseconds before heel strike, at heel strike, and 100 milliseconds after heel strike. A 4-week neuromuscular training program resulted in no significant changes in ankle position or velocity during treadmill walking and running. The mechanisms by which neuromuscular training improves function in normal subjects and those with functional ankle instability do not appear to result in measurable changes in gait kinematics. Our findings raise issues regarding methods of ankle sprain rehabilitation and the measurement of their effectiveness in improving functional activities. Further research in a larger population with functional ankle instability is necessary.

  6. Ultra-low velocity zones beneath the Philippine and Tasman Seas revealed by a trans-dimensional Bayesian waveform inversion

    NASA Astrophysics Data System (ADS)

    Pachhai, Surya; Dettmer, Jan; Tkalčić, Hrvoje

    2015-11-01

    Ultra-low velocity zones (ULVZs) are small-scale structures in the Earth's lowermost mantle inferred from the analysis of seismological observations. These structures exhibit a strong decrease in compressional (P)-wave velocity, shear (S)-wave velocity, and an increase in density. Quantifying the elastic properties of ULVZs is crucial for understanding their physical origin, which has been hypothesized either as partial melting, iron enrichment, or a combination of the two. Possible disambiguation of these hypotheses can lead to a better understanding of the dynamic processes of the lowermost mantle, such as, percolation, stirring and thermochemical convection. To date, ULVZs have been predominantly studied by forward waveform modelling of seismic waves that sample the core-mantle boundary region. However, ULVZ parameters (i.e. velocity, density, and vertical and lateral extent) obtained through forward modelling are poorly constrained because inferring Earth structure from seismic observations is a non-linear inverse problem with inherent non-uniqueness. To address these issues, we developed a trans-dimensional hierarchical Bayesian inversion that enables rigorous estimation of ULVZ parameter values and their uncertainties, including the effects of model selection. The model selection includes treating the number of layers and the vertical extent of the ULVZ as unknowns. The posterior probability density (solution to the inverse problem) of the ULVZ parameters is estimated by reversible jump Markov chain Monte Carlo sampling that employs parallel tempering to improve efficiency/convergence. First, we apply our method to study the resolution of complex ULVZ structure (including gradually varying structure) by probabilistically inverting simulated noisy waveforms. Then, two data sets sampling the CMB beneath the Philippine and Tasman Seas are considered in the inversion. Our results indicate that both ULVZs are more complex than previously suggested. For the

  7. Biomechanical response to ankle-foot orthosis stiffness during running.

    PubMed

    Russell Esposito, Elizabeth; Choi, Harmony S; Owens, Johnny G; Blanck, Ryan V; Wilken, Jason M

    2015-12-01

    The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is an ankle-foot orthosis developed to address the high rates of delayed amputation in the military. Its use has enabled many wounded Service Members to run again. During running, stiffness is thought to influence an orthosis' energy storage and return mechanical properties. This study examined the effect of orthosis stiffness on running biomechanics in patients with lower limb impairments who had undergone unilateral limb salvage. Ten patients with lower limb impairments underwent gait analysis at a self-selected running velocity. 1. Nominal (clinically-prescribed), 2. Stiff (20% stiffer than nominal), and 3. Compliant (20% less stiff than nominal) ankle-foot orthosis stiffnesses were tested. Ankle joint stiffness was greatest in the stiffest strut and lowest in the compliant strut, however ankle mechanical work remained unchanged. Speed, stride length, cycle time, joint angles, moments, powers, and ground reaction forces were not significantly different among stiffness conditions. Ankle joint kinematics and ankle, knee and hip kinetics were different between limbs. Ankle power, in particular, was lower in the injured limb. Ankle-foot orthosis stiffness affected ankle joint stiffness but did not influence other biomechanical parameters of running in individuals with unilateral limb salvage. Foot strike asymmetries may have influenced the kinetics of running. Therefore, a range of stiffness may be clinically appropriate when prescribing ankle-foot orthoses for active individuals with limb salvage. Published by Elsevier Ltd.

  8. Development of a New Robotic Ankle Rehabilitation Platform for Hemiplegic Patients after Stroke

    PubMed Central

    Duan, Lihong

    2018-01-01

    A large amount of hemiplegic survivors are suffering from motor impairment. Ankle rehabilitation exercises act an important role in recovering patients' walking ability after stroke. Currently, patients mainly perform ankle exercise to reobtain range of motion (ROM) and strength of the ankle joint under a therapist's assistance by manual operation. However, therapists suffer from high work intensity, and most of the existed rehabilitation devices focus on ankle functional training and ignore the importance of neurological rehabilitation in the early hemiplegic stage. In this paper, a new robotic ankle rehabilitation platform (RARP) is proposed to assist patients in executing ankle exercise. The robotic platform consists of two three-DOF symmetric layer-stacking mechanisms, which can execute ankle internal/external rotation, dorsiflexion/plantarflexion, and inversion/eversion exercise while the rotation center of the distal zone of the robotic platform always coincides with patients' ankle pivot center. Three exercise modes including constant-speed exercise, constant torque-impedance exercise, and awareness exercise are developed to execute ankle training corresponding to different rehabilitation stages. Experiments corresponding to these three ankle exercise modes are performed, the result demonstrated that the RARP is capable of executing ankle rehabilitation, and the novel awareness exercise mode motivates patients to proactively participate in ankle training. PMID:29736231

  9. Improvement in gait following combined ankle and subtalar arthrodesis.

    PubMed

    Tenenbaum, Shay; Coleman, Scott C; Brodsky, James W

    2014-11-19

    This study assessed the hypothesis that arthrodesis of both the ankle and the hindfoot joints produces an objective improvement of function as measured by gait analysis of patients with severe ankle and hindfoot arthritis. Twenty-one patients with severe ankle and hindfoot arthritis who underwent unilateral tibiotalocalcaneal arthrodesis with an intramedullary nail were prospectively studied with three-dimensional (3D) gait analysis at a minimum of one year postoperatively. The mean age at the time of the operation was fifty-nine years, and the mean duration of follow-up was seventeen months (range, twelve to thirty-one months). Temporospatial measurements included cadence, step length, walking velocity, and total support time. The kinematic parameters were sagittal plane motion of the ankle, knee, and hip. The kinetic parameters were sagittal plane ankle power and moment and hip power. Symmetry of gait was analyzed by comparing the step lengths on the affected and unaffected sides. There was significant improvement in multiple parameters of postoperative gait as compared with the patients' own preoperative function. Temporospatial data showed significant increases in cadence (p = 0.03) and walking speed (p = 0.001) and decreased total support time (p = 0.02). Kinematic results showed that sagittal plane ankle motion had decreased, from 13.2° preoperatively to 10.2° postoperatively, in the operatively treated limb (p = 0.02), and increased from 22.2° to 24.1° (p = 0.01) in the contralateral limb. Hip motion on the affected side increased from 39° to 43° (p = 0.007), and knee motion increased from 56° to 60° (p = 0.054). Kinetic results showed significant increases in ankle moment (p < 0.0001) of the operatively treated limb, ankle power of the contralateral limb (p = 0.009), and hip power on the affected side (p = 0.005) postoperatively. There was a significant improvement in gait symmetry (p = 0.01). There was a small loss of sagittal plane motion in the

  10. A 4-Week Neuromuscular Training Program and Gait Patterns at the Ankle Joint

    PubMed Central

    Coughlan, Garrett; Caulfield, Brian

    2007-01-01

    Context: Previous research into the rehabilitation of ankle sprains has primarily focused on outcome measures that do not replicate functional activities, thus making it difficult to extrapolate the results relative to the weight-bearing conditions under which most ankle sprains occur. Objective: To measure the effects of a training program on gait during walking and running in an active athletic population. Design: Matched-pairs, controlled trial. Setting: University motion analysis laboratory. Patients or Other Participants: Ten subjects from an athletic population (7 healthy, 3 with functional ankle instability: age = 25.8 ± 3.9 years, height = 177.6 ± 6.1 cm, mass = 66.8 ± 7.4 kg) and 10 controls matched for age, sex, activity, and ankle instability (7 healthy, 3 with functional ankle instability: age = 27.4 ± 5.8 years, height = 178.7 ± 10.8 cm, mass = 71.6 ± 10.0 kg). Intervention(s): A 4-week neuromuscular training program undertaken by the treatment group. Main Outcome Measure(s): We measured ankle position and velocity in the frontal (x) and sagittal (y) planes in all subjects during treadmill walking and running for the periods 100 milliseconds before heel strike, at heel strike, and 100 milliseconds after heel strike. Results: A 4-week neuromuscular training program resulted in no significant changes in ankle position or velocity during treadmill walking and running. Conclusions: The mechanisms by which neuromuscular training improves function in normal subjects and those with functional ankle instability do not appear to result in measurable changes in gait kinematics. Our findings raise issues regarding methods of ankle sprain rehabilitation and the measurement of their effectiveness in improving functional activities. Further research in a larger population with functional ankle instability is necessary. PMID:17597944

  11. Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability

    PubMed Central

    Sousa, Andreia S. P.; Leite, João; Costa, Bianca; Santos, Rubim

    2017-01-01

    Context: Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. Objective: To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. Design: Cohort study. Setting: Research laboratory center in a university. Patients or Other Participants: Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. Main Outcome Measure(s): Ankle active and passive joint position sense, kinesthesia, and force sense. Results: We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). Conclusions: Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense. PMID:28318316

  12. Dynamic Postural-Stability Deficits After Cryotherapy to the Ankle Joint.

    PubMed

    Fullam, Karl; Caulfield, Brian; Coughlan, Garrett F; McGroarty, Mark; Delahunt, Eamonn

    2015-09-01

    Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however, its effects on postural stability remain unclear. To investigate the acute effects of a 15-minute ankle-joint cryotherapy application on dynamic postural stability. Controlled laboratory study. University biomechanics laboratory. A total of 29 elite-level collegiate male field-sport athletes (age = 20.8 ± 1.12 years, height = 1.80 ± 0.06 m, mass = 81.89 ± 8.59 kg) participated. Participants were tested on the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the Star Excursion Balance Test before and after a 15-minute ankle-joint cryotherapy application. Normalized reach distances; sagittal-plane kinematics of the hip, knee, and ankle joints; and associated mean velocity of the center-of-pressure path during performance of the ANT, PL, and PM reach directions of the Star Excursion Balance Test. We observed a decrease in reach-distance scores for the ANT, PL, and PM reach directions from precryotherapy to postcryotherapy (P < .05). No differences were observed in hip-, knee-, or ankle-joint sagittal-plane kinematics (P > .05). We noted a decrease in mean velocity of the center-of-pressure path from precryotherapy to postcryotherapy (P < .05) in all reach directions. Dynamic postural stability was adversely affected immediately after cryotherapy to the ankle joint.

  13. Resolving the fine-scale velocity structure of continental hyperextension at the Deep Galicia Margin using full-waveform inversion

    NASA Astrophysics Data System (ADS)

    Davy, R. G.; Morgan, J. V.; Minshull, T. A.; Bayrakci, G.; Bull, J. M.; Klaeschen, D.; Reston, T. J.; Sawyer, D. S.; Lymer, G.; Cresswell, D.

    2018-01-01

    Continental hyperextension during magma-poor rifting at the Deep Galicia Margin is characterized by a complex pattern of faulting, thin continental fault blocks and the serpentinization, with local exhumation, of mantle peridotites along the S-reflector, interpreted as a detachment surface. In order to understand fully the evolution of these features, it is important to image seismically the structure and to model the velocity structure to the greatest resolution possible. Traveltime tomography models have revealed the long-wavelength velocity structure of this hyperextended domain, but are often insufficient to match accurately the short-wavelength structure observed in reflection seismic imaging. Here, we demonstrate the application of 2-D time-domain acoustic full-waveform inversion (FWI) to deep-water seismic data collected at the Deep Galicia Margin, in order to attain a high-resolution velocity model of continental hyperextension. We have used several quality assurance procedures to assess the velocity model, including comparison of the observed and modeled waveforms, checkerboard tests, testing of parameter and inversion strategy and comparison with the migrated reflection image. Our final model exhibits an increase in the resolution of subsurface velocities, with particular improvement observed in the westernmost continental fault blocks, with a clear rotation of the velocity field to match steeply dipping reflectors. Across the S-reflector, there is a sharpening in the velocity contrast, with lower velocities beneath S indicative of preferential mantle serpentinization. This study supports the hypothesis that normal faulting acts to hydrate the upper-mantle peridotite, observed as a systematic decrease in seismic velocities, consistent with increased serpentinization. Our results confirm the feasibility of applying the FWI method to sparse, deep-water crustal data sets.

  14. Mechanical instability after an acute lateral ankle sprain.

    PubMed

    Hubbard, Tricia J; Cordova, Mitchell

    2009-07-01

    To examine the natural recovery of mechanical laxity after an ankle sprain over an 8-week period. Prospective cohort study. Biodynamics research laboratory. Subjects with an acute lateral ankle sprain (n=16; 7 men, 9 women; age, 19.5+/-0.7y; mass, 64.6+/-8.1 kg; height, 171.9+/-9.6 cm) and healthy controls (n=16; 7 men, 9 women; age, 20.4+/-1.7y; mass, 76.9+/-11.1 kg; height, 176.5+/-11.1 cm) participated. Not applicable. Subjects with acute ankle sprains were tested 3 days after injury and again 8 weeks later. Anterior and posterior displacement (mm) and inversion and eversion rotation ( degrees ) were measured with an instrumented arthrometer. For each dependent variable, a 2 x 2 x 2 repeated-measures multivariate analysis of variance was performed. A significant interaction was found between group, time, and side for anterior translation (F=4.24, P=.05). There were also significant main effects for group. There was significantly more anterior displacement at day 3 (F=19.52, P=.001) and at week 8 (F=8.45, P=.010) in the injured group compared with the healthy group. There was also significantly more inversion rotation at day 3 (F=2.70, P=.002) and at week 8 (F=5.4, P=.033) in the injured group compared with the healthy group. The lack of significant differences in mechanical laxity over an 8-week period suggests that natural recovery of laxity takes longer than 8 weeks. Further research needs to be conducted to examine how long this laxity persists and the role ankle rehabilitation plays in mechanical stability restoration.

  15. The role of series ankle elasticity in bipedal walking

    PubMed Central

    Zelik, Karl E.; Huang, Tzu-Wei P.; Adamczyk, Peter G.; Kuo, Arthur D.

    2014-01-01

    The elastic stretch-shortening cycle of the Achilles tendon during walking can reduce the active work demands on the plantarflexor muscles in series. However, this does not explain why or when this ankle work, whether by muscle or tendon, needs to be performed during gait. We therefore employ a simple bipedal walking model to investigate how ankle work and series elasticity impact economical locomotion. Our model shows that ankle elasticity can use passive dynamics to aid push-off late in single support, redirecting the body's center-of-mass (COM) motion upward. An appropriately timed, elastic push-off helps to reduce dissipative collision losses at contralateral heelstrike, and therefore the positive work needed to offset those losses and power steady walking. Thus, the model demonstrates how elastic ankle work can reduce the total energetic demands of walking, including work required from more proximal knee and hip muscles. We found that the key requirement for using ankle elasticity to achieve economical gait is the proper ratio of ankle stiffness to foot length. Optimal combination of these parameters ensures proper timing of elastic energy release prior to contralateral heelstrike, and sufficient energy storage to redirect the COM velocity. In fact, there exist parameter combinations that theoretically yield collision-free walking, thus requiring zero active work, albeit with relatively high ankle torques. Ankle elasticity also allows the hip to power economical walking by contributing indirectly to push-off. Whether walking is powered by the ankle or hip, ankle elasticity may aid walking economy by reducing collision losses. PMID:24365635

  16. The role of series ankle elasticity in bipedal walking.

    PubMed

    Zelik, Karl E; Huang, Tzu-Wei P; Adamczyk, Peter G; Kuo, Arthur D

    2014-04-07

    The elastic stretch-shortening cycle of the Achilles tendon during walking can reduce the active work demands on the plantarflexor muscles in series. However, this does not explain why or when this ankle work, whether by muscle or tendon, needs to be performed during gait. We therefore employ a simple bipedal walking model to investigate how ankle work and series elasticity impact economical locomotion. Our model shows that ankle elasticity can use passive dynamics to aid push-off late in single support, redirecting the body's center-of-mass (COM) motion upward. An appropriately timed, elastic push-off helps to reduce dissipative collision losses at contralateral heelstrike, and therefore the positive work needed to offset those losses and power steady walking. Thus, the model demonstrates how elastic ankle work can reduce the total energetic demands of walking, including work required from more proximal knee and hip muscles. We found that the key requirement for using ankle elasticity to achieve economical gait is the proper ratio of ankle stiffness to foot length. Optimal combination of these parameters ensures proper timing of elastic energy release prior to contralateral heelstrike, and sufficient energy storage to redirect the COM velocity. In fact, there exist parameter combinations that theoretically yield collision-free walking, thus requiring zero active work, albeit with relatively high ankle torques. Ankle elasticity also allows the hip to power economical walking by contributing indirectly to push-off. Whether walking is powered by the ankle or hip, ankle elasticity may aid walking economy by reducing collision losses. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.

    PubMed

    Hanlon, Shawn; Caccese, Jaclyn; Knight, Christopher A; Swanik, Charles Buz; Kaminski, Thomas W

    2016-02-01

    Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding. To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding. Cross-sectional study. Research laboratory. Thirty-three participants aged 20.2 ± 1.7 years were tested. The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded. Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV). Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversion-eversion motion was greater at 0° of knee flexion compared with 90° (P < .001). Additionally, peak EMG amplitude of the gastrocnemius was not different between 0° and 90° of knee flexion during anterior displacement (P = .101). As expected, the simulated muscle-guarding trial reduced anterior displacement compared with the relaxed condition (0° of knee flexion, P = .008; 90° of knee flexion, P = .016) and reduced inversion-eversion motion (0° of knee flexion, P = .03; 90° of knee flexion, P < .001). In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.

  18. Multi-segment foot landing kinematics in subjects with chronic ankle instability.

    PubMed

    De Ridder, Roel; Willems, Tine; Vanrenterghem, Jos; Robinson, Mark A; Palmans, Tanneke; Roosen, Philip

    2015-07-01

    Chronic ankle instability has been associated with altered joint kinematics at the ankle, knee and hip. However, no studies have investigated possible kinematic deviations at more distal segments of the foot. The purpose of this study was to evaluate if subjects with ankle instability and copers show altered foot and ankle kinematics and altered kinetics during a landing task when compared to controls. Ninety-six subjects (38 subjects with chronic ankle instability, 28 copers and 30 controls) performed a vertical drop and side jump task. Foot kinematics were obtained using the Ghent Foot Model and a single-segment foot model. Group differences were evaluated using statistical parametric mapping and analysis of variance. Subjects with ankle instability had a more inverted midfoot position in relation to the rearfoot when compared to controls during the side jump. They also had a greater midfoot inversion/eversion range of motion than copers during the vertical drop. Copers exhibited less plantar flexion/dorsiflexion range of motion in the lateral and medial forefoot. Furthermore, the ankle instability and coper group exhibited less ankle plantar flexion at touchdown. Additionally, the ankle instability group demonstrated a decreased plantar flexion/dorsiflexion range of motion at the ankle compared to the control group. Analysis of ground reaction forces showed a higher vertical peak and loading rate during the vertical drop in subjects with ankle instability. Subjects with chronic ankle instability displayed an altered, stiffer kinematic landing strategy and related alterations in landing kinetics, which might predispose them for episodes of giving way and actual ankle sprains. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. The preventive effect of a soccer-specific ankle brace on acute lateral ankle sprains in girls amateur soccer players: study protocol of a cluster-randomised controlled trial.

    PubMed

    Thijs, Karin; Huisstede, Bionka; Goedhart, Edwin; Backx, Frank

    2017-07-27

    Acute lateral ankle sprains are the single most often diagnosed injury in female soccer players and often result in an inability to play. This highlights the need for effective prevention strategies. Proprioceptive training and/or the use of an external support to decrease inversion of the ankle joint can prevent or reduce the number of acute lateral ankle sprains. The effectiveness of a soccer-specific ankle brace in reducing first-time and recurrent acute lateral ankle sprains has never been investigated in girl soccer players. If effective, ankle braces could be introduced into soccer. Cluster-randomised controlled trial. Girl amateur soccer players (aged 14-18 years) will be allocated to an intervention or control group. The intervention group will be instructed to wear soccer-specific ankle braces on both ankles during soccer training and matches; the control group will continue playing soccer as usual. Primary outcomes are the incidence and severity of acute lateral ankle sprains. Secondary outcomes are the prognostic value of generalised joint hypermobility and functional stability on the risk of acute lateral ankle sprains and compliance with the intervention. The findings from this study may provide evidence to support the use of a soccer-specific ankle brace to prevent lateral ankle sprains during soccer. We hypothesise that this brace will reduce the incidence of ankle sprains among young amateur girl soccer players by 50%. The prevention of such injuries will be beneficial to players, clubs and society. The Netherlands Trial Register (NTR): NTR6045; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Clinical examination and magnetic resonance imaging in the assessment of ankle sprains treated with an orthosis.

    PubMed

    De Simoni, C; Wetz, H H; Zanetti, M; Hodler, J; Jacob, H; Zollinger, H

    1996-03-01

    This is a prospective clinical study of treatment of ankle sprains with an ankle brace that permits ankle dorsiflexion and plantarflexion of 20 degrees, but limits inversion and eversion for 6 weeks. The ankle brace is followed by physiotherapy for another 6 weeks. Thirty patients were evaluated with clinical examination and magnetic resonance (MR) imaging before treatment and after 12 weeks of treatment. MR imaging revealed acute tears in the anterior talofibular ligament in all 30 ankles (100%) and tears in the calcaneofibular ligament in 25 of 30 ankles (83%). At 12 weeks after injury, MR evidence of healing was present for the anterior talofibular ligament in 22 of 30 ankles (73%) and for the calcaneofibular ligament in 23 of 25 ankles (92%). Postural sway analysis after therapy was used to quantify functional stability of the ankle. There was no correlation with MR findings, but there was a correlation with the subjective impression of functional instability. Twenty-eight of 30 patients (93%) had a functionally stable ankle after 12 weeks of treatment. MR findings after ankle sprain could not predict clinical outcome.

  1. Inferring Muscle-Tendon Unit Power from Ankle Joint Power during the Push-Off Phase of Human Walking: Insights from a Multiarticular EMG-Driven Model

    PubMed Central

    2016-01-01

    Introduction Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs). However, such interpretations are confounded by multiarticular (multi-joint) musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions. The objective of this study was to investigate the degree to which ankle joint power overestimates net plantarflexor MTU power during the Push-off phase of walking, due to the behavior of the flexor digitorum and hallucis longus (FDHL)–multiarticular MTUs crossing the ankle and metatarsophalangeal (toe) joints. Methods We performed a gait analysis study on six healthy participants, recording ground reaction forces, kinematics, and electromyography (EMG). Empirical data were input into an EMG-driven musculoskeletal model to estimate ankle power. This model enabled us to parse contributions from mono- and multi-articular MTUs, and required only one scaling and one time delay factor for each subject and speed, which were solved for based on empirical data. Net plantarflexing MTU power was computed by the model and quantitatively compared to inverse dynamics ankle power. Results The EMG-driven model was able to reproduce inverse dynamics ankle power across a range of gait speeds (R2 ≥ 0.97), while also providing MTU-specific power estimates. We found that FDHL dynamics caused ankle power to slightly overestimate net plantarflexor MTU power, but only by ~2–7%. Conclusions During Push-off, FDHL MTU dynamics do not substantially confound the inference of net plantarflexor MTU power from inverse dynamics ankle power. However, other methodological limitations may cause inverse dynamics to overestimate net MTU power; for instance, due to rigid-body foot assumptions. Moving

  2. Lithospheric structure beneath Eastern Africa from joint inversion of receiver functions and Rayleigh wave velocities

    NASA Astrophysics Data System (ADS)

    Dugda, Mulugeta Tuji

    Crust and upper mantle structure beneath eastern Africa has been investigated using receiver functions and surface wave dispersion measurements to understand the impact of the hotspot tectonism found there on the lithospheric structure of the region. In the first part of this thesis, I applied H-kappa stacking of receiver functions, and a joint inversion of receiver functions and Rayleigh wave group velocities to determine the crustal parameters under Djibouti. The two methods give consistent results. The crust beneath the GEOSCOPE station ATD has a thickness of 23+/-1.5 km and a Poisson's ratio of 0.31+/-0.02. Previous studies give crustal thickness beneath Djibouti to be between 8 and 10 km. I found it necessary to reinterprete refraction profiles for Djibouti from a previous study. The crustal structure obtained for ATD is similar to adjacent crustal structure in many other parts of central and eastern Afar. The high Poisson's ratio and Vp throughout most of the crust indicate a mafic composition, suggesting that the crust in Afar consists predominantly of new igneous rock emplaced during the late synrift stage where extension is accommodated within magmatic segments by diking. In the second part of this thesis, the seismic velocity structure of the crust and upper mantle beneath Ethiopia and Djibouti has been investigated by jointly inverting receiver functions and Rayleigh wave group velocities to obtain new constraints on the thermal structure of the lithosphere. Crustal structure from the joint inversion for Ethiopia and Djibouti is similar to previously published models. Beneath the Main Ethiopian Rift (MER) and Afar, the lithospheric mantle has a maximum shear wave velocity of 4.1-4.2 km/s and extends to a depth of at most 50 km. In comparison to the lithosphere away from the East African Rift System in Tanzania, where the lid extends to depths of ˜100-125 km and has a maximum shear velocity of 4.6 km/s, the mantle lithosphere under the Ethiopian Plateau

  3. Assessment of foot and ankle muscle strength using hand held dynamometry in patients with established rheumatoid arthritis.

    PubMed

    Carroll, Matthew; Joyce, William; Brenton-Rule, Angela; Dalbeth, Nicola; Rome, Keith

    2013-03-22

    The foot and ankle are frequently affected in patients with rheumatoid arthritis (RA). One of the negative consequences of RA on the physical function of patients is a decrease in muscle strength. However, little is known about foot and muscle strength in this population. The aim of the study was to evaluate significant differences in foot and ankle muscle strength between patients with established RA against age and sex-matched controls using hand-held dynamometry. The maximal muscle strength of ankle plantarflexion, dorsiflexion, eversion and inversion was assessed in 14 patients with RA, mean (SD) disease duration of 22 (14.1) years, and 20 age and sex-matched control participants using hand-held dynamometry. Significant differences were observed in muscle strength between the two groups in plantarflexion (p = 0.00), eversion (p = 0.04) and inversion (p = 0.01). No significant difference was found in dorsiflexion (p > 0.05). The patients with RA displayed a significantly lower plantarflexion-dorsiflexion ratio than the control participants (p = 0.03). The results from this study showed that the RA patients displayed a significant decrease in ankle dorsiflexion, eversion and inversion when compared to the non-RA control group suggesting that foot and ankle muscle strength may be affected by the pathological processes in RA. This study is a preliminary step for the measurement of muscle impairments within the RA population.

  4. Assessment of foot and ankle muscle strength using hand held dynamometry in patients with established rheumatoid arthritis

    PubMed Central

    2013-01-01

    Background The foot and ankle are frequently affected in patients with rheumatoid arthritis (RA). One of the negative consequences of RA on the physical function of patients is a decrease in muscle strength. However, little is known about foot and muscle strength in this population. The aim of the study was to evaluate significant differences in foot and ankle muscle strength between patients with established RA against age and sex-matched controls using hand-held dynamometry. Methods The maximal muscle strength of ankle plantarflexion, dorsiflexion, eversion and inversion was assessed in 14 patients with RA, mean (SD) disease duration of 22 (14.1) years, and 20 age and sex-matched control participants using hand-held dynamometry. Results Significant differences were observed in muscle strength between the two groups in plantarflexion (p = 0.00), eversion (p = 0.04) and inversion (p = 0.01). No significant difference was found in dorsiflexion (p > 0.05). The patients with RA displayed a significantly lower plantarflexion-dorsiflexion ratio than the control participants (p = 0.03). Conclusions The results from this study showed that the RA patients displayed a significant decrease in ankle dorsiflexion, eversion and inversion when compared to the non-RA control group suggesting that foot and ankle muscle strength may be affected by the pathological processes in RA. This study is a preliminary step for the measurement of muscle impairments within the RA population. PMID:23522448

  5. In Vivo Talocrural Joint Contact Mechanics With Functional Ankle Instability.

    PubMed

    Kobayashi, Takumi; Suzuki, Eiichi; Yamazaki, Naohito; Suzukawa, Makoto; Akaike, Atsushi; Shimizu, Kuniaki; Gamada, Kazuyoshi

    2015-12-01

    Functional ankle instability (FAI) may involve abnormal kinematics and contact mechanics during ankle internal rotation. Understanding of these abnormalities is important to prevent secondary problems in patients with FAI. However, there are no in vivo studies that have investigated talocrural joint contact mechanics during weightbearing ankle internal rotation. The objective of this study to determine talocrural contact mechanics during weightbearing ankle internal rotation in patients with FAI. Twelve male subjects with unilateral FAI (age range, 18-26 years) were enrolled. Computed tomography and fluoroscopic imaging of both lower extremities were obtained during weightbearing passive ankle joint complex rotation. Three-dimensional bone models created from the computed tomographic images were matched to the fluoroscopic images to compute 6 degrees of freedom for talocrural joint kinematics. The closest contact area in the talocrural joint in ankle neutral rotation and maximum internal rotation during either dorsiflexion or plantar flexion was determined using geometric bone models and talocrural joint kinematics data. The closest contact area in the talus shifted anteromedially during ankle dorsiflexion-internal rotation, whereas it shifted posteromedially during ankle plantar flexion-internal rotation. The closest contact area in FAI joints was significantly more medial than that in healthy joints during maximum ankle internal rotation and was associated with excessive talocrural internal rotation or inversion. This study demonstrated abnormal talocrural kinematics and contact mechanics in FAI subjects. Such abnormal kinematics may contribute to abnormal contact mechanics and may increase cartilage stress in FAI joints. Therapeutic, Level IV: cross-sectional case-control study. © 2015 The Author(s).

  6. Lithospheric Structure of Arabia from the Joint Inversion of P- and S-wave Receiver Functions and Dispersion Velocities

    NASA Astrophysics Data System (ADS)

    Julia, Jordi; Al-Amri, Abdullah; Pasyanos, Michael; Rodgers, Arthur; Matzel, Eric; Nyblade, Andrew

    2013-04-01

    Seismic imaging of the lithosphere under the Arabian shield and platform is critical to help answer important geologic questions of regional and global interest. The Arabian Shield can be regarded as an amalgamation of several arcs and microplates of Proterozoic age that culminated in the accretion of the Arabian portion of Gondwana during the Pan-African event at ~550 Ma and the role of important geologic features observed on the surface - such as the lineaments and shear zones separating the Proterozoic terrains in the shield - is not completely understood. Also, current models of Precambrian crustal evolution predict that Proterozoic terranes are underlain by fertile (FeO-rich) cratonic roots that should promote the production of mafic magmas and underplating of the Arabian shield terranes, and the shield contains Tertiary and Quaternary volcanic rocks related to the early stages of the Red Sea formation that might also be related to plume-related lithospheric "erosion". In order to better understand these relationships, we are developing new velocity models of litospheric structure for the Arabian shield and platform from the joint inversion of up to four seismic data sets: P-wave receiver functions, S-wave receiver functions, dispersion velocities from surface-waves, and dispersion velocities from ambient-noise cross-correlations. The joint inversion combines constraints on crustal thickness from P-wave receiver functions, constraints on lithospheric thickness from S-wave receiver functions and constraints on S-velocity and S-velocity gradients from dispersion velocities to produce detailed S-velocity profiles under single recording stations. We will present S-velocity profiles for a number of permanent stations operated by the Saudi Geological Survey and the King ing Abdulaziz Center for Science and Technology as well as stations from past temporary deployments and discuss the implications of the velocity models regarding composition and tectonics of the

  7. Shear wave velocity model beneath CBJI station West Java, Indonesia from joint inversion of teleseismic receiver functions and surface wave dispersion

    NASA Astrophysics Data System (ADS)

    Simanungkalit, R. H.; Anggono, T.; Syuhada; Amran, A.; Supriyanto

    2018-03-01

    Earthquake signal observations around the world allow seismologists to obtain the information of internal structure of the Earth especially the Earth’s crust. In this study, we used joint inversion of receiver functions and surface wave group velocities to investigate crustal structure beneath CBJI station in West Java, Indonesia. Receiver function were calculated from earthquakes with magnitude more than 5 and at distance 30°-90°. Surface wave group velocities were calculated using frequency time analysis from earthquakes at distance of 30°- 40°. We inverted shear wave velocity model beneath the station by conducting joint inversion from receiver functions and surface wave dispersions. We suggest that the crustal thickness beneath CBJI station, West Java, Indonesia is about 35 km.

  8. Dynamic Postural-Stability Deficits After Cryotherapy to the Ankle Joint

    PubMed Central

    Fullam, Karl; Caulfield, Brian; Coughlan, Garrett F.; McGroarty, Mark; Delahunt, Eamonn

    2015-01-01

    Context  Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however, its effects on postural stability remain unclear. Objective  To investigate the acute effects of a 15-minute ankle-joint cryotherapy application on dynamic postural stability. Design  Controlled laboratory study. Setting  University biomechanics laboratory. Patients or Other Participants  A total of 29 elite-level collegiate male field-sport athletes (age = 20.8 ± 1.12 years, height = 1.80 ± 0.06 m, mass = 81.89 ± 8.59 kg) participated. Intervention(s)  Participants were tested on the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the Star Excursion Balance Test before and after a 15-minute ankle-joint cryotherapy application. Main Outcome Measure(s)  Normalized reach distances; sagittal-plane kinematics of the hip, knee, and ankle joints; and associated mean velocity of the center-of-pressure path during performance of the ANT, PL, and PM reach directions of the Star Excursion Balance Test. Results  We observed a decrease in reach-distance scores for the ANT, PL, and PM reach directions from precryotherapy to postcryotherapy (P < .05). No differences were observed in hip-, knee-, or ankle-joint sagittal-plane kinematics (P > .05). We noted a decrease in mean velocity of the center-of-pressure path from precryotherapy to postcryotherapy (P < .05) in all reach directions. Conclusions  Dynamic postural stability was adversely affected immediately after cryotherapy to the ankle joint. PMID:26285088

  9. Locomotive biomechanics in persons with chronic ankle instability and lateral ankle sprain copers.

    PubMed

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2016-07-01

    To compare the locomotive biomechanics of participants with chronic ankle instability (CAI) to those of lateral ankle sprain (LAS) copers. Cross-sectional study. Twenty-eight participants with CAI and 42 LAS copers each performed 5 self-selected paced gait trials. 3-D lower extremity temporal kinematic and kinetic data were collected for these participants from 200ms pre- to 200ms post-heel strike (period 1) and from 200ms pre- to 200ms post-toe off (period 2). The CAI group displayed increased hip flexion bilaterally during period 1 compared to LAS copers. During period 2, CAI participants exhibited reduced hip extension bilaterally, increased knee flexion bilaterally and increased ankle inversion on the 'involved' limb. They also displayed a bilateral decrease in the flexor moment pattern at the knee. Considering that all of the features which distinguished CAI participants from LAS copers were also evident in our previously published research (within 2-weeks following acute first-time LAS); these findings establish a potential link between these features and long-term outcome following first-time LAS. Clinicians must be cognizant of the capacity for these movement and motor control impairments to cascade proximally from the injured joint up the kinetic chain and recognise the value that gait re-training may have in rehabilitation planning to prevent CAI. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. Effect of Wiihabilitation on strength ratio of ankle muscles in adults

    PubMed Central

    Khalil, Aya A.; Mohamed, Ghada A.; El Rahman, Soheir M. Abd; Elhafez, Salam M.; Nassif, Nagui S.

    2016-01-01

    [Purpose] This study was conducted to investigate the effect of Wiihabilitation on the ankle dorsiflexion/plantar flexion strength ratio in adults. [Subjects and Methods] Thirty-two healthy male volunteers were randomly assigned to two equal groups (experimental and control). Participants in the experimental group received a Wiihabilitation training program for six weeks. Data were collected using a Biodex system 3 Isokinetic dynamometer. Peak torques of the dorsiflexors and plantar flexors were measured at an angular velocity of 60°/sec which in turn were used to derive the ankle dorsiflexion/plantar flexion strength ratio. [Results] The mean values of the ankle dorsiflexion/plantar flexion strength ratio decreased significantly between before and after the training in the experimental group, meanwhile there was no significant difference between before and after the training period in the control group . [Conclusion] Wiihabilitation has an impact on the ankle dorsiflexion/plantar flexion strength ratio, so it can be considered an effective training tool in terms of the ankle strength ratio. Thus, it could be recommended for both prevention and rehabilitation of ankle instability patients. PMID:27821951

  11. Effect of Wiihabilitation on strength ratio of ankle muscles in adults.

    PubMed

    Khalil, Aya A; Mohamed, Ghada A; El Rahman, Soheir M Abd; Elhafez, Salam M; Nassif, Nagui S

    2016-10-01

    [Purpose] This study was conducted to investigate the effect of Wiihabilitation on the ankle dorsiflexion/plantar flexion strength ratio in adults. [Subjects and Methods] Thirty-two healthy male volunteers were randomly assigned to two equal groups (experimental and control). Participants in the experimental group received a Wiihabilitation training program for six weeks. Data were collected using a Biodex system 3 Isokinetic dynamometer. Peak torques of the dorsiflexors and plantar flexors were measured at an angular velocity of 60°/sec which in turn were used to derive the ankle dorsiflexion/plantar flexion strength ratio. [Results] The mean values of the ankle dorsiflexion/plantar flexion strength ratio decreased significantly between before and after the training in the experimental group, meanwhile there was no significant difference between before and after the training period in the control group . [Conclusion] Wiihabilitation has an impact on the ankle dorsiflexion/plantar flexion strength ratio, so it can be considered an effective training tool in terms of the ankle strength ratio. Thus, it could be recommended for both prevention and rehabilitation of ankle instability patients.

  12. Estimation of pseudo-2D shear-velocity section by inversion of high frequency surface waves

    USGS Publications Warehouse

    Luo, Y.; Liu, J.; Xia, J.; Xu, Y.; Liu, Q.

    2006-01-01

    A scheme to generate pseudo-2D shear-velocity sections with high horizontal resolution and low field cost by inversion of high frequency surface waves is presented. It contains six steps. The key step is the joint method of crossed correlation and phase shift scanning. This joint method chooses only two traces to generate image of dispersion curve. For Rayleigh-wave dispersion is most important for estimation of near-surface shear-wave velocity, it can effectively obtain reliable images of dispersion curves with a couple of traces. The result of a synthetic example shows the feasibility of this scheme. ?? 2005 Society of Exploration Geophysicists.

  13. Simulation of an ankle rehabilitation system based on scotch- yoke mechanism

    NASA Astrophysics Data System (ADS)

    Racu (Cazacu, C. M.; Doroftei, I.; Plesu, Ghe; Doroftei, I. A.

    2016-08-01

    Due to injuries that occur on the ankle joint, everyday all around the world, more and more rehabilitation devices have been developed in recent years. The prices for ankle rehabilitation systems are still high, thus we developed a new device that we indented to be low cost and easy to manufacture. A model of an ankle rehabilitation device is presented in this paper. The device has two degrees of freedom, for flexion-extension and inversion-eversion move, and will ensure functionality with minimum dimensions. For the 3D model that we design, the dimensions are taken so that the proposed system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg.

  14. Ankle joint distraction arthroplasty for severe ankle arthritis.

    PubMed

    Xu, Yang; Zhu, Yuan; Xu, Xiang-Yang

    2017-02-28

    Ankle distraction arthroplasty is one option for the treatment of severe ankle arthritis in young patients. The outcomes and factors predicting success in distraction arthroplasty are poorly understood. From January 2011 to May 2015, 16 patients who had undergone ankle distraction arthroplasty for ankle arthritis were operated, including six males and ten females. All patients were available for analysis. The main outcome measurements included joint space on weight bearing radiographs, AOFAS-AH scores (American Orthopaedic Foot & Ankle Society ankle-hindfoot score), VAS scores and SF-36 scores. All 16 patients were followed for a mean follow-up of 40.9 ± 14.7 months (range, 17-67 months). Fourteen of the 16 patients still had their native ankle joints. One patient had undergone ankle arthrodesis 1 year after the operation and one patient had converted to spontaneous ankle fusion at the 3 years follow-up postoperative. The VAS score improved from 5.9 ± 0.8 to 3.7 ± 2.2 (p = 0.0028). The mean AOFAS-AH score improved from 41.9 ± 7.2 preoperatively to 68.1 ± 20.0 postoperatively (p = 0.001). The mean SF-36 score improved from 43.1 ± 7.6 preoperatively to 62.7 ± 18.8 postoperatively (p = 0.002). A weight-bearing ankle space larger than 3 mm at 1 year following distraction is a positive predictive factor. In this study, the treatment of ankle motion distraction for end stage ankle arthritis showed benefit in 9/16 (56.25%) patients at 41 months. It is a promising method for young patients with severe ankle arthritis.

  15. Lateral and syndesmotic ankle sprain injuries: a narrative literature review

    PubMed Central

    Dubin, Joshua C.; Comeau, Doug; McClelland, Rebecca I.; Dubin, Rachel A.; Ferrel, Ernest

    2011-01-01

    Objective The purpose of this article is to review the literature that discusses normal anatomy and biomechanics of the foot and ankle, mechanisms that may result in a lateral ankle sprain or syndesmotic sprain, and assessment and diagnostic procedures, and to present a treatment algorithm based on normal ligament healing principles. Methods Literature was searched for years 2000 to 2010 in PubMed and CINAHL. Key search terms were ankle sprain$, ankle injury and ankle injuries, inversion injury, proprioception, rehabilitation, physical therapy, anterior talofibular ligament, syndesmosis, syndesmotic injury, and ligament healing. Discussion Most ankle sprains respond favorably to nonsurgical treatment, such as those offered by physical therapists, doctors of chiropractic, and rehabilitation specialists. A comprehensive history and examination aid in diagnosing the severity and type of ankle sprain. Based on the diagnosis and an understanding of ligament healing properties, a progressive treatment regimen can be developed. During the acute inflammatory phase, the goal of care is to reduce inflammation and pain and to protect the ligament from further injury. During the reparative and remodeling phase, the goal is to progress the rehabilitation appropriately to facilitate healing and restore the mechanical strength and proprioception. Radiographic imaging techniques may need to be used to rule out fractures, complete ligament tears, or instability of the ankle mortise. A period of immobilization and ambulating with crutches in a nonweightbearing gait may be necessary to allow for proper ligament healing before commencing a more active treatment approach. Surgery should be considered in the case of grade 3 syndesmotic sprain injuries or those ankle sprains that are recalcitrant to conservative care. Conclusion An accurate diagnosis and prompt treatment can minimize an athlete's time lost from sport and prevent future reinjury. Most ankle sprains can be successfully

  16. Determination of consistent patterns of range of motion in the ankle joint with a computed tomography stress-test.

    PubMed

    Tuijthof, Gabriëlle Josephine Maria; Zengerink, Maartje; Beimers, Lijkele; Jonges, Remmet; Maas, Mario; van Dijk, Cornelis Niek; Blankevoort, Leendert

    2009-07-01

    Measuring the range of motion of the ankle joint can assist in accurate diagnosis of ankle laxity. A computed tomography-based stress-test (3D CT stress-test) was used that determines the three-dimensional position and orientation of tibial, calcaneal and talar bones. The goal was to establish a quantitative database of the normal ranges of motion of the talocrural and subtalar joints. A clinical case on suspected subtalar instability demonstrated the relevance the proposed method. The range of motion was measured for the ankle joints in vivo for 20 subjects using the 3D CT stress-test. Motion of the tibia and calcaneus relative to the talus for eight extreme foot positions were described by helical parameters. High consistency for finite helical axis orientation (n) and rotation (theta) was shown for: talocrural extreme dorsiflexion to extreme plantarflexion (root mean square direction deviation (eta) 5.3 degrees and theta: SD 11.0 degrees), talorucral and subtalar extreme combined eversion-dorsiflexion to combined inversion-plantarflexion (eta: 6.7 degrees , theta: SD 9.0 degrees and eta:6.3 degrees , theta: SD 5.1 degrees), and subtalar extreme inversion to extreme eversion (eta: 6.4 degrees, theta: SD 5.9 degrees). Nearly all dorsi--and plantarflexion occurs in the talocrural joint (theta: mean 63.3 degrees (SD 11 degrees)). The inversion and internal rotation components for extreme eversion to inversion were approximately three times larger for the subtalar joint (theta: mean 22.9 degrees and 29.1 degrees) than for the talocrural joint (theta: mean 8.8 degrees and 10.7 degrees). Comparison of the ranges of motion of the pathologic ankle joint with the healthy subjects showed an increased inversion and axial rotation in the talocrural joint instead of in the suspected subtalar joint. The proposed diagnostic technique and the acquired database of helical parameters of ankle joint ranges of motion are suitable to apply in clinical cases.

  17. The role of the medial ligaments in lateral stabilization of the ankle joint: an in vitro study.

    PubMed

    Ziai, Pejman; Benca, Emir; Skrbensky, Gobert V; Wenzel, Florian; Auffarth, Alexander; Krpo, Selma; Windhager, Reinhard; Buchhorn, Tomas

    2015-07-01

    The deltoid ligament complex is known as medial stabilizer in the ankle against pronation/eversion. Lateral dual-ligament laxity often results in chronic ankle instability with recurring ankle sprain trauma. The goal of this study is to examine the lateral stabilizing role of the deltoid ligament complex against supination/inversion in case of existing lateral ligament instability. A torsion simulation was performed on 12 fresh human lower leg cadaver specimens in a loading frame and a specially designed mounting platform. The preset torsion between tibia and calcaneus was primarily set at 30° of internal rotation on specimen in plantar flexion and hindfoot inversion. The measured variable was the resisting torque recorded around mechanical tibial axis, which ensures stability in ankle sprain trauma. The first series of measurements were performed on healthy specimens and the following after transecting structures in following order: anterior talofibular ligament (ATFL) in combination with calcaneofibular ligament (CFL), followed by anterior tibiotalar ligament and posterior tibiotalar ligament and finally tibiocalcaneal ligament (TCL). The combined lateral ATFL and CFL instability showed a decrease in the resisting torque, which ensures stability in ankle sprain trauma. Only a transection of TCL (superficial layer of deltoid ligament complex) with existing lateral dual-ligament instability results in a significant decrease in torque (p<0.0001). The goal of the study was to provide the orthopaedic and/or trauma surgeon with quantitative data that may be referred to the substantial stabilizing effect of TCL against supination/inversion in the ankle joint in case of repetitive sprain trauma at a present lateral ligament lesion. Diagnostics of and treatment for lateral ligament instability need to consider the deltoid ligament complex,especially TCL in clinical routine.

  18. Ankle and hip postural strategies defined by joint torques

    NASA Technical Reports Server (NTRS)

    Runge, C. F.; Shupert, C. L.; Horak, F. B.; Zajac, F. E.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    Previous studies have identified two discrete strategies for the control of posture in the sagittal plane based on EMG activations, body kinematics, and ground reaction forces. The ankle strategy was characterized by body sway resembling a single-segment-inverted pendulum and was elicited on flat support surfaces. In contrast, the hip strategy was characterized by body sway resembling a double-segment inverted pendulum divided at the hip and was elicited on short or compliant support surfaces. However, biomechanical optimization models have suggested that hip strategy should be observed in response to fast translations on a flat surface also, provided the feet are constrained to remain in contact with the floor and the knee is constrained to remain straight. The purpose of this study was to examine the experimental evidence for hip strategy in postural responses to backward translations of a flat support surface and to determine whether analyses of joint torques would provide evidence for two separate postural strategies. Normal subjects standing on a flat support surface were translated backward with a range of velocities from fast (55 cm/s) to slow (5 cm/s). EMG activations and joint kinematics showed pattern changes consistent with previous experimental descriptions of mixed hip and ankle strategy with increasing platform velocity. Joint torque analyses revealed the addition of a hip flexor torque to the ankle plantarflexor torque during fast translations. This finding indicates the addition of hip strategy to ankle strategy to produce a continuum of postural responses. Hip torque without accompanying ankle torque (pure hip strategy) was not observed. Although postural control strategies have previously been defined by how the body moves, we conclude that joint torques, which indicate how body movements are produced, are useful in defining postural control strategies. These results also illustrate how the biomechanics of the body can transform discrete control

  19. Assessment of ankle and hindfoot stability and joint pressures using a human cadaveric model of a large lateral talar process excision: a biomechanical study.

    PubMed

    Sands, Andrew; White, Charles; Blankstein, Michael; Zderic, Ivan; Wahl, Dieter; Ernst, Manuela; Windolf, Markus; Hagen, Jennifer E; Richards, R Geoff; Stoffel, Karl; Gueorguiev, Boyko

    2015-03-01

    Lateral talar process fragment excision may be followed by hindfoot instability and altered biomechanics. There is controversy regarding the ideal fragment size for internal fixation versus excision and a concern that excision of a large fragment may lead to significant instability. The aim of this study was to assess the effect of a simulated large lateral talar process excision on ankle and subtalar joint stability.A custom-made seesaw rig was designed to apply inversion/eversion stress loading on 7 fresh-frozen human cadaveric lower legs and investigate them in pre-excision, 5 cm and 10 cm lateral talar process fragment excision states. Anteroposterior radiographs were taken to assess ankle and subtalar joint tilt and calculate angular change from neutral hindfoot alignment to 10-kg forced inversion/eversion. Ankle joint pressures and contact areas were measured under 30-kg axial load in neutral hindfoot alignment.In comparison to the pre-excision state, no significantly different mediolateral angular change was observed in the subtalar joint after 5 and 10 cm lateral talar process fragment excision in inversion and eversion. With respect to the ankle joint, 10-cm fragment excision produced significantly bigger inversion tibiotalar tilt compared with the pre-excision state, P = .04. No significant change of the ankle joint pressure and contact area was detected after 5 and 10-cm excision in comparison with the pre-excison state.An excision of up to 10 cm of the lateral talar process does not cause a significant instability at the level of the subtalar joint but might be a destabilizing factor at the ankle joint under inversion stress. The latter could be related to extensive soft tissue dissection required for resection.

  20. Ankle Joint Intrinsic Dynamics is More Complex than a Mass-Spring-Damper Model.

    PubMed

    Sobhani Tehrani, Ehsan; Jalaleddini, Kian; Kearney, Robert E

    2017-09-01

    This paper describes a new small signal parametric model of ankle joint intrinsic mechanics in normal subjects. We found that intrinsic ankle mechanics is a third-order system and the second-order mass-spring-damper model, referred to as IBK, used by many researchers in the literature cannot adequately represent ankle dynamics at all frequencies in a number of important tasks. This was demonstrated using experimental data from five healthy subjects with no voluntary muscle contraction and at seven ankle positions covering the range of motion. We showed that the difference between the new third-order model and the conventional IBK model increased from dorsi to plantarflexed position. The new model was obtained using a multi-step identification procedure applied to experimental input/output data of the ankle joint. The procedure first identifies a non-parametric model of intrinsic joint stiffness where ankle position is the input and torque is the output. Then, in several steps, the model is converted into a continuous-time transfer function of ankle compliance, which is the inverse of stiffness. Finally, we showed that the third-order model is indeed structurally consistent with agonist-antagonist musculoskeletal structure of human ankle, which is not the case for the IBK model.

  1. Clinically-evident tophi are associated with reduced muscle force in the foot and ankle in people with gout: a cross-sectional study.

    PubMed

    Stewart, Sarah; Dalbeth, Nicola; Otter, Simon; Gow, Peter; Kumar, Sunil; Rome, Keith

    2017-01-01

    The foot and ankle represent a common site for tophi in people with gout, yet it is unclear whether the presence of tophi is related to impaired muscle function. This study aimed to determine the association between foot and ankle tophi and muscle force in people with gout. Participants with gout were stratified into two groups based on the presence of clinically-evident tophi affecting the foot or ankle on physical examination. Isometric muscle force for plantarflexion, dorsiflexion, inversion and eversion was measured using static dynamometry. Mixed-models regression was used to determine the difference in muscle force between the two groups while adjusting for age, disease duration and foot pain. This model was also used to determine the difference in muscle force between presence and absence of tophi at specific locations within the foot and ankle. In addition, Pearson's correlations were used to determine the association between total foot tophus count and muscle force. Fifty-seven participants were included (22 with foot or ankle tophi and 35 without foot or ankle tophi). Foot and ankle tophi were most often seen at the Achilles tendon. After adjusting for age, disease duration and foot pain, participants with tophi had significantly reduced muscle force during plantarflexion ( P  < 0.001), dorsiflexion ( P  = 0.003), inversion ( P  = 0.003) and eversion ( P  = 0.001) when compared to participants without tophi. Those with Achilles tophi had significantly reduced force during plantarflexion ( P  < 0.001), inversion ( P  = 0.008) and eversion ( P  = 0.001). No significant differences in muscle force were observed between the presence and absence of tophi at other foot or ankle locations. There were also no significant correlations between total foot tophus count and muscle force (all P  > 0.05). In people with gout, clinically-evident foot or ankle tophi are associated with muscle force deficits during foot plantarflexion, dorsiflexion

  2. Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding

    PubMed Central

    Hanlon, Shawn; Caccese, Jaclyn; Knight, Christopher A.; Swanik, Charles “Buz”; Kaminski, Thomas W.

    2016-01-01

    Context:  Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding. Objectives:  To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding. Design:  Cross-sectional study. Setting:  Research laboratory. Patients or Other Participants:  Thirty-three participants aged 20.2 ± 1.7 years were tested. Intervention(s):  The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded. Main Outcome Measure(s):  Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV). Results:  Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversion-eversion motion was greater at 0° of knee flexion compared with 90° (P < .001). Additionally, peak EMG amplitude of the gastrocnemius was not different between 0° and 90° of knee flexion during anterior displacement (P = .101). As expected, the simulated muscle-guarding trial reduced anterior displacement compared with the relaxed condition (0° of knee flexion, P = .008; 90° of knee flexion, P = .016) and reduced inversion-eversion motion (0° of knee flexion, P = .03; 90° of knee flexion, P < .001). Conclusions:  In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when

  3. Ankle instability.

    PubMed

    Ferran, Nicholas A; Oliva, Francesco; Maffulli, Nicola

    2009-06-01

    Acute ankle sprains are common, and if inadequately treated may result in chronic instability. Lateral ankle injuries are most common, with deltoid injuries rare and associated with ankle fractures/dislocation. Medial ankle instability is rare. Functional management of acute lateral ankle sprains is the treatment of choice, with acute ligament repair reserved for athletes. Chronic lateral ankle instability is initially managed conservatively, however, failure of rehabilitation is an indication for surgical management. Nonanatomic tenodesis reconstructions have poor long-term results, sacrifice peroneal tendons, and disrupt normal ankle and hindfoot biomechanics. Anatomic repair of the anterior talofibular and calcaneofibular ligaments is recommended when the quality of the ruptured ligaments permits. Anatomic reconstruction with autograft or allograft should be performed when ligaments are attenuated. The role of arthroscopic reconstruction is evolving. Ankle arthroscopy should be performed at the time of repair or reconstruction and should address any other intra-articular causes of pain.

  4. Gulf stream velocity structure through combined inversion of hydrographic and acoustic Doppler data

    NASA Technical Reports Server (NTRS)

    Pierce, S. D.

    1986-01-01

    Near-surface velocities from an acoustic Doppler instrument are used in conjunction with CTD/O2 data to produce estimates of the absolute flow field off Cape Hatteras. The data set consists of two transects across the Gulf Stream made by the R/V Endeavor cruise EN88 in August 1982. An inverse procedure is applied which makes use of both the acoustic Doppler data and property conservation constraints. Velocity sections at approximately 73 deg. W and 71 deg. W are presented with formal errors of 1-2 cm/s. The net Gulf Stream transports are estimated to be 116 + or - 2 Sv across the south leg and 161 + or - 4 Sv across the north. A Deep Western Boundary Current transport of 4 + or - 1 Sv is also estimated. While these values do not necessarily represent the mean, they are accurate estimates of the synoptic flow field in the region.

  5. Fast simulated annealing inversion of surface waves on pavement using phase-velocity spectra

    USGS Publications Warehouse

    Ryden, N.; Park, C.B.

    2006-01-01

    The conventional inversion of surface waves depends on modal identification of measured dispersion curves, which can be ambiguous. It is possible to avoid mode-number identification and extraction by inverting the complete phase-velocity spectrum obtained from a multichannel record. We use the fast simulated annealing (FSA) global search algorithm to minimize the difference between the measured phase-velocity spectrum and that calculated from a theoretical layer model, including the field setup geometry. Results show that this algorithm can help one avoid getting trapped in local minima while searching for the best-matching layer model. The entire procedure is demonstrated on synthetic and field data for asphalt pavement. The viscoelastic properties of the top asphalt layer are taken into account, and the inverted asphalt stiffness as a function of frequency compares well with laboratory tests on core samples. The thickness and shear-wave velocity of the deeper embedded layers are resolved within 10% deviation from those values measured separately during pavement construction. The proposed method may be equally applicable to normal soil site investigation and in the field of ultrasonic testing of materials. ?? 2006 Society of Exploration Geophysicists.

  6. Effects of Lateral and Medial Wedged Insoles on Knee and Ankle Internal Joint Moments During Walking in Healthy Men.

    PubMed

    Fukuchi, Claudiane A; Lewinson, Ryan T; Worobets, Jay T; Stefanyshyn, Darren J

    2016-11-01

    Wedged insoles have been used to treat knee pathologies and to prevent injuries. Although they have received much attention for the study of knee injury, the effects of wedges on ankle joint biomechanics are not well understood. This study sought to evaluate the immediate effects of lateral and medial wedges on knee and ankle internal joint loading and center of pressure (CoP) in men during walking. Twenty-one healthy men walked at 1.4 m/sec in five footwear conditions: neutral, 6° (LW6) and 9° (LW9) lateral wedges, and 6° (MW6) and 9° (MW9) medial wedges. Peak internal knee abduction moments and angular impulses, internal ankle inversion moments and angular impulses, and mediolateral CoP were analyzed. Analysis of variance with post hoc analysis and Pearson correlations were performed to detect differences between conditions. No differences in internal knee joint loading were found between neutral and any of the wedge conditions. However, as the wedge angle increased from medial to lateral, the internal ankle inversion moment (LW6: P = .020; LW9: P < .001; MW6: P = .046; MW9: P < .001) and angular impulse (LW9: P = .012) increased, and the CoP shifted laterally (LW9: P < .001) and medially (MW9: P < .001) compared with the neutral condition. Neither lateral nor medial wedges were effective in altering internal knee joint loading during walking. However, the greater internal ankle inversion moment and angular impulse observed with lateral wedges could lead to a higher risk of ankle injury. Thus, caution should be taken when lateral wedges need to be prescribed.

  7. Broadband Ground Motion Synthesis of the 1999 Turkey Earthquakes Based On: 3-D Velocity Inversion, Finite Difference Calculations and Emprical Greens Functions

    NASA Astrophysics Data System (ADS)

    Gok, R.; Kalafat, D.; Hutchings, L.

    2003-12-01

    We analyze over 3,500 aftershocks recorded by several seismic networks during the 1999 Marmara, Turkey earthquakes. The analysis provides source parameters of the aftershocks, a three-dimensional velocity structure from tomographic inversion, an input three-dimensional velocity model for a finite difference wave propagation code (E3D, Larsen 1998), and records available for use as empirical Green's functions. Ultimately our goal is to model the 1999 earthquakes from DC to 25 Hz and study fault rupture mechanics and kinematic rupture models. We performed the simultaneous inversion for hypocenter locations and three-dimensional P- and S- wave velocity structure of Marmara Region using SIMULPS14 along with 2,500 events with more than eight P- readings and an azimuthal gap of less than 180\\deg. The resolution of calculated velocity structure is better in the eastern Marmara than the western Marmara region due to the dense ray coverage. We used the obtained velocity structure as input into the finite difference algorithm and validated the model by using M < 4 earthquakes as point sources and matching long period waveforms (f < 0.5 Hz). We also obtained Mo, fc and individual station kappa values for over 500 events by performing a simultaneous inversion to fit these parameters with a Brune source model. We used the results of the source inversion to deconvolve out a Brune model from small to moderate size earthquakes (M < 4.0) to obtain empirical Green's function (EGF) for the higher frequency range of ground motion synthesis (0.5 < f > 25 Hz). We additionally obtained the source scaling relation (energy-moment) of these aftershocks. We have generated several scenarios constrained by a priori knowledge of the Izmit and Duzce rupture parameters to validate our prediction capability.

  8. Rigid Ankle Foot Orthosis Deteriorates Mediolateral Balance Control and Vertical Braking during Gait Initiation

    PubMed Central

    Delafontaine, Arnaud; Gagey, Olivier; Colnaghi, Silvia; Do, Manh-Cuong; Honeine, Jean-Louis

    2017-01-01

    Rigid ankle-foot orthoses (AFO) are commonly used for impeding foot drop during the swing phase of gait. They also reduce pain and improve gait kinematics in patients with weakness or loss of integrity of ankle-foot complex structures due to various pathological conditions. However, this comes at the price of constraining ankle joint mobility, which might affect propulsive force generation and balance control. The present study examined the effects of wearing an AFO on biomechanical variables and electromyographic activity of tibialis anterior (TA) and soleus muscles during gait initiation (GI). Nineteen healthy adults participated in the study. They initiated gait at a self-paced speed with no ankle constraint as well as wearing an AFO on the stance leg, or bilaterally. Constraining the stance leg ankle decreased TA activity ipsilaterally during the anticipatory postural adjustment (APA) of GI, and ipsilateral soleus activity during step execution. In the sagittal plane, the decrease in the stance leg TA activity reduced the backward displacement of the center of pressure (CoP) resulting in a reduction of the forward velocity of the center of mass (CoM) measured at foot contact (FC). In the frontal plane, wearing the AFO reduced the displacement of the CoP in the direction of the swing leg during the APA phase. The mediolateral velocity of the CoM increased during single-stance prompting a larger step width to recover balance. During step execution, the CoM vertical downward velocity is normally reduced in order to lessen the impact of the swing leg with the floor and facilitates the rise of the CoM that occurs during the subsequent double-support phase. The reduction in stance leg soleus activity caused by constraining the ankle weakened the vertical braking of the CoM during step execution. This caused the absolute instantaneous vertical velocity of the CoM at FC to be greater in the constrained conditions with respect to the control condition. From a

  9. Arthroscopic treatment of anterolateral impingement of the ankle.

    PubMed

    Ferkel, R D; Karzel, R P; Del Pizzo, W; Friedman, M J; Fischer, S P

    1991-01-01

    We studied 31 patients (17 females, 14 males; average age, 34) with more than 2 years of followup who had chronic anterolateral ankle pain following inversion injury. All had failed to respond to at least 2 months of conservative treatment and had negative stress radiographs to rule out instability. On physical examination, tenderness was localized to the anterolateral corner of the talar dome. Magnetic resonance imaging was the most useful diagnostic screening test, showing synovial thickening consistent with impingement in the anterolateral gutter. At an average of 24 months after injury, all patients underwent ankle arthroscopy, which showed proliferative synovitis and fibrotic scar tissue in the lateral gutter, often with associated chondromalacia of the talus. Operative arthroscopic treatment consisted of partial synovectomy with debridement of scar tissue from the lateral gutter. Postoperatively, patients walked with crutches allowing weightbearing as tolerated. Average return to sports was 6 weeks. Histopathologic analysis performed on the resected tissue showed synovial changes consistent with chronic inflammation. Results of treatment after at least 2 year followup were 15 excellent, 11 good, 4 fair, and 1 poor. Since there are several distinct causes of chronic ankle pain, we prefer to call this problem "anterolateral impingement of the ankle" and believe the term "chronic sprain pain" should be discarded.

  10. Joint Inversion of Body-Wave Arrival Times and Surface-Wave Dispersion Data for Three-Dimensional Seismic Velocity Structure Around SAFOD

    NASA Astrophysics Data System (ADS)

    Zhang, H.; Thurber, C. H.; Maceira, M.; Roux, P.

    2013-12-01

    The crust around the San Andreas Fault Observatory at depth (SAFOD) has been the subject of many geophysical studies aimed at characterizing in detail the fault zone structure and elucidating the lithologies and physical properties of the surrounding rocks. Seismic methods in particular have revealed the complex two-dimensional (2D) and three-dimensional (3D) structure of the crustal volume around SAFOD and the strong velocity reduction in the fault damage zone. In this study we conduct a joint inversion using body-wave arrival times and surface-wave dispersion data to image the P-and S-wave velocity structure of the upper crust surrounding SAFOD. The two data types have complementary strengths - the body-wave data have good resolution at depth, albeit only where there are crossing rays between sources and receivers, whereas the surface waves have very good near-surface resolution and are not dependent on the earthquake source distribution because they are derived from ambient noise. The body-wave data are from local earthquakes and explosions, comprising the dataset analyzed by Zhang et al. (2009). The surface-wave data are for Love waves from ambient noise correlations, and are from Roux et al. (2011). The joint inversion code is based on the regional-scale version of the double-difference (DD) tomography algorithm tomoDD. The surface-wave inversion code that is integrated into the joint inversion algorithm is from Maceira and Ammon (2009). The propagator matrix solver in the algorithm DISPER80 (Saito, 1988) is used for the forward calculation of dispersion curves from layered velocity models. We examined how the structural models vary as we vary the relative weighting of the fit to the two data sets and in comparison to the previous separate inversion results. The joint inversion with the 'optimal' weighting shows more clearly the U-shaped local structure from the Buzzard Canyon Fault on the west side of SAF to the Gold Hill Fault on the east side.

  11. Impaired left ventricular systolic function and increased brachial-ankle pulse-wave velocity are independently associated with rapid renal function progression.

    PubMed

    Chen, Szu-Chia; Lin, Tsung-Hsien; Hsu, Po-Chao; Chang, Jer-Ming; Lee, Chee-Siong; Tsai, Wei-Chung; Su, Ho-Ming; Voon, Wen-Chol; Chen, Hung-Chun

    2011-09-01

    Heart failure and increased arterial stiffness are associated with declining renal function. Few studies have evaluated the association between left ventricular ejection fraction (LVEF) and brachial-ankle pulse-wave velocity (baPWV) and renal function progression. The aim of this study was to assess whether LVEF<40% and baPWV are associated with a decline in the estimated glomerular filtration rate (eGFR) and the progression to a renal end point of ≥25% decline in eGFR. This longitudinal study included 167 patients. The baPWV was measured with an ankle-brachial index-form device. The change in renal function was estimated by eGFR slope. The renal end point was defined as ≥25% decline in eGFR. Clinical and echocardiographic parameters were compared and analyzed. After a multivariate analysis, serum hematocrit was positively associated with eGFR slope, and diabetes mellitus, baPWV (P=0.031) and LVEF<40% (P=0.001) were negatively associated with eGFR slope. Forty patients reached the renal end point. Multivariate, forward Cox regression analysis found that lower serum albumin and hematocrit levels, higher triglyceride levels, higher baPWV (P=0.039) and LVEF<40% (P<0.001) were independently associated with progression to the renal end point. Our results show that LVEF<40% and increased baPWV are independently associated with renal function decline and progression to the renal end point.

  12. MRI evaluation of anterolateral soft tissue impingement of the ankle.

    PubMed

    Ferkel, Richard D; Tyorkin, Max; Applegate, Gregory R; Heinen, Gregory T

    2010-08-01

    The usefulness of magnetic resonance imaging (MRI) has been questioned in evaluating patients with chronic ankle sprain pain. The purpose of this study was to determine the effectiveness and reliability of routine MR imaging in the diagnosis of anterolateral soft tissue impingement. Inclusion criteria required that the MR examinations be performed by the same musculoskeletal radiologist after the most recent scanner upgrade and using a dedicated ankle/hindfoot coil. The surgical and MRI reports of 24 patients who had an arthroscopic diagnosis of anterolateral soft tissue impingement of the ankle were tabulated and categorized. Unlike previous studies, sagittal T1 and Short Tau Inversion Recovery (STIR) images were used primarily in the diagnosis of these lesions. Using this technique, we report a 78.9% accuracy in diagnosis, a sensitivity of 83.3% and a specificity of 78.6%. Fifty-eight percent of patients had an associated diagnosis, which in 33% of patients altered our surgical plan. Although not indicated in all cases of anterolateral ankle impingement, we advocate the use of MR imaging in complicated clinical presentations where the exclusion of additional pathology in the ankle or subtalar joint, and the confirmation of anterolateral soft tissue impingement would be beneficial.

  13. Effects of fatiguing treadmill running on sensorimotor control in athletes with and without functional ankle instability.

    PubMed

    Steib, Simon; Hentschke, Christian; Welsch, Goetz; Pfeifer, Klaus; Zech, Astrid

    2013-08-01

    Sensorimotor control is permanently impaired following functional ankle instability and temporarily decreased following fatigue. Little is known on potential interactions between both conditions. The purpose was to investigate the effect of fatiguing exercise on sensorimotor control in athletes with and without (coper, controls) functional ankle instability. 19 individuals with functional ankle instability, 19 ankle sprain copers, and 19 non-injured controls participated in this cohort study. Maximum reach distance in the star excursion balance test, unilateral jump landing stabilization time, center of pressure sway velocity in single-leg-stance, and passive ankle joint position sense were assessed before and immediately after fatiguing treadmill running. A three factorial linear mixed model was specified for each outcome to evaluate the effects of group, exhausting exercise (fatigue) and their interactions (group by fatigue). Effect sizes were calculated as Cohen's d. Maximum reach distance in the star excursion balance test, jump stabilization time and sway velocity, but not joint position sense, were negatively affected by fatigue in all groups. Effect sizes were moderate, ranging from 0.27 to 0.68. No significant group by fatigue interactions were found except for one measure. Copers showed significantly larger prefatigue to postfatigue reductions in anterior reach direction (P≤0.001; d=-0.55) compared to the ankle instability (P=0.007) and control group (P=0.052). Fatiguing exercise negatively affected postural control but not proprioception. Ankle status did not appear to have an effect on fatigue-induced sensorimotor control impairments. © 2013.

  14. Syndesmotic ankle sprain.

    PubMed

    Childs, Sharon G

    2012-01-01

    Ankle sprain injuries are the most common type of joint sprain. The prevalence of ankle joint sprains accounts for 21% of joint injuries in the body. Although somewhat rare, high-ankle or syndesmotic ankle sprains occur in up to 15% of ankle trauma. This article will present the pathomechanics of the high-ankle or syndesmotic sprain.

  15. Ankle sprain (image)

    MedlinePlus

    An ankle sprain is a common injury to the ankle. The most common way the ankle is injured is when ... swelling, inflammation, and bruising around the ankle. An ankle sprain injury may take a few weeks to many ...

  16. Test-retest reliability of a new device for assessing ankle joint threshold to detect passive movement in healthy adults.

    PubMed

    Sun, Wei; Song, Qipeng; Yu, Bing; Zhang, Cui; Mao, Dewei

    2015-01-01

    This study aimed to evaluate the test-retest reliability of a new device for assessing ankle joint kinesthesia. This device could measure the passive motion threshold of four ankle joint movements, namely plantarflexion, dorsiflexion, inversion and eversion. A total of 21 healthy adults, including 13 males and 8 females, participated in the study. Each participant completed two sessions on two separate days with 1-week interval. The sessions were administered by the same experimenter in the same laboratory. At least 12 trials (three successful trials in each of the four directions) were performed in each session. The mean values in each direction were calculated and analysed. The ICC values of test-retest reliability ranged from 0.737 (dorsiflexion) to 0.935 (eversion), whereas the SEM values ranged from 0.21° (plantarflexion) to 0.52° (inversion). The Bland-Altman plots showed that the reliability of plantarflexion-dorsiflexion was better than that of inversion-eversion. The results evaluated the reliability of the new device as fair to excellent. The new device for assessing kinesthesia could be used to examine the ankle joint kinesthesia.

  17. Neural Excitability and Joint Laxity in Chronic Ankle Instability, Coper, and Control Groups.

    PubMed

    Bowker, Samantha; Terada, Masafumi; Thomas, Abbey C; Pietrosimone, Brian G; Hiller, Claire E; Gribble, Phillip A

    2016-04-01

    Neuromuscular and mechanical deficiencies are commonly studied in participants with chronic ankle instability (CAI). Few investigators have attempted to comprehensively consider sensorimotor and mechanical differences among people with CAI, copers who did not present with prolonged dysfunctions after an initial ankle sprain, and a healthy control group. To determine if differences exist in spinal reflex excitability and ankle laxity among participants with CAI, copers, and healthy controls. Case-control study. Research laboratory. Thirty-seven participants with CAI, 30 participants categorized as copers, and 26 healthy control participants. We assessed spinal reflex excitability of the soleus using the Hoffmann reflex protocol. Participants' ankle laxity was measured with an instrumented ankle arthrometer. The maximum Hoffmann reflex : maximal muscle response ratio was calculated. Ankle laxity was measured as the total displacement in the anterior-posterior directions (mm) and total rotation in the inversion and eversion directions (°). Spinal reflex excitability was diminished in participants with CAI compared with copers and control participants (P = .01). No differences were observed among any of the groups for ankle laxity. Changes in the spinal reflex excitability of the soleus that likely affect ankle stability were seen only in the CAI group, yet no mechanical differences were noted across the groups. These findings support the importance of finding effective ways to increase spinal reflex excitability for the purpose of treating neural excitability dysfunction in patients with CAI.

  18. The effects of obesity on balance recovery using an ankle strategy.

    PubMed

    Matrangola, Sara L; Madigan, Michael L

    2011-06-01

    Obesity is associated with an increased risk of falls. The purpose of this study was to investigate the effects of obesity on balance recovery using an ankle strategy. In addition, computer simulations to understand how increased inertia and weight associated with obesity independently influence balance recovery. Ten normal weight (BMI: 22.7±0.6 kg/m(2)) and ten obese (BMI: 32.2±2.2 kg/m(2)) adult male subjects participated in the study. Subjects recovered balance using an ankle strategy after three types of postural perturbations: an initial angular displacement, an initial angular velocity from the natural stance, and an initial angular velocity from a prescribed position. Balance recovery was quantified by the largest initial angular displacement or angular velocity from which balance could be recovered. Obesity impaired balance recovery from perturbations involving an initial angular velocity, but not from an initial angular displacement. Similarly, computer simulations determined that increased inertia is beneficial to balance recovery when there is little to no initial angular velocity. These findings indicate that the effects of obesity on balance recovery are dependent on the type of perturbation, and that increased inertia associated with obesity can be beneficial for perturbations that involve little to no initial angular velocity. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Ankle sprain - aftercare

    MedlinePlus

    Lateral ankle sprain - aftercare; Medial ankle sprain - aftercare; Medial ankle injury - aftercare; Ankle syndesmosis sprain - aftercare; Syndesmosis injury - aftercare; ATFL injury - aftercare; CFL injury - ...

  20. Spectral fitting inversion of low-frequency normal modes with self-coupling and cross-coupling of toroidal and spheroidal multiplets: numerical experiments to estimate the isotropic and anisotropic velocity structures

    NASA Astrophysics Data System (ADS)

    Oda, Hitoshi

    2016-06-01

    The aspherical structure of the Earth is described in terms of lateral heterogeneity and anisotropy of the P- and S-wave velocities, density heterogeneity, ellipticity and rotation of the Earth and undulation of the discontinuity interfaces of the seismic wave velocities. Its structure significantly influences the normal mode spectra of the Earth's free oscillation in the form of cross-coupling between toroidal and spheroidal multiplets and self-coupling between the singlets forming them. Thus, the aspherical structure must be conversely estimated from the free oscillation spectra influenced by the cross-coupling and self-coupling. In the present study, we improve a spectral fitting inversion algorithm which was developed in a previous study to retrieve the global structures of the isotropic and anisotropic velocities of the P and S waves from the free oscillation spectra. The main improvement is that the geographical distribution of the intensity of the S-wave azimuthal anisotropy is represented by a nonlinear combination of structure coefficients for the anisotropic velocity structure, whereas in the previous study it was expanded into a generalized spherical harmonic series. Consequently, the improved inversion algorithm reduces the number of unknown parameters that must be determined compared to the previous inversion algorithm and employs a one-step inversion method by which the structure coefficients for the isotropic and anisotropic velocities are directly estimated from the fee oscillation spectra. The applicability of the improved inversion is examined by several numerical experiments using synthetic spectral data, which are produced by supposing a variety of isotropic and anisotropic velocity structures, earthquake source parameters and station-event pairs. Furthermore, the robustness of the inversion algorithm is investigated with respect to the back-ground noise contaminating the spectral data as well as truncating the series expansions by finite terms

  1. Stabilization of a three-dimensional limit cycle walking model through step-to-step ankle control.

    PubMed

    Kim, Myunghee; Collins, Steven H

    2013-06-01

    Unilateral, below-knee amputation is associated with an increased risk of falls, which may be partially related to a loss of active ankle control. If ankle control can contribute significantly to maintaining balance, even in the presence of active foot placement, this might provide an opportunity to improve balance using robotic ankle-foot prostheses. We investigated ankle- and hip-based walking stabilization methods in a three-dimensional model of human gait that included ankle plantarflexion, ankle inversion-eversion, hip flexion-extension, and hip ad/abduction. We generated discrete feedback control laws (linear quadratic regulators) that altered nominal actuation parameters once per step. We used ankle push-off, lateral ankle stiffness and damping, fore-aft foot placement, lateral foot placement, or all of these as control inputs. We modeled environmental disturbances as random, bounded, unexpected changes in floor height, and defined balance performance as the maximum allowable disturbance value for which the model walked 500 steps without falling. Nominal walking motions were unstable, but were stabilized by all of the step-to-step control laws we tested. Surprisingly, step-by-step modulation of ankle push-off alone led to better balance performance (3.2% leg length) than lateral foot placement (1.2% leg length) for these control laws. These results suggest that appropriate control of robotic ankle-foot prosthesis push-off could make balancing during walking easier for individuals with amputation.

  2. Ankle Arthroscopic Reconstruction of Lateral Ligaments (Ankle Anti-ROLL)

    PubMed Central

    Takao, Masato; Glazebrook, Mark; Stone, James; Guillo, Stéphane

    2015-01-01

    Ankle instability is a condition that often requires surgery to stabilize the ankle joint that will improve pain and function if nonoperative treatments fail. Ankle stabilization surgery may be performed as a repair in which the native existing anterior talofibular ligament or calcaneofibular ligament (or both) is imbricated or reattached. Alternatively, when native ankle ligaments are insufficient for repair, a reconstruction of the ligaments may be performed in which an autologous or allograft tendon is used to reconstruct the anterior talofibular ligament or calcaneofibular ligament (or both). Currently, ankle stabilization surgery is most commonly performed through an open incision, but arthroscopic ankle stabilization using repair techniques has been described and is being used more often. We present our technique for anatomic ankle arthroscopic reconstruction of the lateral ligaments (anti-ROLL) performed in an all–inside-out manner that is likely safe for patients and minimally invasive. PMID:26900560

  3. Lower extremity function during gait in participants with first time acute lateral ankle sprain compared to controls.

    PubMed

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2015-02-01

    Laboratory analyses of chronic ankle instability populations during gait have elucidated a number of anomalous movement patterns. No current research exists analysing these movement patterns in a group in the acute phase of lateral ankle sprain (LAS) injury. It is possible that participants with an acute LAS display movement patterns continuous with their chronically impaired counterparts. Sixty eight participants with acute LAS and nineteen non-injured participants completed five gait trials. 3D lower extremity temporal kinematic and kinetic data were collected from 200 ms pre- to 200 ms post-heel strike (period 1) and from 200 ms pre- to 200 ms post-toe off (period 2). During period 1, the LAS group displayed increased knee flexion with increased net extensor pattern at the knee joint, increased ankle inversion with a greater inversion moment, and reduced ankle plantar flexion, compared to the non-injured control group. During period 2, the LAS group displayed decreased hip extension with a decrease in the flexor moment at the hip, and decreased ankle plantar flexion with a decrease in the net plantar flexion moment, compared to the non-injured control group. These results indicate that participants with acute LAS display coordination strategies which may play a role in the onset of chronicity or recovery. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Range of motion and ankle injury history association with sex in pediatric and adolescent athletes.

    PubMed

    Sugimoto, Dai; McCartney, Ronald E; Parisien, Robert L; Dashe, Jesse; Borg, Dennis R; Meehan, William P

    2018-02-01

    Ankle sprain is one of the most common musculoskeletal injuries among young athletes, and there remains a gap in the literature regarding susceptibility to such injuries among physically active youth. The primary purpose of this study was to determine the associations between sex, a history of ankle sprain, and ankle range of motion (ROM) in pediatric and adolescent athletes. Athletes under the age of 18 years old who presented to a sports injury prevention center underwent ankle ROM measurements including plantarflexion (PF), inversion (IV), and eversion (EV). A two-way analysis of covariance (ANCOVA) was performed to examine effect of sex and a history of ankle sprain on ROMs. Also, a binary logistic regression was performed to investigate variables that are associated with a history of ankle injury. Among 452 pediatric and adolescent athletes [268 females (13.6 ± 2.3 years old) and 184 males (13.3 ± 2.5 years old)], 128 reported a history of previous ankle sprain. Females demonstrated significantly increased ROMs (PF and IV bilaterally, and right EV) compared to males while there was no effect of a history of ankle sprain on ROMs. Female sex was independently associated with a history of ankle sprain. There was a strong effect of female sex on ROMs rather than a history of ankle injury history. Additionally, pediatric and adolescent females have greater odds of a history of ankle sprain when compared to their male counterparts.

  5. Learning to walk with an adaptive gain proportional myoelectric controller for a robotic ankle exoskeleton.

    PubMed

    Koller, Jeffrey R; Jacobs, Daniel A; Ferris, Daniel P; Remy, C David

    2015-11-04

    Robotic ankle exoskeletons can provide assistance to users and reduce metabolic power during walking. Our research group has investigated the use of proportional myoelectric control for controlling robotic ankle exoskeletons. Previously, these controllers have relied on a constant gain to map user's muscle activity to actuation control signals. A constant gain may act as a constraint on the user, so we designed a controller that dynamically adapts the gain to the user's myoelectric amplitude. We hypothesized that an adaptive gain proportional myoelectric controller would reduce metabolic energy expenditure compared to walking with the ankle exoskeleton unpowered because users could choose their preferred control gain. We tested eight healthy subjects walking with the adaptive gain proportional myoelectric controller with bilateral ankle exoskeletons. The adaptive gain was updated each stride such that on average the user's peak muscle activity was mapped to maximal power output of the exoskeleton. All subjects participated in three identical training sessions where they walked on a treadmill for 50 minutes (30 minutes of which the exoskeleton was powered) at 1.2 ms(-1). We calculated and analyzed metabolic energy consumption, muscle recruitment, inverse kinematics, inverse dynamics, and exoskeleton mechanics. Using our controller, subjects achieved a metabolic reduction similar to that seen in previous work in about a third of the training time. The resulting controller gain was lower than that seen in previous work (β=1.50±0.14 versus a constant β=2). The adapted gain allowed users more total ankle joint power than that of unassisted walking, increasing ankle power in exchange for a decrease in hip power. Our findings indicate that humans prefer to walk with greater ankle mechanical power output than their unassisted gait when provided with an ankle exoskeleton using an adaptive controller. This suggests that robotic assistance from an exoskeleton can allow

  6. Musculoskeletal modelling of human ankle complex: Estimation of ankle joint moments.

    PubMed

    Jamwal, Prashant K; Hussain, Shahid; Tsoi, Yun Ho; Ghayesh, Mergen H; Xie, Sheng Quan

    2017-05-01

    A musculoskeletal model for the ankle complex is vital in order to enhance the understanding of neuro-mechanical control of ankle motions, diagnose ankle disorders and assess subsequent treatments. Motions at the human ankle and foot, however, are complex due to simultaneous movements at the two joints namely, the ankle joint and the subtalar joint. The musculoskeletal elements at the ankle complex, such as ligaments, muscles and tendons, have intricate arrangements and exhibit transient and nonlinear behaviour. This paper develops a musculoskeletal model of the ankle complex considering the biaxial ankle structure. The model provides estimates of overall mechanical characteristics (motion and moments) of ankle complex through consideration of forces applied along ligaments and muscle-tendon units. The dynamics of the ankle complex and its surrounding ligaments and muscle-tendon units is modelled and formulated into a state space model to facilitate simulations. A graphical user interface is also developed during this research in order to include the visual anatomical information by converting it to quantitative information on coordinates. Validation of the ankle model was carried out by comparing its outputs with those published in literature as well as with experimental data obtained from an existing parallel ankle rehabilitation robot. Qualitative agreement was observed between the model and measured data for both, the passive and active ankle motions during trials in terms of displacements and moments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Mantle viscosity structure constrained by joint inversions of seismic velocities and density

    NASA Astrophysics Data System (ADS)

    Rudolph, M. L.; Moulik, P.; Lekic, V.

    2017-12-01

    The viscosity structure of Earth's deep mantle affects the thermal evolution of Earth, the ascent of mantle upwellings, sinking of subducted oceanic lithosphere, and the mixing of compositional heterogeneities in the mantle. Modeling the long-wavelength dynamic geoid allows us to constrain the radial viscosity profile of the mantle. Typically, in inversions for the mantle viscosity structure, wavespeed variations are mapped into density variations using a constant- or depth-dependent scaling factor. Here, we use a newly developed joint model of anisotropic Vs, Vp, density and transition zone topographies to generate a suite of solutions for the mantle viscosity structure directly from the seismologically constrained density structure. The density structure used to drive our forward models includes contributions from both thermal and compositional variations, including important contributions from compositionally dense material in the Large Low Velocity Provinces at the base of the mantle. These compositional variations have been neglected in the forward models used in most previous inversions and have the potential to significantly affect large-scale flow and thus the inferred viscosity structure. We use a transdimensional, hierarchical, Bayesian approach to solve the inverse problem, and our solutions for viscosity structure include an increase in viscosity below the base of the transition zone, in the shallow lower mantle. Using geoid dynamic response functions and an analysis of the correlation between the observed geoid and mantle structure, we demonstrate the underlying reason for this inference. Finally, we present a new family of solutions in which the data uncertainty is accounted for using covariance matrices associated with the mantle structure models.

  8. Pointing the foot without sickling: an examination of ankle movement during jumping.

    PubMed

    Jarvis, Danielle N; Kulig, Kornelia

    2015-03-01

    The sauté is a relatively simple dance jump that can be performed by both highly skilled dancers and non-dancers. However, there are characteristics of jumping unique to trained dancers, especially in terms of foot and ankle movement during flight. Dancers are trained not to "sickle, " or to avoid the anatomically coupled ankle inversion that occurs with plantar flexion, maintaining the appearance of a straight line through the lower leg and foot. The purpose of this study was to examine ankle movements in elite dancers compared to non-dancers. Twenty healthy females, 10 with no prior dance training and 10 professional dancers, performed 20 consecutive sautés while three-dimensional kinematic data were collected. Sagittal and frontal plane kinematics were calculated and vector coding methods were used to quantify coordination patterns within the ankle in the sagittal and frontal planes. This pattern was chosen for analysis to identify the avoidance of a sickled foot by trained dancers. Peak ankle positions and coordination patterns between groups were examined using independent t-tests (a <0.05). Dancers demonstrated greater peak plantar flexion (p<0.01) and less change in ankle angle during the flight phase (p= 0.01), signifying holding the pointed foot position during flight. There was no statistically significant difference in sagittal and frontal plane ankle coupling (p= 0.15); however, the Cohen's d effect size for the difference in coupling was medium-to-large (0.73). Dynamic analysis of the foot and ankle during jumping demonstrates how elite dancers achieve the aesthetic requirements of dance technique.

  9. Biomechanical analysis of ankle ligamentous sprain injury cases from televised basketball games: Understanding when, how and why ligament failure occurs.

    PubMed

    Panagiotakis, Emmanouil; Mok, Kam-Ming; Fong, Daniel Tik-Pui; Bull, Anthony M J

    2017-12-01

    Ankle sprains due to landing on an opponent's foot are common in basketball. There is no analysis to date that provides a quantification of this injury mechanism. The aim of this study was to quantify the kinematics of this specific injury mechanism and relate this to lateral ankle ligament biomechanics. Case series. The model-based image-matching technique was used to quantify calcaneo-fibular-talar kinematics during four ankle inversion sprain injury incidents in televised NBA basketball games. The four incidents follow the same injury pattern in which the players of interest step onto an opponent's foot with significant inversion and a diagnosed ankle injury. A geometric analysis was performed to calculate the in vivo ligament strains and strain rates for the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). Despite the controlled selection of cases, the results show that there are two distinct injury mechanisms: sudden inversion and internal rotation with low levels of plantarflexion; and a similar mechanism without internal rotation. The first of these mechanisms results in high ATFL and CFL strains, whereas the second of these strains the CFL in isolation. The injury mechanism combined with measures of the ligament injury in terms of percentage of strain to failure correlate directly with the severity of the injury quantified by return-to-sport. The opportunity to control excessive internal rotation through proprioceptive training and/or prophylactic footwear or bracing could be utilised to reduce the severity of common ankle injuries in basketball. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. Foot fractures frequently misdiagnosed as ankle sprains.

    PubMed

    Judd, Daniel B; Kim, David H

    2002-09-01

    Most ankle injuries are straightforward ligamentous injuries. However, the clinical presentation of subtle fractures can be similar to that of ankle sprains, and these fractures are frequently missed on initial examination. Fractures of the talar dome may be medial or lateral, and they are usually the result of inversion injuries, although medial injuries may be atraumatic. Lateral talar process fractures are characterized by point tenderness over the lateral process. Posterior talar process fractures are often associated with tenderness to deep palpation anterior to the Achilles tendon over the posterolateral talus, and plantar flexion may exacerbate the pain. These fractures can often be managed nonsurgically with nonweight-bearing status and a short leg cast worn for approximately four weeks. Delays in treatment can result in long-term disability and surgery. Computed tomographic scans or magnetic resonance imaging may be required because these fractures are difficult to detect on plain films.

  11. Predicting functional recovery after acute ankle sprain.

    PubMed

    O'Connor, Sean R; Bleakley, Chris M; Tully, Mark A; McDonough, Suzanne M

    2013-01-01

    Ankle sprains are among the most common acute musculoskeletal conditions presenting to primary care. Their clinical course is variable but there are limited recommendations on prognostic factors. Our primary aim was to identify clinical predictors of short and medium term functional recovery after ankle sprain. A secondary analysis of data from adult participants (N = 85) with an acute ankle sprain, enrolled in a randomized controlled trial was undertaken. The predictive value of variables (age, BMI, gender, injury mechanism, previous injury, weight-bearing status, medial joint line pain, pain during weight-bearing dorsiflexion and lateral hop test) recorded at baseline and at 4 weeks post injury were investigated for their prognostic ability. Recovery was determined from measures of subjective ankle function at short (4 weeks) and medium term (4 months) follow ups. Multivariate stepwise linear regression analyses were undertaken to evaluate the association between the aforementioned variables and functional recovery. Greater age, greater injury grade and weight-bearing status at baseline were associated with lower function at 4 weeks post injury (p<0.01; adjusted R square=0.34). Greater age, weight-bearing status at baseline and non-inversion injury mechanisms were associated with lower function at 4 months (p<0.01; adjusted R square=0.20). Pain on medial palpation and pain on dorsiflexion at 4 weeks were the most valuable prognostic indicators of function at 4 months (p< 0.01; adjusted R square=0.49). The results of the present study provide further evidence that ankle sprains have a variable clinical course. Age, injury grade, mechanism and weight-bearing status at baseline provide some prognostic information for short and medium term recovery. Clinical assessment variables at 4 weeks were the strongest predictors of recovery, explaining 50% of the variance in ankle function at 4 months. Further prospective research is required to highlight the factors that best

  12. Peroneus longus stretch reflex amplitude increases after ankle brace application

    PubMed Central

    Cordova, M; Ingersoll, C

    2003-01-01

    Background: The use of external ankle support is widespread throughout sports medicine. However, the application of ankle bracing to a healthy ankle over a long period has been scrutinised because of possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus. Objective: To investigate the immediate and chronic effects of ankle brace application on the amplitude of peroneus longus stretch reflex. Methods: Twenty physically active college students (mean (SD) age 23.6 (1.7) years, height 168.7 (8.4) cm, and mass 69.9 (12.0) kg) who had been free from lower extremity pathology for the 12 months preceding the study served as subjects. None had been involved in a strength training or conditioning programme in the six months preceding the study. A 3 x 3 x 2 (test condition x treatment condition x time) design with repeated measures on the first and third factor was used. The peroneus longus stretch reflex (% of maximum amplitude) during sudden foot inversion was evaluated under three ankle brace conditions (control, lace up, and semi-rigid) before and after eight weeks of ankle brace use. Results: A 3 x 3 x 2 repeated measures analysis of variance showed that peroneus longus stretch reflex amplitude increased immediately after application of a lace up brace (67.1 (4.4)) compared with the semi-rigid (57.9 (4.3)) and control (59.0 (5.2)) conditions (p<0.05). Peroneus longus stretch reflex also increased after eight weeks of use of the semi-rigid brace compared with the lace up and control conditions (p<0.05). Conclusions: Initial application of a lace up style ankle brace and chronic use of a semi-rigid brace facilitates the amplitude of the peroneus longus stretch reflex. It appears that initial and long term ankle brace use does not diminish the magnitude of this stretch reflex in the healthy ankle. PMID:12782553

  13. A kickball game for ankle rehabilitation by JAVA, JNI, and VRML

    NASA Astrophysics Data System (ADS)

    Choi, Hyungjeen; Ryu, Jeha; Lee, Chansu

    2004-03-01

    This paper presents development of a virtual environment that can be applied to the ankle rehabilitation procedure. We developed a virtual football stadium to intrigue a patient, where two degree of freedom (DOF) plate-shaped object is oriented to kick a ball falling from the sky in accordance with the data from the ankle's dorisflexion/plantarflexion and inversion/eversion motion on the moving platform of the K-Platform. This Kickball Game is implemented by Virtual Reality Modeling Language (VRML). To control virtual objects, data from the K-Platform are transmitted through the communication module implemented in C++. Java, Java Native Interface (JNI) and VRML plug-in are combined together so as to interface the communication module with the virtual environment by VRML. This game may be applied to the Active Range of Motion (AROM) exercise procedure that is one of the ankle rehabilitation procedures.

  14. The effect of repetitive ankle perturbations on muscle reaction time and muscle activity.

    PubMed

    Thain, Peter Kevin; Hughes, Gerwyn Trefor Gareth; Mitchell, Andrew Charles Stephen

    2016-10-01

    The use of a tilt platform to simulate a lateral ankle sprain and record muscle reaction time is a well-established procedure. However, a potential caveat is that repetitive ankle perturbation may cause a natural attenuation of the reflex latency and amplitude. This is an important area to investigate as many researchers examine the effect of an intervention on muscle reaction time. Muscle reaction time, peak and average amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain (combined inversion and plantar flexion movement) were calculated in twenty-two physically active participants. The 40 perturbations were divided into 4 even groups of 10 dominant limb perturbations. Within-participants repeated measures analysis of variance (ANOVA) tests were conducted to assess the effect of habituation over time for each variable. There was a significant reduction in the peroneus longus average amplitude between the aggregated first and last 10 consecutive ankle perturbations (F2.15,45.09=3.90, P=0.03, ɳp(2)=0.16). Authors should implement no more than a maximum of 30 consecutive ankle perturbations (inclusive of practice perturbations) in future protocols simulating a lateral ankle sprain in an effort to avoid significant attenuation of muscle activity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. A novel protocol to evaluate ankle movements during reaching tasks using pediAnklebot.

    PubMed

    Martelli, Francesca; Palermo, Eduardo; Rossi, Stefano

    2017-07-01

    The aim of the study is to design a novel protocol to characterize the ankle movements during dorsal and plantar flexion reaching tasks using the pediAnklebot. Five healthy children were instructed to control a pointer and hit targets appearing on the monitor, by moving their ankle alternatively up and down. The protocol consisted of 60 targets, 30 up and 30 down, reachable via dorsiflexion and plantarflexion movements, respectively. Ankle angular displacements and torques were gathered by encoders and load cells embedded in the robot. Ankle motor performance was evaluated by means of kinematic, submovements and dynamic indices. Results suggest that (i) plantarflexion movements are faster and more accurate than the dorsiflexion ones, but children are able to perform with a higher level of smoothness the latter ones; (ii) children are able to stop the ankle movement more easily at the end of dorsiflexion rather than plantarflexion; (iii) the central nervous system plans plantarflexion and dorsiflexion movements with the same efficiency; (iv) children apply different torque levels during the two motor tasks and they cannot balance the inversion and eversion moments during dorsiflexion. These findings provide an important starting point for the assessment of a reference baseline of motor indices for the ankle joint.

  16. The Effect of 2 Hz and 100 Hz Electrical Stimulation of Acupoint on Ankle Sprain in Rats

    PubMed Central

    2007-01-01

    The electrical stimulation of acupoint (ESA) releases several endogenous neuropeptides, which play important roles in management of pain and inflammation. ESA with low and high frequencies has been shown to release different neuropepides, suggesting its various therapeutic effects. Pain and edema are major problems for ankle sprain. However, there have been few reports on the effects of ESA for ankle sprain. We aimed to investigate that ESA can reduce pain and edema resulting from ankle sprain, and whether there is a difference in therapeutic effects between low and high frequency ESA. To induce ankle sprain in Sprague-Dawley rats, the ankle of right hindpaw was overextended in direction of simultaneous inversion and plantar flexion. Stepping force and edema in the paw of the sprained ankle were measured by electronic balance and plethysmometer, respectively. In both 2 and 100 Hz ESA groups, stepping force was increased significantly in similar degrees (p<0.05). Only 2 Hz ESA produced the significant rapid decrease in ankle edema. This study demonstrates that ESA of 2 Hz and 100 Hz shows comparable analgesic effects, but only 2 Hz ESA can facilitate the reduction of edema caused by ankle sprain. PMID:17449948

  17. The identification of risk factors for ankle sprains sustained during netball participation.

    PubMed

    Attenborough, Alison S; Sinclair, Peter J; Sharp, Tristan; Greene, Andrew; Stuelcken, Max; Smith, Richard M; Hiller, Claire E

    2017-01-01

    Ankle sprains account for a large percentage of injuries sustained in netball. The identification of risk factors for ankle sprain is the preliminary action required to inform future prevention strategies. Prospective study. Ninety-four netball players from club and inter-district teams. Preseason data were collected for; vertical jump height, perceived ankle instability, sprain history, arthrometry inversion-eversion angles, star excursion balance test reach distances, the number of foot lifts during unilateral stance and demi-pointe balance test results. Participants were followed for the duration of one netball season and ankle sprains were recorded. Eleven sprains were recorded for eleven players using a time-loss definition of injury. Ankle sprains occurred at an incidence rate of 1.74/1000 h of netball exposure. One risk factor was identified to increase the odds of sustaining an ankle sprain during netball participation - a reach distance in the posterior-medial direction of the star excursion balance test of less than or equal to 77.5% of leg length (OR = 4.04, 95% CI = 1.00-16.35). The identified risk factor can be easily measured and should be considered for preseason injury risk profiling of netball players. Netball players may benefit from training programs aimed at improving single leg balance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Genetically elevated levels of circulating triglycerides and brachial-ankle pulse wave velocity in a Chinese population.

    PubMed

    Yao, W-M; Zhang, H-F; Zhu, Z-Y; Zhou, Y-L; Liang, N-X; Xu, D-J; Zhou, F; Sheng, Y-H; Yang, R; Gong, L; Yin, Z-J; Chen, F-K; Cao, K-J; Li, X-L

    2013-04-01

    Elevated levels of circulating triglycerides and increased arterial stiffness are associated with cardiovascular disease. Numerous studies have reported an association between levels of circulating triglycerides and arterial stiffness. We used Mendelian randomization to test whether this association is causal. We investigated the association between circulating triglyceride levels, the apolipoprotein A-V (ApoA5) -1131T>C single nucleotide polymorphism and brachial-ankle pulse wave velocity (baPWV) by examining data from 4421 subjects aged 18-74 years who were recruited from the Chinese population. baPWV was significantly associated with the levels of circulating triglycerides after adjusting for age, sex, body mass index (BMI), systolic blood pressure, heart rate, waist-to-hip ratio, antihypertensive treatment and diabetes mellitus status. The -1131C allele was associated with a 5% (95% confidence interval 3-8%) increase in circulating triglycerides (adjusted for age, sex, BMI, waist-to-hip ratio, diabetes mellitus and antihypertensive treatment). Instrumental variable analysis showed that genetically elevated levels of circulating triglycerides were not associated with increased baPWV. These results do not support the hypothesis that levels of circulating triglycerides have a causal role in the development of arterial stiffness.

  19. Inverse scattering theory: Inverse scattering series method for one dimensional non-compact support potential

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yao, Jie, E-mail: yjie2@uh.edu; Lesage, Anne-Cécile; Hussain, Fazle

    2014-12-15

    The reversion of the Born-Neumann series of the Lippmann-Schwinger equation is one of the standard ways to solve the inverse acoustic scattering problem. One limitation of the current inversion methods based on the reversion of the Born-Neumann series is that the velocity potential should have compact support. However, this assumption cannot be satisfied in certain cases, especially in seismic inversion. Based on the idea of distorted wave scattering, we explore an inverse scattering method for velocity potentials without compact support. The strategy is to decompose the actual medium as a known single interface reference medium, which has the same asymptoticmore » form as the actual medium and a perturbative scattering potential with compact support. After introducing the method to calculate the Green’s function for the known reference potential, the inverse scattering series and Volterra inverse scattering series are derived for the perturbative potential. Analytical and numerical examples demonstrate the feasibility and effectiveness of this method. Besides, to ensure stability of the numerical computation, the Lanczos averaging method is employed as a filter to reduce the Gibbs oscillations for the truncated discrete inverse Fourier transform of each order. Our method provides a rigorous mathematical framework for inverse acoustic scattering with a non-compact support velocity potential.« less

  20. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    ERIC Educational Resources Information Center

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  1. Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury

    PubMed Central

    2014-01-01

    Background In incomplete spinal cord injury (iSCI), sensorimotor impairments result in severe limitations to ambulation. To improve walking capacity, physical therapies using robotic-assisted locomotor devices, such as the Lokomat, have been developed. Following locomotor training, an improvement in gait capabilities—characterized by increases in the over-ground walking speed and endurance—is generally observed in patients. To better understand the mechanisms underlying these improvements, we studied the effects of Lokomat training on impaired ankle voluntary movement, known to be an important limiting factor in gait for iSCI patients. Methods Fifteen chronic iSCI subjects performed twelve 1-hour sessions of Lokomat training over the course of a month. The voluntary movement was qualified by measuring active range of motion, maximal velocity peak and trajectory smoothness for the spastic ankle during a movement from full plantar-flexion (PF) to full dorsi-flexion (DF) at the patient’s maximum speed. Dorsi- and plantar-flexor muscle strength was quantified by isometric maximal voluntary contraction (MVC). Clinical assessments were also performed using the Timed Up and Go (TUG), the 10-meter walk (10MWT) and the 6-minute walk (6MWT) tests. All evaluations were performed both before and after the training and were compared to a control group of fifteen iSCI patients. Results After the Lokomat training, the active range of motion, the maximal velocity, and the movement smoothness were significantly improved in the voluntary movement. Patients also exhibited an improvement in the MVC for their ankle dorsi- and plantar-flexor muscles. In terms of functional activity, we observed an enhancement in the mobility (TUG) and the over-ground gait velocity (10MWT) with training. Correlation tests indicated a significant relationship between ankle voluntary movement performance and the walking clinical assessments. Conclusions The improvements of the kinematic and kinetic

  2. Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury.

    PubMed

    Varoqui, Deborah; Niu, Xun; Mirbagheri, Mehdi M

    2014-03-31

    In incomplete spinal cord injury (iSCI), sensorimotor impairments result in severe limitations to ambulation. To improve walking capacity, physical therapies using robotic-assisted locomotor devices, such as the Lokomat, have been developed. Following locomotor training, an improvement in gait capabilities-characterized by increases in the over-ground walking speed and endurance-is generally observed in patients. To better understand the mechanisms underlying these improvements, we studied the effects of Lokomat training on impaired ankle voluntary movement, known to be an important limiting factor in gait for iSCI patients. Fifteen chronic iSCI subjects performed twelve 1-hour sessions of Lokomat training over the course of a month. The voluntary movement was qualified by measuring active range of motion, maximal velocity peak and trajectory smoothness for the spastic ankle during a movement from full plantar-flexion (PF) to full dorsi-flexion (DF) at the patient's maximum speed. Dorsi- and plantar-flexor muscle strength was quantified by isometric maximal voluntary contraction (MVC). Clinical assessments were also performed using the Timed Up and Go (TUG), the 10-meter walk (10MWT) and the 6-minute walk (6MWT) tests. All evaluations were performed both before and after the training and were compared to a control group of fifteen iSCI patients. After the Lokomat training, the active range of motion, the maximal velocity, and the movement smoothness were significantly improved in the voluntary movement. Patients also exhibited an improvement in the MVC for their ankle dorsi- and plantar-flexor muscles. In terms of functional activity, we observed an enhancement in the mobility (TUG) and the over-ground gait velocity (10MWT) with training. Correlation tests indicated a significant relationship between ankle voluntary movement performance and the walking clinical assessments. The improvements of the kinematic and kinetic parameters of the ankle voluntary movement

  3. Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

    PubMed Central

    Iwao, Kamizato; Masataka, Deie; Kohei, Fukuhara

    2014-01-01

    Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament. Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire. Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability. PMID:25401146

  4. The influence of joint rigidity on impact efficiency and ball velocity in football kicking.

    PubMed

    Peacock, James C A; Ball, Kevin

    2018-04-11

    Executing any skill with efficiency is important for performance. In football kicking, conflicting and non-significant results have existed between reducing ankle plantarflexion during foot-ball contact with impact efficiency, making it unclear as to its importance as a coaching instruction. The aims of this study were to first validate a mechanical kicking machine with a non-rigid ankle, and secondly compare a rigid to a non-rigid ankle during the impact phase of football kicking. Measures of foot-ball contact for ten trials per ankle configuration were calculated from data recorded at 4000 Hz and compared. The non-rigid ankle was characterised by initial dorsiflexion followed by plantarflexion for the remainder of impact, and based on similarities to punt and instep kicking, was considered valid. Impact efficiency (foot-to-ball speed ratio) was greater for the rigid ankle (rigid = 1.16 ± 0.02; non-rigid = 1.10 ± 0.01; p < 0.001). The rigid ankle was characterised by significantly greater effective mass and significantly less energy losses. Increasing rigidity allowed a greater portion of mass from the shank to be used during the collision. As the ankle remained in plantarflexion at impact end, stored elastic energy was not converted to ball velocity and was considered lost. Increasing rigidity is beneficial for increasing impact efficiency, and therefore ball velocity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Joint inversion of phase velocity dispersion and H/V ratio curves from seismic noise recordings using a genetic algorithm, considering higher modes

    NASA Astrophysics Data System (ADS)

    Parolai, S.; Picozzi, M.; Richwalski, S. M.; Milkereit, C.

    2005-01-01

    Seismic noise contains information on the local S-wave velocity structure, which can be obtained from the phase velocity dispersion curve by means of array measurements. The H/V ratio from single stations also contains information on the average S-wave velocity and the total thickness of the sedimentary cover. A joint inversion of the two data sets therefore might allow constraining the final model well. We propose a scheme that does not require a starting model because of usage of a genetic algorithm. Furthermore, we tested two suitable cost functions for our data set, using a-priori and data driven weighting. The latter one was more appropriate in our case. In addition, we consider the influence of higher modes on the data sets and use a suitable forward modeling procedure. Using real data we show that the joint inversion indeed allows for better fitting the observed data than using the dispersion curve only.

  6. Neural Excitability and Joint Laxity in Chronic Ankle Instability, Coper, and Control Groups

    PubMed Central

    Bowker, Samantha; Terada, Masafumi; Thomas, Abbey C.; Pietrosimone, Brian G.; Hiller, Claire E.; Gribble, Phillip A.

    2016-01-01

    Context:  Neuromuscular and mechanical deficiencies are commonly studied in participants with chronic ankle instability (CAI). Few investigators have attempted to comprehensively consider sensorimotor and mechanical differences among people with CAI, copers who did not present with prolonged dysfunctions after an initial ankle sprain, and a healthy control group. Objective:  To determine if differences exist in spinal reflex excitability and ankle laxity among participants with CAI, copers, and healthy controls. Design:  Case-control study. Setting:  Research laboratory. Patients or Other Participants:  Thirty-seven participants with CAI, 30 participants categorized as copers, and 26 healthy control participants. Main Outcome Measure(s):  We assessed spinal reflex excitability of the soleus using the Hoffmann reflex protocol. Participants' ankle laxity was measured with an instrumented ankle arthrometer. The maximum Hoffmann reflex : maximal muscle response ratio was calculated. Ankle laxity was measured as the total displacement in the anterior-posterior directions (mm) and total rotation in the inversion and eversion directions (°). Results:  Spinal reflex excitability was diminished in participants with CAI compared with copers and control participants (P = .01). No differences were observed among any of the groups for ankle laxity. Conclusion:  Changes in the spinal reflex excitability of the soleus that likely affect ankle stability were seen only in the CAI group, yet no mechanical differences were noted across the groups. These findings support the importance of finding effective ways to increase spinal reflex excitability for the purpose of treating neural excitability dysfunction in patients with CAI. PMID:27065189

  7. Control of acceleration during sudden ankle supination in people with unstable ankles.

    PubMed

    Vaes, P; Van Gheluwe, B; Duquet, W

    2001-12-01

    Comparative study of differences in functional control during ankle supination in the standing position in matched stable and unstable ankles (ex post facto design). To document acceleration and deceleration during ankle supination in the standing position and to determine differences in control of supination perturbation between stable and unstable ankles. Repetitive ankle sprain can be explained by mechanical instability only in a minority of cases. Exercise therapy for ankle instability is based on clinical experience. Joint stability has not yet been measured in dynamic situations that are similar to the situations leading to a traumatic sprain. The process of motor control during accelerating ankle supination has not been adequately addressed in the literature. Patients with complaints of ankle instability (16 unstable ankles) and nonimpaired controls (18 stable ankles) were examined (N = 17 subjects, 10 women and 7 men). The average age was 23.7 +/- 5.0 years (range, 20-41 y). Control of supination speed was studied during 50 degrees of ankle supination in the standing position using accelerometry (total supination time and deceleration times) and electromyography (latency time). Timing of motor response was estimated by measuring electromechanical delay. The presence of an early, sudden, and presumably passive slowdown of ankle supination in the standing position was observed. Peroneal muscle motor response was detected before the end of the supination. Unstable ankles showed significantly shorter total supination time (109.3 ms versus 124.1 ms) and significantly longer latency time (58.9 ms versus 47.7 ms). Functional control in unstable ankles is less efficient in decelerating the ankle during the supination test procedures used in our study. Our conclusions are based on significantly faster total supination and significantly slower electromyogram response in unstable ankles. The results support the hypothesis that both decelerating the total supination

  8. Quantifying the Uncertainties and Multi-parameter Trade-offs in Joint Inversion of Receiver Functions and Surface Wave Velocity and Ellipticity

    NASA Astrophysics Data System (ADS)

    Gao, C.; Lekic, V.

    2016-12-01

    When constraining the structure of the Earth's continental lithosphere, multiple seismic observables are often combined due to their complementary sensitivities.The transdimensional Bayesian (TB) approach in seismic inversion allows model parameter uncertainties and trade-offs to be quantified with few assumptions. TB sampling yields an adaptive parameterization that enables simultaneous inversion for different model parameters (Vp, Vs, density, radial anisotropy), without the need for strong prior information or regularization. We use a reversible jump Markov chain Monte Carlo (rjMcMC) algorithm to incorporate different seismic observables - surface wave dispersion (SWD), Rayleigh wave ellipticity (ZH ratio), and receiver functions - into the inversion for the profiles of shear velocity (Vs), compressional velocity (Vp), density (ρ), and radial anisotropy (ξ) beneath a seismic station. By analyzing all three data types individually and together, we show that TB sampling can eliminate the need for a fixed parameterization based on prior information, and reduce trade-offs in model estimates. We then explore the effect of different types of misfit functions for receiver function inversion, which is a highly non-unique problem. We compare the synthetic inversion results using the L2 norm, cross-correlation type and integral type misfit function by their convergence rates and retrieved seismic structures. In inversions in which only one type of model parameter (Vs for the case of SWD) is inverted, assumed scaling relationships are often applied to account for sensitivity to other model parameters (e.g. Vp, ρ, ξ). Here we show that under a TB framework, we can eliminate scaling assumptions, while simultaneously constraining multiple model parameters to varying degrees. Furthermore, we compare the performance of TB inversion when different types of model parameters either share the same or use independent parameterizations. We show that different parameterizations

  9. Landing-related ankle injuries do not occur in plantarflexion as once thought: a systematic video analysis of ankle injuries in world-class volleyball.

    PubMed

    Skazalski, Christopher; Kruczynski, Jacek; Bahr, Martin Aase; Bere, Tone; Whiteley, Rod; Bahr, Roald

    2018-01-01

    Ankle injuries are prevalent in elite volleyball and suggested to result from player contact at the net. Traditionally, ankle sprains are thought to happen in a plantarflexed position, but case studies suggest plantarflexion may not be involved. Describe the injury situations and mechanisms of ankle injuries in world-class volleyball based on systematic video analysis of injuries reported through the Fédération Internationale de Volleyball (FIVB) Injury Surveillance System. Videos of 24 injuries from major FIVB tournaments were included for analysis (14 men, 10 women). Five analysts reviewed the videos to determine specific situations and mechanisms leading to injuries. The majority of injuries occurred during two volleyball situations, blocking (n=15) and attacking (n=6). Injuries to blockers were the result of landing on an opponent (n=11) or teammate (n=4). Attacking injuries most frequently occurred when a back-row player landed on a front-row teammate (n=4 of 6). When landing on an opponent under the net, the attacker landed into the opponent's court in 11 of 12 situations but without violating the centre line rule. Injuries mostly resulted from rapid inversion without any substantial plantarflexion. The majority of injuries occur while blocking, often landing on an opponent. The attacker is overwhelmingly to blame for injuries at the net secondary to crossing the centre line. Injuries while attacking often result from a back-row player landing on a front-row teammate. Landing-related injuries mostly result from rapid inversion with the absence of plantarflexion. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Different corticospinal control between discrete and rhythmic movement of the ankle.

    PubMed

    Goto, Yumeno; Jono, Yasutomo; Hatanaka, Ryota; Nomura, Yoshifumi; Tani, Keisuke; Chujo, Yuta; Hiraoka, Koichi

    2014-01-01

    We investigated differences in corticospinal and spinal control between discrete and rhythmic ankle movements. Motor evoked potentials (MEPs) in the tibialis anterior and soleus muscles and soleus H-reflex were elicited in the middle of the plantar flexion phase during discrete ankle movement or in the initial or later cycles of rhythmic ankle movement. The H-reflex was evoked at an intensity eliciting a small M-wave and MEPs were elicited at an intensity of 1.2 times the motor threshold of the soleus MEPs. Only trials in which background EMG level, ankle angle, and ankle velocity were similar among the movement conditions were included for data analysis. In addition, only trials with a similar M-wave were included for data analysis in the experiment evoking H-reflexes. Results showed that H reflex and MEP amplitudes in the soleus muscle during discrete movement were not significantly different from those during rhythmic movement. MEP amplitude in the tibialis anterior muscle during the later cycles of rhythmic movement was significantly larger than that during the initial cycle of the rhythmic movement or during discrete movement. Higher corticospinal excitability in the tibialis anterior muscle during the later cycles of rhythmic movement may reflect changes in corticospinal control from the initial cycle to the later cycles of rhythmic movement.

  11. Terrain stiffness and ankle biomechanics during simulated half-squat parachute landing.

    PubMed

    Niu, Wenxin; Fan, Yubo

    2013-12-01

    A hard surface is potentially one of the risk factors for ankle injuries during parachute landing, but this has never been experimentally validated. This study was designed to evaluate the effects of terrain stiffness on ankle biomechanics during half-squat parachute landing (HSPL). Eight male and eight female healthy participants landed on three surfaces with standard HSPL technique. The three surfaces were cushioned mats with different thicknesses (0 mm, 4 mm, and 8 mm). The effects of terrain hardness and gender and their interaction with ground reaction forces, ankle kinematics, and electromyograms of selected lower-extremity muscles were statistically analyzed with multivariate analysis of variance. The effects of terrain stiffness and the interaction between factors on all variables were not statistically significant. The effects of gender were not statistically significant on most variables. The peak angular velocity of the ankle dorsiflexion was significantly lower in men (mean 1345 degree x s(-1)) than in women (mean 1965 degree x s(-1)). A spongy surface even eliminated the differences between men compared to women in the activity of their tibialis anterior during simulated HSPL. Terrain stiffness, in the ranges tested, did not appear to influence ankle biomechanics among individuals performing HSPL. Additional studies are required to know whether this finding is applicable to realistic parachuting.

  12. Maximum voluntary joint torque as a function of joint angle and angular velocity: model development and application to the lower limb.

    PubMed

    Anderson, Dennis E; Madigan, Michael L; Nussbaum, Maury A

    2007-01-01

    Measurements of human strength can be important during analyses of physical activities. Such measurements have often taken the form of the maximum voluntary torque at a single joint angle and angular velocity. However, the available strength varies substantially with joint position and velocity. When examining dynamic activities, strength measurements should account for these variations. A model is presented of maximum voluntary joint torque as a function of joint angle and angular velocity. The model is based on well-known physiological relationships between muscle force and length and between muscle force and velocity and was tested by fitting it to maximum voluntary joint torque data from six different exertions in the lower limb. Isometric, concentric and eccentric maximum voluntary contractions were collected during hip extension, hip flexion, knee extension, knee flexion, ankle plantar flexion and dorsiflexion. Model parameters are reported for each of these exertion directions by gender and age group. This model provides an efficient method by which strength variations with joint angle and angular velocity may be incorporated into comparisons between joint torques calculated by inverse dynamics and the maximum available joint torques.

  13. Optimal Inversion Parameters for Full Waveform Inversion using OBS Data Set

    NASA Astrophysics Data System (ADS)

    Kim, S.; Chung, W.; Shin, S.; Kim, D.; Lee, D.

    2017-12-01

    In recent years, full Waveform Inversion (FWI) has been the most researched technique in seismic data processing. It uses the residuals between observed and modeled data as an objective function; thereafter, the final subsurface velocity model is generated through a series of iterations meant to minimize the residuals.Research on FWI has expanded from acoustic media to elastic media. In acoustic media, the subsurface property is defined by P-velocity; however, in elastic media, properties are defined by multiple parameters, such as P-velocity, S-velocity, and density. Further, the elastic media can also be defined by Lamé constants, density or impedance PI, SI; consequently, research is being carried out to ascertain the optimal parameters.From results of advanced exploration equipment and Ocean Bottom Seismic (OBS) survey, it is now possible to obtain multi-component seismic data. However, to perform FWI on these data and generate an accurate subsurface model, it is important to determine optimal inversion parameters among (Vp, Vs, ρ), (λ, μ, ρ), and (PI, SI) in elastic media. In this study, staggered grid finite difference method was applied to simulate OBS survey. As in inversion, l2-norm was set as objective function. Further, the accurate computation of gradient direction was performed using the back-propagation technique and its scaling was done using the Pseudo-hessian matrix.In acoustic media, only Vp is used as the inversion parameter. In contrast, various sets of parameters, such as (Vp, Vs, ρ) and (λ, μ, ρ) can be used to define inversion in elastic media. Therefore, it is important to ascertain the parameter that gives the most accurate result for inversion with OBS data set.In this study, we generated Vp and Vs subsurface models by using (λ, μ, ρ) and (Vp, Vs, ρ) as inversion parameters in every iteration, and compared the final two FWI results.This research was supported by the Basic Research Project(17-3312) of the Korea Institute of

  14. Identification of a parametric, discrete-time model of ankle stiffness.

    PubMed

    Guarin, Diego L; Jalaleddini, Kian; Kearney, Robert E

    2013-01-01

    Dynamic ankle joint stiffness defines the relationship between the position of the ankle and the torque acting about it and can be separated into intrinsic and reflex components. Under stationary conditions, intrinsic stiffness can described by a linear second order system while reflex stiffness is described by Hammerstein system whose input is delayed velocity. Given that reflex and intrinsic torque cannot be measured separately, there has been much interest in the development of system identification techniques to separate them analytically. To date, most methods have been nonparametric and as a result there is no direct link between the estimated parameters and those of the stiffness model. This paper presents a novel algorithm for identification of a discrete-time model of ankle stiffness. Through simulations we show that the algorithm gives unbiased results even in the presence of large, non-white noise. Application of the method to experimental data demonstrates that it produces results consistent with previous findings.

  15. [Association between urinary microalbumin-to-creatinine ratio and brachial-ankle pulse wave velocity in hypertensive patients].

    PubMed

    Zhu, Hang; Xue, Hao; Wang, Guangyi; Fu, Zhenhong; Liu, Jie; Shi, Yajun

    2015-04-01

    To explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients. A total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012, and were randomly recruited and patients were divided into normal ACR group (ACR < 30 mg/g, n = 723), micro-albuminuria group (30 mg/g ≤ ACR < 300 mg/g, n = 136) and macro-albuminuria group (ACR ≥ 300 mg/g, n = 18). baPWV was measure by automatic pulse wave velocity measuring system. The baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P < 0.05). The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P < 0.05). Linear correlation analysis revealed that ACR was positively correlated with baPWV (r = 0.413, P < 0.01). Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β = 0.29, R(2) = 0.112, P < 0.01) after adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride. Using ACR < 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable, binary logistic regression analysis showed that ACR ≥ 30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR: 1.73, 95% CI: 1.62-2.98) after adjusting the traditional cardiovascular risk factors. ACR is positively correlated to baPWV in primary hypertension patients, and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.

  16. Isolated syndesmosis ankle injury.

    PubMed

    Valkering, Kars P; Vergroesen, Diederik A; Nolte, Peter A

    2012-12-01

    Isolated syndesmosis injuries often go unrecognized and are diagnosed as lateral ankle sprains; however, they are more disabling than lateral ankle sprains. The reported incidence of isolated syndesmosis injuries in acute ankle sprains ranges between 1% and 16%. When ankle disability lasts for more than 2 months after an ankle sprain, the incidence increases to 23.6%. Diagnostic workup may include stress radiographs, magnetic resonance imaging, or diagnostic arthroscopy. A simple stress test radiograph may reveal an unstable grade III syndesmosis sprain that may go unrecognized on plain anteroposterior and mortise or lateral radiographs of the ankle. The duration of symptoms in isolated syndesmosis injury is longer and more severe, often leading to chronic symptoms or ankle instability requiring operative stabilization.This article describes the clinical presentation, injury classification, and operative stabilization techniques of isolated syndesmosis injuries. The authors performed their preferred operative stabilization technique for isolated syndesmosis injury-arthroscopic debridement of the ankle with syndesmotic stabilization with a syndesmotic screw-in 4 patients. All patients were evaluated 1 year postoperatively with subjective and objective assessment scales. Three of 4 patients showed good improvement of general subjective ankle symptoms and subjective ankle instability rating and a high Sports Ankle Rating System score after 1 year. Copyright 2012, SLACK Incorporated.

  17. The relationships between instrumented measurements of ankle and knee ligamentous laxity and generalized joint laxity.

    PubMed

    Pearsall, A W; Kovaleski, J E; Heitman, R J; Gurchiek, L R; Hollis, J M

    2006-03-01

    The purpose of this study was to evaluate whether lower extremity joint laxity is a function of a particular joint and/or a generalizable characteristic (trait) of the person. Validated instrumented measurements of ankle and knee joint-specific laxity in the same individual were correlated to determine whether a relationship exists. In addition, ankle and knee joint-specific laxity were correlated with generalized joint laxity using the modified Beighton mobility index. Fifty-seven male and female athletes were studied. We examined dominant ankle laxity using an ankle arthrometer and dominate knee anterior laxity using the KT 2000. The dominant ankle was loaded in anteroposterior (AP) drawer and inversion-eversion (I-E) rotation. Laxity was measured as total AP displacement (millimeters) after +/-125 N of applied force and total I-E rotation (degrees) was measured after +/-4 N x m of applied torque. The dominant knee was loaded with an anterior drawer and laxity (millimeters) was measured after manual maximum displacement. Non-significant correlations were observed among the test variables for generalized joint laxity (0.21 to 0.37; P>0.05) and instrumented ankle and knee joint laxity (0.19 to 0.21; P>0.05). When examined by gender, no statistically significant correlations (0.05 to 0.40; P>0.05) were found for either generalized laxity or instrumented ankle and knee joint laxity. These results imply that ankle and knee joint laxity are joint-specific and not generalizable.

  18. Imaging The Shallow Velocity Structure Of The Hikurangi Megathrust Using Full-Waveform Inversion

    NASA Astrophysics Data System (ADS)

    Gray, M.; Bell, R. E.; Morgan, J. V.

    2017-12-01

    The Hikurangi margin, offshore North Island, New Zealand, exhibits a number of different slip behaviours, including shallow slow slip events (SSEs) (<2km to 15 km). There is also a strong contrast in geodetic coupling along the margin. While reflection data provides an image of the structure, no information about physical properties is provided. Full-waveform inversion (FWI) is an imaging technique which incorporates the full seismic wavelet rather than just the first arrivals, as in traditional tomography. By propagating synthetic seismic waves through a velocity model and comparing the synthetic wavelets to the field data, we update the velocity model until the real and synthetic wavelets match. In this way, we can resolve high-resolution physical property variations which influence the seismic wavefield. In our study, FWI was used to resolve the P-wave velocity structure at the Hikurangi megathrust up to 2km. This method enables investigation of how upper-plate structure may influence plate boundary slip behaviour. In 2005, a seismic survey was carried out over the Hikurangi megathrust. The data was acquired from a 12km streamer, allowing FWI analysis up to 2km below the seabed. The results show low velocity zones correlating to faults interpreted from reflection seismic imaging. We believe these low velocity zones, particularly near the frontal thrust resolve faulting in the area, and present these faults as possible fluid conduits. As the dataset was not collected specifically for FWI, the results show promise in resolving more information at depth. As such, both a 3D seismic survey and two drilling expeditions have been approved for the period November 2017 - May 2018. The seismic survey will be carried out with parameters optimal for FWI, allow imaging of the fault boundary, which is not possible with the current 2D data. The cores will provide direct geological evidence which can be used in conjunction with velocity models to discern lithology and structure

  19. [Effect of blood lipid on the change of brachial-ankle pulse wave velocity among prehypertensive population].

    PubMed

    Wang, Lin; Shuai, Ping; Liu, Yuping; Cheng, Youfu; Yang, Hua; Li, Tingxin; Gong, Lirong; Ren, Jiaojiao; Wang, Hongjia

    2014-09-01

    To explore the effect of blood lipid and lipoprotein ratios on the change of brachial-ankle pulse wave velocity (baPWV) among prehypertensive subjects. 11 611 subjects with normal blood pressure (BP) were divided into two groups, which was one with optimal blood pressure (BP<120/80 mmHg) and the other with prehypertension (BP:120-139/80-89 mmHg). Height, weight, baPWV, fasting blood-glucose, TC, TG, LDL-C and HDL-C were detected. The abnormal rate of baPWV in prehypertension group was obviously higher than that in the optimal blood pressure group. For optimal blood pressure group, the abnormality of TG, TC, LDL-C, TC/HDL-C as well as LDL-C/HDL-C, caused the increase of baPWV significantly (P < 0.001). For prehypertensive group, the abnormality of TC and LDL-C caused the significant increase of baPWV (P < 0.001). Results from logistic regression analysis showed that except for age, BMI and fasting blood-glucose, TC/HDL-C increasing was the independent risk factor in optimal blood pressure group, while TG increasing was for the prehypertension group. With different normal BP level, both abnormality of blood lipid and lipoprotein ratio were the independent risk factors for baPWV increasing.

  20. The Effect of Backpack Load Carriage on the Kinetics and Kinematics of Ankle and Knee Joints During Uphill Walking.

    PubMed

    Lee, Jinkyu; Yoon, Yong-Jin; Shin, Choongsoo S

    2017-12-01

    The purpose of this study was to investigate the effect of load carriage on the kinematics and kinetics of the ankle and knee joints during uphill walking, including joint work, range of motion (ROM), and stance time. Fourteen males walked at a self-selected speed on an uphill (15°) slope wearing military boots and carrying a rifle in hand without a backpack (control condition) and with a backpack. The results showed that the stance time significantly decreased with backpack carriage (p < .05). The mediolateral impulse significantly increased with backpack carriage (p < .05). In the ankle joints, the inversion-eversion, and dorsi-plantar flexion ROM in the ankle joints increased with backpack carriage (p < .05). The greater dorsi-plantar flexion ROM with backpack carriage suggested 1 strategy for obtaining high plantar flexor power during uphill walking. The result of the increased mediolateral impulse and inversion-eversion ROM in the ankle joints indicated an increase in body instability caused by an elevated center of mass with backpack carriage during uphill walking. The decreased stance time indicated that an increase in walking speed could be a compensatory mechanism for reducing the instability of the body during uphill walking while carrying a heavy backpack.

  1. Chimpanzee ankle and foot joint kinematics: Arboreal versus terrestrial locomotion.

    PubMed

    Holowka, Nicholas B; O'Neill, Matthew C; Thompson, Nathan E; Demes, Brigitte

    2017-09-01

    Many aspects of chimpanzee ankle and midfoot joint morphology are believed to reflect adaptations for arboreal locomotion. However, terrestrial travel also constitutes a significant component of chimpanzee locomotion, complicating functional interpretations of chimpanzee and fossil hominin foot morphology. Here we tested hypotheses of foot motion and, in keeping with general assumptions, we predicted that chimpanzees would use greater ankle and midfoot joint ranges of motion during travel on arboreal supports than on the ground. We used a high-speed motion capture system to measure three-dimensional kinematics of the ankle and midfoot joints in two male chimpanzees during three locomotor modes: terrestrial quadrupedalism on a flat runway, arboreal quadrupedalism on a horizontally oriented tree trunk, and climbing on a vertically oriented tree trunk. Chimpanzees used relatively high ankle joint dorsiflexion angles during all three locomotor modes, although dorsiflexion was greatest in arboreal modes. They used higher subtalar joint coronal plane ranges of motion during terrestrial and arboreal quadrupedalism than during climbing, due in part to their use of high eversion angles in the former. Finally, they used high midfoot inversion angles during arboreal locomotor modes, but used similar midfoot sagittal plane kinematics across all locomotor modes. The results indicate that chimpanzees use large ranges of motion at their various ankle and midfoot joints during both terrestrial and arboreal locomotion. Therefore, we argue that chimpanzee foot anatomy enables a versatile locomotor repertoire, and urge caution when using foot joint morphology to reconstruct arboreal behavior in fossil hominins. © 2017 Wiley Periodicals, Inc.

  2. Using an electrohydraulic ankle foot orthosis to study modifications in feedforward control during locomotor adaptation to force fields applied in stance

    PubMed Central

    Noel, Martin; Fortin, Karine; Bouyer, Laurent J

    2009-01-01

    Background Adapting to external forces during walking has been proposed as a tool to improve locomotion after central nervous system injury. However, sensorimotor integration during walking varies according to the timing in the gait cycle, suggesting that adaptation may also depend on gait phases. In this study, an ElectroHydraulic AFO (EHO) was used to apply forces specifically during mid-stance and push-off to evaluate if feedforward movement control can be adapted in these 2 gait phases. Methods Eleven healthy subjects walked on a treadmill before (3 min), during (5 min) and after (5 min) exposure to 2 force fields applied by the EHO (mid-stance/push-off; ~10 Nm, towards dorsiflexion). To evaluate modifications in feedforward control, strides with no force field ('catch strides') were unexpectedly inserted during the force field walking period. Results When initially exposed to a mid-stance force field (FF20%), subjects showed a significant increase in ankle dorsiflexion velocity. Catches applied early into the FF20% were similar to baseline (P > 0.99). Subjects gradually adapted by returning ankle velocity to baseline over ~50 strides. Catches applied thereafter showed decreased ankle velocity where the force field was normally applied, indicating the presence of feedforward adaptation. When initially exposed to a push-off force field (FF50%), plantarflexion velocity was reduced in the zone of force field application. No adaptation occurred over the 5 min exposure. Catch strides kinematics remained similar to control at all times, suggesting no feedforward adaptation. As a control, force fields assisting plantarflexion (-3.5 to -9.5 Nm) were applied and increased ankle plantarflexion during push-off, confirming that the lack of kinematic changes during FF50% catch strides were not simply due to a large ankle impedance. Conclusion Together these results show that ankle exoskeletons such as the EHO can be used to study phase-specific adaptive control of the ankle

  3. Using an electrohydraulic ankle foot orthosis to study modifications in feedforward control during locomotor adaptation to force fields applied in stance.

    PubMed

    Noel, Martin; Fortin, Karine; Bouyer, Laurent J

    2009-06-03

    Adapting to external forces during walking has been proposed as a tool to improve locomotion after central nervous system injury. However, sensorimotor integration during walking varies according to the timing in the gait cycle, suggesting that adaptation may also depend on gait phases. In this study, an ElectroHydraulic AFO (EHO) was used to apply forces specifically during mid-stance and push-off to evaluate if feedforward movement control can be adapted in these 2 gait phases. Eleven healthy subjects walked on a treadmill before (3 min), during (5 min) and after (5 min) exposure to 2 force fields applied by the EHO (mid-stance/push-off; approximately 10 Nm, towards dorsiflexion). To evaluate modifications in feedforward control, strides with no force field ('catch strides') were unexpectedly inserted during the force field walking period. When initially exposed to a mid-stance force field (FF 20%), subjects showed a significant increase in ankle dorsiflexion velocity. Catches applied early into the FF 20% were similar to baseline (P > 0.99). Subjects gradually adapted by returning ankle velocity to baseline over approximately 50 strides. Catches applied thereafter showed decreased ankle velocity where the force field was normally applied, indicating the presence of feedforward adaptation. When initially exposed to a push-off force field (FF 50%), plantarflexion velocity was reduced in the zone of force field application. No adaptation occurred over the 5 min exposure. Catch strides kinematics remained similar to control at all times, suggesting no feedforward adaptation. As a control, force fields assisting plantarflexion (-3.5 to -9.5 Nm) were applied and increased ankle plantarflexion during push-off, confirming that the lack of kinematic changes during FF 50% catch strides were not simply due to a large ankle impedance. Together these results show that ankle exoskeletons such as the EHO can be used to study phase-specific adaptive control of the ankle during

  4. Correlations between Angular Velocities in Selected Joints and Velocity of Table Tennis Racket during Topspin Forehand and Backhand

    PubMed Central

    Bańkosz, Ziemowit; Winiarski, Sławomir

    2018-01-01

    The aim of this study was to determine the correlations between angular velocities in individual joints and racket velocity for different topspin forehand and backhand strokes in table tennis. Ten elite female table tennis players participated, presenting different kinds of topspin forehands and backhands – after a no-spin ball (FH1, BH1), after a backspin ball (FH2, BH2) and “heavy” topspin (FH3, BH3). Range of motion was measured with the BTS Smart-E (BTS Bioengineering, Milan, Italy) motion analysis system with a specially developed marker placement protocol for the upper body parts and an acoustic sensor attached to the racket to identify ball-racket contact. In forehand strokes angular velocities of internal arm rotation and adduction in shoulder joint correlated with racket velocity. Racket velocity was correlated with angular velocities (hip extension on the playing side; hip flexion on the opposite side; ankle flexion) in the case of a topspin forehand performed with maximal force –”heavy” topspin (FH3). In backhand strokes the velocities of arm abduction and shoulder girdle rotation towards the playing side correlated with racket velocity. The angular velocity of internal arm rotation and adduction in shoulder joint may be important components of a coordinated stroke, whilst angular velocity can substantially affect the racket speed when one is changing the type of stroke. Key points The aim of this study was to calculate correlations between racket velocity and the angular velocities of individual joints and for variants of topspin forehand and backhand strokes in table tennis. A novel model was used to estimate range of motion (specially developed placement protocol for upper body markers and identification of a ball-racket contact using an acoustic sensor attached to the racket). In forehand strokes angular velocities of internal arm rotation and adduction in shoulder joint were correlated with racket velocity. Correlations between racket

  5. Task-specific ankle robotics gait training after stroke: a randomized pilot study.

    PubMed

    Forrester, Larry W; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I; Macko, Richard F

    2016-06-02

    An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than robotics focused on paretic ankle impairments. Participants with chronic hemiparetic gait were randomized to either six weeks of treadmill-integrated ankle robotics (n = 14) or dose-matched seated ankle robotics (n = 12) videogame training. Selected gait measures were collected at baseline, post-training, and six-week retention. Friedman, and Wilcoxon Sign Rank and Fisher's exact tests evaluated within and between group differences across time, respectively. Six weeks post-training, treadmill robotics proved more effective than seated robotics to increase walking velocity, paretic single support, paretic push-off impulse, and active dorsiflexion range of motion. Treadmill robotics durably improved gait dorsiflexion swing angle leading 6/7 initially requiring ankle braces to self-discarded them, while their unassisted paretic heel-first contacts increased from 44 % to 99.6 %, versus no change in assistive device usage (0/9) following seated robotics. Treadmill-integrated, but not seated ankle robotics training, durably improves gait biomechanics, reversing foot drop, restoring walking propulsion, and establishing safer foot landing in chronic stroke that may reduce reliance on assistive devices. These findings support a task-specific approach integrating adaptive ankle robotics with locomotor training to optimize mobility recovery. NCT01337960. https://clinicaltrials.gov/ct2/show/NCT01337960?term=NCT01337960&rank=1.

  6. Shear Wave Velocity Structure beneath the African-Anatolian Subduction Zone in Southwestern Turkey from Inversions of Rayleigh Waves

    NASA Astrophysics Data System (ADS)

    Teoman, U. M.; Sandvol, E. A.; Kahraman, M.; Sahin, S.; Turkelli, N.

    2011-12-01

    The ongoing subduction of the African Plate under western Anatolia results in a highly complex tectonic structure especially beneath Isparta Angle (IA) and the surroundings where the Hellenic and Cyprian slabs with different subduction geometries intersect. The primary objective is to accurately image the lithospheric structure at this convergent plate boundary and further understand the reasons responsible for the active deformation. Data was gathered from a temporary seismic network consisting of 10 broadband stations that was installed in August 2006 with the support from University of Missouri and nine more stations deployed in March 2007 with the support from Bogazici Research Fund (project ID:07T203). In addition, 21 permanent stations of Kandilli Observatory and Earthquake Research Institute (KOERI) and two from Süleyman Demirel University (SDU) together with five stations from IRIS/Geofon Network were also included to extend the station coverage. We used earthquakes in a distance range of 30-120 degrees with body wave magnitudes larger than 5.5. Depending on the signal to noise ratio, azimuthal coverage of events, and coherence from station, 81 events provided high-quality data for our analysis. The distribution of events shows a good azimuthal coverage, which is important for resolving both lateral heterogeneity and azimuthal anisotropy. We adopted a two-plane-wave inversion technique of Forsyth and Li (2003) to simultaneously solve for the incoming wave field and phase velocity. This relatively simpler representation of a more complex wavefield provided quite stable patterns of amplitude variations in many cases. To begin with, an average phase velocity dispersion curve was obtained and used as an input for tomographic inversions. Two-dimensional tomographic maps of isotropic and azimuthally anisotropic phase velocity variations were generated. Phase velocities can only tell us integrated information about the upper mantle. Furthermore, we inverted phase

  7. Chronic ankle instability: Current perspectives

    PubMed Central

    Al-Mohrej, Omar A.; Al-Kenani, Nader S.

    2016-01-01

    Ankle sprain is reported to be among the most common recurrent injuries. About 20% of acute ankle sprain patients develop chronic ankle instability. The failure of functional rehabilitation after acute ankle sprain leads to the development of chronic ankle instability. Differentiation between functional and anatomical ankle instability is very essential to guide the proper treatment. Stability testing by varus stress test and anterior drawer test should be carried out. Subtalar instability is an important pathology that is commonly by passed during the assessment of chronic ankle instability. Unlike acute ankle sprain, chronic ankle instability might require surgical intervention. The surgical and conservative management options can be very much developed by in-depth knowledge of the ankle anatomy, biomechanics, and pathology. Anatomical repair, augmentation by tendon, or both are the basic methods of surgical intervention. Arthroscopy is becoming more popular in the management of chronic ankle instability. PMID:27843798

  8. Identification of source velocities on 3D structures in non-anechoic environments: Theoretical background and experimental validation of the inverse patch transfer functions method

    NASA Astrophysics Data System (ADS)

    Aucejo, M.; Totaro, N.; Guyader, J.-L.

    2010-08-01

    In noise control, identification of the source velocity field remains a major problem open to investigation. Consequently, methods such as nearfield acoustical holography (NAH), principal source projection, the inverse frequency response function and hybrid NAH have been developed. However, these methods require free field conditions that are often difficult to achieve in practice. This article presents an alternative method known as inverse patch transfer functions, designed to identify source velocities and developed in the framework of the European SILENCE project. This method is based on the definition of a virtual cavity, the double measurement of the pressure and particle velocity fields on the aperture surfaces of this volume, divided into elementary areas called patches and the inversion of impedances matrices, numerically computed from a modal basis obtained by FEM. Theoretically, the method is applicable to sources with complex 3D geometries and measurements can be carried out in a non-anechoic environment even in the presence of other stationary sources outside the virtual cavity. In the present paper, the theoretical background of the iPTF method is described and the results (numerical and experimental) for a source with simple geometry (two baffled pistons driven in antiphase) are presented and discussed.

  9. The hip strength:ankle proprioceptive threshold ratio predicts falls and injury in diabetic neuropathy

    PubMed Central

    Richardson, James K.; DeMott, Trina; Allet, Lara; Kim; Ashton-Miller, James A.

    2014-01-01

    Introduction We determined lower limb neuromuscular capacities associated with falls and fall-related injuries in older people with declining peripheral nerve function. Methods Thirty-two subjects (67.4 ± 13.4 years; 19 with type 2 diabetes), representing a spectrum of peripheral neurologic function, were evaluated with frontal plane proprioceptive thresholds at the ankle, frontal plane motor function at the ankle and hip, and prospective follow-up for 1 year. Results Falls and fall-related injuries were reported by 20 (62.5%) and 14 (43.8%) subjects, respectively. The ratio of hip adductor rate of torque development to ankle proprioceptive threshold (HipSTR/AnkPRO) predicted falls (pseudo-R2 = .726) and injury (pseudo-R2 = .382). No other variable maintained significance in the presence of HipSTR/AnkPRO. Discussion Fall and injury risk in the population studied is related inversely to HipSTR/AnkPRO. Increasing rapidly available hip strength in patients with neuropathic ankle sensory impairment may decrease risk of falls and related injuries. PMID:24282041

  10. Ankle-Dorsiflexion Range of Motion After Ankle Self-Stretching Using a Strap

    PubMed Central

    Jeon, In-cheol; Kwon, Oh-yun; Yi, Chung-Hwi; Cynn, Heon-Seock; Hwang, Ui-jae

    2015-01-01

    Context  A variety of ankle self-stretching exercises have been recommended to improve ankle-dorsiflexion range of motion (DFROM) in individuals with limited ankle dorsiflexion. A strap can be applied to stabilize the talus and facilitate anterior glide of the distal tibia at the talocrural joint during ankle self-stretching exercises. Novel ankle self-stretching using a strap (SSS) may be a useful method of improving ankle DFROM. Objective  To compare the effects of 2 ankle-stretching techniques (static stretching versus SSS) on ankle DFROM. Design  Randomized controlled clinical trial. Setting  University research laboratory. Patients or Other Participants  Thirty-two participants with limited active dorsiflexion (<20°) while sitting (14 women and 18 men) were recruited. Main Outcome Measure(s)  The participants performed 2 ankle self-stretching techniques (static stretching and SSS) for 3 weeks. Active DFROM (ADFROM), passive DFROM (PDFROM), and the lunge angle were measured. An independent t test was used to compare the improvements in these values before and after the 2 stretching interventions. The level of statistical significance was set at α = .05. Results  Active DFROM and PDFROM were greater in both stretching groups after the 3-week interventions. However, ADFROM, PDFROM, and the lunge angle were greater in the SSS group than in the static-stretching group (P < .05). Conclusions  Ankle SSS is recommended to improve ADFROM, PDFROM, and the lunge angle in individuals with limited DFROM. PMID:26633750

  11. Different corticospinal control between discrete and rhythmic movement of the ankle

    PubMed Central

    Goto, Yumeno; Jono, Yasutomo; Hatanaka, Ryota; Nomura, Yoshifumi; Tani, Keisuke; Chujo, Yuta; Hiraoka, Koichi

    2014-01-01

    We investigated differences in corticospinal and spinal control between discrete and rhythmic ankle movements. Motor evoked potentials (MEPs) in the tibialis anterior and soleus muscles and soleus H-reflex were elicited in the middle of the plantar flexion phase during discrete ankle movement or in the initial or later cycles of rhythmic ankle movement. The H-reflex was evoked at an intensity eliciting a small M-wave and MEPs were elicited at an intensity of 1.2 times the motor threshold of the soleus MEPs. Only trials in which background EMG level, ankle angle, and ankle velocity were similar among the movement conditions were included for data analysis. In addition, only trials with a similar M-wave were included for data analysis in the experiment evoking H-reflexes. Results showed that H reflex and MEP amplitudes in the soleus muscle during discrete movement were not significantly different from those during rhythmic movement. MEP amplitude in the tibialis anterior muscle during the later cycles of rhythmic movement was significantly larger than that during the initial cycle of the rhythmic movement or during discrete movement. Higher corticospinal excitability in the tibialis anterior muscle during the later cycles of rhythmic movement may reflect changes in corticospinal control from the initial cycle to the later cycles of rhythmic movement. PMID:25126066

  12. Primary ankle arthrodesis for neglected open Weber B ankle fracture dislocation.

    PubMed

    Thomason, Katherine; Ramesh, Ashwanth; McGoldrick, Niall; Cove, Richard; Walsh, James C; Stephens, Michael M

    2014-01-01

    Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Long-term prognosis of acute lateral ankle ligamentous sprains: high incidence of recurrences and residual symptoms.

    PubMed

    Kemler, Ellen; Thijs, Karin M; Badenbroek, Ilse; van de Port, Ingrid G L; Hoes, Arno W; Backx, Frank J G

    2016-12-01

    Acute lateral ankle ligamentous sprains (ALALS) are common injuries. This injury does not always have a favourable long-term outcome. Studies reporting the prognosis of ALALS after functional treatment are scarce. To determine the prognosis of functionally treated ALALS, in terms of recurrent ALALS and residual symptoms. Retrospective cohort study. Patients were recruited from 20 family practices, nine physical therapy practices, the emergency departments of a regional hospital and a university hospital. Adult patients with an ALALS caused by an inversion trauma were invited to participate in this study 2.5-5 years after their initial injury. Functional treatment of the initial ALALS. Acute lateral ankle ligamentous sprain recurrences and residual symptoms. A total of 44 patients were included, with an average follow-up period after the initial ankle sprain of 204 weeks (range 150-274 weeks). Eight patients (18.1%) had reinjured their ankle. Explicit pain around the ankle joint at physical examination was experienced by 45.5%. Clinical symptoms of anterior ankle impingement were present in 25% (all athletes), with radiologically confirmed tibiotalar osteophyte bone formation in 82% of them. A large proportion of patients with ALALS experience recurrences and persistent symptoms after their initial ankle injury. The high percentage of patients with anterior ankle impingement syndromes illustrates the need for early assessment of this impairment in patients with persistent complaints. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Bilateral transit time assessment of upper and lower limbs as a surrogate ankle brachial index marker.

    PubMed

    Foo, Jong Yong Abdiel

    2008-01-01

    Ankle brachial index is useful in monitoring the pathogenesis of peripheral arterial occlusive diseases. Sphygmomanometer is the standard instrument widely used but frequent prolonged monitoring can be less comfortable for patients. Pulse transit time is known to be inversely correlated with blood pressure and a ratio-based pulse transit time measurement has been proposed as a surrogate ankle brachial index marker. In this study, 17 normotensive adults (9 men; aged 25.4 +/- 3.9 years) were recruited. Two postural change test activities were performed to induce changes in the stiffness of the arterial wall of the moved periphery. Results showed that only readings from the limbs that adopted a new posture registered significant blood pressure and pulse transit time changes (P < .05). Furthermore, there was significant correlation between the ankle brachial index and pulse transit time ratio measure for both test activities (R(2) > or = 0.704). The findings herein suggest that pulse transit time ratio is a surrogate and accommodating ankle brachial index marker.

  15. Walking and Running Require Greater Effort from the Ankle than the Knee Extensor Muscles.

    PubMed

    Kulmala, Juha-Pekka; Korhonen, Marko T; Ruggiero, Luca; Kuitunen, Sami; Suominen, Harri; Heinonen, Ari; Mikkola, Aki; Avela, Janne

    2016-11-01

    The knee and ankle extensors as human primary antigravity muscle groups are of utmost importance in a wide range of locomotor activities. Yet, we know surprisingly little about how these muscle groups work, and specifically, how close to their maximal capacities they function across different modes and intensity of locomotion. Therefore, to advance our understanding of locomotor constraints, we determined and compared relative operating efforts of the knee and ankle extensors during walking, running, and sprinting. Using an inverse dynamics biomechanical analysis, the muscle forces of the knee and ankle extensors during walking (1.6 m·s), running (4.1 m·s), and sprinting (9.3 m·s) were quantified and then related to maximum forces of the same muscle groups obtained from a reference hopping test that permitted natural elastic limb behavior. During walking, the relative effort of the ankle extensors was almost two times greater compared with the knee extensors (35% ± 6% vs 19% ± 5%, P < 0.001). Changing walking to running decreased the difference in the relative effort between the extensor muscle groups, but still, the ankle extensors operated at a 25% greater level than the knee extensors (84% ± 12% vs 63% ± 17%, P < 0.05). At top speed sprinting, the ankle extensors reached their maximum operating level, whereas the knee extensors still worked well below their limits, showing a 25% lower relative effort compared with the ankle extensors (96% ± 11% vs 72% ± 19%, P < 0.01). Regardless of the mode of locomotion, humans operate at a much greater relative effort at the ankle than knee extensor muscles. As a consequence, the great demand on ankle extensors may be a key biomechanical factor limiting our locomotor ability and influencing the way we locomote and adapt to accommodate compromised neuromuscular system function.

  16. Relative sensitivity of depth discrimination for ankle inversion and plantar flexion movements.

    PubMed

    Black, Georgia; Waddington, Gordon; Adams, Roger

    2014-02-01

    25 participants (20 women, 5 men) were tested for sensitivity in discrimination between sets of six movements centered on 8 degrees, 11 degrees, and 14 degrees, and separated by 0.3 degrees. Both inversion and plantar flexion movements were tested. Discrimination of the extent of inversion movement was observed to decline linearly with increasing depth; however, for plantar flexion, the discrimination function for movement extent was found to be non-linear. The relatively better discrimination of plantar flexion movements than inversion movements at around 11 degrees from horizontal is interpreted as an effect arising from differential amounts of practice through use, because this position is associated with the plantar flexion movement made in normal walking. The fact that plantar flexion movements are discriminated better than inversion at one region but not others argues against accounts of superior proprioceptive sensitivity for plantar flexion compared to inversion that are based on general properties of plantar flexion such as the number of muscle fibres on stretch.

  17. Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity.

    PubMed

    Robertson, A D; Matta, G; Basile, V S; Black, S E; Macgowan, C K; Detre, J A; MacIntosh, B J

    2017-08-01

    The relationship between extracranial large-artery characteristics and arterial spin-labeling MR imaging may influence the quality of arterial spin-labeling-CBF images for older adults with and without vascular pathology. We hypothesized that extracranial arterial blood velocity can explain between-person differences in arterial spin-labeling data systematically across clinical populations. We performed consecutive pseudocontinuous arterial spin-labeling and phase-contrast MR imaging on 82 individuals (20-88 years of age, 50% women), including healthy young adults, healthy older adults, and older adults with cerebral small vessel disease or chronic stroke infarcts. We examined associations between extracranial phase-contrast hemodynamics and intracranial arterial spin-labeling characteristics, which were defined by labeling efficiency, temporal signal-to-noise ratio, and spatial coefficient of variation. Large-artery blood velocity was inversely associated with labeling efficiency ( P = .007), temporal SNR ( P < .001), and spatial coefficient of variation ( P = .05) of arterial spin-labeling, after accounting for age, sex, and group. Correction for labeling efficiency on an individual basis led to additional group differences in GM-CBF compared to correction using a constant labeling efficiency. Between-subject arterial spin-labeling variance was partially explained by extracranial velocity but not cross-sectional area. Choosing arterial spin-labeling timing parameters with on-line knowledge of blood velocity may improve CBF quantification. © 2017 by American Journal of Neuroradiology.

  18. Collegiate Football Players' Ankle Range of Motion and Dynamic Balance in Braced and Self-Adherent-Taped Conditions.

    PubMed

    Willeford, Kristin; Stanek, Justin M; McLoda, Todd A

    2018-01-01

    Ankle sprains are one of the most common injuries in the physically active population. Previous researchers have shown that supporting the ankle with taping or bracing is effective in preventing ankle sprains. However, no authors have compared the effects of self-adherent tape and lace-up ankle braces on ankle range of motion (ROM) and dynamic balance in collegiate football players.   To examine the effectiveness of self-adherent tape and lace-up ankle braces in reducing ankle ROM and improving dynamic balance before and after a typical collegiate football practice.   Crossover study.   Collegiate athletic training room.   Twenty-nine National Collegiate Athletic Association Division I football athletes (age = 19.2 ± 1.14 years, height = 187.52 ± 20.54 cm, mass = 106.44 ± 20.54 kg).   Each participant wore each prophylactic ankle support during a single practice, self-adherent tape on 1 leg and lace-up ankle brace on the other. Range of motion and dynamic balance were assessed 3 times for each leg throughout the testing session (baseline, prepractice, postpractice).   Ankle ROM for inversion, eversion, dorsiflexion, and plantar flexion were measured at baseline, immediately after donning the brace or tape, and immediately after a collegiate practice. The Y-Balance Test was used to assess dynamic balance at these same time points.   Both interventions were effective in reducing ROM in all directions compared with baseline; however, dynamic balance did not differ between the tape and brace conditions.   Both the self-adherent tape and lace-up ankle brace provided equal ROM restriction before and after exercise, with no change in dynamic balance.

  19. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study.

    PubMed

    Desloovere, Kaat; Molenaers, Guy; Van Gestel, Leen; Huenaerts, Catherine; Van Campenhout, Anja; Callewaert, Barbara; Van de Walle, Patricia; Seyler, J

    2006-10-01

    Several studies indicated that walking with an ankle foot orthosis (AFO) impaired third rocker. The purpose of this study was to evaluate the effects of two types of orthoses, with similar goal settings, on gait, in a homogeneous group of children, using both barefoot and shoe walking as control conditions. Fifteen children with hemiplegia, aged between 4 and 10 years, received two types of individually tuned AFOs: common posterior leaf-spring (PLS) and Dual Carbon Fiber Spring AFO (CFO) (with carbon fibre at the dorsal part of the orthosis). Both orthoses were expected to prevent plantar flexion, thus improving first rocker, allowing dorsiflexion to improve second rocker, absorbing energy during second rocker, and returning it during the third rocker. The effect of the AFOs was studied using objective gait analysis, including 3D kinematics, and kinetics in four conditions: barefoot, shoes without AFO, and PLS and CFO combined with shoes. Several gait parameters significantly changed in shoe walking compared to barefoot walking (cadence, ankle ROM and velocity, knee shock absorption, and knee angle in swing). The CFO produced a significantly larger ankle ROM and ankle velocity during push-off, and an increased plantar flexion moment and power generation at pre-swing compared to the PLS (<0.01). The results of this study further support the findings of previous studies indicating that orthoses improve specific gait parameters compared to barefoot walking (velocity, step length, first and second ankle rocker, sagittal knee and hip ROM). However, compared to shoes, not all improvements were statistically significant.

  20. The effect of tibiotalar alignment on coronal plane mechanics following total ankle replacement.

    PubMed

    Grier, A Jordan; Schmitt, Abigail C; Adams, Samuel B; Queen, Robin M

    2016-07-01

    Gait mechanics following total ankle replacement (TAR) have reported improved ankle motion following surgery. However, no studies have addressed the impact of preoperative radiographic tibiotalar alignment on post-TAR gait mechanics. We therefore investigated whether preoperative tibiotalar alignment (varus, valgus, or neutral) resulted in significantly different coronal plane mechanics or ground reaction forces post-TAR. We conducted a non-randomized study of 93 consecutive end-stage ankle arthritis patients. Standard weight-bearing radiographs were obtained preoperatively to categorize patients as having neutral (±4°), varus (≥5° of varus), or valgus (≥5° of valgus) coronal plane tibiotalar alignment. All patients underwent a standard walking assessment including three-dimensional lower extremity kinetics and kinematics preoperatively, 12 and 24 months postoperatively. A significant group by time interaction was observed for the propulsive vertical ground reaction force (vGRF), coronal plane hip range of motion (ROM) and the peak hip abduction moment. The valgus group demonstrated an increase in the peak knee adduction angle and knee adduction angle at heel strike when compared to the other groups. Coronal plane ankle ROM, knee and hip angles at heel strike, and the peak hip angle exhibited significant increases across time. Peak ankle inversion moment, peak knee abduction moment and the weight acceptance vGRF also exhibited significant increases across time. Neutral ankle alignment was achieved for all patients by 2 years following TAR. Restoration of neutral ankle alignment at the time of TAR in patients with preoperative varus or valgus tibiotalar alignment resulted in biomechanics similar to those of patients with neutral preoperative tibiotalar alignment by 24-month follow-up. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Early functional outcome of a modified Brostrom-Gould surgery using bioabsorbable suture anchor for chronic lateral ankle instability.

    PubMed

    Shahrulazua, A; Ariff Sukimin, M S; Tengku Muzaffar, T M; Yusof, M I

    2010-03-01

    The purpose of this study was to evaluate the early functional outcome following the use of a bioabsorbable suture anchor to simplify the repair of injured lateral ankle structures as a variation of an established technique known as the Brostrom-Gould procedure. This was a prospective study of 30 ankles with chronic lateral instability that underwent a modified Brostrom-Gould surgery using a bioabsorbable suture anchor, performed by a single surgeon. A total of 29 patients, aged 15 to 52 (mean is 33) years, were enrolled in the study. The follow-up period ranged from three to six (mean is four) months. The function of the patients' ankles was scored using the Kaikkonen Functional Scale, both preoperatively and postoperatively. Preoperatively, all ankles had poor scores (less than 50). Postoperatively, 28 ankles showed excellent scores and two ankles showed good scores, while none obtained a fair or poor score. The difference in the overall means between the postoperative and preoperative scores was statistically significant (p-value is 0.001). Post surgery, 24 ankles had no symptoms, while six had only mild ankle tightness with extreme inversion movement at the last review. All patients were able to walk normally, and 29 ankles regained their normal running capability. There was marked improvement in the ability to descend stairs, to rise on heels and toes, to perform a single-limb stance, and in range of motions of the ankle dorsiflexion as well as in ankle laxity. The modified Brostrom-Gould procedure using a bioabsorbable suture anchor allowed for early ankle rehabilitation and offered a reproducible and excellent early functional outcome with minimal complications.

  2. The effect of ankle foot orthosis stiffness on the energy cost of walking: a simulation study.

    PubMed

    Bregman, D J J; van der Krogt, M M; de Groot, V; Harlaar, J; Wisse, M; Collins, S H

    2011-11-01

    In stroke and multiple sclerosis patients, gait is frequently hampered by a reduced ability to push-off with the ankle caused by weakness of the plantar-flexor muscles. To enhance ankle push-off and to decrease the high energy cost of walking, spring-like carbon-composite Ankle Foot Orthoses are frequently prescribed. However, it is unknown what Ankle Foot Orthoses stiffness should be used to obtain the most efficient gait. The aim of this simulation study was to gain insights into the effect of variation in Ankle Foot Orthosis stiffness on the amount of energy stored in the Ankle Foot Orthosis and the energy cost of walking. We developed a two-dimensional forward-dynamic walking model with a passive spring at the ankle representing the Ankle Foot Orthosis and two constant torques at the hip for propulsion. We varied Ankle Foot Orthosis stiffness while keeping speed and step length constant. We found an optimal stiffness, at which the energy delivered at the hip joint was minimal. Energy cost decreased with increasing energy storage in the ankle foot orthosis, but the most efficient gait did not occur with maximal energy storage. With maximum storage, push-off occurred too late to reduce the impact of the contralateral leg with the floor. Maximum return prior to foot strike was also suboptimal, as push-off occurred too early and its effects were subsequently counteracted by gravity. The optimal Ankle Foot Orthosis stiffness resulted in significant push-off timed just prior to foot strike and led to greater ankle plantar-flexion velocity just before contralateral foot strike. Our results suggest that patient energy cost might be reduced by the proper choice of Ankle Foot Orthosis stiffness. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain.

    PubMed

    Ju, Sung-Bum; Park, Gi Duck

    2017-02-01

    [Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function.

  4. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain

    PubMed Central

    Ju, Sung-Bum; Park, Gi Duck

    2017-01-01

    [Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function. PMID:28265157

  5. A comparison of MRI and clinical examination of acute lateral ankle sprains.

    PubMed

    Frey, C; Bell, J; Teresi, L; Kerr, R; Feder, K

    1996-09-01

    Because of its excellent soft tissue contrast and ability to demonstrate soft tissue structures, magnetic resonance imaging is ideally suited to the evaluation of the soft tissues surrounding the ankle, including the lateral collateral ligaments. This study was undertaken to compare the clinical evaluation of 15 patients who suffered inversion injuries of the ankle with the results found on magnetic resonance imaging within 48 hours of the injury. Physical examination was found to be 100% accurate in the diagnosis of grade III ligament injuries but only 25% accurate in the diagnosis of grade II injuries. Clinicians most often underestimate the damage with a grade II ligament tear. Furthermore, other associated injuries, such as significant capsule ruptures and tendon damage, were often overlooked at physical examination.

  6. Reliability and smallest real difference of the ankle lunge test post ankle fracture.

    PubMed

    Simondson, David; Brock, Kim; Cotton, Susan

    2012-02-01

    This study aimed to determine the reliability and the smallest real difference of the Ankle Lunge test in an ankle fracture patient population. In the post immobilisation stage of ankle fracture, ankle dorsiflexion is an important measure of progress and outcome. The Ankle Lunge test measures weight bearing dorsiflexion, resulting in negative scores (knee to wall distance) and positive scores (toe to wall distance), for which the latter has proven reliability in normal subjects only. A consecutive sample of ankle fracture patients with permission to commence weight bearing, were recruited to the study. Three measurements of the Ankle Lunge Test were performed each by two raters, one senior and one junior physiotherapist. These occurred prior to therapy sessions in the second week after plaster removal. A standardised testing station was utilised and allowed for both knee to wall distance and toe to wall distance measurement. Data was collected from 10 individuals with ankle fracture, with an average age of 36 years (SD 14.8). Seventy seven percent of observations were negative. Intra and inter-rater reliability yielded intra class correlations at or above 0.97, p < .001. There was a significant systematic bias towards improved scores during repeated measurement for one rater (p = .01). The smallest real difference was calculated as 13.8mm. The Ankle Lunge test is a practical and reliable tool for measuring weightbearing dorsiflexion post ankle fracture. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Joint Angular Velocity in Spastic Gait and the Influence of Muscle-Tendon Lengthening*

    PubMed Central

    GRANATA, KEVIN P.; ABEL, MARK F.; DAMIANO, DIANE L.

    2006-01-01

    Background Joint angular velocity (the rate of flexion and extension of a joint) is related to the dynamics of muscle activation and force generation during walking. Therefore, the goal of this research was to examine the joint angular velocity in normal and spastic gait and changes resulting from muscle-tendon lengthening (recession and tenotomy) in patients who have spastic cerebral palsy. Methods The gait patterns of forty patients who had been diagnosed with spastic cerebral palsy (mean age, 8.3 years; range, 3.7 to 14.8 years) and of seventy-three age-matched, normally developing subjects were evaluated with three-dimensional motion analysis and electromyography. The patients who had cerebral palsy were evaluated before muscle-tendon lengthening and nine months after treatment. Results The gait patterns of the patients who had cerebral palsy were characterized by increased flexion of the knee in the stance phase, premature plantar flexion of the ankle, and reduced joint angular velocities compared with the patterns of the normally developing subjects. Even though muscle-tendon lengthening altered sagittal joint angles in gait, the joint angular velocities were generally unchanged at the hip and knee. Only the ankle demonstrated modified angular velocities, including reduced dorsiflexion velocity at foot-strike and improved dorsiflexion velocity through midstance, after treatment. Electromyographic changes included reduced amplitude of the gastrocnemius-soleus during the loading phase and decreased knee coactivity (the ratio of quadriceps and hamstring activation) at toe-off. Principal component analyses showed that, compared with joint-angle data, joint angular velocity was better able to discriminate between the gait patterns of the normal and cerebral palsy groups. Conclusions This study showed that muscle-tendon lengthening corrects biomechanical alignment as reflected by changes in sagittal joint angles. However, joint angular velocity and

  8. Therapeutic interventions for increasing ankle dorsiflexion after ankle sprain: a systematic review.

    PubMed

    Terada, Masafumi; Pietrosimone, Brian G; Gribble, Phillip A

    2013-01-01

    Clinicians perform therapeutic interventions, such as stretching, manual therapy, electrotherapy, ultrasound, and exercises, to increase ankle dorsiflexion. However, authors of previous studies have not determined which intervention or combination of interventions is most effective. To determine the magnitude of therapeutic intervention effects on and the most effective therapeutic interventions for restoring normal ankle dorsiflexion after ankle sprain. We performed a comprehensive literature search in Web of Science and EBSCO HOST from 1965 to May 29, 2011, with 19 search terms related to ankle sprain, dorsiflexion, and intervention and by cross-referencing pertinent articles. Eligible studies had to be written in English and include the means and standard deviations of both pretreatment and posttreatment in patients with acute, subacute, or chronic ankle sprains. Outcomes of interest included various joint mobilizations, stretching, local vibration, hyperbaric oxygen therapy, electrical stimulation, and mental-relaxation interventions. We extracted data on dorsiflexion improvements among various therapeutic applications by calculating Cohen d effect sizes with associated 95% confidence intervals (CIs) and evaluated the methodologic quality using the Physiotherapy Evidence Database (PEDro) scale. In total, 9 studies (PEDro score = 5.22 ± 1.92) met the inclusion criteria. Static-stretching interventions with a home exercise program had the strongest effects on increasing dorsiflexion in patients 2 weeks after acute ankle sprains (Cohen d = 1.06; 95% CI = 0.12, 2.42). The range of effect sizes for movement with mobilization on ankle dorsiflexion among individuals with recurrent ankle sprains was small (Cohen d range = 0.14 to 0.39). Static-stretching intervention as a part of standardized care yielded the strongest effects on dorsiflexion after acute ankle sprains. The existing evidence suggests that clinicians need to consider what may be the limiting factor of

  9. The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability.

    PubMed

    Hadadi, Mohammad; Ebrahimi, Ismaeil; Mousavi, Mohammad Ebrahim; Aminian, Gholamreza; Esteki, Ali; Rahgozar, Mehdi

    2017-02-01

    Chronic ankle instability is associated with neuromechanical changes and poor postural stability. Despite variety of mechanisms of foot and ankle orthoses, almost none apply comprehensive mechanisms to improve postural control in all subgroups of chronic ankle instability patients. The purpose of this study was to investigate the effect of an ankle support implementing combined mechanisms to improve postural control in chronic ankle instability patients. Cross-sectional study. An ankle support with combined mechanism was designed based on most effective action mechanisms of foot and ankle orthoses. The effect of this orthosis on postural control was evaluated in 20 participants with chronic ankle instability and 20 matched healthy participants. The single-limb stance balance test was measured in both groups with and without the new orthosis using a force platform. The results showed that application of combined mechanism ankle support significantly improved all postural sway parameters in chronic ankle instability patients. There were no differences in means of investigated parameters with and without the orthosis in the healthy group. No statistically significant differences were found in postural sway between chronic ankle instability patients and healthy participants after applying the combined mechanism ankle support. The combined mechanism ankle support is effective in improving static postural control of chronic ankle instability patients to close to the postural sway of healthy individual. the orthosis had no adverse effects on balance performance of healthy individuals. Clinical relevance Application of the combined mechanism ankle support for patients with chronic ankle instability is effective in improving static balance. This may be helpful in reduction of recurrence of ankle sprain although further research about dynamic conditions is needed.

  10. Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

    PubMed

    Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

    2015-02-01

    The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

  11. The leather ankle lacer.

    PubMed Central

    Saltzman, C. L.; Shurr, D.; Kamp, J.; Cook, T. A.

    1995-01-01

    The purpose of this study was to evaluate the efficacy of a leather ankle lacer for treating painful problems of the ankle and hindfoot. The evaluation involved patient self assessment, clinical examination and radiographic determination of the effectiveness of the ankle lacer. Overall, patients had moderate pain relief with significant but not complete restriction of motion. Based on this study and our clinical experience, we find the leather ankle lacer to be a compliant and comfortable treatment strategy for patients with painful ankle and hindfoot problems who desire some retained motion. Images Figure 1A & B Figure 2 Figure 3 PMID:7634034

  12. Inverse problems, non-roundness and flat pieces of the effective burning velocity from an inviscid quadratic Hamilton-Jacobi model

    NASA Astrophysics Data System (ADS)

    Jing, Wenjia; Tran, Hung V.; Yu, Yifeng

    2017-05-01

    The main goal of this paper is to understand finer properties of the effective burning velocity from a combustion model introduced by Majda and Souganidis (1994 Nonlinearity 7 1-30). Motivated by results in Bangert (1994 Calculus Variations PDE 2 49-63) and applications in turbulent combustion, we show that when the dimension is two and the flow of the ambient fluid is either weak or very strong, the level set of the effective burning velocity has flat pieces. Due to the lack of an applicable Hopf-type rigidity result, we need to identify the exact location of at least one flat piece. Implications on the effective flame front and other related inverse type problems are also discussed.

  13. Ankle and knee biomechanics during normal walking following ankle plantarflexor fatigue.

    PubMed

    Hunt, Michael A; Hatfield, Gillian L

    2017-08-01

    The purpose of this study was to investigate the immediate effects of unilateral ankle plantarflexor fatigue on bilateral knee and ankle biomechanics during gait. Lower leg kinematics, kinetics, and muscle activation were assessed before and after an ankle plantarflexor fatiguing protocol in 31 healthy individuals. Fatigue (defined as >10% reduction in maximal isometric ankle plantarflexor torque production and a downward shift in the median power frequency of both heads of the gastrocnemius muscle of the fatigued limb) was achieved in 18 individuals, and only their data were used for analysis purposes. Compared to pre-fatigue walking trials, medial gastrocnemius activity was significantly reduced in the study (fatigued) limb. Other main changes following fatigue included significantly more knee flexion during loading, and an associated larger external knee flexion moment in the study limb. At the ankle joint, participants exhibited significantly less peak plantarflexion (occurring at toe-off) with fatigue. No significant differences were observed in the contralateral (non-fatigued) limb. Findings from this study indicate that fatigue of the ankle plantarflexor muscle does not produce widespread changes in gait biomechanics, suggesting that small to moderate changes in maximal ankle plantarflexor force production capacity (either an increase or decrease) will not have a substantial impact on normal lower limb functioning during gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Shoe collar height effect on athletic performance, ankle joint kinematics and kinetics during unanticipated maximum-effort side-cutting performance.

    PubMed

    Lam, Gilbert Wing Kai; Park, Eun Jung; Lee, Ki-Kwang; Cheung, Jason Tak-Man

    2015-01-01

    Side-step cutting manoeuvres comprise the coordination between planting and non-planting legs. Increased shoe collar height is expected to influence ankle biomechanics of both legs and possibly respective cutting performance. This study examined the shoe collar height effect on kinematics and kinetics of planting and non-planting legs during an unanticipated side-step cutting. Fifteen university basketball players performed maximum-effort side-step cutting to the left 45° direction or a straight ahead run in response to a random light signal. Seven successful cutting trials were collected for each condition. Athletic performance, ground reaction force, ankle kinematics and kinetics of both legs were analysed using paired t-tests. Results indicated that high-collar shoes resulted in less ankle inversion and external rotation during initial contact for the planting leg. The high-collar shoes also exhibited a smaller ankle range of motion in the sagittal and transverse planes for both legs, respectively. However, no collar effect was found for ankle moments and performance indicators including cutting performance time, ground contact time, propulsion ground reaction forces and impulses. These findings indicated that high-collar shoes altered ankle positioning and restricted ankle joint freedom movements in both legs, while no negative effect was found for athletic cutting performance.

  15. Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors.

    PubMed

    Tomiyama, Hirofumi; Matsumoto, Chisa; Shiina, Kazuki; Yamashina, Akira

    2016-01-01

    Since 2001, brachial-ankle pulse wave velocity (brachial-ankle PWV) measurement has been applied for risk stratification of patients with atherosclerotic cardiovascular disease and/or its risk factors in Japan. Measurement of the brachial-ankle PWV is simple and well standardized, and its reproducibility and accuracy are acceptable. Several cross-sectional studies have demonstrated a significant correlation between the brachial-ankle PWV and known risk factors for cardiovascular disease; the correlation is stronger in subjects with cardiovascular disease than in those without cardiovascular disease. We conducted a meta-analysis, which demonstrated that the brachial-ankle PWV is an independent predictor of future cardiovascular events. Furthermore, the treatment of cardiovascular risk factors and lifestyle modifications have been shown to improve the brachial-ankle PWV. Thus, at present, brachial-ankle PWV is close to being considered as a useful marker in the management of atherosclerotic cardiovascular disease and/or its risk factors.

  16. Ankle syndesmotic injury.

    PubMed

    Zalavras, Charalampos; Thordarson, David

    2007-06-01

    Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. Syndesmotic injury may occur in isolation or may be associated with ankle fracture. In the absence of fracture, physical examination findings suggestive of injury include ankle tenderness over the anterior aspect of the syndesmosis and a positive squeeze or external rotation test. Radiographic findings usually include increased tibiofibular clear space decreased tibiofibular overlap, and increased medial clear space. However, syndesmotic injury may not be apparent radiographically; thus, routine stress testing is necessary for detecting syndesmotic instability. The goals of management are to restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis. Fixation of the syndesmosis is indicated when evidence of a diastasis is present. This may be detected preoperatively, in the absence of fracture, or intraoperatively, after rigid fixation of the medial malleolus and fibula fractures. Failure to diagnose and stabilize syndesmotic disruption adversely affects outcome.

  17. Muscle Spindle Traffic in Functionally Unstable Ankles During Ligamentous Stress

    PubMed Central

    Needle, Alan R.; Charles B. (Buz), Swanik; Farquhar, William B.; Thomas, Stephen J.; Rose, William C.; Kaminski, Thomas W.

    2013-01-01

    Context: Ankle sprains are common in athletes, with functional ankle instability (FAI) developing in approximately half of cases. The relationship between laxity and FAI has been inconclusive, suggesting that instability may be caused by insufficient sensorimotor function and dynamic restraint. Research has suggested that deafferentation of peripheral mechanoreceptors potentially causes FAI; however, direct evidence confirming peripheral sensory deficits has been elusive because previous investigators relied upon subjective proprioceptive tests. Objective: To develop a method for simultaneously recording peripheral sensory traffic, joint forces, and laxity and to quantify differences between healthy ankles and those with reported instability. Design: Case-control study. Setting: University laboratory. Patients or Other Participants: A total of 29 participants (age = 20.9 ± 2.2 years, height = 173.1 ± 8.9 cm, mass = 74.5 ± 12.7 kg) stratified as having healthy (HA, n = 19) or unstable ankles (UA, n = 10). Intervention(s): Sensory traffic from muscle spindle afferents in the peroneal nerve was recorded with microneurography while anterior (AP) and inversion (IE) stress was applied to ligamentous structures using an ankle arthrometer under test and sham conditions. Main Outcome Measure(s): Laxity (millimeters or degrees) and amplitude of sensory traffic (percentage) were determined at 0, 30, 60, 90, and 125 N of AP force and at 0, 1, 2, 3, and 4 Nm of IE torque. Two-factor repeated-measures analyses of variance were used to determine differences between groups and conditions. Results: No differences in laxity were observed between groups (P > .05). Afferent traffic increased with increased force and torque in test trials (P < .001). The UA group displayed decreased afferent activity at 30 N of AP force compared with the HA group (HA: 30.2% ± 9.9%, UA: 17.1% ± 16.1%, P < .05). Conclusions: The amplitude of sensory traffic increased simultaneously with greater

  18. Intra-articular plica causing ankle impingement in a young handball player: a case report.

    PubMed

    Somorjai, Nicolaas; Jong, Bob; Draijer, W F

    2013-01-01

    Ankle sprains are common injuries that respond well to rehabilitation. In the case of persisting symptoms, the differential diagnosis should include osteochondral defects, tendon injury, mechanical instability, and ankle impingement. In the present case report, we describe a 16-year-old male handball player who presented with persisting pain and locking in the right ankle 3 years after having sustained multiple minor inversion trauma. The clinical examination and conventional radiography showed no abnormalities. On magnetic resonance imaging, a flake fracture at the anteromedial talar dome and/or loose body was assumed. Arthroscopic examination revealed an intra-articular plica originating from an osteochondral fossa at the anteromedial tibial plafond. The plica was debrided. Retrospectively, the arthroscopic findings matched the radiographs and magnetic resonance images. The postoperative protocol consisted of early mobilization. At 6 weeks of follow-up, the patient had no pain and had returned to his sports activities. The present case report illustrates, to the best of our knowledge, the first case of ankle impingement due to a, most likely congenital, intra-articular plica arising from an osteochondral fossa at the anteromedial tibial plafond. This rare clinical condition can be diagnosed with magnetic resonance imaging. Arthroscopic debridement will effectively relieve the symptoms. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Interventions for treating chronic ankle instability.

    PubMed

    de Vries, J S; Krips, R; Sierevelt, I N; Blankevoort, L

    2006-10-18

    Chronic lateral ankle instability occurs in 10% to 20% of people after an acute ankle sprain. The initial form of treatment is conservative but if this fails and ligament laxity is present, surgical intervention is considered. To compare different treatments, both conservative and surgical, for chronic lateral ankle instability. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialized Register (to July 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2005, Issue 3), and MEDLINE (1966 to April 2006), EMBASE (1980 to April 2006), CINAHL (1982 to April 2006) and reference lists of articles. All randomised and quasi-randomised controlled trials of interventions for chronic lateral ankle instability were included. Two review authors independently assessed methodological quality and extracted data. Where appropriate, results of comparable studies were pooled. Seven randomised trials were included and divided into three groups: surgical interventions; rehabilitation programs after surgical interventions; and conservative interventions. None of the studies were methodologically flawless. Only one study described an adequate randomisation procedure. Only two studies, both about rehabilitation programs after surgery, had a moderate risk of bias; all other studies had a high risk of bias. Due to clinical and methodological diversity, extensive pooling of the data was not possible. Surgical interventions (four studies): one study showed more complications after the Chrisman-Snook procedure compared to an anatomical reconstruction, whereas another study showed greater mean talar tilt after an anatomical reconstruction. Subjective instability and hindfoot inversion was greater after a dynamic than after a static tenodesis in a third study. The fourth study showed that the operating time for anatomical reconstructions was shorter for the reinsertion technique than for the imbrication method. Rehabilitation after surgical

  20. Therapeutic Interventions for Increasing Ankle Dorsiflexion After Ankle Sprain: A Systematic Review

    PubMed Central

    Terada, Masafumi; Pietrosimone, Brian G.; Gribble, Phillip A.

    2013-01-01

    Context: Clinicians perform therapeutic interventions, such as stretching, manual therapy, electrotherapy, ultrasound, and exercises, to increase ankle dorsiflexion. However, authors of previous studies have not determined which intervention or combination of interventions is most effective. Objective: To determine the magnitude of therapeutic intervention effects on and the most effective therapeutic interventions for restoring normal ankle dorsiflexion after ankle sprain. Data Sources: We performed a comprehensive literature search in Web of Science and EBSCO HOST from 1965 to May 29, 2011, with 19 search terms related to ankle sprain, dorsiflexion, and intervention and by cross-referencing pertinent articles. Study Selection: Eligible studies had to be written in English and include the means and standard deviations of both pretreatment and posttreatment in patients with acute, subacute, or chronic ankle sprains. Outcomes of interest included various joint mobilizations, stretching, local vibration, hyperbaric oxygen therapy, electrical stimulation, and mental-relaxation interventions. Data Extraction: We extracted data on dorsiflexion improvements among various therapeutic applications by calculating Cohen d effect sizes with associated 95% confidence intervals (CIs) and evaluated the methodologic quality using the Physiotherapy Evidence Database (PEDro) scale. Data Synthesis: In total, 9 studies (PEDro score = 5.22 ± 1.92) met the inclusion criteria. Static-stretching interventions with a home exercise program had the strongest effects on increasing dorsiflexion in patients 2 weeks after acute ankle sprains (Cohen d = 1.06; 95% CI = 0.12, 2.42). The range of effect sizes for movement with mobilization on ankle dorsiflexion among individuals with recurrent ankle sprains was small (Cohen d range = 0.14 to 0.39). Conclusions: Static-stretching intervention as a part of standardized care yielded the strongest effects on dorsiflexion after acute ankle sprains. The

  1. Sprained Ankles

    MedlinePlus

    ... away before the ligament is injured. Types of Sprains In young children, the ankle is the most commonly sprained joint, followed by ... A walking cast may be necessary if the ankle or foot injury has been severe. Most grade 1 sprains will heal within two weeks without subsequent complications. ...

  2. Does the subtalar joint compensate for ankle malalignment in end-stage ankle arthritis?

    PubMed

    Wang, Bibo; Saltzman, Charles L; Chalayon, Ornusa; Barg, Alexej

    2015-01-01

    Patients with ankle arthritis often present with concomitant hindfoot deformity, which may involve the tibiotalar and subtalar joints. However, the possible compensatory mechanisms of these two mechanically linked joints are not well known. In this study we sought to (1) compare ankle and hindfoot alignment of our study cohort with end-stage ankle arthritis with that of a control group; (2) explore the frequency of compensated malalignment between the tibiotalar and subtalar joints in our study cohort; and (3) assess the intraobserver and interobserver reliability of classification methods of hindfoot alignment used in this study. Between March 2006 and September 2013, we performed 419 ankle arthrodesis and ankle replacements (380 patients). In this study, we evaluated radiographs for 233 (56%) ankles (226 patients) which met the following inclusion criteria: (1) no prior subtalar arthrodesis; (2) no previously failed total ankle replacement or ankle arthrodesis; (3) with complete conventional radiographs (all three ankle views were required: mortise, lateral, and hindfoot alignment view). Ankle and hindfoot alignment was assessed by measurement of the medial distal tibial angle, tibial talar surface angle, talar tilting angle, tibiocalcaneal axis angle, and moment arm of calcaneus. The obtained values were compared with those observed in the control group of 60 ankles from 60 people. Only those without obvious degenerative changes of the tibiotalar and subtalar joints and without previous surgeries of the ankle or hindfoot were included in the control group. Demographic data for the patients with arthritis and the control group were comparable (sex, p=0.321; age, p=0.087). The frequency of compensated malalignment between the tibiotalar and subtalar joints, defined as tibiocalcaneal angle or moment arm of the calcaneus being greater or smaller than the same 95% CI statistical cutoffs from the control group, was tallied. All ankle radiographs were independently

  3. Full-waveform Inversion for Localized 3-D S-velocity Structure in D" Beneath the Caribbean using US-Array Data

    NASA Astrophysics Data System (ADS)

    Borgeaud, A. F. E.; Konishi, K.; Kawai, K.; Geller, R. J.

    2015-12-01

    The region beneath Central America is known to have significant lateral velocity heterogeneities from the upper mantle down to the lowermost mantle. It is also known for its long history of subducting oceanic plates and fragmented plate remnants that sunk to the lowermost mantle (e.g., Ren et al., 2007). In this study, we use localized full-waveform inversion to invert for the 3-D S-velocity beneath the Caribbean. We use the DSM (Kawai et al., 2006) to compute 1-D synthetic seismograms and the first-order Born approximation to compute the partial derivatives for 3-D structure. We use a larger dataset with better coverage than Kawai et al. (2014), consisting of S and ScS phases from US-Array data for events in South America. The resulting 3-D model can contribute to understanding whether the cause of the velocity anomalies is thermal, chemical, or due to phase transitions.

  4. X-Ray Exam: Ankle

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Ankle KidsHealth / For Parents / X-Ray Exam: Ankle What's in this article? What ... Have Questions Print What It Is An ankle X-ray is a safe and painless test that ...

  5. Aging Index using Photoplethysmography for a Healthcare Device: Comparison with Brachial-Ankle Pulse Wave Velocity.

    PubMed

    Hong, Kyung Soon; Park, Kyu Tae; Ahn, Jae Mok

    2015-01-01

    Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. In this study, we investigated the association among age, the baPWV, and the APG and found a new aging index reflecting arterial stiffness for a healthcare device. The APG and the baPWV were simultaneously applied to assess the accuracy of the APG in measuring arterial stiffness in association with age. A preamplifier and motion artifact removal algorithm were newly developed to obtain a high quality PPG signal. In total, 168 subjects with a mean ± SD age of 58.1 ± 12.6 years were followed for two months to obtain a set of complete data using baPWV and APG analysis. The baPWV and the B ratio of the APG indices were correlated significantly with age (r = 0.6685, p < 0.0001 and r = -0.4025, p < 0.0001, respectively). A regression analysis revealed that the c and d peaks were independent of age (r = -0.3553, p < 0.0001 and r = -0.3191, p < 0.0001, respectively). We determined the B ratio, which represents an improved aging index and suggest that the APG may provide qualitatively similar information for arterial stiffness.

  6. Aging Index using Photoplethysmography for a Healthcare Device: Comparison with Brachial-Ankle Pulse Wave Velocity

    PubMed Central

    Hong, Kyung Soon; Park, Kyu Tae

    2015-01-01

    Objectives Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. In this study, we investigated the association among age, the baPWV, and the APG and found a new aging index reflecting arterial stiffness for a healthcare device. Methods The APG and the baPWV were simultaneously applied to assess the accuracy of the APG in measuring arterial stiffness in association with age. A preamplifier and motion artifact removal algorithm were newly developed to obtain a high quality PPG signal. In total, 168 subjects with a mean ± SD age of 58.1 ± 12.6 years were followed for two months to obtain a set of complete data using baPWV and APG analysis. Results The baPWV and the B ratio of the APG indices were correlated significantly with age (r = 0.6685, p < 0.0001 and r = -0.4025, p < 0.0001, respectively). A regression analysis revealed that the c and d peaks were independent of age (r = -0.3553, p < 0.0001 and r = -0.3191, p < 0.0001, respectively). Conclusions We determined the B ratio, which represents an improved aging index and suggest that the APG may provide qualitatively similar information for arterial stiffness. PMID:25705555

  7. Understanding and treating lateral ankle sprains and their consequences: a constraints-based approach.

    PubMed

    Wikstrom, Erik A; Hubbard-Turner, Tricia; McKeon, Patrick O

    2013-06-01

    an ankle sprain is more than just a peripheral musculoskeletal pathology with only local consequences. The dynamic systems theory illustrates that the organization of human movement/function is shaped by the interaction of (1) organismic constraints (health of the person); (2) task constraints; and (3) environmental constraints. However, ankle sprains increase the organismic constraints (i.e. changes in joint structure and sensorimotor function) that significantly hinder an individual's function and may be the underlying cause for the continuum of disability associated with CAI. To treat and/or prevent an individual from entering the continuum of disability, greater protection of the ankle ligaments is needed immediately after injury. Subsequent rehabilitation should then focus on goal-oriented rehabilitation (i.e. quality of the movement pattern) rather that task-oriented rehabilitation (i.e. do these exercises). When evaluating patients with ankle inversion trauma and/or instability, it is imperative to remember that an ankle sprain is not simply a local joint injury; it can result in a constrained sensorimotor system that leads to a continuum of disability and life-long consequences such as high injury recurrence and decreased quality of life if not managed properly.

  8. Robotic cadaver testing of a new total ankle prosthesis model (German Ankle System).

    PubMed

    Richter, Martinus; Zech, Stefan; Westphal, Ralf; Klimesch, Yvone; Gosling, Thomas

    2007-12-01

    An investigation was carried out into possible increased forces, torques, and altered motions during load-bearing ankle motion after implantation of two different total ankle prostheses. We hypothesized that the parameters investigated would not differ in relation to the two implants compared. We included two different ankle prostheses (Hintegra, Newdeal, Vienne, France; German Ankle System, R-Innovation, Coburg, Germany). The prostheses were implanted in seven paired cadaver specimens. The specimens were mounted on an industrial robot that enables complex motion under predefined conditions (RX 90, Stäubli, Bayreuth, Germany). The robot detected the load-bearing (30 kg) motion of the 100(th) cycle of the specimens without prostheses as the baseline for the later testing, and mimicked that exact motion during 100 cycles after the prostheses were implanted. The resulting forces, torques, and bone motions were recorded and the differences between the prostheses compared. The Hintegra and German Ankle System, significantly increased the forces and torques in relation to the specimen without a prosthesis with one exception (one-sample-t-test, each p < or = 0.01; exception, parameter lateral force measured with the German Ankle System, p = 0.34). The force, torque, and motion differences between the specimens before and after implantation of the prostheses were lower with the German Ankle System than with the Hintegra (unpaired t-test, each p < or = 0.05). The German Ankle System prosthesis had less of an effect on resulting forces and torques during partial weightbearing passive ankle motion than the Hintegra prosthesis. This might improve function and minimize loosening during the clinical use.

  9. Effects of knee and ankle muscle fatigue on postural control in the unipedal stance.

    PubMed

    Bizid, Riadh; Margnes, Eric; François, Yrieix; Jully, Jean Louis; Gonzalez, Gerard; Dupui, Philippe; Paillard, Thierry

    2009-06-01

    The aim of this study was to compare the effects of acute muscle fatigue of the ankle and knee musculature on postural control by immediate measures after performing fatiguing tasks (POST condition). One group of subjects (n = 8) performed a fatiguing task by voluntary contractions of the triceps surae (group TRI) and the other (n = 9) performed a fatiguing task by voluntary contractions of the quadriceps femoris (group QUA). Each muscle group was exercised until the loss of maximal voluntary contraction torque reached 50% (isokinetic dynamometer). Posture was assessed by measuring the centre of foot pressure (COP) with a force platform during a test of unipedal quiet standing posture with eyes closed. Initially (in PRE condition), the mean COP velocity was not significantly different between group TRI and group QUA. In POST condition, the mean COP velocity increased more in group QUA than in group TRI. The postural control was more impaired by knee muscle fatigue than by ankle muscle fatigue.

  10. The effect of textured ballet shoe insoles on ankle proprioception in dancers.

    PubMed

    Steinberg, Nili; Waddington, Gordon; Adams, Roger; Karin, Janet; Tirosh, Oren

    2016-01-01

    Impaired ankle inversion movement discrimination (AIMD) can lead to ankle sprain injuries. The aim of this study was to explore whether wearing textured insoles improved AIMD compared with barefoot, ballet shoes and smooth insoles, among dancers. Forty-four adolescent male and female dancers, aged 13-19, from The Australian Ballet School were tested for AIMD while barefoot, wearing ballet shoes, smooth insoles, and textured insoles. No interaction was found between the four different footwear conditions, the two genders, or the two levels of dancers in AIMD (p > .05). An interaction was found between the four different footwear conditions and the three tertiles when tested in ballet shoes (p = .006). Although significant differences were found between the upper tertiles and the lower tertiles when tested with ballet shoes, barefoot and with smooth insoles (p < .001; p < .001; p = .047, respectively), when testing with textured insoles dancers in the lower tertile obtained similar scores to those obtained by dancers in the upper tertile (p = .911). Textured insoles improved the discrimination scores of dancers with low AIMD, suggesting that textured insoles may trigger the cutaneous receptors in the plantar surface, increasing the awareness of ankle positioning, which in turn might decrease the chance of ankle injury. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Feedback and Feedforward Control During Walking in Individuals With Chronic Ankle Instability.

    PubMed

    Yen, Sheng-Che; Corkery, Marie B; Donohoe, Amy; Grogan, Maddison; Wu, Yi-Ning

    2016-09-01

    Study Design Controlled laboratory study. Background Recurrent ankle sprains associated with chronic ankle instability (CAI) occur not only in challenging sports but also in daily walking. Understanding whether and how CAI alters feedback and feedforward controls during walking may be important for developing interventions for CAI prevention or treatment. Objective To understand whether CAI is associated with changes in feedback and feedforward control when individuals with CAI are subjected to experimental perturbation during walking. Methods Twelve subjects with CAI and 12 control subjects walked on a treadmill while adapting to external loading that generated inversion perturbation at the ankle joint. Ankle kinematics around heel contact during and after the adaptation were compared between the 2 groups. Results Both healthy and CAI groups showed an increase in eversion around heel contact in early adaptation to the external loading. However, the CAI group adapted back toward the baseline, while the healthy controls showed further increase in eversion in late adaptation. When the external loading was removed in the postadaptation period, healthy controls showed an aftereffect consisting of an increase in eversion around heel contact, but the CAI group showed no aftereffect. Conclusion The results provide preliminary evidence that CAI may alter individuals' feedback and feedforward control during walking. J Orthop Sports Phys Ther 2016;46(9):775-783. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6403.

  12. Comparison of the Lithospheric Structure Beneath Kenya and Ethiopia From Joint Inversion of Receiver Functions and Rayleigh Wave Dispersion Velocities

    NASA Astrophysics Data System (ADS)

    Dugda, M. T.; Nyblade, A. A.; Julia, J.

    2007-12-01

    Shear-wave velocity structure of the crust and upper mantle beneath Kenya has been investigated using joint inversion of receiver functions, and Rayleigh wave group and phase velocities. Most of the data for this study come from the Kenya broadband seismic experiment, conducted between 2001 and 2002. Shear velocity models obtained from the joint inversion show crustal thicknesses of 37 to 42 km beneath the East African Plateau in Kenya and near the edge of the Kenya Rift, and a crustal thickness of about 30 km beneath the Kenya Rift. These crustal parameters are consistent with crustal thicknesses published previously by different authors. A comparison has been made between the lithosphere under Kenya and other parts of the East African Plateau in Tanzania. A comparison between the lithosphere under Kenya and that under Ethiopia has also been made, specifically between the lithosphere under the Ethiopian Plateau and the Kenya Plateau, and between the lithosphere beneath the Main Ethiopian Rift (MER) and the Kenya (Gregory) Rift. The lithospheric mantle beneath the East African Plateau in Kenya has a maximum shear wave velocity of about 4.6 km/s, similar to the value obtained under the East African Plateau in Tanzania. Beneath the Kenya Rift, the lithosphere extends to a depth of at most ~75 km. The average velocity of the mantle lithosphere under the East African Plateau in Kenya appears to be similar to the lithosphere under Tanzania away from the East African Rift System. The lithosphere under the Kenya Plateau is not perturbed as compared to the highly perturbed lithosphere beneath the Ethiopian Plateau. The lithosphere under the Kenya Rift is perturbed as compared to the rest of the region but is not as perturbed as that under the Main Ethiopian Rift or the Afar. Though Kenya and Ethiopia have similar uplift, volcanism and rifting at the surface, they have different lithospheric structures at the bottom. The Afar Flood Basalt Volcanism (AFB) may be the cause of

  13. Ankle Plantarflexor Spasticity Does Not Restrict the Recovery of Ankle Plantarflexor Strength or Ankle Power Generation for Push-Off During Walking Following Traumatic Brain Injury.

    PubMed

    Williams, Gavin; Banky, Megan; Olver, John

    2016-01-01

    The main aim of this project was to determine the impact of plantarflexor spasticity on muscle performance for ambulant people with traumatic brain injury (TBI). A large metropolitan rehabilitation hospital. Seventy-two ambulant people with TBI who were attending physiotherapy for mobility limitations. Twenty-four participants returned for a 6-month follow-up reassessment. Cross-sectional cohort study. Self-selected walking speed, Tardieu scale, ankle plantarflexor strength, and ankle power generation (APG). Participants with ankle plantarflexor spasticity had significantly lower self-selected walking speed; however, there was no significant difference in ankle plantarflexor strength or APG. Participants with ankle plantarflexor spasticity were not restricted in the recovery of self-selected walking speed, ankle plantarflexor strength, or APG, indicating equivalent ability to improve their mobility over time despite the presence of spasticity. Following TBI, people with ankle plantarflexor spasticity have significantly greater mobility limitations than those without spasticity, yet retain the capacity for recovery of self-selected walking speed, ankle plantarflexor strength, and APG.

  14. Crustal shear wave velocity structure in the northeastern Tibet based on the Neighbourhood algorithm inversion of receiver functions

    NASA Astrophysics Data System (ADS)

    Wu, Zhenbo; Xu, Tao; Liang, Chuntao; Wu, Chenglong; Liu, Zhiqiang

    2018-03-01

    The northeastern (NE) Tibet records and represents the far-field deformation response of the collision between the Indian and Eurasian plates in the Cenozoic time. Over the past two decades, studies have revealed the existence of thickened crust in the NE Tibet, but the thickening mechanism is still in debate. We deployed a passive-source seismic profile with 22 temporary broad-band seismic stations in the NE Tibet to investigate the crustal shear wave velocity structure in this region. We selected 288 teleseismic events located in the west Pacific subduction zone near Japan with similar ray path to calculate P-wave receiver functions. Neighbourhood algorithm method is applied to invert the shear wave velocity beneath stations. The inversion result shows a low-velocity zone (LVZ) is roughly confined to the Songpan-Ganzi block and Kunlun mountains and extends to the southern margin of Gonghe basin. Considering the low P-wave velocity revealed by the wide-angle reflection-refraction seismic experiment and high ratio of Vp/Vs based on H-κ grid searching of the receiver functions in this profile, LVZ may be attributed to partial melting induced by temperature change. This observation appears to be consistent with the crustal ductile deformation in this region derived from other geophysical investigations.

  15. Visco-acoustic wave-equation traveltime inversion and its sensitivity to attenuation errors

    NASA Astrophysics Data System (ADS)

    Yu, Han; Chen, Yuqing; Hanafy, Sherif M.; Huang, Jiangping

    2018-04-01

    A visco-acoustic wave-equation traveltime inversion method is presented that inverts for the shallow subsurface velocity distribution. Similar to the classical wave equation traveltime inversion, this method finds the velocity model that minimizes the squared sum of the traveltime residuals. Even though, wave-equation traveltime inversion can partly avoid the cycle skipping problem, a good initial velocity model is required for the inversion to converge to a reasonable tomogram with different attenuation profiles. When Q model is far away from the real model, the final tomogram is very sensitive to the starting velocity model. Nevertheless, a minor or moderate perturbation of the Q model from the true one does not strongly affect the inversion if the low wavenumber information of the initial velocity model is mostly correct. These claims are validated with numerical tests on both the synthetic and field data sets.

  16. Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury.

    PubMed

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2016-04-01

    To quantify the dynamic balance deficits that characterise a group with chronic ankle instability compared to lateral ankle sprain copers and non-injured controls using kinematic and kinetic outcomes. Forty-two participants with chronic ankle instability and twenty-eight lateral ankle sprain copers were initially recruited within 2 weeks of sustaining a first-time, acute lateral ankle sprain and required to attend our laboratory 1 year later to complete the current study protocol. An additional group of non-injured individuals were also recruited to act as a control group. All participants completed the anterior, posterior-lateral and posterior-medial reach directions of the star excursion balance test. Sagittal plane kinematics of the lower extremity and associated fractal dimension of the centre of pressure path were also acquired. Participants with chronic ankle instability displayed poorer performance in the anterior, posterior-medial and posterior-lateral reach directions compared with controls bilaterally, and in the posterior-lateral direction compared with lateral ankle sprain copers on their 'involved' limb only. These performance deficits in the posterior-lateral and posterior-medial directions were associated with reduced flexion and dorsiflexion displacements at the hip, knee and ankle at the point of maximum reach, and coincided with reduced complexity of the centre of pressure path. In comparison with lateral ankle sprain copers and controls, participants with chronic ankle instability were characterised by dynamic balance deficits as measured using the SEBT. This was attested to reduced sagittal plane motions at the hip, knee and ankle joints, and reduced capacity of the stance limb to avail of its supporting base. III.

  17. Modulations of Foot and Ankle Frontal Kinematics for Breaking and Propulsive Movement Characteristics during Side-Step Cutting with Varying Midsole Thicknesses

    PubMed Central

    Lin, Yi-Jia; Lee, Shih-Chi; Chang, Chao-Chin; Liu, Tsung-Han

    2018-01-01

    This study is aimed at determining the effects of midsole thickness on movement characteristic during side cutting movement. Fifteen athletes performed side-step cutting while wearing shoes with varying midsole thicknesses. Temporal-spatial and ground reaction force variables as well as foot and ankle frontal kinematics were used to describe breaking and propulsive movement characteristics and modulation strategies. Regardless of midsole thickness, temporal-spatial variables and breaking and propulsive force during side cutting were statistically unchanged. Significantly greater peaks of ankle inversion and plantarflexion with a thicker sole and greater midtarsal pronation with a thinner sole were observed. Current results demonstrated that hypotheses formed solely based on material testing were insufficient to understand the adaptations in human movement because of the redundancy of the neuromusculoskeletal system. Participants were able to maintain temporal-spatial performance during side cutting while wearing shoes with midsoles of varying thicknesses. Increased pronation for a thinner sole might help reduce the force of impact but might be associated with an increased risk of excessive stress on soft tissue. Increased peak of ankle inversion and plantarflexion for a thicker sole may be unfavorable for the stability of ankle joint. Information provided in human movement testing is crucial for understanding factors associated with movement characteristics and injury and should be considered in the future development of shoe design. PMID:29854000

  18. Contribution of ankle-foot orthosis moment in regulating ankle and knee motions during gait in individuals post-stroke.

    PubMed

    Kobayashi, Toshiki; Orendurff, Michael S; Singer, Madeline L; Gao, Fan; Foreman, K Bo

    2017-06-01

    Ankle-foot orthosis moment resisting plantarflexion has systematic effects on ankle and knee joint motion in individuals post-stroke. However, it is not known how much ankle-foot orthosis moment is generated to regulate their motion. The aim of this study was to quantify the contribution of an articulated ankle-foot orthosis moment to regulate ankle and knee joint motion during gait in individuals post-stroke. Gait data were collected from 10 individuals post-stroke using a Bertec split-belt instrumented treadmill and a Vicon 3-dimensional motion analysis system. Each participant wore an articulated ankle-foot orthosis whose moment resisting plantarflexion was adjustable at four levels. Ankle-foot orthosis moment while walking was calculated under the four levels based on angle-moment relationship of the ankle-foot orthosis around the ankle joint measured by bench testing. The ankle-foot orthosis moment and the joint angular position (ankle and knee) relationship in a gait cycle was plotted to quantify the ankle-foot orthosis moment needed to regulate the joint motion. Ankle and knee joint motion were regulated according to the amount of ankle-foot orthosis moment during gait. The ankle-foot orthosis maintained the ankle angular position in dorsiflexion and knee angular position in flexion throughout a gait cycle when it generated moment from -0.029 (0.011) to -0.062 (0.019) Nm/kg (moment resisting plantarflexion was defined as negative). Quantifying the contribution of ankle-foot orthosis moment needed to regulate lower limb joints within a specific range of motion could provide valuable criteria to design an ankle-foot orthosis for individuals post-stroke. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange.

    PubMed

    Queen, Robin M; Sparling, Tawnee L; Schmitt, Daniel

    2016-09-01

    Individuals with osteoarthritis (OA) of the lower limb find normal locomotion tiring compared with individuals without OA, possibly because OA of any lower limb joint changes limb mechanics and may disrupt transfer of potential and kinetic energy of the center of mass during walking, resulting in increased locomotor costs. Although recovery has been explored in asymptomatic individuals and in some patient populations, the effect of changes in these gait parameters on center of mass movements and mechanical work in patients with OA in specific joints has not been well examined. The results can be used to inform clinical interventions and rehabilitation that focus on improving energy recovery. We hypothesized that (1) individuals with end-stage lower extremity OA would exhibit a decrease in walking velocity compared with asymptomatic individuals and that the joint affected with OA would differntially influence walking velocity, (2) individuals with end-stage lower extremity OA would show decreased energy recovery compared with asymptomatic individuals and that individuals with end-stage hip and ankle OA would have greater reductions in recovery than would individuals with end-stage knee OA owing to restrictions in hip and ankle motion, and (3) that differences in the amplitude and congruity of the center of mass would explain the differences in energy recovery that are observed in each population. Ground reaction forces at a range of self-selected walking speeds were collected from individuals with end-stage radiographic hip OA (n = 27; 14 males, 13 females; average age, 55.6 years; range, 41-70 years), knee OA (n = 20; seven males, 13 females; average age, 61.7 years; range, 49-74 years), ankle OA (n = 30; 14 males, 16 females; average age, 57 years; range, 45-70 years), and asymptomatic individuals (n = 13; eight males, five females; average age, 49.8 years; range, 41-67 years). Participants were all patients with end-stage OA who were scheduled to have joint

  20. An uncommon ankle sprain.

    PubMed

    van Zoest, Wart J F; Janssen, Rob P A; Tseng, Carroll M E S

    2007-11-01

    Ankle sprain is the most frequently occurring acute injury in tennis, accounting for 20-25% of all injuries. In the current paper, we assess the cause of ankle sprain and suggest possibilities to be considered during diagnosis. We assessed a professional tennis player with a partial tear of the long peroneal tendon after an ankle sprain by physical exam, X-ray and MRI. Conservative treatment by means of soft cast and propriocepsis training led to full recovery. Peroneal tendon disorders must be part of the differential diagnosis after ankle sprain in the professional athlete.

  1. Brachial-Ankle Pulse Wave Velocity as a Screen for Arterial Stiffness: A Comparison with Cardiac Magnetic Resonance

    PubMed Central

    Kim, Eun Kyoung; Chang, Sung-A; Jang, Shin Yi; Choi, Ki Hong; Huh, Eun Hee; Kim, Jung Hyun; Kim, Sung Mok; Choe, Yeon Hyeon

    2015-01-01

    Purpose Despite technical simplicity and the low cost of brachial-ankle pulse wave velocity (BA-PWV), its use has been hampered by a lack of data supporting its usefulness and reliability. The aim of this study was to evaluate the usefulness of BA-PWV to measure aortic stiffness in comparison to using cardiovascular magnetic resonance (CMR). Materials and Methods A total of 124 participants without cardiovascular risk factors volunteered for this study. BA-PWV was measured using a vascular testing device. On the same day, using CMR, cross-sectional areas for distensibility and average blood flow were measured at four aortic levels: the ascending, upper thoracic descending, lower thoracic descending, and abdominal aorta. Results Compared to PWV measured by CMR, BA-PWV values were significantly higher and the differences therein were similar in all age groups (all p<0.001). There was a significant correlation between BA-PWV and PWV by CMR (r=0.697, p<0.001). Both BA-PWV and PWV by CMR were significantly and positively associated with age (r=0.652 and 0.724, p<0.001). The reciprocal of aortic distensibility also demonstrated a statistically significant positive correlation with BA-PWV (r=0.583 to 0.673, all p<0.001). Conclusion BA-PWV was well correlated with central aortic PWV and distensibility, as measured by CMR, regardless of age and sex. PMID:25837165

  2. Assessment of Ankle Injuries

    ERIC Educational Resources Information Center

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  3. Chronic Ankle Instability

    MedlinePlus

    ... top of the talus is dome-shaped and... Softball Injuries to the Foot and Ankle Your feet ... ankles take a beating when you are playing softball. Softball players should be aware of the following ...

  4. Ankle-Brachial Index

    MedlinePlus

    ... in which the arteries in your legs or arms are narrowed or blocked. People with peripheral artery ... ankle with your blood pressure measured at your arm. A low ankle-brachial index number can indicate ...

  5. Time-varying impedance of the human ankle in the sagittal and frontal planes during straight walk and turning steps.

    PubMed

    Ficanha, Evandro M; Ribeiro, Guilherme A; Knop, Lauren; Rastgaar, Mo

    2017-07-01

    This paper describes the methods and experiment protocols for estimation of the human ankle impedance during turning and straight line walking. The ankle impedance of two human subjects during the stance phase of walking in both dorsiflexion plantarflexion (DP) and inversion eversion (IE) were estimated. The impedance was estimated about 8 axes of rotations of the human ankle combining different amounts of DP and IE rotations, and differentiating among positive and negative rotations at 5 instants of the stance length (SL). Specifically, the impedance was estimated at 10%, 30%, 50%, 70% and 90% of the SL. The ankle impedance showed great variability across time, and across the axes of rotation, with consistent larger stiffness and damping in DP than IE. When comparing straight walking and turning, the main differences were in damping at 50%, 70%, and 90% of the SL with an increase in damping at all axes of rotation during turning.

  6. Anterior ankle arthroscopy, distraction or dorsiflexion?

    PubMed

    de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

    2010-05-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

  7. Anterior ankle arthroscopy, distraction or dorsiflexion?

    PubMed Central

    Golanó, Pau; Clavero, Joan A.; van Dijk, C. Niek

    2010-01-01

    Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7–1.5) and 0.7 cm (range 0.5–0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy. PMID:20217392

  8. Active ankle motion may result in changes to the talofibular interval in individuals with chronic ankle instability and ankle sprain copers: a preliminary study.

    PubMed

    Croy, Theodore; Cosby, Nicole L; Hertel, Jay

    2013-08-01

    Alterations in talocrural joint arthrokinematics related to repositioning of the talus or fibula following ankle sprain have been reported in radiological and clinical studies. It is unclear if these changes can result from normal active ankle motion. The study objective was to determine if active movement created changes in the sagittal plane talofibular interval in ankles with a history of lateral ankle sprain and instability. Three subject groups [control (n = 17), ankle sprain copers (n = 20), and chronic ankle instability (n = 20)] underwent ultrasound imaging of the anterolateral ankle gutter to identify the lateral malleolus and talus over three trials. Between trials, subjects actively plantar and dorsiflexed the ankle three times. The sagittal plane talofibular interval was assessed by measuring the anteroposterior distance (mm) between the lateral malleolus and talus from an ultrasound image. Between group and trial differences were analyzed with repeated measures analysis of variance and post-hoc t-tests. Fifty-seven subjects participated. A significant group-by-trial interaction was observed (F4,108 = 3.5; P = 0.009). The talofibular interval was increased in both copers [2.4±3.6 mm; 95% confidence interval (CI): 0.73-4.1; P = 0.007] and chronic ankle instability (4.1±4.6 mm; 95% CI: 1.9-6.2; P = 0.001) at trial 3 while no changes were observed in control ankle talar position (0.06±2.8mm; 95% CI: -1.5-1.4; P = 0.93). The talofibular interval increased only in subjects with a history of lateral ankle sprain with large clinical effect sizes observed. These findings suggest that an alteration in the position of the talus or fibula occurred with non-weight bearing sagittal plane motion. These findings may have diagnostic and therapeutic implications for manual therapists.

  9. Design and development of a novel viscoelastic ankle-foot prosthesis based on the human ankle biomechanics.

    PubMed

    Safaeepour, Zahra; Esteki, Ali; Tabatabai Ghomshe, Farhad; Mousavai, Mohammad E

    2014-10-01

    In the present study, a new approach was applied to design and develop a viscoelastic ankle-foot prosthesis. The aim was to replicate the intact ankle moment-angle loop in the normal walking speed. The moment-angle loop of intact ankle was divided into four parts, and the appropriate models including two viscoelastic units of spring-damper mechanism were considered to replicate the passive ankle dynamics. The developed prototype was then tested on a healthy subject with the amputee gait simulator. The result showed that prosthetic ankle moment-angle loop was similar to that of intact ankle with the distinct four periods. The findings suggest that the prototype successfully provided the human ankle passive dynamics. Therefore, the viscoelastic units could imitate the four periods of a normal gait. The novel viscoelastic foot prosthesis could provide natural ankle dynamics in a gait cycle. Applying simple but biomechanical approach is suggested in conception of new designs for prosthetic ankle-foot mechanisms. © The International Society for Prosthetics and Orthotics 2014.

  10. Transdimensional, hierarchical, Bayesian inversion of ambient seismic noise: Australia

    NASA Astrophysics Data System (ADS)

    Crowder, E.; Rawlinson, N.; Cornwell, D. G.

    2017-12-01

    We present models of crustal velocity structure in southeastern Australia using a novel, transdimensional and hierarchical, Bayesian inversion approach. The inversion is applied to long-time ambient noise cross-correlations. The study area of SE Australia is thought to represent the eastern margin of Gondwana. Conflicting tectonic models have been proposed to explain the formation of eastern Gondwana and the enigmatic geological relationships in Bass Strait, which separates Tasmania and the mainland. A geologically complex area of crustal accretion, Bass Strait may contain part of an exotic continental block entrained in colliding crusts. Ambient noise data recorded by an array of 24 seismometers is used to produce a high resolution, 3D shear wave velocity model of Bass Strait. Phase velocity maps in the period range 2-30 s are produced and subsequently inverted for 3D shear wave velocity structure. The transdimensional, hierarchical Bayesian, inversion technique is used. This technique proves far superior to linearised inversion. The inversion model is dynamically parameterised during the process, implicitly controlled by the data, and noise is treated as an inversion unknown. The resulting shear wave velocity model shows three sedimentary basins in Bass Strait constrained by slow shear velocities (2.4-2.9 km/s) at 2-10 km depth. These failed rift basins from the breakup of Australia-Antartica appear to be overlying thinned crust, where typical mantle velocities of 3.8-4.0 km/s occur at depths greater than 20 km. High shear wave velocities ( 3.7-3.8 km/s) in our new model also match well with regions of high magnetic and gravity anomalies. Furthermore, we use both Rayleigh and Love wave phase data to to construct Vsv and Vsh maps. These are used to estimate crustal radial anisotropy in the Bass Strait. We interpret that structures delineated by our velocity models support the presence and extent of the exotic Precambrian micro-continent (the Selwyn Block) that was

  11. Multivariate Formation Pressure Prediction with Seismic-derived Petrophysical Properties from Prestack AVO inversion and Poststack Seismic Motion Inversion

    NASA Astrophysics Data System (ADS)

    Yu, H.; Gu, H.

    2017-12-01

    A novel multivariate seismic formation pressure prediction methodology is presented, which incorporates high-resolution seismic velocity data from prestack AVO inversion, and petrophysical data (porosity and shale volume) derived from poststack seismic motion inversion. In contrast to traditional seismic formation prediction methods, the proposed methodology is based on a multivariate pressure prediction model and utilizes a trace-by-trace multivariate regression analysis on seismic-derived petrophysical properties to calibrate model parameters in order to make accurate predictions with higher resolution in both vertical and lateral directions. With prestack time migration velocity as initial velocity model, an AVO inversion was first applied to prestack dataset to obtain high-resolution seismic velocity with higher frequency that is to be used as the velocity input for seismic pressure prediction, and the density dataset to calculate accurate Overburden Pressure (OBP). Seismic Motion Inversion (SMI) is an inversion technique based on Markov Chain Monte Carlo simulation. Both structural variability and similarity of seismic waveform are used to incorporate well log data to characterize the variability of the property to be obtained. In this research, porosity and shale volume are first interpreted on well logs, and then combined with poststack seismic data using SMI to build porosity and shale volume datasets for seismic pressure prediction. A multivariate effective stress model is used to convert velocity, porosity and shale volume datasets to effective stress. After a thorough study of the regional stratigraphic and sedimentary characteristics, a regional normally compacted interval model is built, and then the coefficients in the multivariate prediction model are determined in a trace-by-trace multivariate regression analysis on the petrophysical data. The coefficients are used to convert velocity, porosity and shale volume datasets to effective stress and then

  12. Anterior ankle impingement syndromes.

    PubMed

    Umans, Hilary R; Cerezal, Luiz

    2008-06-01

    Ankle impingement syndromes are painful conditions that may complicate ankle trauma and are characterized by chronic, progressive pain, swelling, and limitation of movement. These disorders are subclassified according to anatomical location about the tibiotalar joint. This article reviews the various forms of anterior ankle impingement, detailing the unique clinical features, anatomical considerations, pathoetiology, and imaging findings for each.

  13. Attenuation of centre-of-pressure trajectory fluctuations under the prosthetic foot when using an articulating hydraulic ankle attachment compared to fixed attachment.

    PubMed

    De Asha, Alan R; Johnson, Louise; Munjal, Ramesh; Kulkarni, Jai; Buckley, John G

    2013-02-01

    Disruptions to the progress of the centre-of-pressure trajectory beneath prosthetic feet have been reported previously. These disruptions reflect how body weight is transferred over the prosthetic limb and are governed by the compliance of the prosthetic foot device and its ability to simulate ankle function. This study investigated whether using an articulating hydraulic ankle attachment attenuates centre-of-pressure trajectory fluctuations under the prosthetic foot compared to a fixed attachment. Twenty active unilateral trans-tibial amputees completed walking trials at their freely-selected, comfortable walking speed using both their habitual foot with either a rigid or elastic articulating attachment and a foot with a hydraulic ankle attachment. Centre-of-pressure displacement and velocity fluctuations beneath the prosthetic foot, prosthetic shank angular velocity during stance, and walking speed were compared between foot conditions. Use of the hydraulic device eliminated or reduced the magnitude of posteriorly directed centre-of-pressure displacements, reduced centre-of-pressure velocity variability across single-support, increased mean forward angular velocity of the shank during early stance, and increased freely chosen comfortable walking speed (P ≤ 0.002). The attenuation of centre-of-pressure trajectory fluctuations when using the hydraulic device indicated bodyweight was transferred onto the prosthetic limb in a smoother, less faltering manner which allowed the centre of mass to translate more quickly over the foot. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. An uncommon ankle sprain

    PubMed Central

    van Zoest, Wart J F; Janssen, Rob P A; Tseng, Carroll M E S

    2007-01-01

    Objective Ankle sprain is the most frequently occurring acute injury in tennis, accounting for 20–25% of all injuries. In the current paper, we assess the cause of ankle sprain and suggest possibilities to be considered during diagnosis. Methods We assessed a professional tennis player with a partial tear of the long peroneal tendon after an ankle sprain by physical exam, X‐ray and MRI. Results Conservative treatment by means of soft cast and propriocepsis training led to full recovery. Conclusion Peroneal tendon disorders must be part of the differential diagnosis after ankle sprain in the professional athlete. PMID:17957026

  15. Anatomical predisposition of the ankle joint for lateral sprain or lateral malleolar fracture evaluated by radiographic measurements.

    PubMed

    Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, SeungYeol; Kim, Tae Gyun; Choi, Young; Jung, Ki Jin; Kim, Yeon Ho; Koo, Seung Bum; Park, Moon Seok

    2015-01-01

    Injury mechanism and the amount of force are important factors determining whether a fracture or sprain occurs at the time of an ankle inversion injury. However, the anatomical differences between the ankle fracture and sprain have not been investigated sufficiently. This study was performed to investigate whether an anatomical predisposition of the ankle joint results in a lateral malleolar fracture or lateral ankle sprain. Two groups of consecutive patients, one with lateral malleolar fracture (274 patients, mean age 49.0 years) and the other with lateral ankle sprain (400 patients, mean age 38.4 years), were evaluated. Ankle radiographs were examined for 7 measures: distal tibial articular surface (DTAS) angle, bimalleolar tilt (BT), medial malleolar relative length (MMRL), lateral malleolar relative length (LMRL), medial malleolar slip angle (MMSA), anterior inclination of tibia (AI), and fibular position (FP). After an interobserver reliability test, the radiographic measurements were compared between the 2 groups. Linear regression analysis was performed to correct for age and sex effects between the groups. The fracture group and the sprain group showed significant differences in BT (P = .001), MMSA (P < .001), AI (P = .023), and FP (P < .001). In multiple regression analysis, after adjusting for age and sex effects, fracture and sprain groups showed a significant difference in BT (P = .001), MMRL (P < .001), MMSA (P < .001), and FP (P < .001). The lateral malleolar fracture group tended to show more bony constraint than that of the lateral ankle sprain group. Further 3-dimensional assessment of the bony structure and subsequent biomechanical studies are needed to elucidate the mechanism of injury according to the various types of ankle fractures and ankle sprain. Level III, retrospective comparative study. © The Author(s) 2014.

  16. Ankle ligament healing after an acute ankle sprain: an evidence-based approach.

    PubMed

    Hubbard, Tricia J; Hicks-Little, Charlie A

    2008-01-01

    To perform a systematic review to determine the healing time of the lateral ankle ligaments after an acute ankle sprain. We identified English-language research studies from 1964 to 2007 by searching MEDLINE, Physiotherapy Evidence Database (PEDro), SportDiscus, and CINAHL using the terms ankle sprain, ankle rehabilitation, ankle injury, ligament healing, and immobilization. We selected studies that described randomized, controlled clinical trials measuring ligament laxity either objectively or subjectively immediately after injury and at least 1 more time after injury. Two reviewers independently scored the 7 studies that met the inclusion criteria. Because of differences in study designs, a meta-analysis could not be performed. Effect sizes and confidence intervals could be calculated only for 1 study. The percentages of subjective and objective instability were calculated for the remaining studies. Ankle laxity improved over a period of 6 weeks to 1 year. One author showed stress talar tilt values of 16.10 +/- 8.8 degrees immediately after injury and 3.4 +/- 3.6 degrees at 3 months after injury. In 2 articles, the authors reported that positive anterior drawer tests were still present in 3% to 31% of participants at 6 months after injury. Additionally, feelings of instability affected 7% to 42% of participants up to 1 year after injury. In the studies that we examined, it took at least 6 weeks to 3 months before ligament healing occurred. However, at 6 weeks to 1 year after injury, a large percentage of participants still had objective mechanical laxity and subjective ankle instability. Direct comparison among articles is difficult because of differences in methods. More research focusing on more reliable methods of measuring ankle laxity is needed so that clinicians can know how long ligament healing takes after injury. This knowledge will help clinicians to make better decisions during rehabilitation and for return to play.

  17. Chronic musculoskeletal ankle disorders in Sri Lanka.

    PubMed

    Weerasekara, Ishanka; Hiller, Claire E

    2017-05-25

    Musculoskeletal disorders of the lower extremities are commonly affected by chronicity and disability. One of the most commonly affected areas is the ankle. Epidemiological information is limited for chronic musculoskeletal ankle disorders in the general community, particularly in the developing world. This study aimed to determine the prevalence and impact of chronic musculoskeletal ankle disorders in the Sri Lankan community. A cross-sectional stratified random sample of people (n = 1000) aged 18 to 85 years in Sri Lanka was undertaken by questionnaire in the general community setting. Of those questionnaires, 827 participants provided data. Point prevalence for no history of ankle injury or ankle disorders, history of ankle injuries without chronic ankle disorders, and chronic ankle disorders were obtained. Point prevalence of chronic musculoskeletal disorders and causes for chronicity was evaluated. There were 448 (54.2%) participants with no ankle disorders, 164 (19.8%) with a history of ankle injury but no chronic disorders, and 215 (26.0%) with chronic ankle disorders. The major component of chronic ankle disorders was musculoskeletal disorders (n = 113, 13.7% of the total sample), most of which were due to ankle injury (n = 80, 9.7% of the total). Sprains were responsible for 17.7% of the total ankle injuries. Arthritis was the other main cause for chronicity of ankle disorders with 4% of total participants (n = 33). Almost 14% of the Sri Lankan community was affected by chronic musculoskeletal ankle disorders. The majority were due to a previous ankle injury, and arthritis. Most people had to limit or change their physical activity because of the chronic ankle disorder. A very low utility of physiotherapy services was observed.

  18. Total ankle arthroplasty versus ankle arthrodesis. Comparison of sports, recreational activities and functional outcome.

    PubMed

    Schuh, Reinhard; Hofstaetter, Jochen; Krismer, Martin; Bevoni, Roberto; Windhager, Reinhard; Trnka, Hans-Joerg

    2012-06-01

    Ankle arthrodesis (AAD) and total ankle replacement (TAR) are the major surgical treatment options for severe ankle arthritis. There is an ongoing discussion in the orthopaedic community whether ankle arthrodesis or ankle fusion should be the treatment of choice for end stage osteoarthritis. The purpose of this study was to compare the participation in sports and recreational activities in patients who underwent either AAD or TAR for end-stage osteoarthritis of the ankle. A total of 41 patients (21 ankle arthrodesis /20 TAR) were examined at 34.5 (SD18.0) months after surgery. At follow-up, pre- and postoperative participation in sports and recreational activities has been assessed. Activity levels were determined using the ankle activity score according to Halasi et al. and the University of California at Los Angeles (UCLA) activity scale. Clinical and functional outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. The percentage of patients participating in sports and recreational activities, UCLA score and AOFAS score were compared between both treatment groups. In the AAD group 86% were active in sports preoperatively and in the TAR group this number was 76%. Postoperatively in both groups 76% were active in sports (AAD, p = 0.08). The UCLA score was 7.0 (± 1.9) in the AAD group and 6.8 (± 1.8) in the TAR group (p = 0.78). The AOFAS score reached 75.6 (± 14) in the AAD group and 75.6 (± 16) in the TAR group (p = 0.97). The ankle activity score decrease was statistically significant for both groups (p = 0.047). Our study revealed no significant difference between the groups concerning activity levels, participation in sports activities, UCLA and AOFAS score. After AAD the number of patients participating in sports decreased. However, this change was not statistically significant.

  19. Anterior ankle arthrodesis

    PubMed Central

    Slater, Gordon L; Sayres, Stephanie C; O’Malley, Martin J

    2014-01-01

    Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various techniques have been described in the attempt to achieve ankle arthrodesis and there is much debate as to the efficiency of each one. This study aims to evaluate the efficiency of anterior plating in ankle arthrodesis using customised and Synthes TomoFix plates. We present the outcomes of 28 ankle arthrodeses between 2005 and 2012, specifically examining rate of union, patient-reported outcomes scores, and complications. All 28 patients achieved radiographic union at an average of 36 wk; the majority of patients (92.86%) at or before 16 wk, the exceptions being two patients with Charcot joints who were noted to have bony union at a three year review. Patient-reported outcomes scores significantly increased (P < 0.05). Complications included two delayed unions as previously mentioned, infection, and extended postoperative pain. With multiple points for fixation and coaxial screw entry points, the contoured customised plate offers added compression and provides a rigid fixation for arthrodesis stabilization. PMID:24649408

  20. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance.

    PubMed

    Algafly, Amin A; George, Keith P

    2007-06-01

    To determine the impact of the application of cryotherapy on nerve conduction velocity (NCV), pain threshold (PTH) and pain tolerance (PTO). A within-subject experimental design; treatment ankle (cryotherapy) and control ankle (no cryotherapy). Hospital-based physiotherapy laboratory. A convenience sample of adult male sports players (n = 23). NCV of the tibial nerve via electromyogram as well as PTH and PTO via pressure algometer. All outcome measures were assessed at two sites served by the tibial nerve: one receiving cryotherapy and one not receiving cryotherapy. In the control ankle, NCV, PTH and PTO did not alter when reassessed. In the ankle receiving cryotherapy, NCV was significantly and progressively reduced as ankle skin temperature was reduced to 10 degrees C by a cumulative total of 32.8% (p<0.05). Cryotherapy led to an increased PTH and PTO at both assessment sites (p<0.05). The changes in PTH (89% and 71%) and PTO (76% and 56%) were not different between the iced and non-iced sites. The data suggest that cryotherapy can increase PTH and PTO at the ankle and this was associated with a significant decrease in NCV. Reduced NCV at the ankle may be a mechanism by which cryotherapy achieves its clinical goals.

  1. Extracting physical parameters from marine seismic data: New methods in seismic oceanography and velocity inversion

    NASA Astrophysics Data System (ADS)

    Fortin, Will F. J.

    The utility and meaning of a geophysical dataset is dependent on good interpretation informed by high-quality data, processing, and attribute examination via technical methodologies. Active source marine seismic reflection data contains a great deal of information in the location, phase, and amplitude of both pre- and post-stack seismic reflections. Using pre- and post-stack data, this work has extracted useful information from marine reflection seismic data in novel ways in both the oceanic water column and the sub-seafloor geology. In chapter 1 we develop a new method for estimating oceanic turbulence from a seismic image. This method is tested on synthetic seismic data to show the method's ability to accurately recover both distribution and levels of turbulent diffusivity. Then we apply the method to real data offshore Costa Rica where we observe lee waves. Our results find elevated diffusivities near the seafloor as well as above the lee waves five times greater than surrounding waters and 50 times greater than open ocean diffusivities. Chapter 2 investigates subsurface geology in the Cascadia Subduction Zone and outlines a workflow for using pre-stack waveform inversion to produce highly detailed velocity models and seismic images. Using a newly developed inversion code, we achieve better imaging results as compared to the product of a standard, user-intensive method for building a velocity model. Our results image the subduction interface ~30 km farther landward than previous work and better images faults and sedimentary structures above the oceanic plate as well as in the accretionary prism. The resultant velocity model is highly detailed, inverted every 6.25 m with ~20 m vertical resolution, and will be used to examine the role of fluids in the subduction system. These results help us to better understand the natural hazards risks associated with the Cascadia Subduction Zone. Chapter 3 returns to seismic oceanography and examines the dynamics of nonlinear

  2. Estimation of Quasi-Stiffness and Propulsive Work of the Human Ankle in the Stance Phase of Walking

    PubMed Central

    Shamaei, Kamran; Sawicki, Gregory S.; Dollar, Aaron M.

    2013-01-01

    Characterizing the quasi-stiffness and work of lower extremity joints is critical for evaluating human locomotion and designing assistive devices such as prostheses and orthoses intended to emulate the biological behavior of human legs. This work aims to establish statistical models that allow us to predict the ankle quasi-stiffness and net mechanical work for adults walking on level ground. During the stance phase of walking, the ankle joint propels the body through three distinctive phases of nearly constant stiffness known as the quasi-stiffness of each phase. Using a generic equation for the ankle moment obtained through an inverse dynamics analysis, we identify key independent parameters needed to predict ankle quasi-stiffness and propulsive work and also the functional form of each correlation. These parameters include gait speed, ankle excursion, and subject height and weight. Based on the identified form of the correlation and key variables, we applied linear regression on experimental walking data for 216 gait trials across 26 subjects (speeds from 0.75–2.63 m/s) to obtain statistical models of varying complexity. The most general forms of the statistical models include all the key parameters and have an R2 of 75% to 81% in the prediction of the ankle quasi-stiffnesses and propulsive work. The most specific models include only subject height and weight and could predict the ankle quasi-stiffnesses and work for optimal walking speed with average error of 13% to 30%. We discuss how these models provide a useful framework and foundation for designing subject- and gait-specific prosthetic and exoskeletal devices designed to emulate biological ankle function during level ground walking. PMID:23555839

  3. Brain regulation of muscle tone in healthy and functionally unstable ankles.

    PubMed

    Needle, Alan R; Palmer, Jacqueline A; Kesar, Trisha M; Binder-Macleod, Stuart A; Swanik, C Buz

    2013-08-01

    Current research into the etiology of joint instability has yielded inconsistent results, limiting our understanding of how to prevent and treat ligamentous injury effectively. Recently, cortical reorganization was demonstrated in patients with ligamentous injury; however, these neural changes have not been assessed relative to joint laxity. The purpose of the current study was to determine if changes in cortical excitability and inhibition occur in subjects with functional ankle instability, as well as to investigate the relationship between these measures and joint laxity. Posttest only with control group. University laboratory. 12 subjects with no history of ankle sprain (CON) and 12 subjects with a history of unilateral functional ankle instability (UNS). Subjects were tested for joint laxity using an instrumented ankle arthrometer. Cortical excitability and inhibition were assessed using transcranial magnetic stimulation (TMS) to obtain motor-evoked potentials and the cortical silent period from the lower leg muscles. Joint laxity was quantified as peak anterior displacement and inversion rotation. Active motor threshold, slope, and intensity at 50% of peak slope of TMS-derived recruitment curves were used to quantify cortical excitability from lower leg muscles, while the cortical silent period from the peroneus longus was used to represent intracortical inhibition. No significant differences were observed between groups for laxity or cortical measures. CON demonstrated a significant relationship between laxity and tibialis anterior excitability, as well as laxity and silent period, while UNS ankles demonstrated significant relationships between peroneal and soleus excitability and laxity measures. Our results support relationships between laxity and measures of excitability and inhibition that differ between healthy and unstable subjects. Future research should further investigate the mechanisms behind these findings and consider cortical influences when

  4. Clinical Tests Have Limited Predictive Value for Chronic Ankle Instability When Conducted in the Acute Phase of a First-Time Lateral Ankle Sprain Injury.

    PubMed

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2018-04-01

    To evaluate whether a battery of clinical assessments for acute lateral ankle sprain (LAS) can be used to predict long-term recovery. Cohort study. University biomechanics laboratory. Individuals (N=82) were assessed using a clinical test battery within 2 weeks of incurring a first-time LAS. Not applicable. The clinical test battery included scores on the talar glide test (degrees), the anterior drawer, talar tilt, figure of 8 for swelling (millimeters) and knee to wall (millimeters) tests, and handheld goniometric range of motion (inversion, eversion, and plantarflexion [in degrees]). Scores on the Cumberland Ankle Instability Tool taken 12 months after the clinical test battery were used to classify participants as having chronic ankle instability (CAI) or as being LAS copers. Forty percent of participants were designated as having CAI, with 60% being designated as LAS copers. A logistic regression analysis revealed that a combined model using scores from the talar glide, talar tilt, and anterior drawer tests in addition to plantarflexion range of motion was statistically significant (P<.01) and correctly classified cases with moderate accuracy (68.8%). The final model had moderate sensitivity (64%) and good specificity (72%). The clinical tests used in this investigation have limited predictive value for CAI when conducted in the acute phase of a first-time LAS injury. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Tomographic inversion of P-wave velocity and Q structures beneath the Kirishima volcanic complex, Southern Japan, based on finite difference calculations of complex traveltimes

    USGS Publications Warehouse

    Tomatsu, T.; Kumagai, H.; Dawson, P.B.

    2001-01-01

    We estimate the P-wave velocity and attenuation structures beneath the Kirishima volcanic complex, southern Japan, by inverting the complex traveltimes (arrival times and pulse widths) of waveform data obtained during an active seismic experiment conducted in 1994. In this experiment, six 200-250 kg shots were recorded at 163 temporary seismic stations deployed on the volcanic complex. We use first-arrival times for the shots, which were hand-measured interactively. The waveform data are Fourier transformed into the frequency domain and analysed using a new method based on autoregressive modelling of complex decaying oscillations in the frequency domain to determine pulse widths for the first-arrival phases. A non-linear inversion method is used to invert 893 first-arrival times and 325 pulse widths to estimate the velocity and attenuation structures of the volcanic complex. Wavefronts for the inversion are calculated with a finite difference method based on the Eikonal equation, which is well suited to estimating the complex traveltimes for the structures of the Kirishima volcano complex, where large structural heterogeneities are expected. The attenuation structure is derived using ray paths derived from the velocity structure. We obtain 3-D velocity and attenuation structures down to 1.5 and 0.5 km below sea level, respectively. High-velocity pipe-like structures with correspondingly low attenuation are found under the summit craters. These pipe-like structures are interpreted as remnant conduits of solidified magma. No evidence of a shallow magma chamber is visible in the tomographic images.

  6. Ankle Sprains. A Round Table.

    ERIC Educational Resources Information Center

    Physician and Sportsmedicine, 1986

    1986-01-01

    Types of ankle sprains, surgical versus nonsurgical treatment, tape versus brace for support, rehabilitation, exercise, and prevention of ankle sprains are discussed by a panel of experts. An acute ankle taping technique is illustrated. (MT)

  7. Achilles tendon moment arm in humans is not affected by inversion/eversion of the foot: a short report.

    PubMed

    Wolfram, Susann; Morse, Christopher I; Winwood, Keith L; Hodson-Tole, Emma; McEwan, Islay M

    2018-01-01

    The triceps surae primarily acts as plantarflexor of the ankle joint. However, the group also causes inversion and eversion at the subtalar joint. Despite this, the Achilles tendon moment arm is generally measured without considering the potential influence of inversion/eversion of the foot during plantarflexion. This study investigated the effect of foot inversion and eversion on the plantarflexion Achilles tendon moment arm. Achilles tendon moment arms were determined using the centre-of-rotation method in magnetic resonance images of the left ankle of 11 participants. The foot was positioned at 15° dorsiflexion, 0° or 15° plantarflexion using a Styrofoam wedge. In each of these positions, the foot was either 10° inverted, neutral or 10° everted using an additional Styrofoam wedge. Achilles tendon moment arm in neutral foot position was 47.93 ± 4.54 mm and did not differ significantly when the foot was positioned in 10° inversion and 10° eversion. Hence, inversion/eversion position of the foot may not considerably affect the length of the Achilles tendon moment arm. This information could be useful in musculoskeletal models of the human lower leg and foot and when estimating Achilles tendon forces during plantarflexion with the foot positioned in inversion or eversion.

  8. Role of Ankle Arthroscopy in Management of Acute Ankle Fracture.

    PubMed

    Chan, Kwok Bill; Lui, Tun Hing

    2016-11-01

    To report the operative findings of ankle arthroscopy during open reduction and internal fixation of acute ankle fractures. This was a retrospective review of 254 consecutive patients with acute ankle fractures who were treated with open reduction and internal fixation of the fractures, and ankle arthroscopy was performed at the same time. The accuracy of fracture reduction, the presence of syndesmosis disruption and its reduction, and the presence of ligamentous injuries and osteochondral lesions were documented. Second-look ankle arthroscopy was performed during syndesmosis screw removal 6 weeks after the key operation. There were 6 patients with Weber A, 177 patients with Weber B, 51 patients with Weber C, and 20 patients with isolated medial malleolar fractures. Syndesmosis disruption was present in 0% of patients with Weber A fracture, 52% of patients with Weber B fracture, 92% of patients with Weber C fracture, and 20% of the patients with isolated medial malleolar fracture. Three patients with Weber B and one patient with Weber C fracture have occult syndesmosis instability after screw removal. Osteochondral lesion was present in no patient with Weber A fracture, 26% of the Weber B cases, 24% of the Weber C cases, and 20% of isolated medial malleolar fracture cases. The association between the presence of deep deltoid ligament tear and syndesmosis disruption (warranting syndesmosis screw fixation) in Weber B cases was statistically significant but not in Weber C cases. There was no statistically significant association between the presence of posterior malleolar fracture and syndesmosis instability that warrant screw fixation. Ankle arthroscopy is a useful adjuvant tool to understand the severity and complexity of acute ankle fracture. Direct arthroscopic visualization ensures detection and evaluation of intra-articular fractures, syndesmosis disruption, and associated osteochondral lesions and ligamentous injuries. Level IV, case series

  9. Association between the severity of coronary artery stenosis and the combination of the difference in blood pressure between arms and brachial-ankle pulse wave velocity.

    PubMed

    Miyase, Yuiko; Miura, Shin-Ichiro; Shiga, Yuhei; Yano, Masaya; Suematsu, Yasunori; Adachi, Sen; Norimatsu, Kenji; Nakamura, Ayumi; Saku, Keijiro

    2016-01-01

    A difference in systolic blood pressure (SBP) ≥10 mmHg between the arms is associated with an increased risk of coronary artery disease (CAD) and mortality in high-risk patients. Four hundred and fourteen patients were divided into three groups according to the percent most severe luminal narrowing of a coronary artery as diagnosed by coronary computed tomography angiography: no or mild coronary stenosis (0-49%), moderate stenosis (50-69%) and severe stenosis (≥70%) groups. The relative difference in SBP between arms in the severe group was significantly lower than those in the no or mild and moderate groups. The brachial-ankle pulse wave velocity (baPWV) significantly increased as the severity of coronary stenosis increased. We confirmed that severe coronary stenosis was independently associated with both the relative difference in SBP between arms and baPWV, in addition to age, gender, hypertension, dyslipidemia, diabetes mellitus and ankle-brachial index by a logistic regression analysis. The group with a relative difference in SBP between arms of <1 mmHg and baPWV ≥ 1613 cm/s showed a higher percentage of patients with severe coronary stenosis than groups that met neither or only one of these criteria. The combination of the relative difference in SBP between arms and baPWV may be a more effective approach for the non-invasive assessment of the severity of CAD.

  10. Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

    PubMed Central

    Masaki, Hisao; Yunoki, Yasuhiro; Tabuchi, Atushi; Morita, Ichiro; Mohri, Satoshi; Tanemoto, Kazuo

    2015-01-01

    Objective: To clarify the characteristics of ankle-brachial index (ABI), toe-brachial index (TBI), and pulse volume recording (PVR) of the ankle with brachial-ankle pulse wave velocity (baPWV) in healthy young adults. Material and Methods: We analyzed ABI, TBI, baPWV, and PVR in the ankle of healthy adults aged 20 to 25 years (median, 20 years) using an automatic oscillometric device between 2002 and 2013. The ABI, baPWV, and PVR in 1282 legs of 641 subjects (301 men and 340 women) and the TBI in 474 toes of 237 subjects (117 men and 120 women) were evaluated. Results: The measured values showed no bilateral differences. ABI and baPWV were higher in men than in women, but TBI was similar in both sexes. ABI <1.0 was observed in 18.1% of the legs in men and in 25.6% in women. TBI <0.7 was observed in 16.2% of the toes in men and 19.1% in women. For ankle PVR, the % mean arterial pressure was higher in women than in men. The upstroke time was <180 ms in most subjects. Conclusions: For young people, ABI <1.0 or TBI <0.7 may not always indicate vascular abnormalities. When evaluating circulatory indexes, age and sex should be considered. PMID:26421072

  11. Active ankle motion may result in changes to the talofibular interval in individuals with chronic ankle instability and ankle sprain copers: a preliminary study

    PubMed Central

    Croy, Theodore; Cosby, Nicole L; Hertel, Jay

    2013-01-01

    Introduction: Alterations in talocrural joint arthrokinematics related to repositioning of the talus or fibula following ankle sprain have been reported in radiological and clinical studies. It is unclear if these changes can result from normal active ankle motion. The study objective was to determine if active movement created changes in the sagittal plane talofibular interval in ankles with a history of lateral ankle sprain and instability. Methods: Three subject groups [control (n = 17), ankle sprain copers (n = 20), and chronic ankle instability (n = 20)] underwent ultrasound imaging of the anterolateral ankle gutter to identify the lateral malleolus and talus over three trials. Between trials, subjects actively plantar and dorsiflexed the ankle three times. The sagittal plane talofibular interval was assessed by measuring the anteroposterior distance (mm) between the lateral malleolus and talus from an ultrasound image. Between group and trial differences were analyzed with repeated measures analysis of variance and post-hoc t-tests. Results: Fifty-seven subjects participated. A significant group-by-trial interaction was observed (F4,108 = 3.5; P = 0.009). The talofibular interval was increased in both copers [2.4±3.6 mm; 95% confidence interval (CI): 0.73–4.1; P = 0.007] and chronic ankle instability (4.1±4.6 mm; 95% CI: 1.9–6.2; P = 0.001) at trial 3 while no changes were observed in control ankle talar position (0.06±2.8mm; 95% CI: −1.5–1.4; P = 0.93). Discussion: The talofibular interval increased only in subjects with a history of lateral ankle sprain with large clinical effect sizes observed. These findings suggest that an alteration in the position of the talus or fibula occurred with non-weight bearing sagittal plane motion. These findings may have diagnostic and therapeutic implications for manual therapists. PMID:24421623

  12. Thin Lithosphere Beneath the Ethiopian Plateau Revealed by a Joint Inversion of Rayleigh Wave Group Velocities and Receiver Functions

    NASA Astrophysics Data System (ADS)

    Dugda, Mulugeta T.; Nyblade, Andrew A.; Julia, Jordi

    2007-08-01

    The seismic velocity structure of the crust and upper mantle beneath Ethiopia and Djibouti has been investigated by jointly inverting receiver functions and Rayleigh wave group velocities to obtain new constraints on the thermal structure of the lithosphere. Most of the data for this study come from the Ethiopia broadband seismic experiment, conducted between 2000 and 2002. Shear velocity models obtained from the joint inversion show crustal structure that is similar to previously published models, with crustal thicknesses of 35 to 44 km beneath the Ethiopian Plateau, and 25 to 35 km beneath the Main Ethiopian Rift (MER) and the Afar. The lithospheric mantle beneath the Ethiopian Plateau has a maximum shear wave velocity of about 4.3 km/s and extends to a depth of ˜70-80 km. Beneath the MER and Afar, the lithospheric mantle has a maximum shear wave velocity of 4.1-4.2 km/s and extends to a depth of at most 50 km. In comparison to the lithosphere away from the East African Rift System in Tanzania, where the lid extends to depths of ˜100-125 km and has a maximum shear velocity of 4.6 km/s, the mantle lithosphere under the Ethiopian Plateau appears to have been thinned by ˜30-50 km and the maximum shear wave velocity reduced by ˜0.3 km/s. Results from a 1D conductive thermal model suggest that the shear velocity structure of the Ethiopian Plateau lithosphere can be explained by a plume model, if a plume rapidly thinned the lithosphere by ˜30-50 km at the time of the flood basalt volcanism (c. 30 Ma), and if warm plume material has remained beneath the lithosphere since then. About 45-65% of the 1-1.5 km of plateau uplift in Ethiopia can be attributed to the thermally perturbed lithospheric structure.

  13. Transfibular ankle arthrodesis: A novel method for ankle fusion – A short term retrospective study

    PubMed Central

    Balaji, S Muthukumar; Selvaraj, V; Devadoss, Sathish; Devadoss, Annamalai

    2017-01-01

    Background: Ankle arthrodesis has long been the traditional operative treatment for posttraumatic arthritis, rheumatoid arthritis, infection, neuromuscular conditions, and salvage of failed ankle arthroplasty. It remains the treatment of choice for patients in whom heavy and prolonged activity is anticipated. We present our short term followup study of functional outcome of patients who underwent transfibular ankle arthrodesis for arthritis of ankle due to various indications. Materials and Methods: 29 transfibular ankle arthrodesis in 29 patients performed between April 2009 and April 2014 were included in this study. The mean age was 50 years (range 22-75 years). The outcome analysis with a minimum of 1-year postoperative followup were included. All the patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot scale. Results: All cases of ankle fusions (100%) progressed to solid union in a mean postoperative duration of 3.8 months (range 3–6 months). All patients had sound arthrodesis. The mean followup period was 32.52 months (standard deviation ± 10.34). The mean AOFAS score was 74 (pain score = 32, functional score = 42). We found that twenty patients (68.96%) out of 29, had excellent results, 7 (24.13%) had good, and 2 (6.89%) showed fair results. Conclusion: Transfibular ankle arthrodesis is a simple and effective procedure for ankle arthritis. It achieves a high rate of union and good functional outcome on midterm followup. PMID:28216754

  14. Ankle muscle activity modulation during single-leg stance differs between children, young adults and seniors.

    PubMed

    Kurz, Eduard; Faude, Oliver; Roth, Ralf; Zahner, Lukas; Donath, Lars

    2018-02-01

    Incomplete maturation and aging-induced declines of the neuromuscular system affect postural control both in children and older adults and lead to high fall rates. Age-specific comparisons of the modulation of ankle muscle activation and behavioral center of pressure (COP) indices during upright stance have been rarely conducted. The objective of the present study was to quantify aging effects on a neuromuscular level. Thus, surface electromyography (SEMG) modulation and co-activity of ankle muscles during single-leg standing was compared in healthy children, young adults and seniors. Postural steadiness (velocity and mean sway frequency of COP), relative muscle activation (SEMG modulation) and co-activation of two ankle muscles (tibialis anterior, TA; soleus, SO) were examined during single-leg stance in 19 children [age, 9.7 (SD 0.5) years], 30 adults [23.3 (1.5) years] and 29 seniors [62.7 (6.1) years]. Velocity of COP in medio-lateral and anterior-posterior directions, mean sway frequency in anterior-posterior direction, relative muscle activation (TA and SO) and co-activation revealed large age effects (P < 0.003, η p 2  > 0.14). Post-hoc comparisons indicated higher COP velocities, anterior-posterior frequencies, relative SO activation and co-activation in children and seniors when compared with adults. Relative TA activation was higher in children and adults compared with seniors (P < 0.001). Increased postural sway in children and seniors seems to be counteracted with higher TA/SO co-activity and SO modulation. However, TA modulation is higher in children and adults, whereas seniors' TA modulation capacity is diminished. An aging-induced decline of TA motor units might account for deteriorations of TA modulation in seniors.

  15. The influence of landing mat composition on ankle injury risk during a gymnastic landing: a biomechanical quantification.

    PubMed

    Xiao, Xiaofei; Hao, Weiya; Li, Xuhong; Wan, Bingjun; Shan, Gongbing

    2017-01-01

    About 70% injury of gymnasts happened during landing - an interaction between gymnast and landing mat. The most injured joint is the ankle. The current study examined the effect of mechanical properties of landing mat on ankle loading with aims to identify means of decreasing the risk of ankle injury. Gymnastic skill - salto backward stretched with 3/2 twist was captured by two high-speed camcorders and digitized by using SIMI-Motion software. A subject-specific, 14-segment rigid-body model and a mechanical landing-mat model were built using BRG.LifeMODTM. The landings were simulated with varied landing-mat mechanical properties (i.e., stiffness, dampness and friction coefficients). Real landing performance could be accurately reproduced by the model. The simulations revealed that the ankle angle was relatively sensitive to stiffness and dampness of the landing mat, the ankle loading rate increased 26% when the stiffness was increased by 30%, and the changing of dampness had notable effect on horizontal ground reaction force and foot velocity. Further, the peak joint-reaction force and joint torque were more sensitive to friction than to stiffness and dampness of landing mat. Finally, ankle muscles would dissipate about twice energy (189%) when the friction was increased by 30%. Loads to ankles during landing would increase as the stiffness and dampness of the landing mat increase. Yet, increasing friction would cause a substantial rise of the ankle internal loads. As such, the friction should be a key factor influencing the risk of injury. Unfortunately, this key factor has rarely attracted attention in practice.

  16. Spring-like Ankle Foot Orthoses reduce the energy cost of walking by taking over ankle work.

    PubMed

    Bregman, D J J; Harlaar, J; Meskers, C G M; de Groot, V

    2012-01-01

    In patients with central neurological disorders, gait is often limited by a reduced ability to push off with the ankle. To overcome this reduced ankle push-off, energy-storing, spring-like carbon-composite Ankle Foot Orthoses (AFO) can be prescribed. It is expected that the energy returned by the AFO in late stance will support ankle push-off, and reduce the energy cost of walking. In 10 patients with multiple sclerosis and stroke the energy cost of walking, 3D kinematics, joint power, and joint work were measured during gait, with and without the AFO. The mechanical characteristics of the AFO were measured separately, and used to calculate the contribution of the AFO to the ankle kinetics. We found a significant decrease of 9.8% in energy cost of walking when walking with the AFO. With the AFO, the range of motion of the ankle was reduced by 12.3°, and the net work around the ankle was reduced by 29%. The total net work in the affected leg remained unchanged. The AFO accounted for 60% of the positive ankle work, which reduced the total amount of work performed by the leg by 11.1% when walking with the AFO. The decrease in energy cost when walking with a spring-like energy-storing AFO in central neurological patients is not induced by an augmented net ankle push-off, but by the AFO partially taking over ankle work. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction.

    PubMed

    Li, Hong-Yun; Zheng, Jie-Jiao; Zhang, Jian; Cai, Ye-Hua; Hua, Ying-Hui; Chen, Shi-Yi

    2016-04-01

    Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability. A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients. At 6 months after the operation, with the patients' eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation. Postural control was improved by reconstructing the lateral ligaments. IV.

  18. Acute ankle sprain in dancers.

    PubMed

    Russell, Jeffrey A

    2010-01-01

    Ankle sprain is a common injury in dancers. Because of the relative frequency of this injury and its wide acceptance as a likely part of an active lifestyle, in many individuals it may not receive the careful attention it deserves. An extreme ankle range of motion and excellent ankle stability are fundamental to success in dance. Hence, following a proper treatment protocol is crucial for allowing a dancer who suffers an ankle sprain to return to dance as soon as possible without impaired function. This article reviews the basic principles of the etiology and management of ankle sprain in dancers. Key concepts are on-site examination and treatment, early restoration, dance-specific rehabilitation, and a carefully administered safe return to dance. Additionally, injuries that may occur in conjunction with ankle sprain are highlighted, and practical, clinically relevant summary concepts for dance healthcare professionals, dance scientists, dance teachers, and dancers are provided.

  19. Evaluation of joint position sense measured by inversion angle replication error in patients with an osteochondral lesion of the talus.

    PubMed

    Nakasa, Tomoyuki; Adachi, Nobuo; Shibuya, Hayatoshi; Okuhara, Atsushi; Ochi, Mitsuo

    2013-01-01

    The etiology of the osteochondral lesion of the talar dome (OLT) remains unclear. A joint position sense deficit of the ankle is reported to be a possible cause of ankle disorder. Repeated contact of the articular surface of the talar dome with the plafond during inversion might be a cause of OLT. The aim of the present study was to evaluate the joint position sense deficit by measuring the replication error of the inversion angle in patients with OLT. The replication error, which is the difference between the index angle and replication angle in inversion, was measured in 15 patients with OLT. The replication error in 15 healthy volunteers was evaluated as a control group. The side to side differences of the replication errors between the patients with OLT and healthy volunteers and the replication errors in each angle between the involved and uninvolved ankle in the patients with OLT were investigated. Finally, the side to side differences of the replication errors between the patients with OLT with a traumatic and nontraumatic history were compared. The side to side difference in the patients with OLT (1.3° ± 0.2°) was significantly greater than that in the healthy subjects (0.4° ± 0.7°) (p ≤ .05). Significant differences were found between the involved and uninvolved sides at 10°, 15°, 20°, and 25° in the patients with OLT. No significant difference (p > .05) was found between the patients with traumatic and nontraumatic OLT. The present study found that the patients with OLT have a joint position sense deficit during inversion movement, regardless of a traumatic history. Although various factors for the etiology of OLT have been reported, the joint position sense deficit in inversion might be a cause of OLT. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Comparison of Multisegmental Foot and Ankle Motion Between Total Ankle Replacement and Ankle Arthrodesis in Adults.

    PubMed

    Seo, Sang Gyo; Kim, Eo Jin; Lee, Doo Jae; Bae, Kee Jeong; Lee, Kyoung Min; Lee, Dong Yeon

    2017-09-01

    Total ankle replacement (TAR) and ankle arthrodesis (AA) are usually performed for severe ankle arthritis. We compared postoperative foot segmental motion during gait in patients treated with TAR and AA. Gait analysis was performed in 17 and 7 patients undergoing TAR and AA, respectively. Subjects were evaluated using a 3-dimensional multisegmental foot model with 15 markers. Temporal gait parameters were calculated. The maximum and minimum values and the differences in hallux, forefoot, hindfoot, and arch in 3 planes (sagittal, coronal, transverse) were compared between the 2 groups. One hundred healthy adults were evaluated as a control. Gait speed was faster in the TAR ( P = .028). On analysis of foot and ankle segmental motion, the range of hindfoot sagittal motion was significantly greater in the TAR (15.1 vs 10.2 degrees in AA; P = .004). The main component of motion increase was hindfoot dorsiflexion (12.3 and 8.6 degrees). The range of forefoot sagittal motion was greater in the TAR (9.3 vs 5.8 degrees in AA; P = .004). Maximum ankle power in the TAR (1.16) was significantly higher than 0.32 in AA; P = .008). However, the range of hindfoot and forefoot sagittal motion was decreased in both TAR and AA compared with the control group ( P = .000). Although biomechanical results of TAR and AA were not similar to those in the normal controls, joint motions in the TAR more closely matched normal values. Treatment decision making should involve considerations of the effect of surgery on the adjacent joints. Level III, case-control study.

  1. [Ankle arthrodesis with interposition graft as a salvage procedure after failed total ankle replacement].

    PubMed

    Schill, Stephan

    2007-12-01

    Restoration of painless function to the lower limb by ankle fusion after failure of total ankle arthroplasty. Loose total ankle replacement. Severe ankle destruction and axial deviation in rheumatoid patients. Severe osteoarthritis in the subtalar and ankle joints. Infected total ankle replacement. Severe arterial occlusive disease of the affected extremity. Transfibular approach to the subtalar and ankle joints. Osteotomy and resection of the distal fibula 7-8 cm proximal to the tip of the lateral malleolus. Removal of the prosthetic components, synovectomy, and revitalization of the remaining bone surface. Removal of any residual articular cartilage from the subtalar joint surfaces. Determination of the extent of bone loss and defect filling with horizontally or vertically placed tricortical and cancellous bone graft from the resected fibula and, if necessary, from the ipsilateral anterior iliac crest. Tibiotalocalcaneal arthrodesis by retrograde insertion of a retrograde locking nail. Wound closure in layers. Split below-knee cast. Mobilization with below-knee cast without weight bearing for 6 weeks. Dynamic locking of the intramedullary nail. Partial weight bearing with a walker up to 20 kg for an additional 6 weeks. Gradual increase in weight bearing in accordance with radiologic evidence of consolidation. Fitted orthopedic shoe with rocker-bottom sole, and made to measure insoles. From January 2003 to September 2006, 15 patients with infected ankle prosthesis loosening (six Thompson-Richards prostheses, eight S.T.A.R. prostheses, and one Salto prosthesis) were treated. All patients underwent tibiotalocalcaneal interposition arthrodesis with femoral nailing in retrograde technique. The average AOFAS (American Orthopaedic Foot and Ankle Society) Score was 57.9 points (35-81 points) postoperatively. One patient developed a nonunion and revision surgery will have to be performed. Another patient with delayed wound healing and skin necrosis needed plastic surgery.

  2. Relation between respiratory function and arterial stiffness assessed using brachial-ankle pulse wave velocity in healthy workers.

    PubMed

    Inomoto, Atsushi; Fukuda, Rika; Deguchi, Junko; Toyonaga, Toshihiro

    2017-09-01

    [Purpose] Current studies report that patients with chronic obstructive pulmonary disease (COPD) may also have arteriosclerosis. This study aimed to investigate the relationship between respiratory function and arterial stiffness in healthy workers using the brachial-ankle pulse wave velocity (baPWV). [Subjects and Methods] This study included 104 male Japanese workers without COPD. We collected participant information and measured hemodynamics, body composition, and respiratory function. [Results] In the correlation analysis, baPWV showed a significant positive correlation with age, smoking index, systolic blood pressure, diastolic blood pressure, and heart rate, and a significant negative correlation with height, fat free mass, lower limb muscle mass, forced vital capacity (FVC), and forced expiratory volume in one second (FEV1). In multiple regression analysis using factors other than baPWV and respiratory function as adjustment variables, both FVC and FEV1 showed a significant negative relationship with baPWV (p=0.009 and p=0.027, respectively). FEV1/FVC was not significantly related to baPWV (p=0.704). [Conclusion] The results of this study indicated that FEV1/FVC and the proportion of FEV1 predicted, which are indicators of airflow limitation, are not predictors of baPWV in workers without airflow limitation. However, since baPWV showed a significant negative relationship with FVC and FEV 1, the reduction in respiratory function that does not cause airflow limitation, such as FVC or FEV1 decline, may be related to an increase in the risk of arterial stiffness.

  3. Altered knee and ankle kinematics during squatting in those with limited weight-bearing-lunge ankle-dorsiflexion range of motion.

    PubMed

    Dill, Karli E; Begalle, Rebecca L; Frank, Barnett S; Zinder, Steven M; Padua, Darin A

    2014-01-01

    Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee flexion. To our knowledge, researchers have not studied individuals with limited or normal ankle DF-ROM to investigate the relationship between those factors and the lower extremity movement patterns associated with anterior cruciate ligament injury. To determine, using 2 different measurement techniques, whether knee- and ankle-joint kinematics differ between participants with limited and normal ankle DF-ROM. Cross-sectional study. Sports medicine research laboratory. Forty physically active adults (20 with limited ankle DF-ROM, 20 with normal ankle DF-ROM). Ankle DF-ROM was assessed using 2 techniques: (1) nonweight-bearing ankle DF-ROM with the knee straight, and (2) weight-bearing lunge (WBL). Knee flexion, knee valgus-varus, knee internal-external rotation, and ankle DF displacements were assessed during the overhead-squat, single-legged squat, and jump-landing tasks. Separate 1-way analyses of variance were performed to determine whether differences in knee- and ankle-joint kinematics existed between the normal and limited groups for each assessment. We observed no differences between the normal and limited groups when classifying groups based on nonweight-bearing passive-ankle DF-ROM. However, individuals with greater ankle DF-ROM during the WBL displayed greater knee-flexion and ankle-DF displacement and peak knee flexion during the overhead-squat and single-legged squat tasks. In addition, those individuals also demonstrated greater knee-varus displacement during the single-legged squat. Greater ankle DF-ROM assessed during the WBL was associated with greater knee-flexion and ankle-DF displacement during both squatting tasks as well as greater knee-varus displacement during the single-legged squat. Assessment of ankle DF-ROM using the WBL provided important insight into compensatory

  4. Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures.

    PubMed

    Nosewicz, Tomasz L; Beerekamp, M Suzan H; De Muinck Keizer, Robert-Jan O; Schepers, Tim; Maas, Mario; Niek van Dijk, C; Goslings, J Carel

    2016-08-01

    Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level IV, observational study. © The Author(s) 2016.

  5. Acute traumatic open posterolateral dislocation of the ankle without tearing of the tibiofibular syndesmosis ligaments: a case report.

    PubMed

    Demiralp, Bahtiyar; Komurcu, Mahmut; Ozturk, Cagatay; Ozturan, Kutay; Tasatan, Ersin; Erler, Kaan

    2008-01-01

    Pure open dislocation of the ankle, or dislocation not accompanied by rupture of the tibiofibular syndesmosis ligaments or fractures of the malleoli or of the posterior border of the tibia, is an extremely rare injury. A 62-year-old man injured his right ankle in a motor vehicle accident. Besides posterolateral ankle dislocation, there was a 7-cm transverse skin cut on the medial malleolus, and the distal end of the tibia was exposed. After reduction, we made a 2- to 2.5-cm longitudinal incision on the lateral malleolus; the distal fibular fracture was exposed. Two Kirschner wires were placed intramedullary in a retrograde manner, and the fracture was stabilized. The deltoid ligament and the medial capsule were repaired. The tibiofibular syndesmosis ligaments were intact. At the end of postoperative year 1, right ankle joint range of motion had a limit of approximately 5 degrees in dorsiflexion, 10 degrees in plantarflexion, 5 degrees in inversion, and 0 degrees in eversion. The joint appeared normal on radiographs, with no signs of osteoarthritis or calcification. The best result can be obtained with early reduction, debridement, medial capsule and deltoid ligament restoration, and early rehabilitation. Clinical and radiographic features at long-term follow-up also confirm good mobility of the ankle without degenerative change or mechanical instability.

  6. Retrospective comparison of the Low Risk Ankle Rules and the Ottawa Ankle Rules in a pediatric population.

    PubMed

    Ellenbogen, Amy L; Rice, Amy L; Vyas, Pranav

    2017-09-01

    A recent multicenter prospective Canadian study presented prospective evidence supporting the Low Risk Ankle Rules (LRAR) as a means of reducing the number of ankle radiographs ordered for children presenting with an ankle injury while maintaining nearly 100% sensitivity. This is in contrast to a previous prospective study which showed that this rule yielded only 87% sensitivity. It is important to further investigate the LRAR and compare them with the already validated Ottawa Ankle Rules (OAR) to potentially curb healthcare costs and decrease unnecessary radiation exposure without compromising diagnostic accuracy. We conducted a retrospective chart review of 980 qualifying patients ages 12months to 18years presenting with ankle injury to a commonly staffed 310 bed children's hospital and auxiliary site pediatric emergency department. There were 28 high-risk fractures identified. The Ottawa Ankle Rules had a sensitivity of 100% (95% CI 87.7-100), specificity of 33.1% (95% CI 30.1-36.2), and would have reduced the number of ankle radiographs ordered by 32.1%. The Low Risk Ankle Rules had a sensitivity of 85.7% (95% CI 85.7-96), specificity of 64.9% (95% CI 61.8-68), and would have reduced the number of ankle radiographs ordered by 63.1%. The latter rule missed 4 high-risk fractures. The Low Risk Ankle Rules may not be sensitive enough for use in Pediatric Emergency Departments, while the Ottawa Ankle Rules again demonstrated 100% sensitivity. Further research on ways to implement the Ottawa Ankle Rules and maximize its ability to decrease wait times, healthcare costs, and improve patient satisfaction are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. A three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses.

    PubMed

    Fatone, Stefania; Johnson, William Brett; Tucker, Kerice

    2016-04-01

    Misalignment of an articulated ankle-foot orthosis joint axis with the anatomic joint axis may lead to discomfort, alterations in gait, and tissue damage. Theoretical, two-dimensional models describe the consequences of misalignments, but cannot capture the three-dimensional behavior of ankle-foot orthosis use. The purpose of this project was to develop a model to describe the effects of ankle-foot orthosis ankle joint misalignment in three dimensions. Computational simulation. Three-dimensional scans of a leg and ankle-foot orthosis were incorporated into a link segment model where the ankle-foot orthosis joint axis could be misaligned with the anatomic ankle joint axis. The leg/ankle-foot orthosis interface was modeled as a network of nodes connected by springs to estimate interface pressure. Motion between the leg and ankle-foot orthosis was calculated as the ankle joint moved through a gait cycle. While the three-dimensional model corroborated predictions of the previously published two-dimensional model that misalignments in the anterior -posterior direction would result in greater relative motion compared to misalignments in the proximal -distal direction, it provided greater insight showing that misalignments have asymmetrical effects. The three-dimensional model has been incorporated into a freely available computer program to assist others in understanding the consequences of joint misalignments. Models and simulations can be used to gain insight into functioning of systems of interest. We have developed a three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses. The model has been incorporated into a freely available computer program to assist understanding of trainees and others interested in orthotics. © The International Society for Prosthetics and Orthotics 2014.

  8. Muscle Reaction Time During a Simulated Lateral Ankle Sprain After Wet-Ice Application or Cold-Water Immersion.

    PubMed

    Thain, Peter K; Bleakley, Christopher M; Mitchell, Andrew C S

    2015-07-01

    Cryotherapy is used widely in sport and exercise medicine to manage acute injuries and facilitate rehabilitation. The analgesic effects of cryotherapy are well established; however, a potential caveat is that cooling tissue negatively affects neuromuscular control through delayed muscle reaction time. This topic is important to investigate because athletes often return to exercise, rehabilitation, or competitive activity immediately or shortly after cryotherapy. To compare the effects of wet-ice application, cold-water immersion, and an untreated control condition on peroneus longus and tibialis anterior muscle reaction time during a simulated lateral ankle sprain. Randomized controlled clinical trial. University of Hertfordshire human performance laboratory. A total of 54 physically active individuals (age = 20.1 ± 1.5 years, height = 1.7 ± 0.07 m, mass = 66.7 ± 5.4 kg) who had no injury or history of ankle sprain. Wet-ice application, cold-water immersion, or an untreated control condition applied to the ankle for 10 minutes. Muscle reaction time and muscle amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain were calculated. The ankle-sprain simulation incorporated a combined inversion and plantar-flexion movement. We observed no change in muscle reaction time or muscle amplitude after cryotherapy for either the peroneus longus or tibialis anterior (P > .05). Ten minutes of joint cooling did not adversely affect muscle reaction time or muscle amplitude in response to a simulated lateral ankle sprain. These findings suggested that athletes can safely return to sporting activity immediately after icing. Further evidence showed that ice can be applied before ankle rehabilitation without adversely affecting dynamic neuromuscular control. Investigation in patients with acute ankle sprains is warranted to assess the clinical applicability of these interventions.

  9. Muscle Reaction Time During a Simulated Lateral Ankle Sprain After Wet-Ice Application or Cold-Water Immersion

    PubMed Central

    Thain, Peter K.; Bleakley, Christopher M.; Mitchell, Andrew C. S.

    2015-01-01

    Context Cryotherapy is used widely in sport and exercise medicine to manage acute injuries and facilitate rehabilitation. The analgesic effects of cryotherapy are well established; however, a potential caveat is that cooling tissue negatively affects neuromuscular control through delayed muscle reaction time. This topic is important to investigate because athletes often return to exercise, rehabilitation, or competitive activity immediately or shortly after cryotherapy. Objective To compare the effects of wet-ice application, cold-water immersion, and an untreated control condition on peroneus longus and tibialis anterior muscle reaction time during a simulated lateral ankle sprain. Design Randomized controlled clinical trial. Setting University of Hertfordshire human performance laboratory. Patients or Other Participants A total of 54 physically active individuals (age = 20.1 ± 1.5 years, height = 1.7 ± 0.07 m, mass = 66.7 ± 5.4 kg) who had no injury or history of ankle sprain. Intervention(s) Wet-ice application, cold-water immersion, or an untreated control condition applied to the ankle for 10 minutes. Main Outcome Measure(s) Muscle reaction time and muscle amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain were calculated. The ankle-sprain simulation incorporated a combined inversion and plantar-flexion movement. Results We observed no change in muscle reaction time or muscle amplitude after cryotherapy for either the peroneus longus or tibialis anterior (P > .05). Conclusions Ten minutes of joint cooling did not adversely affect muscle reaction time or muscle amplitude in response to a simulated lateral ankle sprain. These findings suggested that athletes can safely return to sporting activity immediately after icing. Further evidence showed that ice can be applied before ankle rehabilitation without adversely affecting dynamic neuromuscular control. Investigation in patients with acute ankle sprains is

  10. Ottawa Ankle Rules and Subjective Surgeon Perception to Evaluate Radiograph Necessity Following Foot and Ankle Sprain

    PubMed Central

    Pires, RES; Pereira, AA; Abreu-e-Silva, GM; Labronici, PJ; Figueiredo, LB; Godoy-Santos, AL; Kfuri, M

    2014-01-01

    Background: Foot and ankle injuries are frequent in emergency departments. Although only a few patients with foot and ankle sprain present fractures and the fracture patterns are almost always simple, lack of fracture diagnosis can lead to poor functional outcomes. Aim: The present study aims to evaluate the reliability of the Ottawa ankle rules and the orthopedic surgeon subjective perception to assess foot and ankle fractures after sprains. Subjects and Methods: A cross-sectional study was conducted from July 2012 to December 2012. Ethical approval was granted. Two hundred seventy-four adult patients admitted to the emergency department with foot and/or ankle sprain were evaluated by an orthopedic surgeon who completed a questionnaire prior to radiographic assessment. The Ottawa ankle rules and subjective perception of foot and/or ankle fractures were evaluated on the questionnaire. Results: Thirteen percent (36/274) patients presented fracture. Orthopedic surgeon subjective analysis showed 55.6% sensitivity, 90.1% specificity, 46.5% positive predictive value and 92.9% negative predictive value. The general orthopedic surgeon opinion accuracy was 85.4%. The Ottawa ankle rules presented 97.2% sensitivity, 7.8% specificity, 13.9% positive predictive value, 95% negative predictive value and 19.9% accuracy respectively. Weight-bearing inability was the Ottawa ankle rule item that presented the highest reliability, 69.4% sensitivity, 61.6% specificity, 63.1% accuracy, 21.9% positive predictive value and 93% negative predictive value respectively. Conclusion: The Ottawa ankle rules showed high reliability for deciding when to take radiographs in foot and/or ankle sprains. Weight-bearing inability was the most important isolated item to predict fracture presence. Orthopedic surgeon subjective analysis to predict fracture possibility showed a high specificity rate, representing a confident method to exclude unnecessary radiographic exams. PMID:24971221

  11. Measurement of passive ankle stiffness in subjects with chronic hemiparesis using a novel ankle robot

    PubMed Central

    Roy, Anindo; Bever, Christopher T.; Forrester, Larry W.; Macko, Richard F.; Hogan, Neville

    2011-01-01

    Our objective in this study was to assess passive mechanical stiffness in the ankle of chronic hemiparetic stroke survivors and to compare it with those of healthy young and older (age-matched) individuals. Given the importance of the ankle during locomotion, an accurate estimate of passive ankle stiffness would be valuable for locomotor rehabilitation, potentially providing a measure of recovery and a quantitative basis to design treatment protocols. Using a novel ankle robot, we characterized passive ankle stiffness both in sagittal and in frontal planes by applying perturbations to the ankle joint over the entire range of motion with subjects in a relaxed state. We found that passive stiffness of the affected ankle joint was significantly higher in chronic stroke survivors than in healthy adults of a similar cohort, both in the sagittal as well as frontal plane of movement, in three out of four directions tested with indistinguishable stiffness values in plantarflexion direction. Our findings are comparable to the literature, thus indicating its plausibility, and, to our knowledge, report for the first time passive stiffness in the frontal plane for persons with chronic stroke and older healthy adults. PMID:21346215

  12. Joint inversion of fundamental and higher mode Rayleigh waves

    USGS Publications Warehouse

    Luo, Y.-H.; Xia, J.-H.; Liu, J.-P.; Liu, Q.-S.

    2008-01-01

    In this paper, we analyze the characteristics of the phase velocity of fundamental and higher mode Rayleigh waves in a six-layer earth model. The results show that fundamental mode is more sensitive to the shear velocities of shallow layers (< 7 m) and concentrated in a very narrow band (around 18 Hz) while higher modes are more sensitive to the parameters of relatively deeper layers and distributed over a wider frequency band. These properties provide a foundation of using a multi-mode joint inversion to define S-wave velocity. Inversion results of both synthetic data and a real-world example demonstrate that joint inversion with the damped least squares method and the SVD (Singular Value Decomposition) technique to invert Rayleigh waves of fundamental and higher modes can effectively reduce the ambiguity and improve the accuracy of inverted S-wave velocities.

  13. Mobile ankle and knee perturbator.

    PubMed

    Andersen, Jacob Buus; Sinkjaer, Thomas

    2003-10-01

    A mobile ankle and knee perturbator has been developed. It consists of a functional joint with an integrated clutch. Four Bowden wires connect the joint to a powerful motor and a double pneumatic cylinder. When needed during any time of the gait cycle, it is possible to impose an ankle rotation by engaging the clutch and rotating the ankle or knee joint with a predefined displacement. The system is designed to investigate electrophysiological and biomechanical features of the human ankle or knee joint during gait.

  14. Anisotropy effects on 3D waveform inversion

    NASA Astrophysics Data System (ADS)

    Stekl, I.; Warner, M.; Umpleby, A.

    2010-12-01

    In the recent years 3D waveform inversion has become achievable procedure for seismic data processing. A number of datasets has been inverted and presented (Warner el al 2008, Ben Hadj at all, Sirgue et all 2010) using isotropic 3D waveform inversion. However the question arises will the results be affected by isotropic assumption. Full-wavefield inversion techniques seek to match field data, wiggle-for-wiggle, to synthetic data generated by a high-resolution model of the sub-surface. In this endeavour, correctly matching the travel times of the principal arrivals is a necessary minimal requirement. In many, perhaps most, long-offset and wide-azimuth datasets, it is necessary to introduce some form of p-wave velocity anisotropy to match the travel times successfully. If this anisotropy is not also incorporated into the wavefield inversion, then results from the inversion will necessarily be compromised. We have incorporated anisotropy into our 3D wavefield tomography codes, characterised as spatially varying transverse isotropy with a tilted axis of symmetry - TTI anisotropy. This enhancement approximately doubles both the run time and the memory requirements of the code. We show that neglect of anisotropy can lead to significant artefacts in the recovered velocity models. We will present inversion results of inverting anisotropic 3D dataset by assuming isotropic earth and compare them with anisotropic inversion result. As a test case Marmousi model extended to 3D with no velocity variation in third direction and with added spatially varying anisotropy is used. Acquisition geometry is assumed as OBC with sources and receivers everywhere at the surface. We attempted inversion using both 2D and full 3D acquisition for this dataset. Results show that if no anisotropy is taken into account although image looks plausible most features are miss positioned in depth and space, even for relatively low anisotropy, which leads to incorrect result. This may lead to

  15. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance

    PubMed Central

    Algafly, Amin A; George, Keith P

    2007-01-01

    Objectives To determine the impact of the application of cryotherapy on nerve conduction velocity (NCV), pain threshold (PTH) and pain tolerance (PTO). Design A within‐subject experimental design; treatment ankle (cryotherapy) and control ankle (no cryotherapy). Setting Hospital‐based physiotherapy laboratory. Participants A convenience sample of adult male sports players (n = 23). Main outcome measures NCV of the tibial nerve via electromyogram as well as PTH and PTO via pressure algometer. All outcome measures were assessed at two sites served by the tibial nerve: one receiving cryotherapy and one not receiving cryotherapy. Results In the control ankle, NCV, PTH and PTO did not alter when reassessed. In the ankle receiving cryotherapy, NCV was significantly and progressively reduced as ankle skin temperature was reduced to 10°C by a cumulative total of 32.8% (p<0.05). Cryotherapy led to an increased PTH and PTO at both assessment sites (p<0.05). The changes in PTH (89% and 71%) and PTO (76% and 56%) were not different between the iced and non‐iced sites. Conclusions The data suggest that cryotherapy can increase PTH and PTO at the ankle and this was associated with a significant decrease in NCV. Reduced NCV at the ankle may be a mechanism by which cryotherapy achieves its clinical goals. PMID:17224445

  16. Position versus force control: using the 2-DOF robotic ankle trainer to assess ankle's motor control.

    PubMed

    Farjadian, Amir B; Nabian, Mohsen; Hartman, Amber; Corsino, Johnathan; Mavroidis, Constantinos; Holden, Maureen K

    2014-01-01

    An estimated of 2,000,000 acute ankle sprains occur annually in the United States. Furthermore, ankle disabilities are caused by neurological impairments such as traumatic brain injury, cerebral palsy and stroke. The virtually interfaced robotic ankle and balance trainer (vi-RABT) was introduced as a cost-effective platform-based rehabilitation robot to improve overall ankle/balance strength, mobility and control. The system is equipped with 2 degrees of freedom (2-DOF) controlled actuation along with complete means of angle and torque measurement mechanisms. Vi-RABT was used to assess ankle strength, flexibility and motor control in healthy human subjects, while playing interactive virtual reality games on the screen. The results suggest that in the task with 2-DOF, subjects have better control over ankle's position vs. force.

  17. One dimensional P wave velocity structure of the crust beneath west Java and accurate hypocentre locations from local earthquake inversion

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Supardiyono; Santosa, Bagus Jaya; Physics Department, Faculty of Mathematics and Natural Sciences, Sepuluh Nopember Institute of Technology, Surabaya

    A one-dimensional (1-D) velocity model and station corrections for the West Java zone were computed by inverting P-wave arrival times recorded on a local seismic network of 14 stations. A total of 61 local events with a minimum of 6 P-phases, rms 0.56 s and a maximum gap of 299 Degree-Sign were selected. Comparison with previous earthquake locations shows an improvement for the relocated earthquakes. Tests were carried out to verify the robustness of inversion results in order to corroborate the conclusions drawn out from our reasearch. The obtained minimum 1-D velocity model can be used to improve routine earthquakemore » locations and represents a further step toward more detailed seismotectonic studies in this area of West Java.« less

  18. RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain.

    PubMed

    Stecco, Antonio; Stecco, Carla; Macchi, Veronica; Porzionato, Andrea; Ferraro, Claudio; Masiero, Stefano; De Caro, Raffaele

    2011-12-01

    Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p < 0.0001). There were also significant improvements (p < 0.05) in stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data.

  19. Ankle injuries in athletes.

    PubMed

    Wilkerson, L A

    1992-06-01

    Ankle injuries are the most frequent cause of physician evaluation in a sports-oriented environment. The lateral ligaments are most commonly injured. With a detailed history, physical and radiographic examination to avoid missing underlying pathology, the primary care physician can diagnose and treat the majority of ankle injuries. Occasionally, stress radiographs, arthograms, or magnetic resonance imaging (MRI) is needed. The vast majority of ankle sprains can be treated with adhesive tape strapping or semirigid orthotics and nonsteroidal anti-inflammatory medication followed by rehabilitation. Key points of rehabilitation are control of pain and swelling acutely with nonsteroidal anti-inflammatories and RICE (rest, ice, compression, and elevation), then restoring normal range of motion, strengthening muscle groups, and retraining proprioception of the ankle joint.

  20. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale; translation and validation of the Dutch language version for ankle fractures.

    PubMed

    de Boer, A Siebe; Tjioe, Roderik J C; Van der Sijde, Fleur; Meuffels, Duncan E; den Hoed, Pieter T; Van der Vlies, Cornelis H; Tuinebreijer, Wim E; Verhofstad, Michael H J; Van Lieshout, Esther M M

    2017-08-03

    The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale is among the most commonly used instruments for measuring outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It consists of a patient-reported and a physician-reported part. A validated, Dutch version of this instrument is currently not available. The aim of this study was to translate the instrument into Dutch and to determine the measurement properties of the AOFAS Ankle-Hindfoot Scale Dutch language version (DLV) in patients with a unilateral ankle fracture. Multicentre (two Dutch hospitals), prospective observational study. In total, 142 patients with a unilateral ankle fracture were included. Ten patients were lost to follow-up. Patients completed the subjective (patient-reported) part of the AOFAS Ankle-Hindfoot Scale-DLV. A physician or trained physician-assistant completed the physician-reported part. For comparison and evaluation of the measuring characteristics, the Foot Function Index and the Short Form-36 were completed by the patient. Descriptive statistics (including floor and ceiling effects), reliability (ie, internal consistency), construct validity, reproducibility (ie, test-retest reliability, agreement and smallest detectable change) and responsiveness were determined. The AOFAS-DLV and its subscales showed good internal consistency (Cronbach's α >0.90). Construct validity and longitudinal validity were proven to be adequate (76.5% of predefined hypotheses were confirmed). Floor effects were not present. Ceiling effects were present from 6 months onwards, as expected. Responsiveness was adequate, with a smallest detectable change of 12.0 points. The AOFAS-DLV is a reliable, valid and responsive measurement instrument for evaluating functional outcome in patients with a unilateral ankle fracture. This implies that the questionnaire is suitable to compare different treatment modalities within this population or to compare outcome across

  1. [Arthroscopic therapy of ankle joint impingement syndrome after operation of ankle joint fracture dislocation].

    PubMed

    Feng, Zhibin; Mi, Kun; Wei, Renzhi; Liu, Wu; Wang, Bin

    2011-07-01

    To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, there were 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from -20 to -5 degrees (mean, -10.6 degrees), and the palmar flexion was 30-40 degrees (mean, 35.5 degrees). The total score was 48.32 +/- 9.24 and the pain score was 7.26 +/- 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25 degrees (mean, 19.6 degrees) and the palmar flexion was 35-45 degrees (mean, 40.7 degrees). Eight patients had mild limited ROM; the dorsal extension was 5-15 degrees (mean, 7.2 degrees) and the palmar flexion was 35-45 degrees (mean, 39.5 degrees). Four patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5 degrees (mean, 2.6 degrees) and the palmar flexion was 35-40 degrees (mean, 37.5 degrees). The total score was 89.45 +/- 9.55 and the pain score was 1.42 +/- 1.26 after

  2. Altered Knee and Ankle Kinematics During Squatting in Those With Limited Weight-Bearing–Lunge Ankle-Dorsiflexion Range of Motion

    PubMed Central

    Dill, Karli E.; Begalle, Rebecca L.; Frank, Barnett S.; Zinder, Steven M.; Padua, Darin A.

    2014-01-01

    Context: Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee flexion. To our knowledge, researchers have not studied individuals with limited or normal ankle DF-ROM to investigate the relationship between those factors and the lower extremity movement patterns associated with anterior cruciate ligament injury. Objective: To determine, using 2 different measurement techniques, whether knee- and ankle-joint kinematics differ between participants with limited and normal ankle DF-ROM. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty physically active adults (20 with limited ankle DF-ROM, 20 with normal ankle DF-ROM). Main Outcome Measure(s): Ankle DF-ROM was assessed using 2 techniques: (1) nonweight-bearing ankle DF-ROM with the knee straight, and (2) weight-bearing lunge (WBL). Knee flexion, knee valgus-varus, knee internal-external rotation, and ankle DF displacements were assessed during the overhead-squat, single-legged squat, and jump-landing tasks. Separate 1-way analyses of variance were performed to determine whether differences in knee- and ankle-joint kinematics existed between the normal and limited groups for each assessment. Results: We observed no differences between the normal and limited groups when classifying groups based on nonweight-bearing passive-ankle DF-ROM. However, individuals with greater ankle DF-ROM during the WBL displayed greater knee-flexion and ankle-DF displacement and peak knee flexion during the overhead-squat and single-legged squat tasks. In addition, those individuals also demonstrated greater knee-varus displacement during the single-legged squat. Conclusions: Greater ankle DF-ROM assessed during the WBL was associated with greater knee-flexion and ankle-DF displacement during both squatting tasks as well as greater knee-varus displacement during

  3. Anatomy of the ankle ligaments: a pictorial essay.

    PubMed

    Golanó, Pau; Vega, Jordi; de Leeuw, Peter A J; Malagelada, Francesc; Manzanares, M Cristina; Götzens, Víctor; van Dijk, C Niek

    2016-04-01

    Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.

  4. What Is a Foot and Ankle Surgeon?

    MedlinePlus

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  5. Acute ankle sprain: conservative or surgical approach?

    PubMed Central

    Al-Mohrej, Omar A.; Al-Kenani, Nader S.

    2016-01-01

    Ankle sprains fall into two main categories: acute ankle sprains and chronic ankle instability, which are among the most common recurrent injuries during occupational activities, athletic events, training and army service. Acute ankle sprain is usually managed conservatively and functional rehabilitation failure by conservative treatment leads to development of chronic ankle instability, which most often requires surgical intervention. Enhancing the in-depth knowledge of the ankle anatomy, biomechanics and pathology helps greatly in deciding the management options. Cite this article: Al-Mohrej OA, Al-Kenani NS. Acute ankle sprain: conservative or surgical approach? EFORT Open Rev 2016;1:34-44. DOI: 10.1302/2058-5241.1.000010. PMID:28461926

  6. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium.

    PubMed

    Delahunt, Eamonn; Bleakley, Chris M; Bossard, Daniela S; Caulfield, Brian M; Docherty, Carrie L; Doherty, Cailbhe; Fourchet, François; Fong, Daniel T; Hertel, Jay; Hiller, Claire E; Kaminski, Thomas W; McKeon, Patrick O; Refshauge, Kathryn M; Remus, Alexandria; Verhagen, Evert; Vicenzino, Bill T; Wikstrom, Erik A; Gribble, Phillip A

    2018-06-09

    Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop long-term injury-associated symptoms and chronic ankle instability. The development of chronic ankle instability is consequent on the interaction of mechanical and sensorimotor insufficiencies/impairments that manifest following acute lateral ankle sprain injury. To reduce the propensity for developing chronic ankle instability, clinical assessments should evaluate whether patients in the acute phase following lateral ankle sprain injury exhibit any mechanical and/or sensorimotor impairments. This modified Delphi study was undertaken under the auspices of the executive committee of the International Ankle Consortium. The primary aim was to develop recommendations, based on expert (n=14) consensus, for structured clinical assessment of acute lateral ankle sprain injuries. After two modified Delphi rounds, consensus was achieved on the clinical assessment of acute lateral ankle sprain injuries. Consensus was reached on a minimum standard clinical diagnostic assessment. Key components of this clinical diagnostic assessment include: establishing the mechanism of injury, as well as the assessment of ankle joint bones and ligaments. Through consensus, the expert panel also developed the International Ankle Consortium Rehabilitation-Oriented ASsessmenT (ROAST). The International Ankle Consortium ROAST will help clinicians identify mechanical and/or sensorimotor impairments that are associated with chronic ankle instability. This consensus statement from the International Ankle Consortium aims to be a key resource for clinicians who regularly assess individuals with acute lateral ankle sprain injuries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted

  7. Inversion of Surface Wave Phase Velocities for Radial Anisotropy to an Depth of 1200 km

    NASA Astrophysics Data System (ADS)

    Xing, Z.; Beghein, C.; Yuan, K.

    2012-12-01

    This study aims to evaluate three dimensional radial anisotropy to an depth of 1200 km. Radial anisotropy describes the difference in velocity between horizontally polarized Rayleigh waves and vertically polarized Love waves. Its presence in the uppermost 200 km mantle has well been documented by different groups, and has been regarded as an indicator of mantle convection which aligns the intrinsically anisotropic minerals, largely olivine, to form large scale anisotropy. However, there is no global agreement on whether anisotropy exists in the region below 200 km. Recent models also associate a fast vertically polarized shear wave with vertical upwelling mantle flow. The data used in this study is the globally isotropic phase velocity models of fundamental and higher mode Love and Rayleigh waves (Visser, 2008). The inclusion of higher mode surface wave phase velocity provides sensitivities to structure at depth that extends to below the transition zone. While the data is the same as used by Visser (2008), a quite different parameterization is applied. All the six parameters - five elastic parameters A, C, F, L, N and density - are now regarded as independent, which rules out possible biased conclusions induced by scaling relation method used in several previous studies to reduce the number of parameters partly due to limited computing resources. The data need to be modified by crustal corrections (Crust2.0) as we want to look at the mantle structure only. We do this by eliminating the perturbation in surface wave phase velocity caused by the difference in crustal structure with respect to the referent model PREM. Sambridge's Neighborhood Algorithm is used to search the parameter space. The introduction of such a direct search technique pales the traditional inversion method, which requires regularization or some unnecessary priori restriction on the model space. On the contrary, the new method will search the full model space, providing probability density

  8. Anatomy of the ankle ligaments: a pictorial essay

    PubMed Central

    Vega, Jordi; de Leeuw, Peter A. J.; Malagelada, Francesc; Manzanares, M. Cristina; Götzens, Víctor; van Dijk, C. Niek

    2010-01-01

    Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail. PMID:20309522

  9. Finite-fault source inversion using adjoint methods in 3D heterogeneous media

    NASA Astrophysics Data System (ADS)

    Somala, Surendra Nadh; Ampuero, Jean-Paul; Lapusta, Nadia

    2018-04-01

    Accounting for lateral heterogeneities in the 3D velocity structure of the crust is known to improve earthquake source inversion, compared to results based on 1D velocity models which are routinely assumed to derive finite-fault slip models. The conventional approach to include known 3D heterogeneity in source inversion involves pre-computing 3D Green's functions, which requires a number of 3D wave propagation simulations proportional to the number of stations or to the number of fault cells. The computational cost of such an approach is prohibitive for the dense datasets that could be provided by future earthquake observation systems. Here, we propose an adjoint-based optimization technique to invert for the spatio-temporal evolution of slip velocity. The approach does not require pre-computed Green's functions. The adjoint method provides the gradient of the cost function, which is used to improve the model iteratively employing an iterative gradient-based minimization method. The adjoint approach is shown to be computationally more efficient than the conventional approach based on pre-computed Green's functions in a broad range of situations. We consider data up to 1 Hz from a Haskell source scenario (a steady pulse-like rupture) on a vertical strike-slip fault embedded in an elastic 3D heterogeneous velocity model. The velocity model comprises a uniform background and a 3D stochastic perturbation with the von Karman correlation function. Source inversions based on the 3D velocity model are performed for two different station configurations, a dense and a sparse network with 1 km and 20 km station spacing, respectively. These reference inversions show that our inversion scheme adequately retrieves the rise time when the velocity model is exactly known, and illustrates how dense coverage improves the inference of peak slip velocities. We investigate the effects of uncertainties in the velocity model by performing source inversions based on an incorrect

  10. Finite-fault source inversion using adjoint methods in 3-D heterogeneous media

    NASA Astrophysics Data System (ADS)

    Somala, Surendra Nadh; Ampuero, Jean-Paul; Lapusta, Nadia

    2018-07-01

    Accounting for lateral heterogeneities in the 3-D velocity structure of the crust is known to improve earthquake source inversion, compared to results based on 1-D velocity models which are routinely assumed to derive finite-fault slip models. The conventional approach to include known 3-D heterogeneity in source inversion involves pre-computing 3-D Green's functions, which requires a number of 3-D wave propagation simulations proportional to the number of stations or to the number of fault cells. The computational cost of such an approach is prohibitive for the dense data sets that could be provided by future earthquake observation systems. Here, we propose an adjoint-based optimization technique to invert for the spatio-temporal evolution of slip velocity. The approach does not require pre-computed Green's functions. The adjoint method provides the gradient of the cost function, which is used to improve the model iteratively employing an iterative gradient-based minimization method. The adjoint approach is shown to be computationally more efficient than the conventional approach based on pre-computed Green's functions in a broad range of situations. We consider data up to 1 Hz from a Haskell source scenario (a steady pulse-like rupture) on a vertical strike-slip fault embedded in an elastic 3-D heterogeneous velocity model. The velocity model comprises a uniform background and a 3-D stochastic perturbation with the von Karman correlation function. Source inversions based on the 3-D velocity model are performed for two different station configurations, a dense and a sparse network with 1 and 20 km station spacing, respectively. These reference inversions show that our inversion scheme adequately retrieves the rise time when the velocity model is exactly known, and illustrates how dense coverage improves the inference of peak-slip velocities. We investigate the effects of uncertainties in the velocity model by performing source inversions based on an incorrect

  11. Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis

    PubMed Central

    Kim, Seong-Gil

    2018-01-01

    Background The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. Material/Methods This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. Results In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (p<0.05). In simple correlation analysis, all variables that passed the correlation analysis procedure had significant influence (p<0.05). In multiple linear regression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). Conclusions Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement. PMID:29760375

  12. Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis.

    PubMed

    Kim, Seong-Gil; Kim, Wan-Soo

    2018-05-15

    BACKGROUND The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. MATERIAL AND METHODS This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. RESULTS In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (p<0.05). In simple correlation analysis, all variables that passed the correlation analysis procedure had significant influence (p<0.05). In multiple linear regression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). CONCLUSIONS Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement.

  13. Crustal structure of northern Egypt from joint inversion of receiver functions and surface wave dispersion velocities

    NASA Astrophysics Data System (ADS)

    Badawy, Ahmed; Hegazi, Mona; Gaber, Hanan; Korrat, Ibrahim

    2018-05-01

    In this study, we used a combined inversion of body wave receiver functions and surface wave dispersion measurements to provide constraints on the crustal structure of northern Egypt. The two techniques are complementary to each other: receiver functions (RFs) are sensitive to shear-wave velocity contrasts, while surface wave dispersion (SWD) measurements are sensitive to finite variations of shear-wave velocity with depth. A database of 122 teleseismic events digitally recorded by the Egyptian National Seismological Network (ENSN) stations has been used as well. To enhance the resulting RFs at each ENSN station, the H-k stacking method was applied. A joint inversion process between the resulting receiver functions and the surface wave dispersion curves was applied as well. We have produced three averaged velocity structure models for distinct geographic and tectonic provinces namely Sinai, eastern desert, and western desert from east to the west respectively. These models will deeply help in estimation the epicenter distance of earthquake, focal mechanism solutions, and earthquake hazard analysis in northern Egypt. An obvious image of the subsurface structure has been determined which shows that generally the crustal structure of northern Egypt consists of three layers covered with a sequence of sediments that differs in thickness from across the region except in the Sharm area where the sedimentary cover is absent. The obtained results indicate that crustal thickness differs from east to west and reaches its maximum value of about 36 km at Siwa station (SWA) in the western desert and its minimum value of about 28 km at Sharm station (SHR) of the southern tip of the Sinai Peninsula. The Vp/Vs ratio varies between 1.71 and 2.07 in northern Egypt. Generally, the high values (1.93) of (Vp/Vs) at SWA station may reflect the well-known rich aquifer with fully saturated sediments of the Swia Oasis in the Western Desert. Moreover, the highest value (2.07) of (Vp/Vs) at

  14. Crustal structure of northern Egypt from joint inversion of receiver functions and surface wave dispersion velocities

    NASA Astrophysics Data System (ADS)

    Badawy, Ahmed; Hegazi, Mona; Gaber, Hanan; Korrat, Ibrahim

    2018-01-01

    In this study, we used a combined inversion of body wave receiver functions and surface wave dispersion measurements to provide constraints on the crustal structure of northern Egypt. The two techniques are complementary to each other: receiver functions (RFs) are sensitive to shear-wave velocity contrasts, while surface wave dispersion (SWD) measurements are sensitive to finite variations of shear-wave velocity with depth. A database of 122 teleseismic events digitally recorded by the Egyptian National Seismological Network (ENSN) stations has been used as well. To enhance the resulting RFs at each ENSN station, the H-k stacking method was applied. A joint inversion process between the resulting receiver functions and the surface wave dispersion curves was applied as well. We have produced three averaged velocity structure models for distinct geographic and tectonic provinces namely Sinai, eastern desert, and western desert from east to the west respectively. These models will deeply help in estimation the epicenter distance of earthquake, focal mechanism solutions, and earthquake hazard analysis in northern Egypt. An obvious image of the subsurface structure has been determined which shows that generally the crustal structure of northern Egypt consists of three layers covered with a sequence of sediments that differs in thickness from across the region except in the Sharm area where the sedimentary cover is absent. The obtained results indicate that crustal thickness differs from east to west and reaches its maximum value of about 36 km at Siwa station (SWA) in the western desert and its minimum value of about 28 km at Sharm station (SHR) of the southern tip of the Sinai Peninsula. The Vp/Vs ratio varies between 1.71 and 2.07 in northern Egypt. Generally, the high values (1.93) of (Vp/Vs) at SWA station may reflect the well-known rich aquifer with fully saturated sediments of the Swia Oasis in the Western Desert. Moreover, the highest value (2.07) of (Vp/Vs) at

  15. Mountain Building in Central and Western Tien Shan Orogen: Insight from Joint Inversion of Surface Wave Phase Velocities and Body Wave Travel Times

    NASA Astrophysics Data System (ADS)

    Wu, S.; Yang, Y.; Wang, K.

    2017-12-01

    The Tien Shan orogeny, situated in central Asia about 2000 km away from the collision boundary between Indian plate and Eurasian plate, is one of the highest, youngest, and most active intracontinental mountain belts on the earth. It first formed during the Paleozoic times and became reactivated at about 20Ma. Although many studies on the dynamic processes of the Tien Shan orogeny have been carried out before, its tectonic rejuvenation and uplift mechanism are still being debated. A high-resolution model of crust and mantle beneath Tien Shan is critical to discern among competing models for the mountain building. In this study, we collect and process seismic data recorded by several seismic arrays in the central and western Tien Shan region to generate surface wave dispersion curves at 6-140 s period using ambient noise tomography (ANT) and two-plane surface wave tomography (TPWT) methods. Using these dispersion curves, we construct a high-resolution 3-D image of shear wave velocity (Vs) in the crust and upper mantle up to 300 km depth. Our current model constrained only by surface waves shows that, under the Tien Shan orogenic belt, a strong low S-wave velocity anomaly exists in the uppermost mantle down to the depth of 200km, supporting the model that the hot upper mantle is upwelling under the Tien Shan orogenic belt, which may be responsible for the mountain building. To the west of central Tien Shan across the Talas-Fergana fault, low S-wave velocity anomalies in the upper mantle become much weaker and finally disappear beneath the Fergana basin. Because surface waves are insensitive to the structures below 300 km, body wave arrival times will be included for a joint inversion with surface waves to generate S-wave velocity structure from the surface down to the mantle transition zone. The joint inversion of both body and surface waves provide complementary constraints on structures at different depths and helps to achieve a more realistic model compared with

  16. Cost-effectiveness analysis of total ankle arthroplasty.

    PubMed

    SooHoo, Nelson F; Kominski, Gerald

    2004-11-01

    There is renewed interest in total ankle arthroplasty as an alternative to ankle fusion in the treatment of end-stage ankle arthritis. Despite a lack of long-term data on the clinical outcomes associated with these implants, the use of ankle arthroplasty is expanding. The purpose of this cost-effectiveness analysis was to evaluate whether the currently available literature justifies the emerging use of total ankle arthroplasty. This study also identifies thresholds for the durability and function of ankle prostheses that, if met, would support more widespread dissemination of this new technology. A decision model was created for the treatment of ankle arthritis. The literature was reviewed to identify possible outcomes and their probabilities following ankle fusion and ankle arthroplasty. Each outcome was weighted for quality of life with use of a utility factor, and effectiveness was expressed in units of quality-adjusted life years. Gross costs were estimated from Medicare charge and reimbursement data for the relevant codes. The effect of the uncertainty of estimates of costs and effectiveness was assessed with sensitivity analysis. The reference case of our model assumed a ten-year duration of survival of the prosthesis, resulting in an incremental cost-effectiveness ratio for ankle arthroplasty of $18,419 per quality-adjusted life year gained. This reflects a gain of 0.52 quality-adjusted life years at a cost of $9578 when ankle arthroplasty is chosen over fusion. This ratio compares favorably with the cost-effectiveness of other medical and surgical interventions. Sensitivity analysis determined that the cost per quality-adjusted life year gained with ankle arthroplasty rises above $50,000 if the prosthesis is assumed to fail before seven years. Treatment options with ratios above $50,000 per quality-adjusted life year are commonly considered to have limited cost-effectiveness. This threshold is also crossed when the theoretical functional advantages of ankle

  17. Movement Strategies among Groups of Chronic Ankle Instability, Coper, and Control.

    PubMed

    Son, S Jun; Kim, Hyunsoo; Seeley, Matthew K; Hopkins, J Ty

    2017-08-01

    Comprehensive evaluation of movement strategies during functional movement is a difficult undertaking. Because of this challenge, studied movements have been oversimplified. Furthermore, evaluating movement strategies at only a discrete time point(s) provide limited insight into how movement strategies may change or adapt in chronic ankle instability (CAI) patients. This study aimed to identify abnormal movement strategies in individuals with a history of ankle sprain injury during a sports maneuver compared with healthy controls. Sixty-six participants, consisting of 22 CAI patients, 22 ankle sprain copers, and 22 healthy controls, participated in this study. Functional profiles of lower extremity kinematics, kinetics, and EMG activation from initial contact (0% of stance) to toe-off (100% of stance) were collected and analyzed during a jump landing/cutting task using a functional data analysis approach. Compared with copers, CAI patients displayed landing positions of less plantarflexion, less inversion, more knee flexion, more hip flexion, and less hip abduction during the first 25% of stance. However, restricted dorsiflexion angle was observed in both CAI patients and copers relative to controls during the midlanding to mid-side-cutting phase when the ankle and knee reached its peak range of motion (e.g., dorsiflexion and knee flexion). Reduced EMG activation of tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius may be due to altered kinematics that reduce muscular demands on the involved muscles. CAI patients displayed altered movement strategies, perhaps in an attempt to avoid perceived positions of risk. Although sagittal joint positions seemed to increase the external torque on the knee and hip extensors, frontal joint positions appeared to reduce the muscular demands on evertor and hip abductor muscles.

  18. Investigating the anticipatory postural adjustment phase of gait initiation in different directions in chronic ankle instability patients.

    PubMed

    Ebrahimabadi, Zahra; Naimi, Sedigheh Sadat; Rahimi, Abbas; Sadeghi, Heydar; Hosseini, Seyed Majid; Baghban, Alireza Akbarzadeh; Arslan, Syed Asadullah

    2018-01-01

    The main objective of the present study was to analyze how supra spinal motor control mechanisms are altered in different directions during anticipatory postural phase of gait initiation in chronic ankle instability patients. It seems that supra spinal pathways modulate anticipatory postural adjustment phase of gait initiation. Yet, there is a dearth of research on the effect of chronic ankle instability on the anticipatory postural adjustment phase of gait initiation in different directions. A total of 20 chronic ankle instability participants and 20 healthy individuals initiated gait on a force plate in forward, 30° lateral, and 30° medial directions. According to the results of the present study, the peak lateral center of pressure shift decreased in forward direction compared to that in other directions in both groups. Also, it was found that the peak lateral center of pressure shift and the vertical center of mass velocity decreased significantly in chronic ankle instability patients, as compared with those of the healthy individuals. According to the results of the present study, it seems that chronic ankle instability patients modulate the anticipatory postural adjustment phase of gait initiation, compared with healthy control group, in order to maintain postural stability. These changes were observed in different directions, too. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Isokinetic muscle performance of the hip and ankle muscles in women with fibromyalgia.

    PubMed

    Yetişgin, Alparslan; Tiftik, Tülay; Kara, Murat; Karabay, İlkay; Akkuş, Selami; Ersöz, Murat

    2016-06-01

    To compare isokinetic muscle performances of a proximal (hip) and a distal (ankle) muscle of fibromyalgia syndrome (FMS) patients with those of age- and body mass index (BMI)-matched healthy subjects. Thirty female patients with FMS (mean age: 41.5 ± 6.7 years [range, 27-54]) and 30 age- (mean age: 40.6 ± 6.0 years [range, 27-54]) and BMI-matched female healthy controls were consecutively enrolled. Demographic and clinical characteristics of the subjects were recorded. Isokinetic measurements of hip and ankle flexion and extension at angular velocities of 60°/s and 180°/s, peak torques, flexor-extensor torque ratios, muscle fatigue resistance values and average power were obtained. Mean disease duration of FMS patients was 2.4 ± 1.9 years. Mean weight, height and BMI values were 70.4 ± 12.5 kg, 159.5 ± 6.0 cm and 27.7 ± 4.7 kg/m² (FMS patients) and 69.3 ± 10.1 kg, 161.7 ± 6.2 cm and 26.6 ± 4.3 kg/m² (control subjects), respectively (all P > 0.05). All isokinetic values were statistically decreased in the FMS group when compared with the control group, except for the peak torques at angular velocity of 180°/s on flexion of the hip and extension of the ankle and the total work and average power on extension of the ankle. We did not find any correlation between isokinetic values and disease related parameters of FMS patients. In the light of our results, we may conclude that muscle strength and muscle fatigue seem to decrease in FMS patients' both proximal and distal lower extremity muscles. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  20. Management of Osseous and Soft-Tissue Ankle Equinus During Total Ankle Replacement.

    PubMed

    Roukis, Thomas S; Simonson, Devin C

    2015-10-01

    Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These techniques include anterior tibiotalar joint cheilectomy, posterior superficial muscle compartment lengthening, posterior ankle capsule release, and release of the posterior portions of the medial and lateral collateral ligament complexes. The rationale for these procedures and the operative sequence of events for these procedures are presented. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Musculoskeletal modelling deconstructs the paradoxical effects of elastic ankle exoskeletons on plantar-flexor mechanics and energetics during hopping

    PubMed Central

    Farris, Dominic James; Hicks, Jennifer L.; Delp, Scott L.; Sawicki, Gregory S.

    2014-01-01

    Experiments have shown that elastic ankle exoskeletons can be used to reduce ankle joint and plantar-flexor muscle loading when hopping in place and, in turn, reduce metabolic energy consumption. However, recent experimental work has shown that such exoskeletons cause less favourable soleus (SO) muscle–tendon mechanics than is observed during normal hopping, which might limit the capacity of the exoskeleton to reduce energy consumption. To directly link plantar-flexor mechanics and energy consumption when hopping in exoskeletons, we used a musculoskeletal model of the human leg and a model of muscle energetics in simulations of muscle–tendon dynamics during hopping with and without elastic ankle exoskeletons. Simulations were driven by experimental electromyograms, joint kinematics and exoskeleton torque taken from previously published data. The data were from seven males who hopped at 2.5 Hz with and without elastic ankle exoskeletons. The energetics model showed that the total rate of metabolic energy consumption by ankle muscles was not significantly reduced by an ankle exoskeleton. This was despite large reductions in plantar-flexor force production (40–50%). The lack of larger metabolic reductions with exoskeletons was attributed to increases in plantar-flexor muscle fibre velocities and a shift to less favourable muscle fibre lengths during active force production. This limited the capacity for plantar-flexors to reduce activation and energy consumption when hopping with exoskeleton assistance. PMID:25278469

  2. Correlations between Angular Velocities in Selected Joints and Velocity of Table Tennis Racket during Topspin Forehand and Backhand.

    PubMed

    Bańkosz, Ziemowit; Winiarski, Sławomir

    2018-06-01

    The aim of this study was to determine the correlations between angular velocities in individual joints and racket velocity for different topspin forehand and backhand strokes in table tennis. Ten elite female table tennis players participated, presenting different kinds of topspin forehands and backhands - after a no-spin ball (FH1, BH1), after a backspin ball (FH2, BH2) and "heavy" topspin (FH3, BH3). Range of motion was measured with the BTS Smart-E (BTS Bioengineering, Milan, Italy) motion analysis system with a specially developed marker placement protocol for the upper body parts and an acoustic sensor attached to the racket to identify ball-racket contact. In forehand strokes angular velocities of internal arm rotation and adduction in shoulder joint correlated with racket velocity. Racket velocity was correlated with angular velocities (hip extension on the playing side; hip flexion on the opposite side; ankle flexion) in the case of a topspin forehand performed with maximal force -"heavy" topspin (FH3). In backhand strokes the velocities of arm abduction and shoulder girdle rotation towards the playing side correlated with racket velocity. The angular velocity of internal arm rotation and adduction in shoulder joint may be important components of a coordinated stroke, whilst angular velocity can substantially affect the racket speed when one is changing the type of stroke.

  3. Design of a robotic gait trainer using spring over muscle actuators for ankle stroke rehabilitation.

    PubMed

    Bharadwaj, Kartik; Sugar, Thomas G; Koeneman, James B; Koeneman, Edward J

    2005-11-01

    Repetitive task training is an effective form of rehabilitation for people suffering from debilitating injuries of stroke. We present the design and working concept of a robotic gait trainer (RGT), an ankle rehabilitation device for assisting stroke patients during gait. Structurally based on a tripod mechanism, the device is a parallel robot that incorporates two pneumatically powered, double-acting, compliant, spring over muscle actuators as actuation links which move the ankle in dorsiflex ion/plantarflexion and inversion/eversion. A unique feature in the tripod design is that the human anatomy is part of the robot, the first fixed link being the patient's leg. The kinematics and workspace of the tripod device have been analyzed determining its range of motion. Experimental gait data from an able-bodied person wearing the working RGT prototype are presented.

  4. Biomechanics of ramp descent in unilateral trans-tibial amputees: Comparison of a microprocessor controlled foot with conventional ankle-foot mechanisms.

    PubMed

    Struchkov, Vasily; Buckley, John G

    2016-02-01

    Walking down slopes and/or over uneven terrain is problematic for unilateral trans-tibial amputees. Accordingly, 'ankle' devices have been added to some dynamic-response feet. This study determined whether use of a microprocessor controlled passive-articulating hydraulic ankle-foot device improved the gait biomechanics of ramp descent in comparison to conventional ankle-foot mechanisms. Nine active unilateral trans-tibial amputees repeatedly walked down a 5° ramp, using a hydraulic ankle-foot with microprocessor active or inactive or using a comparable foot with rubber ball-joint (elastic) 'ankle' device. When inactive the hydraulic unit's resistances were those deemed to be optimum for level-ground walking, and when active, the plantar- and dorsi-flexion resistances switched to a ramp-descent mode. Residual limb kinematics, joints moments/powers and prosthetic foot power absorption/return were compared across ankle types using ANOVA. Foot-flat was attained fastest with the elastic foot and second fastest with the active hydraulic foot (P<0.001). Prosthetic shank single-support mean rotation velocity (p =0.006), and the flexion (P<0.001) and negative work done at the residual knee (P=0.08) were reduced, and negative work done by the ankle-foot increased (P<0.001) when using the active hydraulic compared to the other two ankle types. The greater negative 'ankle' work done when using the active hydraulic compared to other two ankle types, explains why there was a corresponding reduction in flexion and negative work at the residual knee. These findings suggest that use of a microprocessor controlled hydraulic foot will reduce the biomechanical compensations used to walk down slopes. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Crustal velocity structure and earthquake processes of Garhwal-Kumaun Himalaya: Constraints from regional waveform inversion and array beam modeling

    NASA Astrophysics Data System (ADS)

    Negi, Sanjay S.; Paul, Ajay; Cesca, Simone; Kamal; Kriegerowski, Marius; Mahesh, P.; Gupta, Sandeep

    2017-08-01

    In order to understand present day earthquake kinematics at the Indian plate boundary, we analyse seismic broadband data recorded between 2007 and 2015 by the regional network in the Garhwal-Kumaun region, northwest Himalaya. We first estimate a local 1-D velocity model for the computation of reliable Green's functions, based on 2837 P-wave and 2680 S-wave arrivals from 251 well located earthquakes. The resulting 1-D crustal structure yields a 4-layer velocity model down to the depths of 20 km. A fifth homogeneous layer extends down to 46 km, constraining the Moho using travel-time distance curve method. We then employ a multistep moment tensor (MT) inversion algorithm to infer seismic moment tensors of 11 moderate earthquakes with Mw magnitude in the range 4.0-5.0. The method provides a fast MT inversion for future monitoring of local seismicity, since Green's functions database has been prepared. To further support the moment tensor solutions, we additionally model P phase beams at seismic arrays at teleseismic distances. The MT inversion result reveals the presence of dominant thrust fault kinematics persisting along the Himalayan belt. Shallow low and high angle thrust faulting is the dominating mechanism in the Garhwal-Kumaun Himalaya. The centroid depths for these moderate earthquakes are shallow between 1 and 12 km. The beam modeling result confirm hypocentral depth estimates between 1 and 7 km. The updated seismicity, constrained source mechanism and depth results indicate typical setting of duplexes above the mid crustal ramp where slip is confirmed along out-of-sequence thrusting. The involvement of Tons thrust sheet in out-of-sequence thrusting indicate Tons thrust to be the principal active thrust at shallow depth in the Himalayan region. Our results thus support the critical taper wedge theory, where we infer the microseismicity cluster as a result of intense activity within the Lesser Himalayan Duplex (LHD) system.

  6. Osteoligamentous injuries of the medial ankle joint.

    PubMed

    Lötscher, P; Lang, T H; Zwicky, L; Hintermann, B; Knupp, M

    2015-12-01

    Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ankle joint osteoarthritis.

  7. Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain.

    PubMed

    Vega, Jordi; Peña, Fernando; Golanó, Pau

    2016-04-01

    The aim of this study was to determine which intra-articular injuries are associated with chronic anterolateral pain and functional instability after an ankle sprain. From 2008 to 2010, records of all patients who underwent ankle joint arthroscopy with anterolateral pain and functional instability after an ankle sprain were reviewed. A systematic arthroscopic examination of the intra-articular structures of the ankle joint was performed. Location and characteristics of the injuries were identified and recorded. A total of 36 ankle arthroscopic procedures were reviewed. A soft-tissue occupying mass over the lateral recess was present in 18 patients (50%). A partial injury of the anterior talofibular ligament (ATFL) was observed in 24 patients (66.6%). Cartilage abrasion due to the distal fascicle of the anteroinferior tibiofibular ligament coming into contact with the talus was seen in 21 patients (58.3%), but no thickening of the ligament was observed. Injury to the intra-articular posterior structures, including the transverse ligament in 19 patients (52.7%) and the posterior surface of the distal tibia in 21 patients (58.3%), was observed. Intra-articular pathological findings have been observed in patients affected by anterolateral pain after an ankle sprain. Despite no demonstrable abnormal lateral laxity, morphologic ATFL abnormality has been observed on arthroscopic evaluation. An injury of the ATFL is present in patients with chronic anterolateral pain and functional instability after an ankle sprain. A degree of microinstability due to a deficiency of the ATFL could explain the intra-articular pathological findings and the patients' complaints. IV.

  8. Effect of muscle tone on ankle kinetics during gait with ankle-foot orthoses in persons with stroke.

    PubMed

    Mizuno, Shiho; Sonoda, Shigeru; Takeda, Kotaro; Maeshima, Shinichiro

    2017-12-01

    Background Individuals exhibiting hemiplegia and increased ankle plantar flexors muscle tone following stroke are frequently prescribed an ankle-foot orthosis (AFO) to regain functional ambulation. The effect of muscle tone on ankle kinetics when walking with an AFO remains unknown. Objectives To investigate the effect of plantar flexion (PF) muscle tone on ankle plantar flexion torque during walking with an ankle-foot orthosis Methods The study included 80 participants with first-ever stroke whose manual muscle testing (MMT) of ankle DF 0-4, and 10 healthy subjects. Participants were instructed to walk on a treadmill, at a comfortable speed, wearing an instrumented AFO. Minimum PF torque during the last half of swing was extracted as an outcome measure. Resistive PF torques during passive slow and fast stretches were measured with a custom-built device, with torques at 10° DF (T10°-slow and T10°-fast) extracted as defining parameters for stiffness and muscle tone, respectively. Results Correlations between both T10°-slow and T10°-fast variables with minimum PF torque were fair among ankle DF MMT 0-3 groups (r = 0.71 -0.74, p < 0.01), with no correlation observed among the MMT 4 group and healthy subjects. Conclusions Effects of muscle tone on ankle kinetics during swing phase, with an AFO, were observed in persons with severe ankle DF paresis. Quantitative evaluation of ankle kinetics during gait with an AFO in addition to evaluation of muscle tone at rest is contributory to objective assessment of a muscle tone, not subjective rating scale at rest, or visual inspection of walking.

  9. Inverse Bremsstrahlung in Shocked Astrophysical Plasmas

    NASA Technical Reports Server (NTRS)

    Baring, Matthew G.; Jones, Frank C.; Ellison, Donald C.

    2000-01-01

    There has recently been interest in the role of inverse bremsstrahlung, the emission of photons by fast suprathermal ions in collisions with ambient electrons possessing relatively low velocities, in tenuous plasmas in various astrophysical contexts. This follows a long hiatus in the application of suprathermal ion bremsstrahlung to astrophysical models since the early 1970s. The potential importance of inverse bremsstrahlung relative to normal bremsstrahlung, i.e. where ions are at rest, hinges upon the underlying velocity distributions of the interacting species. In this paper, we identify the conditions under which the inverse bremsstrahlung emissivity is significant relative to that for normal bremsstrahlung in shocked astrophysical plasmas. We determine that, since both observational and theoretical evidence favors electron temperatures almost comparable to, and certainly not very deficient relative to proton temperatures in shocked plasmas, these environments generally render inverse bremsstrahlung at best a minor contributor to the overall emission. Hence inverse bremsstrahlung can be safely neglected in most models invoking shock acceleration in discrete sources such as supernova remnants. However, on scales approximately > 100 pc distant from these sources, Coulomb collisional losses can deplete the cosmic ray electrons, rendering inverse bremsstrahlung, and perhaps bremsstrahlung from knock-on electrons, possibly detectable.

  10. Design of a simple, lightweight, passive-elastic ankle exoskeleton supporting ankle joint stiffness

    NASA Astrophysics Data System (ADS)

    Kim, Seyoung; Son, Youngsu; Choi, Sangkyu; Ham, Sangyong; Park, Cheolhoon

    2015-09-01

    In this study, a passive-elastic ankle exoskeleton (PEAX) with a one-way clutch mechanism was developed and then pilot-tested with vertical jumping to determine whether the PEAX is sufficiently lightweight and comfortable to be used in further biomechanical studies. The PEAX was designed to supplement the function of the Achilles tendon and ligaments as they passively support the ankle torque with their inherent stiffness. The main frame of the PEAX consists of upper and lower parts connected to each other by tension springs (N = 3) and lubricated hinge joints. The upper part has an offset angle of 5° with respect to the vertical line when the springs are in their resting state. Each spring has a slack length of 8 cm and connects the upper part to the tailrod of the lower part in the neutral position. The tailrod freely rotates with low friction but has a limited range of motion due to the stop pin working as a one-way clutch. Because of the one-way clutch system, the tension springs store the elastic energy only due to an ankle dorsiflexion when triggered by the stop pin. This clutch mechanism also has the advantage of preventing any inconvenience during ankle plantarflexion because it does not limit the ankle joint motion during the plantarflexion phase. In pilot jumping tests, all of the subjects reported that the PEAX was comfortable for jumping due to its lightweight (approximately 1 kg) and compact (firmly integrated with shoes) design, and subjects were able to nearly reach their maximum vertical jump heights while wearing the PEAX. During the countermovement jump, elastic energy was stored during dorsiflexion by spring extension and released during plantarflexion by spring restoration, indicating that the passive spring torque (i.e., supportive torque) generated by the ankle exoskeleton partially supported the ankle joint torque throughout the process.

  11. Design of a simple, lightweight, passive-elastic ankle exoskeleton supporting ankle joint stiffness.

    PubMed

    Kim, Seyoung; Son, Youngsu; Choi, Sangkyu; Ham, Sangyong; Park, Cheolhoon

    2015-09-01

    In this study, a passive-elastic ankle exoskeleton (PEAX) with a one-way clutch mechanism was developed and then pilot-tested with vertical jumping to determine whether the PEAX is sufficiently lightweight and comfortable to be used in further biomechanical studies. The PEAX was designed to supplement the function of the Achilles tendon and ligaments as they passively support the ankle torque with their inherent stiffness. The main frame of the PEAX consists of upper and lower parts connected to each other by tension springs (N = 3) and lubricated hinge joints. The upper part has an offset angle of 5° with respect to the vertical line when the springs are in their resting state. Each spring has a slack length of 8 cm and connects the upper part to the tailrod of the lower part in the neutral position. The tailrod freely rotates with low friction but has a limited range of motion due to the stop pin working as a one-way clutch. Because of the one-way clutch system, the tension springs store the elastic energy only due to an ankle dorsiflexion when triggered by the stop pin. This clutch mechanism also has the advantage of preventing any inconvenience during ankle plantarflexion because it does not limit the ankle joint motion during the plantarflexion phase. In pilot jumping tests, all of the subjects reported that the PEAX was comfortable for jumping due to its lightweight (approximately 1 kg) and compact (firmly integrated with shoes) design, and subjects were able to nearly reach their maximum vertical jump heights while wearing the PEAX. During the countermovement jump, elastic energy was stored during dorsiflexion by spring extension and released during plantarflexion by spring restoration, indicating that the passive spring torque (i.e., supportive torque) generated by the ankle exoskeleton partially supported the ankle joint torque throughout the process.

  12. Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton.

    PubMed

    Kao, Pei-Chun; Lewis, Cara L; Ferris, Daniel P

    2010-01-19

    To guide development of robotic lower limb exoskeletons, it is necessary to understand how humans adapt to powered assistance. The purposes of this study were to quantify joint moments while healthy subjects adapted to a robotic ankle exoskeleton and to determine if the period of motor adaptation is dependent on the magnitude of robotic assistance. The pneumatically powered ankle exoskeleton provided plantar flexor torque controlled by the wearer's soleus electromyography (EMG). Eleven naïve individuals completed two 30-min sessions walking on a split-belt instrumented treadmill at 1.25m/s while wearing the ankle exoskeleton. After two sessions of practice, subjects reduced their soleus EMG activation by approximately 36% and walked with total ankle moment patterns similar to their unassisted gait (r(2)=0.98+/-0.02, THSD, p>0.05). They had substantially different ankle kinematic patterns compared to their unassisted gait (r(2)=0.79+/-0.12, THSD, p<0.05). Not all of the subjects reached a steady-state gait pattern within the two sessions, in contrast to a previous study using a weaker robotic ankle exoskeleton (Gordon and Ferris, 2007). Our results strongly suggest that humans aim for similar joint moment patterns when walking with robotic assistance rather than similar kinematic patterns. In addition, greater robotic assistance provided during initial use results in a longer adaptation process than lesser robotic assistance. Copyright 2009 Elsevier Ltd. All rights reserved.

  13. The feasibility of point-of-care ankle ultrasound examination in patients with recurrent ankle sprain and chronic ankle instability: Comparison with magnetic resonance imaging.

    PubMed

    Lee, Sun Hwa; Yun, Seong Jong

    2017-10-01

    To evaluate the feasibility of point-of-care ankle ultrasound compared with magnetic resonance imaging (MRI) for diagnosing major ligaments and Achilles tendon injuries in patients with recurrent ankle sprain and chronic instability, and to evaluate inter-observer reliability between an emergency physician and a musculoskeletal radiology fellow. A prospective cross-sectional study was conducted in an emergency department. Patients with recurrent ankle sprain and chronic instability were recruited. An emergency physician and a musculoskeletal radiology fellow independently evaluated the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), distal anterior tibiofibular ligament (ATiFL), deltoid ligament, and Achilles tendon using point-of-care ankle ultrasound. Findings were classified normal, partial tear, and complete tear. MRI was used as the reference standard. We calculated diagnostic values for point-of-care ankle ultrasound for both reviewers and compared them using DeLong's test. Intra-class correlation coefficients (ICCs) were calculated for agreement between each reviewer and the reference standard, and between the two reviewers. Eighty-five patients were enrolled. Point-of-care ankle ultrasound showed acceptable sensitivity (96.4-100%), specificity (95.0-100%), and accuracy (96.5-100%); these performance markers did not differ significantly between reviewers. Agreement between each reviewer and the reference standard was excellent (emergency physician, ICC=0.846-1.000; musculoskeletal radiology fellow, ICC=0.930-1.000), as was inter-observer agreement (ICC=0.873-1.000). Point-of-care ankle ultrasound is as precise as MRI for detecting major ankle ligament and Achilles tendon injuries; it could be used for immediate diagnosis and further pre-operative imaging. Moreover, it may reduce the interval from emergency department admission to admission for surgical intervention, and may save costs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Directing clinical care using lower extremity biomechanics in patients with ankle osteoarthritis and ankle arthroplasty.

    PubMed

    Queen, Robin

    2017-11-01

    Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach. Our recent studies have explored physical performance and energy recovery and revealed unexpected patterns and sequelae to treatment including incomplete restoration of gait function. These studies demonstrated for the first time the extreme levels and range of gait and balance dysfunction present in ankle osteoarthritis patients as well as quantifying the ways in which the affected joint alters movement and loading patterns not just in the painful joint, but throughout both the ipsilateral and contralateral lower extremity. Through this work, we determined that relieving pain alone through TAA is not enough to restore normal walking mechanics and balance due to underlying causes including limited ankle range of motion and balance deficits leading to long-term disability despite treatment. The results indicate the need to consider additional therapeutic interventions aimed at restoring balance, ankle range of motion, and movement symmetry in order to improve long-term health and function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2345-2355, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  15. Improved ankle push-off power following cheilectomy for hallux rigidus: a prospective gait analysis study.

    PubMed

    Smith, Sheryl M; Coleman, Scott C; Bacon, Stacy A; Polo, Fabian E; Brodsky, James W

    2012-06-01

    There is limited objective scientific information on the functional effects of cheilectomy. The purpose of this study was to test the hypothesis that cheilectomy for hallux rigidus improves gait by increasing ankle push-off power. Seventeen patients with symptomatic Stage 1 or Stage 2 hallux rigidus were studied. Pre- and postoperative first metatarsophalangeal (MTP) range of motion and AOFAS hallux scores were recorded. A gait analysis was performed within 4 weeks prior to surgery and repeated at a minimum of 1 year after surgery. Gait analysis was done using a three-dimensional motion capture system and a force platform embedded in a 10-m walkway. Gait velocity sagittal plane ankle range of motion and peak sagittal plane ankle push-off power were analyzed. Following cheilectomy, significant increases were noted for first MTP range of motion and AOFAS hallux score. First MTP motion improved an average of 16.7 degrees, from means of 33.9 degrees preoperatively to 50.6 degrees postoperatively (p<0.001). AOFAS hallux score increased from 62 to 81 (p<0.007). As demonstrated through gait anaylsis, a significant increase in postoperative peak sagittal plane ankle push-off power from 1.71±0.92 W/kg to 2.05±0.75 W/kg (p<0.04). In addition to clinically increased range of motion and improved AOFAS Hallux score, first MTP joint cheilectomy produced objective improvement in gait, as measured by increased peak sagittal-plane ankle push-off power.

  16. Using a pseudo-dynamic source inversion approach to improve earthquake source imaging

    NASA Astrophysics Data System (ADS)

    Zhang, Y.; Song, S. G.; Dalguer, L. A.; Clinton, J. F.

    2014-12-01

    Imaging a high-resolution spatio-temporal slip distribution of an earthquake rupture is a core research goal in seismology. In general we expect to obtain a higher quality source image by improving the observational input data (e.g. using more higher quality near-source stations). However, recent studies show that increasing the surface station density alone does not significantly improve source inversion results (Custodio et al. 2005; Zhang et al. 2014). We introduce correlation structures between the kinematic source parameters: slip, rupture velocity, and peak slip velocity (Song et al. 2009; Song and Dalguer 2013) in the non-linear source inversion. The correlation structures are physical constraints derived from rupture dynamics that effectively regularize the model space and may improve source imaging. We name this approach pseudo-dynamic source inversion. We investigate the effectiveness of this pseudo-dynamic source inversion method by inverting low frequency velocity waveforms from a synthetic dynamic rupture model of a buried vertical strike-slip event (Mw 6.5) in a homogeneous half space. In the inversion, we use a genetic algorithm in a Bayesian framework (Moneli et al. 2008), and a dynamically consistent regularized Yoffe function (Tinti, et al. 2005) was used for a single-window slip velocity function. We search for local rupture velocity directly in the inversion, and calculate the rupture time using a ray-tracing technique. We implement both auto- and cross-correlation of slip, rupture velocity, and peak slip velocity in the prior distribution. Our results suggest that kinematic source model estimates capture the major features of the target dynamic model. The estimated rupture velocity closely matches the target distribution from the dynamic rupture model, and the derived rupture time is smoother than the one we searched directly. By implementing both auto- and cross-correlation of kinematic source parameters, in comparison to traditional smoothing

  17. Measures of functional limitation as predictors of disablement in athletes with acute ankle sprains.

    PubMed

    Wilson, R W; Gansneder, B M

    2000-09-01

    Prospective multivariate design. To determine the usefulness of activity scores, self-reported athletic ability, and selected measures of physical impairment as predictors of disability duration in athletes with ankle inversion sprains. Although several measures of physical impairment and functional limitation are used to assess the consequences of injury following ankle sprain, researchers have yet to establish which measures provide the most accurate predictions of disability duration. Physical impairment, activity limitation, and disability duration were measured in 21 athletes (13 men and 8 women; mean age = 20.3 +/- 1.7 years) with acute ankle sprains. Sagittal plane ankle range of motion and volumetric displacement were used as impairment indicators. Weight-bearing activity scores (task completion count) and self-reported athletic ability (visual analog scale) were used to represent functional limitation. Elapsed time from injury to return to full athletic participation was used as the criterion measure of disability duration. The impairment measures accounted for approximately one-third of the variance in disability duration (R2 = 0.342). Adding the activity limitation measures to the regression model improved predictions of disability duration (R2 = 0.670; stepwise R2 change = 0.328). The measures of activity limitation alone, however, accounted for approximately 67% (R2 = 0.665) of the total variance in the number of days lost due to injury. Measures of activity limitation were the strongest predictors of elapsed time from injury to return to full athletic participation.

  18. The V sign in lateral talar process fractures: an experimental study using a foot and ankle model.

    PubMed

    Jentzsch, Thorsten; Hasler, Anita; Renner, Niklas; Peterhans, Manuel; Sutter, Reto; Espinosa, Norman; Wirth, Stephan H

    2017-07-03

    Lateral talar process fractures (LTPF) are often missed on conventional radiographs. A positive V sign is an interruption of the contour of the LTP. It has been suggested, but not proven to be pathognomonic for LTPF. The objective was to study whether the V sign is pathognomonic for LTPF and if it can be properly assessed in different ankle positions and varying fracture types. An experimental study was conducted. Two investigators assessed lateral radiographs (n = 108) of a foot and ankle model. The exposure variables were different ankle positions and fracture types. The primary outcome was the correct detection of a V sign. The secondary outcomes were the detection of the V sign depending on ankle position and fracture type as well as the uncertainty. The interobserver agreement on the V sign and type of fracture were fair (κ = 0.35, 95% CI 0.18-0.53, p < 0.001 and κ = 0.37, 95% CI 0.26-0.48, p < 0.001). The mean sensitivity, specificity, PPV, NPV, and likelihood ratio for the detection of the V sign were 77% (95% CI 67-86%), 59% (95% CI 39-78%), 85% (95% CI 75-92%), 46% (95% CI 29-63%), and 2. The mean uncertainty in the V sign detection was 38%. The V sign identification stratified by ankle position and fracture type showed significant better results with increasing inversion (p = 0.035 and p = 0.011) and type B fractures (p = 0.001 and p = 0.013). The V sign may not be pathognomonic and is not recommended as the only modality for the detection of LTPF. It is better visualized with inversion, but does not depend on plantar flexion or internal rotation. It is also better seen in type B fractures. It is difficult to detect and investigator-dependent. It may be helpful in a clinical setting to point into a direction, but a CT scan may be used if in doubt about a LTPF.

  19. Kinematic Mechanisms of How Power Training Improves Healthy Old Adults' Gait Velocity.

    PubMed

    Beijersbergen, Chantal M I; Granacher, Urs; Gäbler, Martijn; Devita, Paul; Hortobágyi, Tibor

    2017-01-01

    Slow gait predicts many adverse clinical outcomes in old adults, but the mechanisms of how power training can minimize the age-related loss of gait velocity is unclear. We examined the effects of 10 wk of lower extremity power training and detraining on healthy old adults' lower extremity muscle power and gait kinematics. As part of the Potsdam Gait Study, participants started with 10 wk of power training followed by 10 wk of detraining (n = 16), and participants started with a 10-wk control period followed by 10 wk of power training (n = 16). We measured gait kinematics (stride characteristic and joint kinematics) and isokinetic power of the ankle plantarflexor (20°·s, 40°·s, and 60°·s) and knee extensor and flexor (60°·s, 120°·s, and 180°·s) muscles at weeks 0, 10, and 20. Power training improved isokinetic muscle power by ~30% (P ≤ 0.001) and fast (5.9%, P < 0.05) but not habitual gait velocity. Ankle plantarflexor velocity measured during gait at fast pace decreased by 7.9% (P < 0.05). The changes isokinetic muscle power and joint kinematics did not correlate with increases in fast gait velocity. The mechanisms that increased fast gait velocity involved higher cadence (r = 0.86, P ≤ 0.001) rather than longer strides (r = 0.49, P = 0.066). Detraining did not reverse the training-induced increases in muscle power and fast gait velocity. Because increases in muscle power and modifications in joint kinematics did not correlate with increases in fast gait velocity, kinematic mechanisms seem to play a minor role in improving healthy old adults' fast gait velocity after power training.

  20. Development and validation of the Sports Athlete Foot and Ankle Score: an instrument for sports-related ankle injuries.

    PubMed

    Morssinkhof, M L A; Wang, O; James, L; van der Heide, H J L; Winson, I G

    2013-09-01

    Many existing scoring systems assess ankle function, but there is no evidence that any of them has been validated in a group of patients with a higher demand on their ankle function. Problems include ceiling effects, not being able to detect change or they do not contain a sports-subscale. The aim of this study was to create a validated self-administered scoring system for ankle injuries in the higher performing athlete. First, 26 patients were interviewed to solicit opinions needed to create the final score, which is modified from the Foot and Ankle Outcome Score (FAOS). Second, SAFAS was validated in a group of 25 athletes with and 14 athletes without ankle injury. It is a self-administered region specific sports foot and ankle score that contains four subscales assessing the levels of symptoms, pain, daily living and sports. The Spearman correlation coefficients between SAFAS and the Foot and Ankle Ability Measure (FAAM) ranged from 0.78 to 0.88. Content validity is established by key informant interviews, expert opinions and a high satisfaction rate of 75%. Cronbach's alpha indicated good internal consistency of each subscale ranging from 0.77 to 0.92. SAFAS has shown good evidence for being a valid instrudent for assessing sports-related ankle injuries in high-performing athletes. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  1. Determination of rock-sample anisotropy from P- and S-wave traveltime inversion

    NASA Astrophysics Data System (ADS)

    Pšenčík, Ivan; Růžek, Bohuslav; Lokajíček, Tomáš; Svitek, Tomáš

    2018-04-01

    We determine anisotropy of a rock sample from laboratory measurements of P- and S-wave traveltimes using weak-anisotropy approximation and parametri-zation of the medium by a special set of anisotropy parameters. For the traveltime inversion we use first-order velocity expressions in the weak-anisotropy approximation, which allow to deal with P and S waves separately. Each wave is described by 15 anisotropy parameters, 9 of which are common for both waves. The parameters allow an approximate construction of separate P- or common S-wave phase-velocity surfaces. Common S wave concept is used to simplify the treatment of S waves. In order to obtain all 21 anisotropy parameters, P- and S-wave traveltimes must be inverted jointly. The proposed inversion scheme has several advantages. As a consequence of the use of weak-anisotropy approximation and assumed homogeneity of the rock sample, equations used for the inversion are linear. Thus the inversion procedure is non-iterative. In the approximation used, phase and ray velocities are equal in their magnitude and direction. Thus analysis whether the measured velocity is the ray or phase velocity is unnecessary. Another advantage of the proposed inversion scheme is that, thanks to the use of the common S-wave concept, it does not require identification of S-wave modes. It is sufficient to know the two S-wave traveltimes without specification, to which S-wave mode they belong. The inversion procedure is tested first on synthetic traveltimes and then used for the inversion of traveltimes measured in laboratory. In both cases, we perform first the inversion of P-wave traveltimes alone and then joint inversion of P- and S-wave traveltimes, and compare the results.

  2. Electromiography comparison of distal and proximal lower limb muscle activity patterns during external perturbation in subjects with and without functional ankle instability.

    PubMed

    Kazemi, Khadijeh; Arab, Amir Massoud; Abdollahi, Iraj; López-López, Daniel; Calvo-Lobo, César

    2017-10-01

    Ankle sprain is one of the most common injuries among athletes and the general population. Most ankle injuries commonly affect the lateral ligament complex. Changes in postural sway and hip abductor muscle strength may be generated after inversion ankle sprain. Therefore, the consequences of ankle injury may affect proximal structures of the lower limb. The aim is to describe and compare the activity patterns of distal and proximal lower limb muscles following external perturbation in individuals with and without functional ankle instability. The sample consisted of 16 women with functional ankle instability and 18 healthy women were recruited to participate in this research. The external perturbation via body jacket using surface electromyography, amplitude and onset of muscle activity of gluteus maximums, gluteus medius, tibialis anterior, and peroneus longus was recorded and analyzed during external perturbation. There were differences between the onset of muscles activity due to perturbation direction in the two groups (healthy and functional ankle instability). In the healthy group, there were statistically significant differences in amplitude of proximal muscle activity with distal muscle activity during front perturbation with eyes open and closed. In the functional ankle instability group; there were statistically significant differences in amplitude of proximal muscle activity with distal muscle activity during perturbation of the front and back with eyes open. There were statistically significant differences in the onset of muscle activity and amplitude of muscle activity, with-in and between groups (P<0.05). Therefore, in the presence of functional ankle instability, activation patterns of the lower limb proximal muscles may be altered. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Joint inversion of high-frequency surface waves with fundamental and higher modes

    USGS Publications Warehouse

    Luo, Y.; Xia, J.; Liu, J.; Liu, Q.; Xu, S.

    2007-01-01

    Joint inversion of multimode surface waves for estimating the shear (S)-wave velocity has received much attention in recent years. In this paper, we first analyze sensitivity of phase velocities of multimodes of surface waves for a six-layer earth model, and then we invert surface-wave dispersion curves of the theoretical model and a real-world example. Sensitivity analysis shows that fundamental mode data are more sensitive to the S-wave velocities of shallow layers and are concentrated on a very narrow frequency band, while higher mode data are more sensitive to the parameters of relatively deeper layers and are distributed over a wider frequency band. These properties provide a foundation of using a multimode joint inversion to define S-wave velocities. Inversion results of both synthetic data and a real-world example demonstrate that joint inversion with the damped least-square method and the singular-value decomposition technique to invert high-frequency surface waves with fundamental and higher mode data simultaneously can effectively reduce the ambiguity and improve the accuracy of S-wave velocities. ?? 2007.

  4. Ankle Distraction Arthroplasty: Indications, Technique, and Outcomes.

    PubMed

    Bernstein, Mitchell; Reidler, Jay; Fragomen, Austin; Rozbruch, S Robert

    2017-02-01

    Ankle distraction is an alternative to ankle arthrodesis or total ankle arthroplasty in younger patients with arthritis. Ankle distraction involves the use of external fixation to mechanically unload the ankle joint, which allows for stable, congruent range of motion in the setting of decreased mechanical loading, potentially promoting cartilage repair. Adjunct surgical procedures are frequently done to address lower-extremity malalignment, ankle equinus contractures, and impinging tibiotalar osteophytes. Patients can bear full weight during the treatment course. The distraction frame frequently uses a hinge, and patients are encouraged to do daily range-of-motion exercises. Although the initial goal of the procedure is to delay arthrodesis, many patients achieve lasting clinical benefits, obviating the need for total ankle arthroplasty or fusion. Complications associated with external fixation are common, and patients should be counseled that clinical improvements occur slowly and often are not achieved until at least 1 year after frame removal.

  5. The cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains.

    PubMed

    Fatoye, Francis; Haigh, Carol

    2016-05-01

    To examine the cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains. Economic evaluation based on cost-utility analysis. Ankle sprains are a source of morbidity and absenteeism from work, accounting for 15-20% of all sports injuries. Semi-rigid ankle brace and taping are functional treatment interventions used by Musculoskeletal Physiotherapists and Nurses to facilitate return to work following acute ankle sprains. A decision model analysis, based on cost-utility analysis from the perspective of National Health Service was used. The primary outcomes measure was incremental cost-effectiveness ratio, based on quality-adjusted life years. Costs and quality of life data were derived from published literature, while model clinical probabilities were sourced from Musculoskeletal Physiotherapists. The cost and quality adjusted life years gained using semi-rigid ankle brace was £184 and 0.72 respectively. However, the cost and quality adjusted life years gained following taping was £155 and 0.61 respectively. The incremental cost-effectiveness ratio for the semi-rigid brace was £263 per quality adjusted life year. Probabilistic sensitivity analysis showed that ankle brace provided the highest net-benefit, hence the preferred option. Taping is a cheaper intervention compared with ankle brace to facilitate return to work following first-time ankle sprains. However, the incremental cost-effectiveness ratio observed for ankle brace was less than the National Institute for Health and Care Excellence threshold and the intervention had a higher net-benefit, suggesting that it is a cost-effective intervention. Decision-makers may be willing to pay £263 for an additional gain in quality adjusted life year. The findings of this economic evaluation provide justification for the use of semi-rigid ankle brace by Musculoskeletal Physiotherapists and Nurses to facilitate return to work in individuals with first-time ankle

  6. Wave-equation migration velocity inversion using passive seismic sources

    NASA Astrophysics Data System (ADS)

    Witten, B.; Shragge, J. C.

    2015-12-01

    Seismic monitoring at injection sites (e.g., CO2 sequestration, waste water disposal, hydraulic fracturing) has become an increasingly important tool for hazard identification and avoidance. The information obtained from this data is often limited to seismic event properties (e.g., location, approximate time, moment tensor), the accuracy of which greatly depends on the estimated elastic velocity models. However, creating accurate velocity models from passive array data remains a challenging problem. Common techniques rely on picking arrivals or matching waveforms requiring high signal-to-noise data that is often not available for the magnitude earthquakes observed over injection sites. We present a new method for obtaining elastic velocity information from earthquakes though full-wavefield wave-equation imaging and adjoint-state tomography. The technique exploits the fact that the P- and S-wave arrivals originate at the same time and location in the subsurface. We generate image volumes by back-propagating P- and S-wave data through initial Earth models and then applying a correlation-based extended-imaging condition. Energy focusing away from zero lag in the extended image volume is used as a (penalized) residual in an adjoint-state tomography scheme to update the P- and S-wave velocity models. We use an acousto-elastic approximation to greatly reduce the computational cost. Because the method requires neither an initial source location or origin time estimate nor picking of arrivals, it is suitable for low signal-to-noise datasets, such as microseismic data. Synthetic results show that with a realistic distribution of microseismic sources, P- and S-velocity perturbations can be recovered. Although demonstrated at an oil and gas reservoir scale, the technique can be applied to problems of all scales from geologic core samples to global seismology.

  7. Effects of visual feedback balance training on the balance and ankle instability in adult men with functional ankle instability.

    PubMed

    Nam, Seung-Min; Kim, Kyoung; Lee, Do Youn

    2018-01-01

    [Purpose] This study examined the effects of visual feedback balance training on the balance and ankle instability in adult men with functional ankle instability. [Subjects and Methods] Twenty eight adults with functional ankle instability, divided randomly into an experimental group, which performed visual feedback balance training for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Bio rescue was used for balance ability. It measured limit of stability at one minute. For ankle instability was measured using Cumberland ankle instability tool (CAIT). This measure was performed before and after the experiments in each group. [Results] The experimental group had significant increase in the Limit of Stability and CAIT score. The control group had significant increase in CAIT score. While the Limit of Stability increased without significance. [Conclusion] In conclusion, visual feedback balance training can be recommended as a treatment method for patients with functional ankle instability.

  8. Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: The Kangbuk Samsung Health Study.

    PubMed

    Cainzos-Achirica, Miguel; Rampal, Sanjay; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Zhao, Di; Cho, Juhee; Choi, Yuni; Pastor-Barriuso, Roberto; Lim, So Yeon; Bruguera, Jordi; Elosua, Roberto; Lima, Joao A C; Shin, Hocheol; Guallar, Eliseo

    2015-08-01

    To evaluate the association between brachial-ankle pulse wave velocity (baPWV), a convenient, non-radiating, readily available measurement of arterial stiffness, and coronary artery calcium (CAC), a reliable marker of coronary atherosclerosis, in a large sample of young and middle-aged asymptomatic adults; and to assess the incremental value of baPWV for detecting prevalent CAC beyond traditional risk factors. Cross-sectional study of 15,185 asymptomatic Korean adults who voluntarily underwent a comprehensive health screening program including measurement of baPWV and CAC. BaPWV was measured using an oscillometric method with cuffs placed on both arms and ankles. CAC burden was assessed using a multi-detector CT scan and scored following Agatston's method. The prevalence of CAC > 0 and CAC > 100 increased across baPWV quintiles. The multivariable-adjusted odds ratios (95% CI) for CAC > 0 comparing baPWV quintiles 2-5 versus quintile 1 were 1.06 (0.87-1.30), 1.24 (1.02-1.50), 1.39 (1.15-1.69) and 1.60 (1.31-1.96), respectively (P trend < 0.001). Similarly, the relative prevalence ratios for CAC > 100 were 1.30 (0.74-2.26), 1.59 (0.93-2.71), 1.74 (1.03-2.94) and 2.59 (1.54-4.36), respectively (P trend < 0.001). For CAC > 100, the area under the ROC curve for baPWV alone was 0.71 (0.68-0.74), and the addition of baPWV to traditional risk factors significantly improved the discrimination and calibration of models for detecting prevalent CAC > 0 and CAC > 100. BaPWV was independently associated with the presence and severity of CAC in a large sample of young and middle-aged asymptomatic adults. BaPWV may be a valuable tool for identifying apparently low-risk individuals with increased burden of coronary atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. High Resolution Velocity Structure in Eastern Turkey

    NASA Astrophysics Data System (ADS)

    Pasyanos, M. E.; Gok, R.; Zor, E.; Walter, W. R.

    2004-12-01

    We investigate the crust and upper mantle structure of eastern Turkey where the Anatolian, Arabian and Eurasian Plates meet, forming a complex tectonic regime. The Bitlis suture is a continental collision zone between the Anatolian plateau and the Arabian plate. Broadband data available through the Eastern Turkey Seismic Experiment (ETSE) provide a unique opportunity for studying the high resolution velocity structure of the region. Zor et al. (2003) found an average 46 km thick crust in the Anatolian plateau using a six-layered grid search inversion of the ETSE receiver functions. Receiver functions are sensitive to the velocity contrast of interfaces and the relative travel time of converted and reverberated waves between those interfaces. The interpretation of receiver functions alone, however, may result in an apparent depth-velocity trade-off [Ammon et al., 1990]. In order to improve upon this velocity model, we have combined the receiver functions with surface wave data using the joint inversion method of Julia et al. (2000). In this technique, the two sets of observations are combined into a single algebraic equation and each data set is weighted by an estimate of the uncertainty in the observations. The receiver functions are calculated using an iterative time-domain deconvolution technique. We also consider azimuthal changes in the receiver functions and have stacked them into different groups accordingly. We are improving our surface wave model by making Love and Rayleigh dispersion measurements at the ETSE stations and incorporating them into a regional group velocity model for periods between 10 and 100 seconds. Preliminary results indicate a strong trend in the long period group velocities toward the northeast, indicating slow upper mantle velocities in the area consistent with Pn, Sn and receiver function results. Starting models used for the joint inversions include both a 1-D model from a 12-ton dam shot recorded by ETSE [Gurbuz et al., 2004] and

  10. Transdimensional inversion of scattered body waves for 1D S-wave velocity structure - Application to the Tengchong volcanic area, Southwestern China

    NASA Astrophysics Data System (ADS)

    Li, Mengkui; Zhang, Shuangxi; Bodin, Thomas; Lin, Xu; Wu, Tengfei

    2018-06-01

    Inversion of receiver functions is commonly used to recover the S-wave velocity structure beneath seismic stations. Traditional approaches are based on deconvolved waveforms, where the horizontal component of P-wave seismograms is deconvolved by the vertical component. Deconvolution of noisy seismograms is a numerically unstable process that needs to be stabilized by regularization parameters. This biases noise statistics, making it difficult to estimate uncertainties in observed receiver functions for Bayesian inference. This study proposes a method to directly invert observed radial waveforms and to better account for data noise in a Bayesian formulation. We illustrate its feasibility with two synthetic tests having different types of noises added to seismograms. Then, a real site application is performed to obtain the 1-D S-wave velocity structure beneath a seismic station located in the Tengchong volcanic area, Southwestern China. Surface wave dispersion measurements spanning periods from 8 to 65 s are jointly inverted with P waveforms. The results show a complex S-wave velocity structure, as two low velocity zones are observed in the crust and uppermost mantle, suggesting the existence of magma chambers, or zones of partial melt. The upper magma chambers may be the heart source that cause the thermal activity on the surface.

  11. Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.

    PubMed

    Toyota, Yukihiro; Tamura, Maasa; Kirino, Yohei; Sugiyama, Yumiko; Tsuchida, Naomi; Kunishita, Yosuke; Kishimoto, Daiga; Kamiyama, Reikou; Miura, Yasushi; Minegishi, Kaoru; Yoshimi, Ryusuke; Ueda, Atsuhisa; Nakajima, Hideaki

    2017-05-01

    To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA). Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients' visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0-3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable. Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS. US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.

  12. Quantitative evaluation of the viscoelastic properties of the ankle joint complex in patients suffering from ankle sprain by the anterior drawer test.

    PubMed

    Lin, Che-Yu; Shau, Yio-Wha; Wang, Chung-Li; Chai, Huei-Ming; Kang, Jiunn-Horng

    2013-06-01

    Biological tissues such as ligaments exhibit viscoelastic behaviours. Injury to the ligament may induce changes of these viscoelastic properties, and these changes could serve as biomarkers to detect the injury. In the present study, a novel instrument was developed to non-invasive quantify the viscoelastic properties of the ankle in vivo by the anterior drawer test. The purpose of the study was to investigate the reliability of the instrument and to compare the viscoelastic properties of the ankle between patients suffering from ankle sprain and controls. Eight patients and eight controls participated in the present study. The reliability test was performed on three randomly chosen subjects. In patient and control test, both ankles of each subject were tested to evaluate the viscoelastic properties of the ankle. The viscosity index was defined for quantitatively evaluating the viscosity of the ankle. Greater viscosity index was associated with lower viscosity. Injured and uninjured ankles of patient and both ankles of controls were compared. The instrument exhibited excellent test-retest reliability (r > 0.9). Injured ankles exhibited significantly less viscosity than uninjured ankles, since injured ankles of patients had significantly higher viscosity index (8,148 ± 5,266) compared with uninjured ankles of patients (948 ± 617; p = 0.008) and controls (1,326 ± 613; p < 0.001). The study revealed that the viscoelastic properties of the ankle can serve as sensitive and useful clinical biomarkers to differentiate between injured and uninjured ankles. The method may provide a clinical examination for objectively evaluating lateral ankle ligament injuries.

  13. Which Treatment is More Effective for Functional Ankle Instability: Strengthening or Combined Muscle Strengthening and Proprioceptive Exercises?

    PubMed

    Kim, Ki-Jong; Kim, Young-Eok; Jun, Hyun-Ju; Lee, Jin-Su; Ji, Sung-Ha; Ji, Sang-Goo; Seo, Tae-Hwa; Kim, Young-Ok

    2014-03-01

    [Purpose] The purpose of this study was to implement combined muscle strengthening and proprioceptive exercises to examine the effects of combined exercises on functional ankle instability. [Subjects and Methods] Experiments were conducted with 30 adult males and females. The study subjects were randomly assigned to either a control group (Group A), a muscle strengthening exercise group (Group B), or a combined muscle strengthening and proprioceptive exercise group (Group C) consisting of 10 subjects each. In Group A, measurements were only conducted before and after the experiment without any intervention, whereas the exercise programs for Group B and Group C were implemented three days per week for four weeks. [Results] Muscle strength showed significant increases in Groups B and C compared with the control group during plantar flexion, dorsiflexion, inversion, and eversion. The Cumberland ankle instability tool showed significant increases in Group B and Group C compared with Group A and significant increases in Group C compared with Group B. [Conclusion] Applying combined muscle strengthening and proprioceptive exercises to those who have functional ankle instability is more effective than applying only muscle strengthening exercises.

  14. The effect of external ankle support on knee and ankle joint movement and loading in netball players.

    PubMed

    Vanwanseele, Benedicte; Stuelcken, Max; Greene, Andrew; Smith, Richard

    2014-09-01

    External ankle support has been successfully used to prevent ankle sprains. However, some recent studies have indicated that reducing ankle range of motion can place larger loads on the knee. The aim of this study was to investigate the effect of external ankle support (braces and high-top shoes) on the ankle and knee joint loading during a netball specific landing task. A repeated measure design. High performance netball players with no previously diagnosed severe ankle or knee injury (n=11) were recruited from NSW Institute of Sport netball programme. The kinematic and kinetic data were collected simultaneously using a 3-D Motion Analysis System and one Kistler force plate to measure ground reaction forces. Players performed a single leg landing whilst receiving a pass while wearing a standard netball shoe, the same shoe with a lace-up brace and a high-top shoe. Only the brace condition significantly reduced the ankle range of motion in the frontal plane (in/eversion) by 3.95 ± 3.74 degrees compared to the standard condition. No changes were found for the knee joint loading in the brace condition. The high-top shoes acted to increase the peak knee internal rotation moment by 15%. Both the brace and high-top conditions brought about increases in the peak ankle plantar flexion moment during the landing phase. Lace-up braces can be used by netball players to restrict ankle range of motion during a single leg landing while receiving a pass without increasing the load on the knee joint. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  15. Serial Testing of Postural Control After Acute Lateral Ankle Sprain

    PubMed Central

    Buckley, W. E.; Denegar, Craig R.

    2001-01-01

    Objective: To identify subjects' changes in postural control during single-leg stance in the 4 weeks after acute lateral ankle sprain. Design and Setting: We used a 2 × 2 × 3 (side-by-plane-by-session) within-subjects design with repeated measures on all 3 factors. All tests were performed in a university laboratory. Subjects: Seventeen young adults (9 men, 8 women; age, 21.8 ± 5.9 years; mass, 74.9 ± 10.5 kg; height, 176.9 ± 7.1 cm) who had sustained unilateral acute mild or moderate lateral ankle sprains. Measurements: Measures of center-of-pressure excursion length, root mean square velocity of center-of-pressure excursions (VEL), and range of center-of-pressure excursions (RANGE) were calculated separately in the frontal and sagittal planes during 5-second trials of static single-leg stance. Results: We noted significant side-by-plane-by-session interactions for magnitude of center-of-pressure excursions in a given trial (PSL) (P = .004), VEL (P = .011), and RANGE (P = .009). Both PSL and VEL in the frontal plane were greater in the injured limbs compared with the uninjured limbs on day 1 and during week 2 but not during week 4, whereas sagittal-plane differences existed during all 3 testing sessions. Injured-limb, frontal-plane RANGE scores were greater than uninjured values at day 1 but not during weeks 2 or 4. No significant differences in sagittal-plane RANGE scores were seen. Conclusions: Postural control was significantly impaired in the injured limbs at day 1 and during week 2 after lateral ankle sprain but not during week 4. Consistent improvement in postural control measures on both injured and uninjured limbs was seen throughout the 4 weeks after ankle sprain. PMID:12937477

  16. Multi-parameter Full-waveform Inversion for Acoustic VTI Medium with Surface Seismic Data

    NASA Astrophysics Data System (ADS)

    Cheng, X.; Jiao, K.; Sun, D.; Huang, W.; Vigh, D.

    2013-12-01

    Full-waveform Inversion (FWI) attracts wide attention recently in oil and gas industry as a new promising tool for high resolution subsurface velocity model building. While the traditional common image point gather based tomography method aims to focus post-migrated data in depth domain, FWI aims to directly fit the observed seismic waveform in either time or frequency domain. The inversion is performed iteratively by updating the velocity fields to reduce the difference between the observed and the simulated data. It has been shown the inversion is very sensitive to the starting velocity fields, and data with long offsets and low frequencies is crucial for the success of FWI to overcome this sensitivity. Considering the importance of data with long offsets and low frequencies, in most geologic environment, anisotropy is an unavoidable topic for FWI especially at long offsets, since anisotropy tends to have more pronounced effects on waves traveled for a great distance. In VTI medium, this means more horizontal velocity will be registered in middle-to-long offset data, while more vertical velocity will be registered in near-to-middle offset data. Up to date, most of real world applications of FWI still remain in isotropic medium, and only a few studies have been shown to account for anisotropy. And most of those studies only account for anisotropy in waveform simulation, but not invert for those anisotropy fields. Multi-parameter inversion for anisotropy fields, even in VTI medium, remains as a hot topic in the field. In this study, we develop a strategy for multi-parameter FWI for acoustic VTI medium with surface seismic data. Because surface seismic data is insensitivity to the delta fields, we decide to hold the delta fields unchanged during our inversion, and invert only for vertical velocity and epsilon fields. Through parameterization analysis and synthetic tests, we find that it is more feasible to invert for the parameterization as vertical and horizontal

  17. Clinical evaluation of a new noninvasive ankle arthrometer.

    PubMed

    Nauck, Tanja; Lohrer, Heinz; Gollhofer, Albert

    2010-06-01

    A nonradiographic arthrometer was developed to objectively quantify anterior talar drawer instability in stable and unstable ankles. Diagnostic validity of this device was previously demonstrated in a cadaver study. The aim of the present study was to validate the ankle arthrometer in an in vivo setting. Twenty-three subjects participated in the study. An orthopedic surgeon first performed a manual anterior talar drawer test to classify the subjects' ankles as stable or unstable. The subjects were then evaluated using the ankle arthrometer, and filled out a validated self-reported questionnaire (German version of the Foot and Ankle Ability Measure [FAAM-G]). Ankle stiffness was calculated from the low linear region (40-60 N) of the load deformation curves obtained from the ankle arthrometer. Reliability testing of these stiffness values was done based on load deformation curves, with 150 and 200 N maximum anterior drawer loads applied in the ankle arthrometer. Using the manual anterior drawer test, 16 ankles were classified as stable and 7 were classified as unstable. Arthrometer stiffness analysis differentiated stable from unstable ankles (P = 0.00 and P = 0.01, respectively). Test-retest demonstrated an accurate reliability (intraclass correlation coefficient = 0.80). A significant correlation was found between both FAAM-G subscales and the arthrometer stiffness values (r = 0.43 and 0.54; P = 0.04 and 0.01). Discussion Subjects with and without mechanical ankle instability could be differentiated by ankle arthrometer stiffness analysis and the FAAM-G questionnaire results. This nonradiographic device may be relevant for screening athletes at risk for ankle injuries, for clinical follow-up studies, and implementing preventive strategies. Validity and reliability of the new ankle arthrometer is demonstrated in a small cohort in an in vivo setting.

  18. Full waveform inversion using a decomposed single frequency component from a spectrogram

    NASA Astrophysics Data System (ADS)

    Ha, Jiho; Kim, Seongpil; Koo, Namhyung; Kim, Young-Ju; Woo, Nam-Sub; Han, Sang-Mok; Chung, Wookeen; Shin, Sungryul; Shin, Changsoo; Lee, Jaejoon

    2018-06-01

    Although many full waveform inversion methods have been developed to construct velocity models of subsurface, various approaches have been presented to obtain an inversion result with long-wavelength features even though seismic data lacking low-frequency components were used. In this study, a new full waveform inversion algorithm was proposed to recover a long-wavelength velocity model that reflects the inherent characteristics of each frequency component of seismic data using a single-frequency component decomposed from the spectrogram. We utilized the wavelet transform method to obtain the spectrogram, and the decomposed signal from the spectrogram was used as transformed data. The Gauss-Newton method with the diagonal elements of an approximate Hessian matrix was used to update the model parameters at each iteration. Based on the results of time-frequency analysis in the spectrogram, numerical tests with some decomposed frequency components were performed using a modified SEG/EAGE salt dome (A-A‧) line to demonstrate the feasibility of the proposed inversion algorithm. This demonstrated that a reasonable inverted velocity model with long-wavelength structures can be obtained using a single frequency component. It was also confirmed that when strong noise occurs in part of the frequency band, it is feasible to obtain a long-wavelength velocity model from the noise data with a frequency component that is less affected by the noise. Finally, it was confirmed that the results obtained from the spectrogram inversion can be used as an initial velocity model in conventional inversion methods.

  19. Footwear and ankle stability in the basketball player.

    PubMed

    Petrov, O; Blocher, K; Bradbury, R L; Saxena, A; Toy, M L

    1988-04-01

    Ankle stability in basketball players is affected by footwear. Athletic shoe manufacturers have introduced specialized lacing systems and high-top performance shoes to improve ankle stability. These performance shoes not only aid in preventing ankle injuries, but also protect injured ankles.

  20. Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

    PubMed

    Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

    2013-01-01

    Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in

  1. Crustal and uppermost mantle S-wave velocity below the East European Craton in northern Poland from the inversion of ambient-noise records

    NASA Astrophysics Data System (ADS)

    Lepore, Simone; Polkowski, Marcin; Grad, Marek

    2018-02-01

    The P-wave velocities (V p) within the East European Craton in Poland are well known through several seismic experiments which permitted to build a high-resolution 3D model down to 60 km depth. However, these seismic data do not provide sufficient information about the S-wave velocities (V s). For this reason, this paper presents the values of lithospheric V s and P-wave-to-S-wave velocity ratios (V p/V s) calculated from the ambient noise recorded during 2014 at "13 BB star" seismic array (13 stations, 78 midpoints) located in northern Poland. The 3D V p model in the area of the array consists of six sedimentary layers having total thickness within 3-7 km and V p in the range 1.85.3 km/s, a three-layer crystalline crust of total thickness 40 km and V p within 6.15-7.15 km/s, and the uppermost mantle, where V p is about 8.25 km/s. The V s and V p/V s values are calculated by the inversion of the surface-wave dispersion curves extracted from the noise cross correlation between all the station pairs. Due to the strong velocity differences among the layers, several modes are recognized in the 0.021 Hz frequency band: therefore, multimodal Monte Carlo inversions are applied. The calculated V s and V p/V s values in the sedimentary cover range within 0.992.66 km/s and 1.751.97 as expected. In the upper crust, the V s value (3.48 ± 0.10 km/s) is very low compared to the starting value of 3.75 ± 0.10 km/s. Consequently, the V p/V s value is very large (1.81 ± 0.03). To explain that the calculated values are compared with the ones for other old cratonic areas.

  2. Lower limb joint motion during a cross cutting movement differs in individuals with and without chronic ankle instability.

    PubMed

    Koshino, Yuta; Yamanaka, Masanori; Ezawa, Yuya; Ishida, Tomoya; Kobayashi, Takumi; Samukawa, Mina; Saito, Hiroshi; Takeda, Naoki

    2014-11-01

    To compare the kinematics of lower limb joints between individuals with and without chronic ankle instability (CAI) during cross-turn and -cutting movements. Cross-sectional study. Motion analysis laboratory. Twelve subjects with CAI and twelve healthy controls. Hip flexion, adduction, and internal rotation, knee flexion, and ankle dorsiflexion and inversion angles were calculated in the 200 ms before initial ground contact and from initial ground contact to toe-off (stance phase) in a cross-turn movement during gait and a cross-cutting movement from a forward jump, and compared across the two groups. In the cross-cutting movement, the CAI group exhibited greater hip and knee flexion than the control group during the stance phase, and more hip abduction during the period before initial contact and the stance phase. In the cross-turn movement the joint kinematics were similar in the two groups. CAI subjects exhibited an altered pattern of the proximal joint kinematics during a cross-cutting movement. It is important for clinicians to assess the function of the hip and knee as well as the ankle, and to incorporate coordination training for the entire lower limb into rehabilitation after lateral ankle sprains. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Non-perturbational surface-wave inversion: A Dix-type relation for surface waves

    USGS Publications Warehouse

    Haney, Matt; Tsai, Victor C.

    2015-01-01

    We extend the approach underlying the well-known Dix equation in reflection seismology to surface waves. Within the context of surface wave inversion, the Dix-type relation we derive for surface waves allows accurate depth profiles of shear-wave velocity to be constructed directly from phase velocity data, in contrast to perturbational methods. The depth profiles can subsequently be used as an initial model for nonlinear inversion. We provide examples of the Dix-type relation for under-parameterized and over-parameterized cases. In the under-parameterized case, we use the theory to estimate crustal thickness, crustal shear-wave velocity, and mantle shear-wave velocity across the Western U.S. from phase velocity maps measured at 8-, 20-, and 40-s periods. By adopting a thin-layer formalism and an over-parameterized model, we show how a regularized inversion based on the Dix-type relation yields smooth depth profiles of shear-wave velocity. In the process, we quantitatively demonstrate the depth sensitivity of surface-wave phase velocity as a function of frequency and the accuracy of the Dix-type relation. We apply the over-parameterized approach to a near-surface data set within the frequency band from 5 to 40 Hz and find overall agreement between the inverted model and the result of full nonlinear inversion.

  4. Static Postural Stability in Chronic Ankle Instability, An Ankle Sprain and Healthy Ankles.

    PubMed

    Kwon, Yong Ung

    2018-05-18

    To identify the single leg balance (SLB) test that discriminates among healthy, coper, and chronic ankle instability (CAI) groups and to determine effects of ankle muscles on the balance error scoring system (BESS) among the three populations. 60 subjects (20 per group) performed the SLB test with eyes open (EO) and eyes closed (EC). Normalized mean amplitude (NMA) of the tibia anterior (TA), fibularis longus (FL), and medial gastrocnemius (MG) muscles and BESS were measured while performing the SLB test. The coper group had a lower error score than the CAI group in the EC. NMA was greater in the CAI group compared to in the healthy and coper groups regardless of muscle type. NMA of the TA was less than the PL and MG regardless of the group in the EO. The CAI group demonstrated greater NMAs of the PL and MG than the healthy and coper groups in the EC. The CAI group demonstrated greater NMA of the PL and MG by compensating their ankle muscles in the EO and EC. BESS suggests that the coper group may have coping mechanisms to stabilize static postural control compared to the CAI group. The EC may be better to detect static postural instability in the CAI or coper group. © Georg Thieme Verlag KG Stuttgart · New York.

  5. The Cumberland Ankle Instability Tool (CAIT) in the Dutch population with and without complaints of ankle instability.

    PubMed

    Vuurberg, Gwendolyn; Kluit, Lana; van Dijk, C Niek

    2018-03-01

    To develop a translated Dutch version of the Cumberland Ankle Instability Tool (CAIT) and test its psychometric properties in a Dutch population with foot and ankle complaints. The CAIT was translated into the Dutch language using a forward-backward translation design. Of the 130 subsequent patients visiting the outpatient clinic for foot and ankle complaints who were asked to fill out a questionnaire containing the CAIT, the Foot and Ankle Outcome Score (FAOS), and the numeric rating scale (NRS) pain, 98 completed the questionnaire. After a 1-week period, patients were asked to fill out a second questionnaire online containing the CAIT and NRS pain. This second questionnaire was completed by 70 patients. With these data, the construct validity, test-retest reliability, internal consistency, measurement error, and ceiling and floor effects were assessed. Additionally, a cut-off value to discriminate between stable and unstable ankles, in patients with ankle complaints, was calculated. Construct validity showed moderate correlations between the CAIT and FAOS subscales (Spearman's correlation coefficient (SCC) = 0.36-0.43), and the NRS pain (SCC = -0.55). The cut-off value was found at 11.5 points of the total CAIT score (range 0-30). Test-retest reliability showed to be excellent with an intraclass correlation coefficient of 0.94. Internal consistency was high (Cronbach's α = 0.86). No ceiling or floor effects were detected. Based on the results, the Dutch version of the CAIT is a valid and reliable questionnaire to assess ankle instability in the Dutch population and is able to differentiate between a functionally unstable and stable ankle. The tool is the first suitable tool to objectify the severity of ankle instability specific complaints and assess change in the Dutch population. Level of evidence II.

  6. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... top of the talus is dome-shaped and... Softball Injuries to the Foot and Ankle Your feet ... ankles take a beating when you are playing softball. Softball players should be aware of the following ...

  7. Relationships between mechanical joint stability and somatosensory function in individuals with chronic ankle instability.

    PubMed

    Kirby, Jessica L; Houston, Megan N; Gabriner, Michael L; Hoch, Matthew C

    2016-08-01

    Individuals with chronic ankle instability (CAI) have demonstrated alterations in ankle mechanics and deficits in sensory function. However, relationships between mechanical stability and somatosensory function have not been examined, nor have those between somatosensory function and injury history characteristics. Therefore, the objective of this study was to examine relationships between (1) somatosensory function and mechanical stability and (2) somatosensory function and injury history characteristics. Forty adults with CAI volunteered to participate. In a single testing session, participants completed mechanical and sensory assessments in a counterbalanced order. Dependent variables included anterior/posterior displacement (mm), inversion/eversion rotation (°), SWM index values, JPS absolute error (°), number of previous ankle sprains, and number of "giving way" episodes in the previous 3 months. Spearman's Rho correlations examined the relationships between somatosensory function and (1) mechanical stability and (2) injury history characteristics (p<0.05). No significant correlations were identified between any variables (p>0.11), and all r-values were considered weak. These results revealed somatosensory function was not significantly correlated to mechanical stability or injury history characteristics. This indicates peripheral sensory impairments associated with CAI are likely caused by factors other than mechanical stability and injury history characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a meta-analysis of comparative studies.

    PubMed

    Kim, Hyun Jung; Suh, Dong Hun; Yang, Jae Hyuk; Lee, Jin Woo; Kim, Hak Jun; Ahn, Hyeong Sik; Han, Seung Woo; Choi, Gi Won

    2017-01-01

    Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are the main surgical treatment options for end-stage ankle arthritis. Although the superiority of each modality remains debated, there remains a lack of high-quality evidence-based studies, such as randomized controlled clinical trials, and meta-analyses of comparative studies. We performed a meta-analysis of comparative studies to determine whether there is a significant difference between these two procedures in terms of (i) clinical scores and patient satisfaction, (ii) re-operations, and (iii) complications. We conducted a comprehensive search in the MEDLINE, EMBASE, and Cochrane library databases. Only retrospective or prospective comparative studies were included in this meta-analysis. The literature search, data extraction, and quality assessment were conducted by two independent reviewers. The primary outcomes were clinical scores and patient satisfaction. We also investigated the prevalence of complications and the re-operation rate. Ten comparative studies were included (four prospective and six retrospective studies). There were no significant differences between the two procedures in the American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Short Form-36 physical component summary and mental component summary scores, visual analogue scale for pain, and patient satisfaction rate. The risk of re-operation and major surgical complications were significantly increased in the TAA group. The meta-analysis revealed that TAA and AA could achieve similar clinical outcomes, whereas the incidence of re-operation and major surgical complication was significantly increased in TAA. Further studies of high methodological quality with long-term follow-up are required to confirm our conclusions.

  9. Predicted percentage dissatisfied with ankle draft.

    PubMed

    Liu, S; Schiavon, S; Kabanshi, A; Nazaroff, W W

    2017-07-01

    Draft is unwanted local convective cooling. The draft risk model of Fanger et al. (Energy and Buildings 12, 21-39, 1988) estimates the percentage of people dissatisfied with air movement due to overcooling at the neck. There is no model for predicting draft at ankles, which is more relevant to stratified air distribution systems such as underfloor air distribution (UFAD) and displacement ventilation (DV). We developed a model for predicted percentage dissatisfied with ankle draft (PPD AD ) based on laboratory experiments with 110 college students. We assessed the effect on ankle draft of various combinations of air speed (nominal range: 0.1-0.6 m/s), temperature (nominal range: 16.5-22.5°C), turbulence intensity (at ankles), sex, and clothing insulation (<0.7 clo; lower legs uncovered and covered). The results show that whole-body thermal sensation and air speed at ankles are the dominant parameters affecting draft. The seated subjects accepted a vertical temperature difference of up to 8°C between ankles (0.1 m) and head (1.1 m) at neutral whole-body thermal sensation, 5°C more than the maximum difference recommended in existing standards. The developed ankle draft model can be implemented in thermal comfort and air diffuser testing standards. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Seismic velocity structure and microearthquake source properties at The Geysers, California, geothermal area

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    O'Connell, D.R.

    1986-12-01

    The method of progressive hypocenter-velocity inversion has been extended to incorporate S-wave arrival time data and to estimate S-wave velocities in addition to P-wave velocities. S-wave data to progressive inversion does not completely eliminate hypocenter-velocity tradeoffs, but they are substantially reduced. Results of a P and S-wave progressive hypocenter-velocity inversion at The Geysers show that the top of the steam reservoir is clearly defined by a large decrease of V/sub p//V/sub s/ at the condensation zone-production zone contact. The depth interval of maximum steam production coincides with minimum observed V/sub p//V/sub s/, and V/sub p//V/sub s/ increses below the shallowmore » primary production zone suggesting that reservoir rock becomes more fluid saturated. The moment tensor inversion method was applied to three microearthquakes at The Geysers. Estimated principal stress orientations were comparable to those estimated using P-wave firstmotions as constraints. Well constrained principal stress orientations were obtained for one event for which the 17 P-first motions could not distinguish between normal-slip and strike-slip mechanisms. The moment tensor estimates of principal stress orientations were obtained using far fewer stations than required for first-motion focal mechanism solutions. The three focal mechanisms obtained here support the hypothesis that focal mechanisms are a function of depth at The Geysers. Progressive inversion as developed here and the moment tensor inversion method provide a complete approach for determining earthquake locations, P and S-wave velocity structure, and earthquake source mechanisms.« less

  11. Overuse ankle injuries in professional Irish dancers.

    PubMed

    Walls, R J; Brennan, S A; Hodnett, P; O'Byrne, J M; Eustace, S J; Stephens, M M

    2010-03-01

    Overuse ankle injuries have been described in elite athletes and professional ballet dancers however the spectrum of injuries experienced by professional Irish dancers has not been defined. A troupe of actively performing dancers from an Irish-dance show were recruited (eight male, ten female; mean age, 26 years). The prevalence of overuse injuries in the right ankle was determined from magnetic resonance imaging. Foot and ankle self-report questionnaires were also completed (AOFAS and FAOS). Only three ankles were considered radiologically normal. Achilles tendinopathy, usually insertional, was the most frequent observation (n=14) followed by plantar fasciitis (n=7), bone oedema (n=2) and calcaneocuboid joint degeneration (n=2). There were limited correlations between MRI patterns and clinical scores indicating that many conditions are sub-clinical. Dancers with ankle pain had poor low (p=0.004) and high (p=0.013) level function. Overuse ankle injuries are common in Irish dancers. Incorporating eccentric exercises and plantar fascia stretching into a regular training program may benefit this population. Copyright 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  12. Modelling of human walking to optimise the function of ankle-foot orthosis in Guillan-Barré patients with drop foot.

    PubMed

    Jamshidi, N; Rostami, M; Najarian, S; Menhaj, M B; Saadatnia, M; Firooz, S

    2009-04-01

    This paper deals with the dynamic modelling of human walking. The main focus of this research was to optimise the function of the orthosis in patients with neuropathic feet, based on the kinematics data from different categories of neuropathic patients. The patient's body on the sagittal plane was modelled for calculating the torques generated in joints. The kinematics data required for mathematical modelling of the patients were obtained from the films of patients captured by high speed camera, and then the films were analysed through a motion analysis software. An inverse dynamic model was used for estimating the spring coefficient. In our dynamic model, the role of muscles was substituted by adding a spring-damper between the shank and ankle that could compensate for their weakness by designing ankle-foot orthoses based on the kinematics data obtained from the patients. The torque generated in the ankle was varied by changing the spring constant. Therefore, it was possible to decrease the torque generated in muscles which could lead to the design of more comfortable and efficient orthoses. In this research, unlike previous research activities, instead of studying the abnormal gait or modelling the ankle-foot orthosis separately, the function of the ankle-foot orthosis on the abnormal gait has been quantitatively improved through a correction of the torque.

  13. Advanced Multivariate Inversion Techniques for High Resolution 3D Geophysical Modeling (Invited)

    NASA Astrophysics Data System (ADS)

    Maceira, M.; Zhang, H.; Rowe, C. A.

    2009-12-01

    We focus on the development and application of advanced multivariate inversion techniques to generate a realistic, comprehensive, and high-resolution 3D model of the seismic structure of the crust and upper mantle that satisfies several independent geophysical datasets. Building on previous efforts of joint invesion using surface wave dispersion measurements, gravity data, and receiver functions, we have added a fourth dataset, seismic body wave P and S travel times, to the simultaneous joint inversion method. We present a 3D seismic velocity model of the crust and upper mantle of northwest China resulting from the simultaneous, joint inversion of these four data types. Surface wave dispersion measurements are primarily sensitive to seismic shear-wave velocities, but at shallow depths it is difficult to obtain high-resolution velocities and to constrain the structure due to the depth-averaging of the more easily-modeled, longer-period surface waves. Gravity inversions have the greatest resolving power at shallow depths, and they provide constraints on rock density variations. Moreover, while surface wave dispersion measurements are primarily sensitive to vertical shear-wave velocity averages, body wave receiver functions are sensitive to shear-wave velocity contrasts and vertical travel-times. Addition of the fourth dataset, consisting of seismic travel-time data, helps to constrain the shear wave velocities both vertically and horizontally in the model cells crossed by the ray paths. Incorporation of both P and S body wave travel times allows us to invert for both P and S velocity structure, capitalizing on empirical relationships between both wave types’ seismic velocities with rock densities, thus eliminating the need for ad hoc assumptions regarding the Poisson ratios. Our new tomography algorithm is a modification of the Maceira and Ammon joint inversion code, in combination with the Zhang and Thurber TomoDD (double-difference tomography) program.

  14. Mixing properties of coaxial jets with large velocity ratios and large inverse density ratios

    NASA Astrophysics Data System (ADS)

    Alexander Schumaker, S.; Driscoll, James F.

    2012-05-01

    An experimental study was conducted to better understand the mixing properties of coaxial jets as several parameters were systematically varied, including the velocity ratio, density ratio, and the Reynolds number. Diameters of the inner and outer jet were also varied. Coaxial jets are commonly used to mix fluids due to the simplicity of their geometry and the rapid mixing that they provide. A measure of the overall mixing efficiency is the stoichiometric mixing length (Ls), which is the distance along the jet centerline where the two fluids have mixed to some desired concentration, which was selected to be the stoichiometric concentration for H2/O2 and CH4/O2 in this case. For 56 cases, the profiles of mean mixture fraction, rms mixture fraction fluctuations (unmixedness), and Ls were measured using acetone planar laser induced fluorescence diagnostics. Results were compared to three mixing models. The entrainment model of Villermaux and Rehab showed good agreement with the data, indicating that the proper non-dimensional scaling parameter is the momentum flux ratio M. The work extends the existing database of coaxial jet scalar mixing properties because it considers the specific regime of large values of both the velocity ratio and the inverse density ratio, which is the regime in which rocket injectors operate. Also the work focuses on the mixing up to Ls where previous work focused on the mixing up to the end of the inner core. The Reynolds numbers achieved for a number of cases were considerably larger than previous gas mixing studies, which insures that the jet exit boundary conditions are fully turbulent.

  15. A simple model to estimate plantarflexor muscle-tendon mechanics and energetics during walking with elastic ankle exoskeletons

    PubMed Central

    Sawicki, Gregory S.; Khan, Nabil S.

    2016-01-01

    Goal A recent experiment demonstrated that when humans wear unpowered elastic ankle exoskeletons with intermediate spring stiffness they can reduce their metabolic energy cost to walk by ~7%. Springs that are too compliant or too stiff have little benefit. The purpose of this study was to use modeling and simulation to explore the muscle-level mechanisms for the ‘sweet-spot’ in stiffness during exoskeleton assisted walking. Methods We developed a simple lumped, uniarticular musculoskeletal model of the plantarflexors operating in parallel with an elastic ‘exo-tendon’. Using an inverse approach with constrained kinematics and kinetics, we rapidly simulated human walking over a range of exoskeleton stiffness values and examined the underlying neuromechanics and energetics of the biological plantarflexors. Results Stiffer ankle exoskeleton springs resulted in larger decreases in plantarflexor muscle forces, activations and metabolic energy consumption. However, in the process of unloading the compliant biological muscle-tendon unit (MTU), the muscle fascicles (CE) experienced larger excursions that negatively impacted series elastic element (SEE) recoil that is characteristic of a tuned ‘catapult mechanism’. Conclusion The combination of disrupted muscle-tendon dynamics and the need to produce compensatory forces/moments to maintain overall net ankle moment invariance could explain the ‘sweet spot’ in metabolic performance at intermediate ankle exoskeleton stiffness. Future work will aim to provide experimental evidence to support the model predictions presented here using ultrasound imaging of muscle-level dynamics during walking with elastic ankle exoskeletons. Significance Engineers must account for the muscle-level effects of exoskeleton designs in order to achieve maximal performance objectives. PMID:26485350

  16. Differences in in vivo muscle fascicle and tendinous tissue behavior between the ankle plantarflexors during running.

    PubMed

    Lai, A K M; Lichtwark, G A; Schache, A G; Pandy, M G

    2018-03-30

    The primary human ankle plantarflexors, soleus (SO), medial gastrocnemius (MG), and lateral gastrocnemius (LG) are typically regarded as synergists and play a critical role in running. However, due to differences in muscle-tendon architecture and joint articulation, the muscle fascicles and tendinous tissue of the plantarflexors may exhibit differences in their behavior and interactions during running. We combined in vivo dynamic ultrasound measurements with inverse dynamics analyses to identify and explain differences in muscle fascicle, muscle-tendon unit, and tendinous tissue behavior of the primary ankle plantarflexors across a range of steady-state running speeds. Consistent with their role as a force generator, the muscle fascicles of the uniarticular SO shortened less rapidly than the fascicles of the MG during early stance. Furthermore, the MG and LG exhibited delays in tendon recoil during the stance phase, reflecting their ability to transfer power and work between the knee and ankle via tendon stretch and storage of elastic strain energy. Our findings add to the growing body of evidence surrounding the distinct mechanistic functions of uni- and biarticular muscles during dynamic movements. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Total ankle replacement systems available in the United States.

    PubMed

    Coetzee, J Chris; Deorio, James K

    2010-01-01

    Ankle replacement continues to be a viable option for treating patients with ankle arthritis. Over the past 10 years, there has been a significant increase in the number of ankle replacement systems available for use. Current controversy centers on whether fixed- or mobile-bearing devices are most advantageous. Most total ankle systems used outside the United States are mobile-bearing devices, whereas ankle replacement systems used in the United States are all essentially fixed-bearing devices. Not all ankles with degenerative changes are amenable to replacement surgery, and several exclusion criteria are well documented. Ankle replacement is especially complicated because of the ankle's proximity to the foot and the important role that the balance and alignment of the foot play in the success of the ankle replacement. Foot deformities should be treated before or at the time of ankle replacement surgery. Ignoring foot deformities can lead to failure of the ankle replacement. It is also of paramount importance to consider the stability of the ankle ligaments. An unstable ankle with a varus or valgus deformity of more than 20 degrees is probably not amenable to ankle replacement. There are currently no reliable options to predictably reconstruct the lateral or medial ligaments in these severe deformities. It is important to be aware of the ankle replacement systems currently available in the United States and understand the key features of each design. Devices approved by the US Food and Drug Administration, a device that is awaiting approval, and a device that is being evaluated by the Food and Drug Administration in a prospective randomized clinical trial are discussed, along with an objective comparison of fixed- and mobile-bearing devices.

  18. Velocity Structure of the Iran Region Using Seismic and Gravity Observations

    NASA Astrophysics Data System (ADS)

    Syracuse, E. M.; Maceira, M.; Phillips, W. S.; Begnaud, M. L.; Nippress, S. E. J.; Bergman, E.; Zhang, H.

    2015-12-01

    We present a 3D Vp and Vs model of Iran generated using a joint inversion of body wave travel times, Rayleigh wave dispersion curves, and high-wavenumber filtered Bouguer gravity observations. Our work has two main goals: 1) To better understand the tectonics of a prominent example of continental collision, and 2) To assess the improvements in earthquake location possible as a result of joint inversion. The body wave dataset is mainly derived from previous work on location calibration and includes the first-arrival P and S phases of 2500 earthquakes whose initial locations qualify as GT25 or better. The surface wave dataset consists of Rayleigh wave group velocity measurements for regional earthquakes, which are inverted for a suite of period-dependent Rayleigh wave velocity maps prior to inclusion in the joint inversion for body wave velocities. We use gravity anomalies derived from the global gravity model EGM2008. To avoid mapping broad, possibly dynamic features in the gravity field intovariations in density and body wave velocity, we apply a high-pass wavenumber filter to the gravity measurements. We use a simple, approximate relationship between density and velocity so that the three datasets may be combined in a single inversion. The final optimized 3D Vp and Vs model allows us to explore how multi-parameter tomography addresses crustal heterogeneities in areas of limited coverage and improves travel time predictions. We compare earthquake locations from our models to independent locations obtained from InSAR analysis to assess the improvement in locations derived in a joint-inversion model in comparison to those derived in a more traditional body-wave-only velocity model.

  19. Peculiarities in Ankle Cartilage.

    PubMed

    Kraeutler, Matthew J; Kaenkumchorn, Tanyaporn; Pascual-Garrido, Cecilia; Wimmer, Markus A; Chubinskaya, Susanna

    2017-01-01

    Posttraumatic osteoarthritis (PTOA) is the most common form of osteoarthritis (OA) of the ankle joint. PTOA occurs as a result of several factors, including the poor regenerative capacity of hyaline articular cartilage as well as increased contact stresses following trauma. The purpose of this article is to review the epidemiology, pathogenesis, and potential targets for treatment of PTOA in the ankle joint. Previous reviews primarily addressed clinical approaches to ankle PTOA, while the focus of the current article will be specifically on the newly acquired knowledge of the cellular mechanisms that drive PTOA in the ankle joint and means for potential targeted therapeutics that might halt the progression of cartilage degeneration and/or improve the outcome of surgical interventions. Three experimental treatment strategies are discussed in this review: (1) increasing the anabolic potential of chondrocytes through treatment with growth factors such as bone morphogenetic protein-7; (2) limiting chondrocyte cell death either through the protection of cell membrane with poloxamer 188 or inhibiting activity of intracellular proteases, caspases, which are responsible for cell death by apoptosis; and (3) inhibiting catabolic/inflammatory responses of chondrocytes by treating them with anti-inflammatory agents such as tumor necrosis factor-α antagonists. Future studies should focus on identifying the appropriate timing for treatment and an appropriate combination of anti-inflammatory, chondro- and matrix-protective biologics to limit the progression of trauma-induced cartilage degeneration and prevent the development of PTOA in the ankle joint.

  20. Functional ankle control of rock climbers

    PubMed Central

    Schweizer, A; Bircher, H; Kaelin, X; Ochsner, P

    2005-01-01

    Objective: To evaluate whether rock climbing type exercise would be of value in rehabilitating ankle injuries to improve ankle stability and coordination. Results: The rock climbers showed significantly better results in the stabilometry and greater absolute and relative maximum strength of flexion in the ankle. The soccer players showed greater absolute but not relative strength in extension. Conclusion: Rock climbing, because of its slow and controlled near static movements, may be of value in the treatment of functional ankle instability. However, it has still to be confirmed whether it is superior to the usual rehabilitation exercises such as use of the wobble board. PMID:15976164

  1. A Survey of Parachute Ankle Brace Breakages

    DTIC Science & Technology

    2008-01-10

    experience an ankle fracture , and 1.75 times more likely to experience an ankle injury of any type. Injuries to other parts of the lower body...A SURVEY OF PARACHUTE ANKLE BRACE BREAKAGES USACHPPM REPORT NO. 12-MA01Q2A-08 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704...CONTRACT NUMBER 5b. GRANT NUMBER 4. TITLE AND SUBTITLE A Survey of Parachute Ankle Brace Breakages 5c. PROGRAM ELEMENT NUMBER 5d. PROJECT NUMBER

  2. The Effect of Velocity of Joint Mobilization on Corticospinal Excitability in Individuals With a History of Ankle Sprain.

    PubMed

    Fisher, Beth E; Piraino, Andrew; Lee, Ya-Yun; Smith, Jo Armour; Johnson, Sean; Davenport, Todd E; Kulig, Kornelia

    2016-07-01

    Study Design Controlled laboratory study. Background Joint mobilization and manipulation decrease pain and improve patient function. Yet, the processes underlying these changes are not well understood. Measures of corticospinal excitability provide insight into potential mechanisms mediated by the central nervous system. Objectives To investigate the differential effects of joint mobilization and manipulation at the talocrural joint on corticospinal excitability in individuals with resolved symptoms following ankle sprain. Methods Twenty-seven participants with a history of ankle sprain were randomly assigned to the control, joint mobilization, or thrust manipulation group. The motor-evoked potential (MEP) and cortical silent period (CSP) of the tibialis anterior and gastrocnemius were obtained with transcranial magnetic stimulation at rest and during active contraction of the tibialis anterior. The slopes of MEP/CSP input/output curves and the maximal MEP/CSP values were calculated to indicate corticospinal excitability. Behavioral measures, including ankle dorsiflexion and dynamic balance, were evaluated. Results A repeated-measures analysis of variance of the MEP slope showed a significant group-by-time interaction for the tibialis anterior at rest (P = .002) and during active contraction (P = .042). After intervention, the thrust manipulation group had an increase in corticospinal excitability, while the corticospinal excitability decreased in the mobilization group. The thrust manipulation group, but not other groups, also demonstrated a significant increase in the maximal MEP amplitude of the tibialis anterior after intervention. Conclusion The findings suggest that joint manipulation and mobilization have different effects on corticospinal excitability. The increased corticospinal excitability following thrust manipulation may provide a window for physical therapists to optimize muscle recruitment and subsequently movement. The trial was registered at

  3. Effects of repeated ankle stretching on calf muscle-tendon and ankle biomechanical properties in stroke survivors

    PubMed Central

    Gao, Fan; Ren, Yupeng; Roth, Elliot J.; Harvey, Richard; Zhang, Li-Qun

    2011-01-01

    Background The objective of this study was to investigate changes in active and passive biomechanical properties of the calf muscle-tendon unit induced by controlled ankle stretching in stroke survivors. Methods Ten stroke survivors with ankle spasticity/contracture and ten healthy control subjects received intervention of 60-min ankle stretching. Joint biomechanical properties including resistance torque, stiffness and index of hysteresis were evaluated pre- and post-intervention. Achilles tendon length was measured using ultrasonography. The force output of the triceps surae muscles was characterized via the torque-angle relationship, by stimulating the calf muscles at a controlled intensity across different ankle positions. Findings Compared to healthy controls, the ankle position corresponding to the peak torque of the stroke survivors was shifted towards plantar flexion (P<0.001). Stroke survivors showed significantly higher resistance torques and joint stiffness (P<0.05), and these higher resistances were reduced significantly after the stretching intervention, especially in dorsiflexion (P = 0.013). Stretching significantly improved the force output of the impaired calf muscles in stroke survivors under matched stimulations (P<0.05). Ankle range of motion was also increased by stretching (P<0.001). Interpretation At the joint level, repeated stretching loosened the ankle joint with increased passive joint range of motion and decreased joint stiffness. At the muscle-tendon level, repeated stretching improved calf muscle force output, which might be associated with decreased muscle fascicle stiffness, increased fascicle length and shortening of the Achilles tendon. The study provided evidence of improvement in muscle tendon properties through stretching intervention. PMID:21211873

  4. Paratrooper's Ankle Fracture: Posterior Malleolar Fracture

    PubMed Central

    Young, Ki Won; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-01-01

    Background We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Methods Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. Results The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Conclusions Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were

  5. Paratrooper's ankle fracture: posterior malleolar fracture.

    PubMed

    Young, Ki Won; Kim, Jin-su; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-03-01

    We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to

  6. Force and displacement measurements of the distal fibula during simulated ankle loading tests for high ankle sprains.

    PubMed

    Markolf, Keith L; Jackson, Steven; McAllister, David R

    2012-09-01

    Syndesmosis (high ankle) sprains produce disruption of the distal tibiofibular ligaments. Forces on the distal fibula that produce these injuries are unknown. Twenty-seven fresh-frozen lower extremities were used for this study. A load cell recorded forces acting on the distal fibula from forced ankle dorsiflexion and applied external foot torque; medial-lateral and anterior-posterior displacements of the distal fibula were recorded. Fibular forces and axial displacements were also recorded with applied axial force. During forced ankle dorsiflexion and external foot torque tests, the distal fibula always displaced posteriorly with respect to the tibia with no measurable medial-lateral displacement. With 10 Nm dorsiflexion moment, cutting the tibiofibular ligaments approximately doubled fibular force and displacement values. Cutting the tibiofibular ligaments significantly increased fibular displacement from applied external foot torque. Fibular forces and axial displacements from applied axial weight-bearing force were highest with the foot dorsiflexed. The highest mean fibular force in the study (271.9 N) occurred with 10 Nm external foot torque applied to a dorsiflexed foot under 1000 N axial force. Two important modes of loading that could produce high ankle sprains were identified: forced ankle dorsiflexion and external foot torque applied to a dorsiflexed ankle loaded with axial force. The distal tibiofibular ligaments restrained fibular displacement during these tests. Residual mortise widening observed at surgery may be the result of tibiofibular ligament injuries caused by posterior displacement of the fibula. Therefore, a syndesmosis screw used to fix the fibula would be subjected to posterior bending forces from these loading modes. Ankle bracing to prevent extreme ankle dorsiflexion during rehabilitation may be advisable to prevent excessive fibular motions that could affect syndesmosis healing.

  7. Comparative gait analysis of ankle arthrodesis and arthroplasty: initial findings of a prospective study.

    PubMed

    Hahn, Michael E; Wright, Elise S; Segal, Ava D; Orendurff, Michael S; Ledoux, William R; Sangeorzan, Bruce J

    2012-04-01

    Little is known about functional outcomes of ankle arthroplasty compared with arthrodesis. This study compared pre-surgical and post-surgical gait measures in both patient groups. Eighteen patients with end-stage ankle arthritis participated in an ongoing longitudinal study (pre-surgery, 12 months post-surgery) involving gait analysis, assessment of pain and physical function. Outcome measures included temporal-distance, kinematic and kinetic data, the Short Form 36 (SF-36) body pain score, and average daily step count. A mixed effects linear model was used to detect effects of surgical group (arthrodesis and arthroplasty, n = 9 each) with walking speed as a covariate (α = 0.05). Both groups were similar in demographics and anthropometrics. Followup time was the same for each group. There were no complications in either group. Pain decreased (p < 0.001) and gait function improved (gait velocity, p = 0.02; stride length, p = 0.035) in both groups. Neither group increased average daily step count. Joint range of motion (ROM) differences were observed between groups after surgery (increased hip ROM in arthrodesis, p = 0.001; increased ankle ROM in arthroplasty, p = 0.036). Peak plantar flexor moment increased in arthrodesis patients and decreased in arthroplasty patients (p = 0.042). Initial findings of this ongoing clinical study indicate pain reduction and improved gait function 12 months after surgery for both treatments. Arthroplasty appears to regain more natural ankle joint function, with increased ROM. Long-term follow up should may reveal more clinically meaningful differences.

  8. Two genetic loci associated with ankle injury.

    PubMed

    Kim, Stuart K; Kleimeyer, John P; Ahmed, Marwa A; Avins, Andrew L; Fredericson, Michael; Dragoo, Jason L; Ioannidis, John P A

    2017-01-01

    Ankle injuries, including sprains, strains and other joint derangements and instability, are common, especially for athletes involved in indoor court or jumping sports. Identifying genetic loci associated with these ankle injuries could shed light on their etiologies. A genome-wide association screen was performed using publicly available data from the Research Program in Genes, Environment and Health (RPGEH) including 1,694 cases of ankle injury and 97,646 controls. An indel (chr21:47156779:D) that lies close to a collagen gene, COL18A1, showed an association with ankle injury at genome-wide significance (p = 3.8x10-8; OR = 1.99; 95% CI = 1.75-2.23). A second DNA variant (rs13286037 on chromosome 9) that lies within an intron of the transcription factor gene NFIB showed an association that was nearly genome-wide significant (p = 5.1x10-8; OR = 1.63; 95% CI = 1.46-1.80). The ACTN3 R577X mutation was previously reported to show an association with acute ankle sprains, but did not show an association in this cohort. This study is the first genome-wide screen for ankle injury that yields insights regarding the genetic etiology of ankle injuries and provides DNA markers with the potential to inform athletes about their genetic risk for ankle injury.

  9. Two genetic loci associated with ankle injury

    PubMed Central

    Kleimeyer, John P.; Ahmed, Marwa A.; Avins, Andrew L.; Fredericson, Michael; Dragoo, Jason L.; Ioannidis, John P. A.

    2017-01-01

    Ankle injuries, including sprains, strains and other joint derangements and instability, are common, especially for athletes involved in indoor court or jumping sports. Identifying genetic loci associated with these ankle injuries could shed light on their etiologies. A genome-wide association screen was performed using publicly available data from the Research Program in Genes, Environment and Health (RPGEH) including 1,694 cases of ankle injury and 97,646 controls. An indel (chr21:47156779:D) that lies close to a collagen gene, COL18A1, showed an association with ankle injury at genome-wide significance (p = 3.8x10-8; OR = 1.99; 95% CI = 1.75–2.23). A second DNA variant (rs13286037 on chromosome 9) that lies within an intron of the transcription factor gene NFIB showed an association that was nearly genome-wide significant (p = 5.1x10-8; OR = 1.63; 95% CI = 1.46–1.80). The ACTN3 R577X mutation was previously reported to show an association with acute ankle sprains, but did not show an association in this cohort. This study is the first genome-wide screen for ankle injury that yields insights regarding the genetic etiology of ankle injuries and provides DNA markers with the potential to inform athletes about their genetic risk for ankle injury. PMID:28957384

  10. Biomechanics of the ankle-foot system during stair ambulation: implications for design of advanced ankle-foot prostheses.

    PubMed

    Sinitski, Emily H; Hansen, Andrew H; Wilken, Jason M

    2012-02-02

    Unilateral lower limb prosthesis users display temporal, kinematic, and kinetic asymmetries between limbs while ascending and descending stairs. These asymmetries are due, in part, to the inability of current prosthetic devices to effectively mimic normal ankle function. The purpose of this study was to provide a comprehensive set of biomechanical data for able-bodied and unilateral transtibial amputee (TTA) ankle-foot systems for level-ground (LG), stair ascent (SA), and stair descent (SD), and to characterize deviations from normal performance associated with prosthesis use. Ankle joint kinematics, kinetics, torque-angle curves, and effective shapes were calculated for twelve able-bodied individuals and twelve individuals with TTA. The data from this study demonstrated the prosthetic limb can more effectively mimic the range of motion and power output of a normal ankle-foot during LG compared to SA and SD. There were larger differences between the prosthetic and able-bodied limbs during SA and SD, most evident in the torque-angle curves and effective shapes. These data can be used by persons designing ankle-foot prostheses and provide comparative data for assessment of future ankle-foot prosthesis designs. Published by Elsevier Ltd.

  11. Effects of 2 ankle destabilization devices on electromyography measures during functional exercises in individuals with chronic ankle instability.

    PubMed

    Donovan, Luke; Hart, Joseph M; Hertel, Jay

    2015-03-01

    Randomized crossover laboratory study. To determine the effects of ankle destabilization devices on surface electromyography (sEMG) measures of selected lower extremity muscles during functional exercises in participants with chronic ankle instability. Ankle destabilization devices are rehabilitation tools that can be worn as a boot or sandal to increase lower extremity muscle activation during walking in healthy individuals. However, they have not been tested in a population with pathology. Fifteen adults with chronic ankle instability participated. Surface electromyography electrodes were located over the anterior tibialis, fibularis longus, lateral gastrocnemius, rectus femoris, biceps femoris, and gluteus medius. The activity level of these muscles was recorded in a single testing session during unipedal stance with eyes closed, the Star Excursion Balance Test, lateral hops, and treadmill walking. Each task was performed under 3 conditions: shod, ankle destabilization boot, and ankle destabilization sandal. Surface electromyography signal amplitudes were measured for each muscle during each exercise for all 3 conditions. Participants demonstrated a significant increase, with moderate to large effect sizes, in sEMG signal amplitude of the fibularis longus in the ankle destabilization boot and ankle destabilization sandal conditions during the unipedal eyes-closed balance test, the Star Excursion Balance Test in the anterior and posteromedial directions, lateral hops, and walking, when compared to the shod condition. Both devices also resulted in an increase in sEMG signal amplitudes, with large effect sizes of the lateral gastrocnemius, rectus femoris, biceps femoris, and gluteus medius during the unipedal-stance-with-eyes-closed test, compared to the shod condition. Wearing ankle destabilization devices caused greater muscle activation during functional exercises in individuals with chronic ankle instability. Based on the magnitude of the effect, there were

  12. [Eleven-Year Experience with Total Ankle Arthroplasty].

    PubMed

    Popelka, S; Sosna, A; Vavřík, P; Jahoda, D; Barták, V; Landor, I

    2016-01-01

    PURPOSE OF THE STUDY Total joint replacement is one of the options in surgical treatment of advanced ankle arthritis. It allows the ankle to remain mobile but, unfortunately, it does not provide the same longevity as total knee or hip replacements. Therefore, decisions concerning the kind of treatment are very individual and depend on the clinical status and opinion of each patient. MATERIAL AND METHODS A total of 132 total ankle replacements were carried out in the period from 2004 to 2015. The prostheses used included the Ankle Evolutive System (AES) in 52 patients, Mobility Total Ankle System (DePuy) in 24 patients and, recently, Rebalance Total Ankle Replacement implant in 53 patients. Three patients allergic to metal received the Taric prosthesis. Revision arthroplasty using the Hintegra prosthesis was carried out in four patients. The outcome of arthroplasty was evaluated on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale. Indications for total ankle arthroplasty included post-traumatic arthritis in 83 patients, rheumatoid arthritis in 37 and primary arthritis in 12 patients. There were 78 women and 54 men, with an average age of 55.6 years at the time of surgery. RESULTS The average follow-up was 6.1 years (1-11 years). The average AOFAS score of the whole group increased from 33.2 before surgery to 82.5 after it. The primary indication had an important role. Arthroplasty outcomes were poorer in patients with post-traumatic arthritis than in those with rheumatoid arthritis or primary arthritis. In patients with post-traumatic arthritis, the average AOFAS score rose to 78.6 due to restricted motion of the ankle, and some patients continued to have pain when walking. The average AOFAS score in a total of 49 patients who had rheumatoid arthritis or primary arthritis reached a value of 86.4. Post-operative complications were recorded in ten patients (7.6%) in whom part of the wound was healing by second intention. Ossification was also a

  13. Rayleigh wave nonlinear inversion based on the Firefly algorithm

    NASA Astrophysics Data System (ADS)

    Zhou, Teng-Fei; Peng, Geng-Xin; Hu, Tian-Yue; Duan, Wen-Sheng; Yao, Feng-Chang; Liu, Yi-Mou

    2014-06-01

    Rayleigh waves have high amplitude, low frequency, and low velocity, which are treated as strong noise to be attenuated in reflected seismic surveys. This study addresses how to identify useful shear wave velocity profile and stratigraphic information from Rayleigh waves. We choose the Firefly algorithm for inversion of surface waves. The Firefly algorithm, a new type of particle swarm optimization, has the advantages of being robust, highly effective, and allows global searching. This algorithm is feasible and has advantages for use in Rayleigh wave inversion with both synthetic models and field data. The results show that the Firefly algorithm, which is a robust and practical method, can achieve nonlinear inversion of surface waves with high resolution.

  14. Single-leg drop landing movement strategies 6 months following first-time acute lateral ankle sprain injury.

    PubMed

    Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E

    2015-12-01

    No research exists predicating a link between acute ankle sprain injury-affiliated movement patterns and those of chronic ankle instability (CAI) populations. The aim of the current study was to perform a biomechanical analysis of participants, 6 months after they sustained a first-time acute lateral ankle sprain (LAS) injury to establish this link. Fifty-seven participants with a 6-month history of first-time LAS and 20 noninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment of force) data were acquired for the joints of the lower extremity, from 200 ms pre-initial contact (IC) to 200 ms post-IC. Individual joint stiffnesses and the peak magnitude of the vertical component of the ground reaction force (GRF) were also computed. LAS participants displayed increases in hip flexion and ankle inversion on their injured limb (P < 0.05); this coincided with a reduction in the net flexion-extension moment at the hip joint, with an increase in its stiffness (P < 0.05). There was no difference in the magnitude of the peak vertical GRF for either limb compared with controls. These results demonstrate that altered movement strategies persist in participants, 6 months following acute LAS, which may precipitate the onset of CAI. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. [Posterior ankle impingement syndrome].

    PubMed

    Bojanić, Ivan; Janjić, Tamara; Dimnjaković, Damjan; Križan, Sanja; Smoljanović, Tomislav

    2015-01-01

    Posterior ankle impingement syndrome (PAIS) is a clinical syndrome characterized by posterior ankle pain which occurs in maximal forced plantar flexion of the foot. PAIS can be the result of an acute injury of the ankle, which is more often in general population, or it can be the result of the overuse syndrome, which is more often in athletes and ballet dancers. The etiology of PAIS may involve bony structures or soft tissue structures, or, more often, the combination of both. The diagnosis of PAIS is based on patient's clinical history and physical examination with the hyperplantarflexion test as a very important part of it. Physical examination should be completed with imaging techniques, which most often include magnetic resonance imaging (MRI) or computed tomography (CT) to confirm the diagnosis of PAIS. Conservative treatment is recommended as the primary treatment strategy. In those cases where 3 to 6 months of conservative treatment fails, open or, more often, arthroscopic/endoscopic surgery may be recommended. Nowadays, a 2-portal endoscopic approach introduced by van Dijk et al. in 2000 is the method of choice for the treatment of posterior ankle impingement syndrome.

  16. [Lateral instability of the upper ankle joint].

    PubMed

    Harrasser, N; Eichelberg, K; Pohlig, F; Waizy, H; Toepfer, A; von Eisenhart-Rothe, R

    2016-11-01

    Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments. Arthroscopic techniques offer the advantage of joint inspection and addressing intra-articular pathologies in combination with ligament repair. Accompanying pathologies must be adequately addressed during ligament repair to avoid persistent ankle discomfort. If syndesmotic insufficiency and tibiofibular instability are suspected, the objective should be early diagnosis with MRI and surgical repair.

  17. The management of failed ankle replacement.

    PubMed

    Kotnis, R; Pasapula, C; Anwar, F; Cooke, P H; Sharp, R J

    2006-08-01

    Advances in the design of the components for total ankle replacement have led to a resurgence of interest in this procedure. Between January 1999 and December 2004, 16 patients with a failed total ankle replacement were referred to our unit. In the presence of infection, a two-stage salvage procedure was planned. The first involved the removal of the components and the insertion of a cement spacer. Definitive treatment options included hindfoot fusion with a circular frame or amputation. When there was no infection, a one-stage salvage procedure was planned. Options included hindfoot fusion with an intramedullary nail or revision total ankle replacement. When there was suspicion of infection, a percutaneous biopsy was performed. The patients were followed up for a minimum of 12 months. Of the 16 patients, 14 had aseptic loosening, five of whom underwent a revision total ankle replacement and nine a hindfoot fusion. Of the two with infection, one underwent fusion and the other a below-knee amputation. There were no cases of wound breakdown, nonunion or malunion. Management of the failed total ankle replacement should be performed by experienced surgeons and ideally in units where multidisciplinary support is available. Currently, a hindfoot fusion appears to be preferable to a revision total ankle replacement.

  18. Trends in Ankle Arthroscopy and Its Use in the Management of Pathologic Conditions of the Lateral Ankle in the United States: A National Database Study.

    PubMed

    Werner, Brian C; Burrus, M Tyrrell; Park, Joseph S; Perumal, Venkat; Gwathmey, F Winston

    2015-07-01

    This study aimed to investigate current trends in ankle arthroscopy across time, sex, age, and region of the United States as well as the use of ankle arthroscopy in the management of lateral ankle instability. Patients who underwent ankle arthroscopy and those who underwent ankle arthroscopy and lateral ankle ligament repair or peroneal retinacular repair from 2007 through 2011 were identified using the PearlDiver national database. These searches yielded volumes of unique patients, sex and age distribution, and regional volumes of patients. Χ-square linear-by-linear association analysis was used for comparisons, with P < .05 considered significant. We identified 15,366 ankle arthroscopy procedures in the database from 2007 to 2011. Over the 5-year study period, there was a significant increase in the overall number of ankle arthroscopies being performed, from 2,814 in 2007 to 3,314 in 2011 (P < .0001). Female patients had ankle arthroscopy more frequently than did male patients (P = .027). The majority of patients who had ankle arthroscopy were between the ages of 30 and 49 years. The use of ankle arthroscopy during lateral ligament repair procedures increased from 37.2% in 2007 to 43.7% in 2011 (P < .0001). The incidence of combined ankle arthroscopy and peroneal tendon retinacular repair increased 50%, from 2.8/100 ankle arthroscopies in 2007 to 4.2/100 ankle arthroscopies in 2011 (P < .0001). The incidence of ankle arthroscopy increased significantly from 2007 to 2011, outpacing shoulder, knee, and elbow arthroscopy. Ankle arthroscopy was performed more frequently in female patients and most commonly in patients younger than 50 years. The use of ankle arthroscopy in the surgical management of lateral ankle instability also increased significantly. The incidence of concomitant ankle arthroscopy and lateral ligament repair increased significantly, as did the incidence of concomitant ankle arthroscopy and repair of peroneal tendon subluxation. Level IV

  19. Neuromuscular control and rehabilitation of the unstable ankle

    PubMed Central

    Hung, You-jou

    2015-01-01

    Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. However, there is no consensus on whether the neuromuscular control and proprioception are compromised in unstable ankles. To reduce the prevalence of ankle sprains, the effectiveness of engaging balance training to enhance the neuromuscular control and proprioception of the ankle joint is also questionable. PMID:26085985

  20. Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments

    PubMed Central

    Crevoisier, Xavier; Assal, Mathieu; Stanekova, Katarina

    2016-01-01

    The pathogenesis of hallux valgus deformity is multifactorial. Conservative treatment can alleviate pain but is unable to correct the deformity. Surgical treatment must be adapted to the type and severity of the deformity. Success of surgical treatment ranges from 80% to 95%, and complication rates range from 10% to 30%. Ankle osteoarthrosis most commonly occurs as a consequence of trauma. Ankle arthrodesis and total ankle replacement are the most common surgical treatments of end stage ankle osteoarthrosis. Both types of surgery result in similar clinical improvement at midterm; however, gait analysis has demonstrated the superiority of total ankle replacement over arthrodesis. More recently, conservative surgery (extraarticular alignment osteotomies) around the ankle has gained popularity in treating early- to mid-stage ankle osteoarthrosis. Adult acquired flatfoot deformity is a consequence of posterior tibial tendon dysfunction in 80% of cases. Classification is based upon the function of the tibialis posterior tendon, the reducibility of the deformity, and the condition of the ankle joint. Conservative treatment includes orthotics and eccentric muscle training. Functional surgery is indicated for treatment in the early stages. In case of fixed deformity, corrective and stabilising surgery is performed. Cite this article: Crevoisier X, Assal M, Stanekova K. Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments. EFORT Open Rev 2016;1:58–64. DOI: 10.1302/2058-5241.1.000015. PMID:28461929