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Sample records for agility total ankle

  1. Intraoperative Radiation Exposure During Revision Total Ankle Replacement.

    PubMed

    Roukis, Thomas S; Iceman, Kelli; Elliott, Andrew D

    2016-01-01

    Intraoperative C-arm image intensification is required for primary total ankle replacement implantation. Significant radiation exposure has been linked to these procedures; however, the radiation exposure during revision total ankle replacement remains unknown. Therefore, we sought to evaluate the radiation exposure encountered during revision total ankle replacement. The data from 41 patients were retrospectively analyzed from a prospective database: 19 Agility(™) to Agility(™); 4 Agility(™) to Custom Agility(™); 9 Agility(™) to INBONE(®) II; 5 Agility(™) to Salto Talaris(®) XT; 2 Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT; and 2 INBONE(®) I to INBONE(®) II revision total ankle replacements were performed. Two broad categories were identified: partial revision (Agility(™) to Agility(™), Agility(™) to Custom Agility(™), INBONE(®) I to INBONE(®) II) and complete conversion (Agility(™) to INBONE(®) II, Agility(™) to Salto Talaris(®) XT, Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT). The mean radiation exposure per case was significant at 3.49 ± 2.21 mGy. Complete conversions, specifically Agility(™) to INBONE(®) II, exhibited the greatest radiation exposure and C-arm time. Revision implant selection and revision type (complete or partial) directly contributed to radiation exposure. Accordingly, revision systems requiring less radiation exposure are preferable. Surgeons should strive to minimize intraoperative complications and limit additional procedures to those necessary, because both lead to additional radiation exposure. PMID:27320191

  2. Total Ankle Arthroplasty: An Imaging Overview

    PubMed Central

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  3. Posterior Ankle Structure Injury During Total Ankle Replacement.

    PubMed

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management. PMID:27291681

  4. Total ankle replacement. The results in 200 ankles.

    PubMed

    Wood, P L R; Deakin, S

    2003-04-01

    Between 1993 and 2000 we implanted 200 cementless, mobile-bearing STAR total ankle replacements. None was lost to follow-up for reasons other than the death of a patient. The mean follow-up was for 46 months (24 to 101). A complication requiring further surgery developed in eight ankles and 14 were revised or fused. The cumulative survival rate at five years was 92.7% (95% CI 86.6 to 98.8) with time to decision to revision or fusion as an endpoint. The most frequent complications were delayed wound healing and fracture of a malleolus. These became less common with experience of the operation. The radiological appearance of the interface of the tibial implant was significantly related to its operative fit and to the type of bioactive coating. PMID:12729104

  5. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    PubMed Central

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  6. Total ankle replacement for posttraumatic arthritis

    PubMed Central

    Weme, Rebecca A Nieuwe; van Solinge, Guido; N Doornberg, Job; Sierevelt, Inger; Haverkamp, Daniël; Doets, H Cornelis

    2015-01-01

    Background and purpose Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. Patients and methods We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. Results Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. Interpretation The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure. PMID:25772269

  7. Ankle replacement

    MedlinePlus

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...

  8. Total Ankle Arthroplasty: An Overview of the Canadian Experience.

    PubMed

    Latham, Warren C W; Lau, Johnny T C

    2016-06-01

    Total ankle arthroplasty use has increased across Canada over the last two decades. Multiple implant designs are readily available and implanted across Canada. Although arthrodesis is a reliable procedure for treating end-stage ankle arthritis, ankle replacement is often the preferred surgical treatment by patients. A recent prospective study evaluated intermediate-term outcomes of ankle replacement and arthrodesis at multiple centers across Canada, with variability in prosthesis type, surgeon, and surgical technique. Intermediate-term clinical outcomes of total ankle replacement and ankle arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; however, rates of reoperation and major complications were higher after ankle replacement. PMID:27261806

  9. Total ankle replacement. Early experiences with STAR prosthesis.

    PubMed Central

    Murnaghan, J. M.; Warnock, D. S.; Henderson, S. A.

    2005-01-01

    Early designs of Total Ankle Replacement (TAR) had a high failure rate. More recent experience with the 3-piece, meniscal bearing, total ankle replacement has been more promising. We report a review of the early results of our first 22 prostheses in 20 patients undergoing Scandinavian Total Ankle Replacement (STAR) in Northern Ireland. There was a mean follow-up time of 26 months. Seventeen patients are pain-free at the ankle joint during normal daily activities. Two of the early cases have required revision surgery due to technical errors. Other complications have included malleolar fractures, poor wound healing and postoperative stiffness. These early results show high levels of patient satisfaction, and we are encouraged to continue with total ankle arthroplasty. There is a steep initial learning curve and use of TAR should be restricted to foot and ankle surgeons. Images Fig 1 Figs 2a and b Figs 2 c and d PMID:16022128

  10. Total ankle replacement. Early experiences with STAR prosthesis.

    PubMed

    Murnaghan, J M; Warnock, D S; Henderson, S A

    2005-05-01

    Early designs of Total Ankle Replacement (TAR) had a high failure rate. More recent experience with the 3-piece, meniscal bearing, total ankle replacement has been more promising. We report a review of the early results of our first 22 prostheses in 20 patients undergoing Scandinavian Total Ankle Replacement (STAR) in Northern Ireland. There was a mean follow-up time of 26 months. Seventeen patients are pain-free at the ankle joint during normal daily activities. Two of the early cases have required revision surgery due to technical errors. Other complications have included malleolar fractures, poor wound healing and postoperative stiffness. These early results show high levels of patient satisfaction, and we are encouraged to continue with total ankle arthroplasty. There is a steep initial learning curve and use of TAR should be restricted to foot and ankle surgeons. PMID:16022128

  11. The influence of ankle dorsiflexion on jumping capacity and the modified agility t-test performance.

    PubMed

    Salinero, Juan J; Abian-Vicen, Javier; Del Coso, Juan; González-Millán, Cristina

    2014-01-01

    Dorsiflexion sport shoes aim to increase jumping capacity and speed by means of a lower position of the heel in comparison with the forefoot, favouring additional stretching of the ankle plantar flexors. In previous studies, contradictory results have been found on the benefits of using this type of shoe. With the aim of comparing a dorsiflexion sport shoe model (DF) with a conventional sport shoe (CS), 41 participants performed a countermovement jump (CMJ) test and an agility test (MAT) with both models of shoe. There were no significant differences in the jump test [CS=35.3 cm (6.4) and DF=35.6 cm (6.4), P>0.05]. In the agility test, the conventional shoe obtained better results than the model with dorsiflexion with regard to time taken to complete the circuit [CS=6236 ms (540) and DF=6377 ms (507), P<0.05)]. In spite of producing pre-stretching of the plantar muscles, the DF sport shoes were not effective for improving either jump power or agility in a specific test. PMID:24533520

  12. Effects of Preventative Ankle Taping on Planned Change-of-Direction and Reactive Agility Performance and Ankle Muscle Activity in Basketballers

    PubMed Central

    Jeffriess, Matthew D.; Schultz, Adrian B.; McGann, Tye S.; Callaghan, Samuel J.; Lockie, Robert G.

    2015-01-01

    This study investigated the effects of preventative ankle taping on planned change-of-direction and reactive agility performance and peak ankle muscle activity in basketballers. Twenty male basketballers (age = 22.30 ± 3.97 years; height = 1.84 ± 0.09 meters; body mass = 85.96 ± 11.88 kilograms) with no ankle pathologies attended two testing sessions. Within each session, subjects completed six planned and six reactive randomized trials (three to the left and three to the right for each condition) of the Y-shaped agility test, which was recorded by timing lights. In one session, subjects had both ankles un-taped. In the other, both ankles were taped using a modified subtalar sling. Peak tibialis anterior, peroneus longus (PL), peroneus brevis (PB), and soleus muscle activity was recorded for both the inside and outside legs across stance phase during the directional change, which was normalized against 10-meter sprint muscle activity (nEMG). Both the inside and outside cut legs during the change-of-direction step were investigated. Repeated measures ANOVA determined performance time and nEMG differences between un-taped and taped conditions. There were no differences in planned change-of-direction or reactive agility times between the conditions. Inside cut leg PL nEMG decreased when taped for the planned left, reactive left, and reactive right cuts (p = 0.01). Outside leg PB and soleus nEMG increased during the taped planned left cut (p = 0.02). There were no other nEMG changes during the cuts with taping. Taping did not affect change-of-direction or agility performance. Inside leg PL activity was decreased, possibly due to the tape following the line of muscle action. This may reduce the kinetic demand for the PL during cuts. In conclusion, ankle taping did not significantly affect planned change-of-direction or reactive agility performance, and did not demonstrate large changes in activity of the muscle complex in healthy basketballers. Key points Ankle

  13. Conversion of ankle autofusion to total ankle replacement using the Salto XT revision prosthesis.

    PubMed

    Williamson, Emilie R C; Demetracopoulos, Constantine A; Ellis, Scott J

    2016-09-01

    Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered. We describe the clinical and radiographic outcomes achieved in this case. At 12 months post-operatively the patient reported significant reduction of pain, increased FAOS scores and had increased ankle range of motion. PMID:27502236

  14. Technique of Arthroscopic Treatment of Impingement After Total Ankle Arthroplasty.

    PubMed

    Gross, Christopher E; Neumann, Julie A; Godin, Jonathan A; DeOrio, James K

    2016-04-01

    Rates of medial and/or lateral gutter impingement after total ankle replacement are not insignificant. If impingement should occur, it typically arises an average of 17 months after total ankle replacement. Our patient underwent treatment for right ankle medial gutter bony impingement with arthroscopic debridement 5 years after her initial total ankle replacement. Standard anteromedial and anterolateral portals and a 30° 2.7-mm-diameter arthroscope were used. An aggressive soft-tissue and bony resection was performed using a combination of curettes, a 3.5-mm shaver, a 5.5-mm unsheathed burr, a drill, and a radiofrequency ablator. This case shows that arthroscopic treatment is an effective and potentially advantageous alternative to open treatment of impingement after total ankle replacement. In addition, symptoms of impingement often improve in a short amount of time after arthroscopic debridement of the medial and/or lateral gutter. PMID:27354942

  15. Total ankle replacement – surgical treatment and rehabilitation

    PubMed Central

    Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting. PMID:27407223

  16. Force-controlled dynamic wear testing of total ankle replacements.

    PubMed

    Reinders, Jörn; von Stillfried, Falko; Altan, Emel; Sonntag, Robert; Heitzmann, Daniel W W; Kretzer, Jan Philippe

    2015-01-01

    Currently, our knowledge of wear performance in total ankle replacements is limited. The aim of this study is to develop a scenario for force-controlled testing and wear testing of total ankle replacements. A force-controlled wear test was developed: based on cadaver measurements, the passive stabilization (ligaments and soft tissue) of the ankle joint was characterized and a restraint model for ankle stabilization was developed. Kinematics and kinetics acting at the replaced ankle joint were defined based on literature data and gait analysis. Afterwards, force-controlled wear testing was carried out on a mobile, three-component, total ankle replacement design. Wear was assessed gravimetrically and wear particles were analyzed. Wear testing resulted in a mean wear rate of 18.2±1.4mm(3)/10(6) cycles. Wear particles showed a mean size of 0.23μm with an aspect ratio of 1.61±0.96 and a roundness of 0.62±0.14. Wear testing of total ankle replacement shows that a relevant wear mass is generated with wear particles in a biologically relevant size range. The developed wear test provides a basis for future wear testing of total ankle replacements. PMID:25448342

  17. Simultaneous bilateral total ankle replacement using a 3-component prosthesis

    PubMed Central

    2011-01-01

    Background and purpose Total ankle replacement is an established surgical procedure in patients with end-stage ankle osteoarthritis. We analyzed complications and medium-term results in patients with simultaneous bilateral total ankle replacement. Patients and methods 10 women and 16 men, mean age 60 (SD 13) years, were followed for a median of 5 (2–10) years. Results There were no intraoperative or perioperative complications, with the exception of 1 patient with prolonged wound healing. Major revision surgery was necessary in 6 of the 52 ankles, including 4 revisions of prosthetic components. The average pain score decreased from 6.9 (4−10) to 1.8 (0−4) points. The American Orthopaedic Foot and Ankle Society hindfoot score increased from 32 (SD 14) points preoperatively to 74 (SD 12) points postoperatively. The average range of motion increased from 28° (SD 12) preoperatively to 38° (SD 9) postoperatively. All 8 categories of SF-36 score improved. Interpretation Simultaneous bilateral total ankle replacement is a suitable method for restoration of function and attainment of pain relief in patients with bilateral end-stage ankle osteoarthritis. The results of this procedure, including complication rates, revision rates, and functional outcome, are comparable to those reported in patients with unilateral total ankle replacement. PMID:21999622

  18. Agile

    NASA Technical Reports Server (NTRS)

    Trimble, Jay Phillip

    2013-01-01

    This is based on a previous talk on agile development. Methods for delivering software on a short cycle are described, including interactions with the customer, the affect on the team, and how to be more effective, streamlined and efficient.

  19. Total ankle arthroplasty with severe preoperative varus deformity.

    PubMed

    Hanselman, Andrew E; Powell, Brian D; Santrock, Robert D

    2015-04-01

    Advancements in total ankle arthroplasty (TAA) over the past several decades have led to improved patient outcomes and implant survivorship. Despite these innovations, many implant manufacturers still consider a preoperative coronal plane deformity greater than 10° a relative contraindication to TAA. Without proper intraoperative alignment, these implants may experience abnormal wear and hardware failure. Correcting these deformities, often through the use of soft tissue procedures and/or osteotomies, not only increases the difficulty of a case, but also the intraoperative time and radiation exposure. The authors report a case in which a 54-year-old man with a severe right ankle varus deformity of 29° underwent successful TAA using the INBONE II Prophecy total ankle system (Wright Medical Technology, Inc, Memphis, Tennessee) and additional soft tissue reconstruction. Intraoperatively, the patient's coronal deformity was corrected to 1.8°. At 8 months postoperatively, the patient ambulated without restriction and had substantial improvement in validated patient outcome scores, specifically the Academy of Orthopaedic Surgeons Foot and Ankle Module and the Short Form Health Survey-12 This unique report documents the first time that this particular implant, with an exclusive preoperative computed tomography-derived patient-specific guide, has been used effectively for a severe preoperative varus deformity greater than 20° without the need for an osteotomy. Future studies should be directed toward the prospective evaluation of different total ankle implant systems and their outcomes with severe coronal plane deformity, specifically computed tomography-derived patient-specific guided implants. PMID:25901630

  20. Treatment of Isolated Ankle Osteoarthritis with Arthrodesis or the Total Ankle Replacement: A Comparison of Early Outcomes

    PubMed Central

    Saltzman, Charles L.; Kadoko, Robert G.

    2010-01-01

    Background Ankle arthrodesis and replacement are two common surgical treatment options for end-stage ankle osteoarthritis. However, the relative value of these alternative procedures is not well defined. This study compared the clinical and radiographic outcomes as well as the early perioperative complications of the two procedures. Methods Between January 2, 1998 and May 31, 2002, 138 patients were treated with ankle fusion or replacements. Seventy one patients had isolated posttraumatic or primary ankle arthritis. However, patients with inflammatory arthritis, neuropathic arthritis, concomitant hind foot fusion, revision procedures and two component system ankle replacement were excluded. Among them, one group of 42 patients had a total ankle replacement (TAR), whereas the other group of 29 patients underwent ankle fusion. A complete follow-up could be performed on 89% (37/42) and 73% (23/29) of the TAR and ankle fusion group, respectively. The mean follow-up period was 4.2 years (range, 2.2 to 5.9 years). Results The outcomes of both groups were compared using a student's t-test. Only the short form heath survery mental component summary score and Ankle Osteoarthritis Scale pain scale showed significantly better outcomes in the TAR group (p < 0.05). In the radiographic evaluation, there was no significant difference in preoperative and postoperative osteoarthritis between the TAR and fusion groups. Conclusions The clinical results of TAR are similar to those of fusion at an average follow-up of 4 years. However, the arthroplasty group showed better pain relief and more postoperative complications that required surgery. PMID:20190994

  1. Wear study of Total Ankle Replacement explants by microstructural analysis.

    PubMed

    Cottrino, S; Fabrègue, D; Cowie, A P; Besse, J-L; Tadier, S; Gremillard, L; Hartmann, D J

    2016-08-01

    The implantation of Total Ankle Replacement (TAR) prostheses generally gives satisfactory results. However, a high revision rate is associated with the Ankle Evolutive System (AES) implant, due to periprosthetic osteolysis that generates significant cortical lesions and bone cysts in the periprosthetic region. Radioclinical and histological analyses of peri-implant tissues show the presence of numerous foreign particles that may come from the implant. It is known that a precocious wear of materials may lead to an important rate of foreign body in tissues and may generate osteolysis lesions and inflammatory reactions. Thus the objectives of this retrospective study of 10 AES TAR implants (recovered after revision surgeries) are to understand how the prostheses wear out, which part is the most stressed and to determine the nature and size of foreign body particles. A better understanding of friction mechanisms between the three parts of the implant and of the nature and morphology of foreign particles generated was needed to explain the in vivo behavior of the implant. This was achieved using microstuctural and tomographic analysis of both implants parts and periprosthetic tissues. PMID:26807869

  2. Ballooning osteolysis in 71 failed total ankle arthroplasties.

    PubMed

    Singh, Gurpal; Reichard, Theresa; Hameister, Rita; Awiszus, Friedemann; Schenk, Katja; Feuerstein, Bernd; Roessner, Albert; Lohmann, Christoph

    2016-08-01

    Background and purpose - Aseptic loosening is a major cause of failure in total ankle arthroplasty (TAA). In contrast to other total joint replacements, large periarticular cysts (ballooning osteolysis) have frequently been observed in this context. We investigated periprosthetic tissue responses in failed TAA, and performed an element analysis of retrieved tissues in failed TAA. Patients and methods - The study cohort consisted of 71 patients undergoing revision surgery for failed TAA, all with hydroxyapatite-coated implants. In addition, 5 patients undergoing primary TAA served as a control group. Radiologically, patients were classified into those with ballooning osteolysis and those without, according to defined criteria. Histomorphometric, immunohistochemical, and elemental analysis of tissues was performed. Von Kossa staining and digital microscopy was performed on all tissue samples. Results - Patients without ballooning osteolysis showed a generally higher expression of lymphocytes, and CD3+, CD11c+, CD20+, and CD68+ cells in a perivascular distribution, compared to diffuse expression. The odds of having ballooning osteolysis was 300 times higher in patients with calcium content >0.5 mg/g in periprosthetic tissue than in patients with calcium content ≤0.5 mg/g (p < 0.001). Interpretation - There have been very few studies investigating the pathomechanisms of failed TAA and the cause-effect nature of ballooning osteolysis in this context. Our data suggest that the hydroxyapatite coating of the implant may be a contributory factor. PMID:27196532

  3. Epidemiology of Total Ankle Arthroplasty: Trends in New York State.

    PubMed

    Seaworth, Christine M; Do, Huong T; Vulcano, Ettore; Mani, Sriniwasan B; Lyman, Stephen L; Ellis, Scott J

    2016-05-01

    The rate of total ankle arthroplasty (TAA) is increasing in the United States as its popularity and indications expand. There currently is no national joint registry available to monitor outcomes, and few studies have addressed the challenges faced with TAA. The purpose of this study was to evaluate the incidence, complications, and survival rates associated with TAA using a large statewide administrative discharge database. Individuals who underwent primary TAA from 1997 to 2010 were identified in the Statewide Planning and Research Cooperative System database from the New York State Department of Health. The age, sex, comorbidities, state of residence, primary diagnosis, and readmissions within 90 days were analyzed for patients with an ICD-9-CM procedure code of 81.56 (TAA). Failure of a TAA implant was defined as revision, tibiotalar arthrodesis, amputation, or implant removal. During the 14-year period, 420 patients underwent 444 TAAs (mean patient age of 61 years, 59% women, mean Charlson-Deyo comorbidity score of 0.45, and 86% New York State residents). The primary diagnosis was 37.4% osteoarthritis, 34.3% traumatic arthritis, and 15.5% rheumatoid arthritis. Surgery for failure was associated only with a younger age (56.5 vs 62 years, P=.005). The rate of subsequent failure procedures following TAAs performed in New York State was 13.8%. The incidence of TAAs is steadily increasing. The overall survival rate in New York State is better than rates reported in other national registries, but it is not yet comparable to those of hip and knee replacements. [Orthopedics. 2016; 39(3):170-176.]. PMID:27135448

  4. Does rural residence impact total ankle arthroplasty utilization and outcomes?

    PubMed

    Singh, Jasvinder A; Ramachandaran, Rekha

    2016-02-01

    The objective of this study was to compare total ankle arthroplasty (TAA) utilization and outcomes by patient residence. We used the Nationwide Inpatient Sample (NIS) from 2003 to 2011 to compare utilization and outcomes (post-arthroplasty discharge disposition, length of hospitalization, and mortality) by rural vs. urban residence. Ten thousand eight hundred thirty-three patients in urban and 3,324 patients in rural area underwent TAA. Compared to rural residents, urban residents had: lower mean age, 62.4 vs. 61.8 years (p < 0.0001); higher percent of women, 49 vs. 56 % (p = 0.0008); and lower proportion of Whites, 93 vs. 86 % (p = 0.0005). There were rural-urban disparities in TAA utilization in 2003 (0.32 vs. 0.39/100,000; p = 0.021), but not in 2011 (1.19 vs. 1.17/100,00; p = 0.80). TAA outcomes did not differ by rural vs. urban residence: (1) 11.3 % rural vs. 14.2 % urban residents were discharged to an inpatient facility (p = 0.098); (2) length of hospital stay above the median stay, was 44.8 vs. 42.2 % (p = 0.30); and (3) mortality was 0.2 vs. 0.1 %, respectively (p = 0.81). Multivariable-adjusted logistic regression models did not show any significant differences in discharge to home, length of stay, or mortality, by residence. Our study demonstrated an absence of any evidence of rural-urban differences in TAA outcomes. The rural-urban differences in TAA utilization noted in 2003 were no longer significant in 2011. PMID:25771850

  5. 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. PMID:22763319

  6. Combined Total Ankle Arthroplasty With Posterior Tibial Tendon Transfer for End-Stage Cavovarus Deformity.

    PubMed

    Schuberth, John M; Bowlby, Melinda A; Christensen, Jeffrey C

    2016-01-01

    Posterior tibial tendon transfer has been described to reduce and balance the cavovarus deformity in those patients who receive a total ankle replacement for end-stage arthritis. In this article, we discuss the indications and provide a detailed description of the technique for this powerful procedure. Case examples that demonstrate the utility of the procedure are provided. PMID:27095088

  7. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    PubMed

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle. PMID:27423250

  8. Finite element analysis of stress and wear characterization in total ankle replacements.

    PubMed

    Jay Elliot, Bradley; Gundapaneni, Dinesh; Goswami, Tarun

    2014-06-01

    Total Ankle Arthroplasty is performed in order to reduce the pain and loss of ambulation in patients with various forms of arthritis and trauma. Although replacement devices fail by a number of mechanisms, wear in the polyethylene liner constitutes one of the dominating failure modes. This leads to instability and loosening of the implant. Mechanisms that contribute to wear in the liners are high contact and subsurface stresses that break down the material over time. Therefore, it is important to understand the gait that generates these stresses. Methods to characterize and decrease wear in Ohio Total Ankle Replacements (TARs) have been performed in this research. This research utilizes finite element analysis of Wright State University (WSU) patented TAR models. From the Finite element analysis (FEA) results, mathematical models of contact conditions and wear mechanics were developed. The maximum wear rate values obtained in the study (at 25.598MPa, 3.74mm(3)/year) and maximum surface Mises stress obtained with new optimization model (11.52MPa) seem to be comparable with the maximum wear values obtained in other similar studies. These models were used to determine the best methods for wear characterization and reduction. Furthermore, optimization models were developed based on geometry of the implants. These equations optimize geometry, thus congruency and anatomical simulations for total ankle implants. PMID:24583238

  9. Salvage of Failed Total Ankle Replacement Using a Custom Titanium Truss.

    PubMed

    Mulhern, Jennifer L; Protzman, Nicole M; White, Amari M; Brigido, Stephen A

    2016-01-01

    Subsidence of the talar component results in significant morbidity after total ankle replacement. When recognized, prompt revision could be needed to preserve the function of the implant; however, this is not always the case. In situations in which the implant cannot be revised, tibiotalocalcaneal arthrodesis might be necessary to salvage the extremity. The purpose of the present report is to describe the use of a custom titanium alloy truss to fill a bony void created by explantation of the implant components. Total ankle replacement was performed as the initial surgery to address end-stage osteoarthritis. Two years after the index procedure, the patient underwent revision of the polyethylene and talar components with subtalar arthrodesis secondary to progressive subtalar osteoarthritis and talar subsidence. The implant subsequently became infected and was removed. The patient underwent re-implantation after the infection had resolved, but significant talar subsidence required conversion to a tibiotalocalcaneal arthrodesis with a custom titanium alloy truss and retrograde intramedullary nail. At the most recent follow-up appointment, the patient was weightbearing on a stable extremity and pain free. Radiographic examination confirmed appropriate implant alignment and evidence of bone formation throughout the titanium truss. Although our results are restricted to a single case with initial, limited follow-up data, combining sound structural mechanics with an open architecture and unique texture, the custom titanium truss appears to maintain the limb length and promote healing across a large void. PMID:26884264

  10. Total ankle replacement: a population-based study of 515 cases from the Finnish Arthroplasty Register

    PubMed Central

    Koivu, Helka; Eskelinen, Antti; Ikävalko, Mikko; Paavolainen, Pekka; Remes, Ville

    2010-01-01

    Background and purpose Although total ankle replacement (TAR) is a recognized procedure for treatment of the painful arthritic ankle, the best choice of implant and the long-term results are still unknown. We evaluated the survival of two TAR designs and factors associated with survival using data from the nationwide arthroplasty registry in Finland. Methods 573 primary TARs were performed during the period 1982–2006 because of rheumatic, arthritic, or posttraumatic ankle degeneration. We selected contemporary TAR designs that were each used in more than 40 operations, including the S.T.A.R. (n = 217) and AES (n = 298), to assess their respective survival rates. The mean age of the patients was 55 (17–86) years and 63% of operations were performed in women. Kaplan-Meier analysis and the Cox regression model were used for survival analysis. The effects of age, sex, diagnosis, and hospital volume were also studied. Results The annual incidence of TAR was 1.5 per 105 inhabitants. The 5-year overall survivorship for the whole TAR cohort was 83% (95% CI: 81–86), which agrees with earlier reports. The most frequent reasons for revision were aseptic loosening of one or both of the prosthesis components (39%) and instability (39%). We found no difference in survival rate between the S.T.A.R. and AES designs. Furthermore, age, sex, diagnosis, and hospital volume (< 10 and > 100 replacements in each of 17 hospitals) did not affect the TAR survival. Interpretation Based on our findings, we cannot conclude that any prosthesis was superior to any other. A high number of technical errors in primary TARs suggests that this low-volume field of implant arthroplasty should be centralized to fewer units. PMID:20180720

  11. Painful Osteophytes, Ectopic Bone, and Pain in the Malleolar Gutters Following Total Ankle Replacement: Management and Strategies.

    PubMed

    Overley, Benjamin D; Beideman, Thomas C

    2015-10-01

    The development of osteophytes, ectopic bone, or malleolar impingement following total ankle replacement represents common complications that will frequently lead to secondary procedures to relieve painful impingement. Many studies have been conducted to discover the cause of these postoperative impingement syndromes; however, there is a paucity of literature with regard to the prevention, diagnosis, and management of these conditions. The authors discuss the potential causes of formation of osteophytes and ectopic bone formation, as well as malleolar impingement syndromes following primary total ankle replacement with focus placed on diagnosis and management of these complications. PMID:26407737

  12. Evaluating Component Migration: Comparing Two Generations of the INBONE(®) Total Ankle Replacement.

    PubMed

    Brigido, Stephen A; Wobst, Garrett M; Galli, Melissa M; Protzman, Nicole M

    2015-01-01

    Although total ankle replacement (TAR) designs have radically evolved, the compressive forces at the ankle can cause aseptic loosening, talar subsidence, and implant failure. The purpose of the present report was to compare the implant migration associated with the INBONE(®) I, a TAR system with a stemmed talar component, and the newer generation INBONE(®) II, a TAR system without a stemmed talar component (Wright Medical Technology, Inc., Arlington, TN). Because core decompression could weaken the integrity of the talus, we hypothesized that the stemmed component would result in greater implant migration. A total of 35 consecutive patients (age 58.2 ± 12.1 years; 23 men) were included. Of these 35 patients, 20 (57.1%) had been treated with the INBONE(®) I and 15 (42.9%) with the INBONE(®) II. To assess implant migration, using anteroposterior radiographs, the distance from the apex of the tibial component to the most distal aspect of the talar stem or to the mid-saddle of the nonstemmed component was measured. The measurements were recorded from the immediate postoperative radiographs and the 12-month postoperative radiographs. Implant migration was quantified as the difference between the 12-month and the immediate postoperative measurements. Despite our hypothesis, no significant difference was found in implant migration between the INBONE(®) I (0.7 ± 1.2 mm) and INBONE(®) II (0.6 ± 1.3 mm, p = .981). However, previously published data have suggested that implant migration can continue for ≥2 years after surgery. Therefore, additional investigations with larger sample sizes and longer follow-up periods are needed to draw definitive conclusions. PMID:26033824

  13. Ankle arthroscopy

    MedlinePlus

    Ankle surgery; Arthroscopy - ankle; Surgery - ankle - arthroscopy; Surgery - ankle - arthroscopic ... You will likely receive general anesthesia before this surgery. This means you will be asleep and unable ...

  14. Clinical experiences with three different designs of ankle prostheses.

    PubMed

    Rippstein, Pascal F

    2002-12-01

    Until 1995, fusion was in our institution the only rational surgical option for a severe ankle arthrosis. Consistent reports about good mid- and long-term results with ankle replacement allowed us to change our minds. Ankle replacement became the gold standard and fusion was then almost totally banished. Because ankle arthrosis can be morphologically different from one patient to another, we soon believed that one single type of ankle prosthesis would not be the universal optimal solution for all patients. We therefore divided the ankle arthrosis into three groups. Each group shows the best solution from each of the ankle prostheses with which we had gained experience (Agility, STAR, and BP). The Agility prosthesis, which was indicated for ankles with extremely damaged geometry, did not restore sufficiently the ankle motion. Preoperatively stiff ankles remained stiff postoperatively. Additionally, significant residual pain was more likely to occur in those patients. These cases did not show significant advantages compared with ankle fusion, especially from a functional point of view. Fusion for these stiff ankles is therefore today our first treatment of choice. In our experience, the malleolar joints do not have to be replaced. Even a severe arthrosis at this level does not produce significant pain, provided that osteophytes have been removed and joint height has been restored by the implanted prosthesis. It is our strong belief that these malleolar joints are also less sensitive to pain, similar to the femoropatellar joint. For these reasons, a replacement of the malleolar joints and the resurfacing of the talar sides is not necessary. Leaving the talar sides untouched requires less bone resection and makes the implantation of the talar component easier. Although we obtained good results with the STAR prosthesis, we progressively abandoned it because of these reasons, and we preferred the BP prosthesis. The BP prosthesis works on the same biomechanic principle as

  15. Do we need hip-ankle radiographs to assess the coronal alignment and implant position after total knee replacement?

    PubMed Central

    Dargel, Jens; Oppermann, Johannes; Eysel, Peer; Penning, Lenhard

    2016-01-01

    Aims and Objectives: Restoration of the coronal alignment of the knee is known to be one of the major criteria of a successful total knee arthroplasty (TKA). It therefore appears to be mandatory to routinely assess the postoperative limb alignment using hip-ankle radiographs and to identify implants that may be at risk of premature failure. However, there is no clear consensus whether weight-bearing hip-ankle radiographs or rather standardized a-p knee-radiographs should be used to assess implant position and coronal alignment after TKA. It is the aim of the present study to investigate if implant position and the mechanical alignment after TKA can reproducibly be assessed using standardized a-p knee-radiographs or rather if weight-bearing hip-ankle radiographs are needed. Materials and Methods: This study was performed on 100 postoperative weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position (MPTA, LDFA) was assessed using the MediCAD software, which served as a control. The hip-ankle radiographs were then digitally cropped to 80%, 60% and 40% of the leg-length. In each cropped radiograph, tibial coronal implant position was assessed by referencing against the visible mid-shaft, whereas femoral implant position was referenced against the visible mid-shaft (anatomical axis) or against a surrogate mechanical axis, which was drawn perpendicular to the distal tangent of the femoral component. Each measurement was performed by three independent observers. The difference between the alignment parameters in the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated for each parameter. Results: The ICC for inter-observer agreement of measurement of the mechanical femorotibial angle was significantly higher in hip-ankle radiographs (.95) when compared with a radiograph cropped

  16. Is the internet a reliable source of information for patients seeking total ankle replacement?

    PubMed

    Elliott, Andrew D; Bartel, Annette F P; Simonson, Devin; Roukis, Thomas S

    2015-01-01

    The modern patient population relies on the Internet to provide knowledge about medical procedures. However, a gap between established medical guidelines and the information provided on the Internet exists. Because of the general poor quality of the medical information available on the Internet and the increasing popularity of total ankle replacement (TAR) with its known potential serious complications, we undertook the present study to evaluate the information on TAR available to the general public through the Internet and to determine the quality of information according to authorship type and site certification status. Three common search engines were used to identify a total of 105 websites. The TAR information quality was rated as "excellent," "high," "moderate," "low," or "unacceptable." The sites were evaluated for authorship or sponsorship, content, and other criteria. The data were analyzed as a complete set, as a comparison among authorship types (academic, private, industry, or other), and by certification status. Websites with scores of excellent or high were 35% of the sites reviewed, and 48% were ranked as poor or unacceptable. Of the authorship types, the highest quality authorship was for the industry and other sites, which rated high or excellent 46% of the time. Eight percent of the sites evaluated were certified; however, certification status was not associated with improved information quality. Our study has demonstrated a low quality of TAR information available across all website types, regardless of authorship type. We suggest a partnership between professional organizations and physicians to ensure that provider websites reflect the current indications and contraindications of TAR to enhance patient education. PMID:25746768

  17. Surgical tip: Titanium foam blocks can simplify fusion of failed total ankle replacements.

    PubMed

    Nunag, Perrico; Vun, Shen Hwa; Atiya, Sami; Pillai, Anand; Kurdy, Nasser

    2014-09-01

    Ankle arthrodesis following failed ankle replacements is a technically challenging task because of the large defect left behind after the prosthesis is removed. The usual practice is to use bulk grafts which are either autografts or allografts to fill the defect. We report our experience with the use of a titanium foam block specifically designed for fusion of failed ankle replacements. This particular method was chosen to avoid the technical difficulties and morbidities associated with the use of bulk autografts and allografts. We describe the surgical technique and early results in the first two cases performed in our unit. The satisfactory clinical and radiologic results in the two cases demonstrate the ability of the titanium foam block to simplify an otherwise complex procedure without compromising the outcome. PMID:24994679

  18. Computer-assisted preoperative planning of a novel design of total ankle replacement.

    PubMed

    Leardini, Alberto; Rapagnà, Luca; Ensini, Andrea; Catani, Fabio; Cappello, Angelo

    2002-03-01

    Computer-assisted preoperative planning are particularly sought for enhancing surgical implantation and improving clinical outcome of ankle joint replacement arthroplasty. A planning tool was designed to enhance the surgical implantation of a novel ligament-compatible three-component prosthesis. The tool includes a geometric and mechanical model of the ankle complex. The geometry of the articular surfaces and of main ligaments is defined from digitisation on a scanned lateral radiographs of the joint. From the expected movement arc and from component dimensions, a mechanical model of the ligaments is used to select the optimal size and the position the three prosthesis components. The planning is based on the minimisation of ligament change in length and of bone stock to be removed. The main output report is a detailed picture of the replaced ankle with indications of component locations and quantitative measure of bone cuts. An advanced report also superimposes the resulting prediction of prosthesis component kinematics at the replaced joint to the original radiographs. PMID:11853950

  19. Quantification of Subtalar Posterior Facet Involvement During Intramedullary Guidance of Total Ankle Arthroplasty:A Cadaveric Study.

    PubMed

    DeMill, Shyler L; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2015-01-01

    Total ankle arthroplasty is an evolving treatment of ankle arthritis. One implant uses intramedullary guidance to enhance accuracy by accessing the tibial canal through the inferior aspect of the foot, potentially placing the subtalar joint articulation at risk. The purpose of the present cadaveric anatomic evaluation was to identify posterior subtalar articular facet joint involvement during intramedullary guidance to the tibial canal. Ten below-the-knee cadaveric specimens were used. After drilling into the tibial medullary canal with a 6-mm drill bit and using the standard targeting jig, the specimens were dissected, and the posterior facet was evaluated. We graded posterior facet involvement according to the location of the drill hole and, if within the facet, the percentage of the facet violated by the drill bit, with 100% representing the full circumference of the 6-mm drill bit. Of the 8 specimens in which the drill bit passed through the subtalar posterior articular facet, the encroachment was peripheral in all cases, with no specimen showing circumferential 6-mm drill bit articular penetration (no cases with 100%). Sinus tarsi penetration occurred in 20% of the cases. The dissections with articular involvement included 3 specimens with >50% of the drill bit penetrating and 5 with <50%. The portion of the posterior facet involved among the specimens that were violated was anterocentral in the joint. A risk of damage to the posterior facet of the subtalar joint exists with intramedullary total ankle systems. Our study has demonstrated that the drill bit will involve the anterocentral and anterolateral portions of the posterior facet of the subtalar joint, with <6 mm articular disruption in all cases. PMID:26015304

  20. Pulmonary embolism and mortality following total ankle replacement: a data linkage study using the NJR data set

    PubMed Central

    Zaidi, Razi; MacGregor, Alexander; Cro, Suzie; Goldberg, Andy

    2016-01-01

    Objective To determine the mortality rate following total ankle replacement (TAR) and incidence of 90 day pulmonary embolism (PE) along with the associated risk factors. Design Data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. Linkage was performed in a deterministic fashion. HES episodes 90 days after the index procedure were analysed for PE. Mortality data were obtained pertaining to all the index procedures from the NJR for analysis. Participants All primary and revision ankle replacement patients captured on the NJR between February 2008 and February 2013. Results The 90-day mortality following TAR was 0.13% (95% CI 0.03 to 0.52) and 1-year mortality was 0.72% (95% CI 0.40 to 1.30); no deaths were as a result of PE. The incidence of PE within 90 days following primary TAR was 0.51% (95% CI 0.23 to 1.13). There was only one PE following revision surgery. Patients with an Royal College of Surgeons Charlson score greater than zero were at 13 times greater risk of PE (p=0.003). Conclusions There is low incidence of PE following TAR, but multiple comorbidities are a leading risk factor for its occurrence. PMID:27329444

  1. Agility Following the Application of Cold Therapy

    PubMed Central

    Evans, Todd A.; Ingersoll, Christopher; Knight, Kenneth L.; Worrell, Teddy

    1995-01-01

    Cold application is commonly used before strenuous exercise due to its hypalgesic effects. Some have questioned this procedure because of reports that cold may reduce isokinetic torque. However, there have been no investigations of actual physical performance following cold application. The purpose of this study was to determine if a 20-minute ice immersion treatment to the foot and ankle affected the performance of three agility tests: the carioca maneuver, the cocontraction test, and the shuttle run. Twenty-four male athletic subjects were tested during two different treatment sessions following an orientation session. Subjects were tested following a 20-minute 1°C ice immersion treatment to the dominant foot and ankle and 20 minutes of rest. Following each treatment, subjects performed three trials of each agility test, with 30 seconds rest between each trial, and 1 minute between each different agility test. The order in which each subject performed the agility tests was determined by a balanced Latin square. A MANOVA with repeated measures was used to determine if there was an overall significant difference in the agility times recorded between the cold and control treatments and if the order of the treatment sessions affected the scores. Although the mean agility time scores were slightly slower following the cold treatment, cooling the foot and ankle caused no difference in agility times. Also, there was no difference resulting from the treatment orders. We felt that the slightly slower scores may have been a result of tissue stiffness and/or subject's apprehension immediately following the cold treatment. Cold application to the foot and ankle can be used before strenuous exercise without altering agility. Imagesp232-a PMID:16558341

  2. Quality measures for total ankle replacement, 30-day readmission and reoperation rates within 1 year of surgery: a data linkage study using the NJR data set

    PubMed Central

    Zaidi, Razi; Macgregor, Alexander J; Goldberg, Andy

    2016-01-01

    Objective To report on the rate of 30-day readmission and the rate of additional or revision surgery within 12 months following total ankle replacement (TAR). Design A data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. These two databases were linked in a deterministic fashion. HES episodes 12 months following the index procedure were isolated and analysed. Logistic regression was used to model predictors of reoperation and revision for primary ankle replacement. Participants All patients who underwent primary and revision ankle replacements according to the NJR between February 2008 and February 2013. Results The rate of 30-day readmission following primary and revision ankle replacement was 2.2% and 1.3%, respectively. In the 12 months following primary and revision ankle replacements, the revision rate (where implants needed to be removed) was 1.2% with increased odds in those orthopaedic units preforming <20 ankle replacements per year and patients with a preoperative fixed equinus deformity. The reoperation other than revision (where implants were not removed) in the 12 months following primary and revision TARs was 6.6% and 9.3%, respectively. Rheumatoid arthritis, cemented prosthesis and high ASA grade significantly increased the odds of reoperation. Conclusions TAR has a 30-day readmission rate of 2.2%, which is similar to that of knee replacement but lower than that of total hip replacement. 6.6% of patients undergoing primary TAR require a reoperation within 12 months of the index procedure. Early revision rates are significantly higher in low-volume centres. PMID:27217286

  3. Ankle Problems

    MedlinePlus

    ... intense you're unable to walk on the ankle? Yes You may have a FRACTURE or a severe SPRAIN. Don't walk on the injured foot. Raise the leg and place ice on the swollen area. See your doctor promptly. No ... but you're still able to walk on the ankle? Yes You may have a SPRAINED ANKLE, or ...

  4. Time Trends in Total Ankle Arthroplasty in the U.S.: A Study of the Nationwide Inpatient Sample

    PubMed Central

    Singh, Jasvinder A.; Ramachandaran, Rekha

    2014-01-01

    Objective To assess the time-trends in utilization, clinical characteristics and outcomes of patients undergoing total ankle arthroplasty (TAA) in the U.S. Methods We used the Nationwide Inpatient Sample (NIS) data from 1998 to 2010 to examine time-trends in the utilization rates of TAA. We used the Cochran Armitage test for trend to assess time-trends across the years and the analysis of variance (ANOVA), Wilcoxon test or chi-squared test (as appropriate) to compare the first (1998–2000) and the last time periods (2009–10). Results TAA utilization rate increased significant from 1998 to 2010: 0.13 to 0.84 per 100,000 overall, 0.14 to 0.88 per 100,000 in females and from 0.11 to 0.81 per 100,000 in males (p<0.0001 for each comparison for time-trends). Compared to the 1998–2000, those undergoing TAA in 2009–10: were older (41% fewer patients <50 years, p<0.0001); less likely to have RA as the underlying diagnosis (55% fewer patients, p=0.0001); more likely to have Deyo-Charlson index of two or more (197% more, p=0.0010); and had a shorter length of stay at 2.5 days (17% reduction, p<0.0001). Mortality was rare, ranging 0 to 0.6% and discharge to inpatient facility ranged 12.6–14.1%; we noted no significant time-trends in either (p>0.05). Conclusions The utilization rate of TAA increased rapidly in the U.S. from 1998 to 2010, but post-arthroplasty mortality rate was stable. Underlying diagnosis and medical comorbidity changed over time and both can impact outcomes after TAA. Further studies should examine how the outcomes and complications of TAA have evolved over time. PMID:24907036

  5. A Comparative Study Between Total Contact Cast and Pressure-Relieving Ankle Foot Orthosis in Diabetic Neuropathic Foot Ulcers

    PubMed Central

    Chakraborty, Partha Pratim; Ray, Sayantan; Biswas, Dibakar; Baidya, Arjun; Bhattacharjee, Rana; Mukhopadhyay, Pradip; Ghosh, Sujoy; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2014-01-01

    Background: Off-loading of the ulcer area is extremely important for the healing of plantar ulcers. Off-loading with total contact cast (TCC) may be superior to other off-loading strategies studied so far, but practical limitations can dissuade clinicians from using this modality. This study was conducted to evaluate the efficacy of TCC compared with that of a pressure-relieving ankle foot orthosis (PRAFO) in healing of diabetic neuropathic foot ulcers and their effect on gait parameters. Methods: Thirty adult diabetic patients attending the foot clinic with neuropathic plantar ulcers irrespective of sex, age, duration and type of diabetes were randomly assigned to 1 of 2 off-loading modalities (TCC and PRAFO). Main outcome measures were ulcer healing after 4 weeks of randomization and effect of each of the modalities on various gait parameters. Results: The percentage reduction of the ulcer surface area at 4 weeks from baseline was 75.75 ± 9.25 with TCC and 34.72 ± 13.07 with PRAFO, which was significantly different (P < .001). The results of this study however, showed that most of the gait parameters were better with PRAFO than with TCC. Conclusions: This study comprehensively evaluated the well known advantages and disadvantages of a removable (PRAFO) and a nonremovable device (TCC) in the treatment of diabetic neuropathic foot ulcer. Further studies are needed involving larger subjects and using 3D gait analysis to collect more accurate data on gait parameters and wound healing with different off-loading devices. PMID:25452635

  6. A Comparison of Total and Intrinsic Muscle Stiffness Among Flexors and Extensors of the Ankle, Knee and Elbow

    NASA Technical Reports Server (NTRS)

    Lemoine, Sandra M.

    1997-01-01

    This study examined 3 methods that assessed muscle stiffness. Muscle stiffness has been quantified by tissue reactive force (transverse stiffness), vibration, and force (or torque) over displacement. Muscle stiffness also has two components: reflex (due to muscle sensor activity) and intrinsic (tonic firing of motor units, elastic nature of actin and myosin cross bridges, and connective tissue). This study compared three methods of measuring muscle stiffness of agonist-antagonist muscle pairs of the ankle, knee and elbow.

  7. 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 ...

  8. Ankle impingement.

    PubMed

    Lavery, Kyle P; McHale, Kevin J; Rossy, William H; Theodore, George

    2016-01-01

    Ankle impingement is a syndrome that encompasses a wide range of anterior and posterior joint pathology involving both osseous and soft tissue abnormalities. In this review, the etiology, pathoanatomy, diagnostic workup, and treatment options for both anterior and posterior ankle impingement syndromes are discussed. PMID:27608626

  9. Ankle Sprains

    MedlinePlus

    ... What's the Treatment for a Sprained Ankle? More Serious Sprains en español Esguinces de tobillo As a field hockey player, Jill was used to twisting her ankle. She'd always been able to walk it off and get back in the game. But one day she stepped on another player's ...

  10. Sprained Ankles

    MedlinePlus

    ... Body I think my child has sprained her ankle. How can I tell for sure? Sprains are injuries to the ligaments that connect bones ... away before the ligament is injured. Types of Sprains In young children, the ankle is the most commonly sprained joint, followed by ...

  11. [Ankle braces prevent ligament injuries].

    PubMed

    Karlsson, Jon

    2002-09-01

    The Cochrane collaboration has performed a meta-analysis of all studies found on the prevention of ankle ligament injuries, frequent in sports like soccer, European handball and basketball. Interventions include the use of modified footwear and associated supports, training programmes and health education. Five randomized trials totalling 3,954 participants were included. With the exception of ankle disc training, all prophylactic interventions entailed the application of an external ankle support in the form of a semi-rigid orthosis, air-cast or high top shoes. The studies showed a significant reduction in the number of ankle sprains in individuals allocated to external ankle support. This reduction was greater for those with a previous history of ankle sprains. PMID:12362747

  12. AGILE Data Center and AGILE science highlights

    NASA Astrophysics Data System (ADS)

    Pittori, C.

    2013-06-01

    AGILE is a scientific mission of the Italian Space Agency (ASI) with INFN, INAF e CIFS participation, devoted to gamma-ray astrophysics. The satellite is in orbit since April 23rd, 2007. Gamma-ray astrophysics above 100 MeV is an exciting field of astronomical sciences that has received a strong impulse in recent years. Despite the small size and budget, AGILE produced several important scientific results, among which the unexpected discovery of strong and rapid gamma-ray flares from the Crab Nebula. This discovery won to the AGILE PI and the AGILE Team the prestigious Bruno Rossi Prize for 2012, an international recognition in the field of high energy astrophysics. We present here the AGILE data center main activities, and we give an overview of the AGILE scientific highlights after 5 years of operations.

  13. Ankle replacement

    MedlinePlus

    ... to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. A piece of plastic is then inserted between the two metal parts. Screws maybe placed to stabilize your ankle. The surgeon ...

  14. Ankle sprain - Series (image)

    MedlinePlus

    The ankle joint connects the foot with the leg. The ankle joint allows the foot to move upward and ... outward motion. Muscles, tendons, and ligaments surround the ankle providing the stability the ankle joint needs for ...

  15. A systematic review on ankle injury and ankle sprain in sports.

    PubMed

    Fong, Daniel Tik-Pui; Hong, Youlian; Chan, Lap-Ki; Yung, Patrick Shu-Hang; Chan, Kai-Ming

    2007-01-01

    This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports. PMID:17190537

  16. Adhesive capsulitis of the ankle (frozen ankle).

    PubMed

    van Moppes, F I; van den Hoogenband, C R; Greep, J M

    1979-09-01

    Adhesive capsulitis or "frozen ankle" is a syndrome resulting from repeated ankle sprains, or perhaps following immobilization after trauma. Ankle arthrography is a useful and safe diagnostic procedure in this syndrome. Typical arthrographic features are described together with case histories of two patients with frozen ankle. We suggest that early mobilization of the patient following trauma is particularly important in preventing the development of a forzen ankle syndrome. PMID:508071

  17. Agile Software Development

    ERIC Educational Resources Information Center

    Biju, Soly Mathew

    2008-01-01

    Many software development firms are now adopting the agile software development method. This method involves the customer at every level of software development, thus reducing the impact of change in the requirement at a later stage. In this article, the principles of the agile method for software development are explored and there is a focus on…

  18. Rehabilitation of Syndesmotic (High) Ankle Sprains

    PubMed Central

    Williams, Glenn N.; Allen, Eric J.

    2010-01-01

    Context: High ankle sprains are common in athletes who play contact sports. Most high ankle sprains are treated nonsurgically with a rehabilitation program. Evidence Acquisition: All years of PUBMED, Cochrane Database of Systematic Reviews, CINAHL PLUS, SPORTDiscuss, Google Scholar, and Web of Science were searched to August 2010, cross-referencing existing publications. Keywords included syndesmosis ankle sprain or high ankle sprain and the following terms: rehabilitation, treatment, cryotherapy, braces, orthosis, therapeutic modalities, joint mobilization, massage, pain, pain medications, TENS (ie, transcutaneous electric nerve stimulation), acupuncture, aquatic therapy, strength, neuromuscular training, perturbation training, and outcomes. Results: Level of evidence, 5. A 3-phase rehabilitation program is described. The acute phase is directed at protecting the joint while minimizing pain, inflammation, muscle weakness, and loss of motion. Most patients are treated with some form of immobilization and have weightbearing restrictions. A range of therapeutic modalities are used to minimize pain and inflammation. Gentle mobilization and resistance exercises are used to gain mobility and maintain muscle size and strength. The subacute phase is directed at normalizing range of motion, strength, and function in activities of daily living. Progressive mobilization and strengthening are hallmarks of this phase. Neuromuscular training is begun and becomes the central component of rehabilitation. The advanced training phase focuses on preparing the patient for return to sports participation. Perturbation of support surfaces, agility drills, plyometrics, and sport-specific training are central components of this phase. Conclusion: The rehabilitation guidelines discussed may assist clinicians in managing syndesmotic ankle sprains. PMID:23015976

  19. Ankle sprain - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100209.htm Ankle sprain - Series To use the sharing features on ... 4 out of 4 Normal anatomy Overview The ankle joint connects the foot with the leg. The ...

  20. Ankle Injuries and Disorders

    MedlinePlus

    Your ankle bone and the ends of your two lower leg bones make up the ankle joint. Your ligaments, which connect bones to one ... muscles and tendons move it. The most common ankle problems are sprains and fractures. A sprain is ...

  1. 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…

  2. Arthroscopic Ankle Arthrodesis.

    PubMed

    Hutchinson, Byron

    2016-10-01

    Arthroscopic ankle arthrodesis is a cost-effective option for many patients with posttraumatic arthritis of the ankle joint. Rehabilitation is generally quicker than conventional open techniques, and rates of fusion are comparable or better than traditional open techniques. Unless the arthroscopic surgeon has considerable experience, the best results are seen in patients with very little deformity in the ankle joint. PMID:27599442

  3. An agile implementation of SCRUM

    NASA Astrophysics Data System (ADS)

    Gannon, Michele

    Is Agile a way to cut corners? To some, the use of an Agile Software Development Methodology has a negative connotation - “ Oh, you're just not producing any documentation” . So can a team with no experience in Agile successfully implement and use SCRUM?

  4. The sprained ankle.

    PubMed

    Puffer, J C

    2001-01-01

    The sprained ankle is the most common musculoskeletal injury seen by physicians caring for active youngsters and adults. It accounts for approximately one fourth of all sports-related injuries and is commonly seen in athletes participating in basketball, soccer, or football. It has been shown that one third of West Point cadets suffer an ankle sprain during their 4 years at the military academy. While diagnosis and management of the sprained ankle is usually straightforward, several serious injuries can masquerade as an ankle sprain, and it is important for the clinician to recognize these to prevent long-term morbidity. In this article the basic anatomy of the ankle, mechanisms by which the ankle is injured, and the differential diagnosis of the acutely injured ankle are reviewed. Appropriate evaluation of the injured ankle and the criteria that should be utilized for determining the necessity of radiographs are discussed as well as management of the acutely sprained ankle and the role of prevention in reducing the risk of ankle injury. PMID:11464730

  5. 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)

  6. Foot, leg, and ankle swelling

    MedlinePlus

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...

  7. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... News, Videos & Podcasts » Articles » Text Size Print Bookmark Ankle Fractures Often Not Diagnosed Long-term Complications Result from Poor Recovery Mistaking an ankle fracture for an ankle sprain has serious consequences ...

  8. Developments in Agile Manufacturing

    SciTech Connect

    Clinesmith, M.G.

    1993-09-01

    As part of a project design initiative, Sandia National Laboratories and AlliedSignal Inc. Kansas City Division have joined efforts to develop a concurrent engineering capability for the manufacturing of complex precision components. The primary effort of this project, called Agile Manufacturing, is directed toward: (1) Understand the error associated with manufacturing and inspection. (2) Develop methods for correcting error. (3) Integrate diverse software technologies into a compatible process. The Agile Manufacturing System (AMS) is a system that integrates product design, manufacturing, and inspection into a closed loop, concurrent engineering process. The goal of developing the Agile Manufacturing System is to: (1) Optimize accuracy in manufacturing and inspection. (A) Use of softgage software for product evaluation. This will ensure ANSI Y14.5 compliance. (B) Establish and monitor bias between CMM and machine center. (C) Map probe deflection error and apply correction to inspection results. This applies to both on machine probing and CMM inspections. (D) Inspection process. (2) Compress the cycle time from product concept to production level manufacturing and verification. (3) Create a self-correcting process that feeds inspection results back into the machining process. (4) Link subordinate processes (cutting/probing path, softgage model, etc.) to the solid model definition.

  9. Perspectives on Agile Coaching

    NASA Astrophysics Data System (ADS)

    Fraser, Steven; Lundh, Erik; Davies, Rachel; Eckstein, Jutta; Larsen, Diana; Vilkki, Kati

    There are many perspectives to agile coaching including: growing coaching expertise, selecting the appropriate coach for your context; and eva luating value. A coach is often an itinerant who may observe, mentor, negotiate, influence, lead, and/or architect everything from team organization to system architecture. With roots in diverse fields ranging from technology to sociology coaches have differing motivations and experience bases. This panel will bring together coaches to debate and discuss various perspectives on agile coaching. Some of the questions to be addressed will include: What are the skills required for effective coaching? What should be the expectations for teams or individu als being coached? Should coaches be: a corporate resource (internal team of consultants working with multiple internal teams); an integral part of a specific team; or external contractors? How should coaches exercise influence and au thority? How should management assess the value of a coaching engagement? Do you have what it takes to be a coach? - This panel will bring together sea soned agile coaches to offer their experience and advice on how to be the best you can be!

  10. How to Care for a Sprained Ankle

    MedlinePlus

    ... Sprained Ankle How to Care for a Sprained Ankle Page Content Ankle sprains are very common injuries. ... Grade I, II or III. Treating your Sprained Ankle Treating your sprained ankle properly may prevent chronic ...

  11. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases. PMID:16224109

  12. Agile Walking Robot

    NASA Technical Reports Server (NTRS)

    Larimer, Stanley J.; Lisec, Thomas R.; Spiessbach, Andrew J.; Waldron, Kenneth J.

    1990-01-01

    Proposed agile walking robot operates over rocky, sandy, and sloping terrain. Offers stability and climbing ability superior to other conceptual mobile robots. Equipped with six articulated legs like those of insect, continually feels ground under leg before applying weight to it. If leg sensed unexpected object or failed to make contact with ground at expected point, seeks alternative position within radius of 20 cm. Failing that, robot halts, examines area around foot in detail with laser ranging imager, and replans entire cycle of steps for all legs before proceeding.

  13. Frequency agile relativistic magnetrons

    SciTech Connect

    Levine, J.S.; Harteneck, B.D.; Price, H.D.

    1995-11-01

    The authors are developing a family of frequency agile relativistic magnetrons to continuously cover the bands from 1 to 3 GHz. They have achieved tuning ranges of > 33%. The magnetrons have been operated repetitively in burst mode at rates up to 100 pps for 10 sec. Power is extracted from two resonators, and is in the range of 400--600 MW, fairly flat across the tuning bandwidth. They are using a network of phase shifters and 3-dB hybrids to combine the power into a single arm and to provide a continuously adjustable attenuator.

  14. Agile Infrastructure Monitoring

    NASA Astrophysics Data System (ADS)

    Andrade, P.; Ascenso, J.; Fedorko, I.; Fiorini, B.; Paladin, M.; Pigueiras, L.; Santos, M.

    2014-06-01

    At the present time, data centres are facing a massive rise in virtualisation and cloud computing. The Agile Infrastructure (AI) project is working to deliver new solutions to ease the management of CERN data centres. Part of the solution consists in a new "shared monitoring architecture" which collects and manages monitoring data from all data centre resources. In this article, we present the building blocks of this new monitoring architecture, the different open source technologies selected for each architecture layer, and how we are building a community around this common effort.

  15. Frequency agile optical parametric oscillator

    DOEpatents

    Velsko, Stephan P.

    1998-01-01

    The frequency agile OPO device converts a fixed wavelength pump laser beam to arbitrary wavelengths within a specified range with pulse to pulse agility, at a rate limited only by the repetition rate of the pump laser. Uses of this invention include Laser radar, LIDAR, active remote sensing of effluents/pollutants, environmental monitoring, antisensor lasers, and spectroscopy.

  16. Frequency agile optical parametric oscillator

    DOEpatents

    Velsko, S.P.

    1998-11-24

    The frequency agile OPO device converts a fixed wavelength pump laser beam to arbitrary wavelengths within a specified range with pulse to pulse agility, at a rate limited only by the repetition rate of the pump laser. Uses of this invention include Laser radar, LIDAR, active remote sensing of effluents/pollutants, environmental monitoring, antisensor lasers, and spectroscopy. 14 figs.

  17. Strength and agility training in adolescents with Down syndrome: a randomized controlled trial.

    PubMed

    Lin, Hsiu-Ching; Wuang, Yee-Pay

    2012-01-01

    The purpose of this study was to investigate the effects of a proposed strength and agility training program of adolescents with Down syndrome. Ninety-two adolescents were recruited and evenly randomized to two intervention groups (exercise group vs. control group). The mean age for the exercise and the control group was 10.6±3.2 and 11.2±3.5 respectively. The exercise training program consisted of a 5-min treadmill exercise and one 20-min virtual-reality based activity administered three times a week for 6 weeks. Pre- and post-test measures were taken for muscle strength and agility performance. The measured muscle included hip extensor, hip flexor, knee extensor, knee flexors, hip abductors, and ankle plantarflexor. A handheld dynamometer was used to measure the lower extremities muscle strength, and agility performance was assessed by the strength and agility subtests of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition. The exercise group had significant improvements in agility (p=0.02, d=0.80) and muscle strength of all muscle group (all p's<0.05, d=0.51-0.89) assessed in comparison to the control group after the 6-week intervention. Knee muscle groups including both flexors and extensors had the greatest gains among all the muscles measured. A short-term exercise training program used in this study is capable of improving muscle strength and agility performance of adolescents with DS. PMID:22820064

  18. Aircraft agility maneuvers

    NASA Technical Reports Server (NTRS)

    Cliff, Eugene M.; Thompson, Brian G.

    1992-01-01

    A new dynamic model for aircraft motions is presented. This model can be viewed as intermediate between a point-mass model, in which the body attitude angles are control-like, and a rigid-body model, in which the body-attitude angles evolve according to Newton's Laws. Specifically, consideration is given to the case of symmetric flight, and a model is constructed in which the body roll-rate and the body pitch-rate are the controls. In terms of this body-rate model a minimum-time heading change maneuver is formulated. When the bounds on the body-rates are large the results are similar to the point-mass model in that the model can very quickly change the applied forces and produce an acceleration to turn the vehicle. With finite bounds on these rates, the forces change in a smooth way. This leads to a measurable effect of agility.

  19. Agile manufacturing concept

    NASA Astrophysics Data System (ADS)

    Goldman, Steven L.

    1994-03-01

    The initial conceptualization of agile manufacturing was the result of a 1991 study -- chaired by Lehigh Professor Roger N. Nagel and California-based entrepreneur Rick Dove, President of Paradigm Shifts, International -- of what it would take for U.S. industry to regain global manufacturing competitiveness by the early twenty-first century. This industry-led study, reviewed by senior management at over 100 companies before its release, concluded that incremental improvement of the current system of manufacturing would not be enough to be competitive in today's global marketplace. Computer-based information and production technologies that were becoming available to industry opened up the possibility of an altogether new system of manufacturing, one that would be characterized by a distinctive integration of people and technologies; of management and labor; of customers, producers, suppliers, and society.

  20. Ankle fracture - aftercare

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this ... Sit with your foot elevated higher than your knee at least 4 times a day Apply an ...

  1. Ankle injuries in basketball players.

    PubMed

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

    We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential. PMID:8536029

  2. A spherical parallel three degrees-of-freedom robot for ankle-foot neuro-rehabilitation.

    PubMed

    Malosio, Matteo; Negri, Simone Pio; Pedrocchi, Nicola; Vicentini, Federico; Caimmi, Marco; Molinari Tosatti, Lorenzo

    2012-01-01

    The ankle represents a fairly complex bone structure, resulting in kinematics that hinders a flawless robot-assisted recovery of foot motility in impaired subjects. The paper proposes a novel device for ankle-foot neuro-rehabilitation based on a mechatronic redesign of the remarkable Agile Eye spherical robot on the basis of clinical requisites. The kinematic design allows the positioning of the ankle articular center close to the machine rotation center with valuable benefits in term of therapy functions. The prototype, named PKAnkle, Parallel Kinematic machine for Ankle rehabilitation, provides a 6-axes load cell for the measure of subject interaction forces/torques, and it integrates a commercial EMG-acquisition system. Robot control provides active and passive therapeutic exercises. PMID:23366645

  3. Assessment of AK (Above Knee) Prosthesis with Different Ankle Assembly Using GRF Pattern in Stance Phase

    NASA Astrophysics Data System (ADS)

    Kim, Sung-Min; Kim, Sung-Jae; Bae, Ha-Suk

    In this study, ground reaction force (GRF), absolute symmetry index (ASI) and coefficient of variation (CV) of fixed, single-axis and multi-axis prosthetic ankle assemblies were investigated by biomechanical evaluation of above knee amputees. In the experiments, 37 normal male volunteers, two male and two female Above Knee (AK) amputees GRF data were tested with fixed, single-axis and multi-axis prosthetic ankle assembly. A gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance phase for ten points. The results showed that fixed-axis ankle assembly was superior to other two ankle assemblies for forwarding and braking forces. Multi-axis ankle was relatively superior to other two ankle assemblies for gait balancing and movement of the mass center. Single-axis ankle was relatively superior to the other two ankle assemblies for CV and ASI of GRF.

  4. Elements of an Art - Agile Coaching

    NASA Astrophysics Data System (ADS)

    Lundh, Erik

    This tutorial gives you a lead on becoming or redefining yourself as an Agile Coach. Introduction to elements and dimensions of state-of-the-art Agile Coaching. How to position the agile coach to be effective in a larger setting. Making the agile transition - from a single team to thousands of people. How to support multiple teams as a coach. How to build a coaches network in your company. Challenges when the agile coach is a consultant and the organization is large.

  5. The Telemetry Agile Manufacturing Effort

    SciTech Connect

    Brown, K.D.

    1995-01-01

    The Telemetry Agile Manufacturing Effort (TAME) is an agile enterprising demonstration sponsored by the US Department of Energy (DOE). The project experimented with new approaches to product realization and assessed their impacts on performance, cost, flow time, and agility. The purpose of the project was to design the electrical and mechanical features of an integrated telemetry processor, establish the manufacturing processes, and produce an initial production lot of two to six units. This paper outlines the major methodologies utilized by the TAME, describes the accomplishments that can be attributed to each methodology, and finally, examines the lessons learned and explores the opportunities for improvement associated with the overall effort. The areas for improvement are discussed relative to an ideal vision of the future for agile enterprises. By the end of the experiment, the TAME reduced production flow time by approximately 50% and life cycle cost by more than 30%. Product performance was improved compared with conventional DOE production approaches.

  6. Human factors in agile manufacturing

    SciTech Connect

    Forsythe, C.

    1995-03-01

    As industries position themselves for the competitive markets of today, and the increasingly competitive global markets of the 21st century, agility, or the ability to rapidly develop and produce new products, represents a common trend. Agility manifests itself in many different forms, with the agile manufacturing paradigm proposed by the Iacocca Institute offering a generally accepted, long-term vision. In its many forms, common elements of agility or agile manufacturing include: changes in business, engineering and production practices, seamless information flow from design through production, integration of computer and information technologies into all facets of the product development and production process, application of communications technologies to enable collaborative work between geographically dispersed product development team members and introduction of flexible automation of production processes. Industry has rarely experienced as dramatic an infusion of new technologies or as extensive a change in culture and work practices. Human factors will not only play a vital role in accomplishing the technical and social objectives of agile manufacturing. but has an opportunity to participate in shaping the evolution of industry paradigms for the 21st century.

  7. Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton

    PubMed Central

    Kao, Pei-Chun; Lewis, Cara L.; Ferris, Daniel P.

    2009-01-01

    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 1.25 m/s while wearing the ankle exoskeleton. After two sessions of practice, subjects reduced their soleus EMG activation by ~36% and walked with total ankle moment patterns similar to their unassisted gait (r2 = 0.98±0.02, THSD, p>0.05). They had substantially different ankle kinematic patterns compared to their unassisted gait (r2 = 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. PMID:19878952

  8. 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. PMID:19878952

  9. 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

  10. Agile automated vision

    NASA Astrophysics Data System (ADS)

    Fandrich, Juergen; Schmitt, Lorenz A.

    1994-11-01

    The microelectronic industry is a protagonist in driving automated vision to new paradigms. Today semiconductor manufacturers use vision systems quite frequently in their fabs in the front-end process. In fact, the process depends on reliable image processing systems. In the back-end process, where ICs are assembled and packaged, today vision systems are only partly used. But in the next years automated vision will become compulsory for the back-end process as well. Vision will be fully integrated into every IC package production machine to increase yields and reduce costs. Modem high-speed material processing requires dedicated and efficient concepts in image processing. But the integration of various equipment in a production plant leads to unifying handling of data flow and interfaces. Only agile vision systems can act with these contradictions: fast, reliable, adaptable, scalable and comprehensive. A powerful hardware platform is a unneglectable requirement for the use of advanced and reliable, but unfortunately computing intensive image processing algorithms. The massively parallel SIMD hardware product LANTERN/VME supplies a powerful platform for existing and new functionality. LANTERN/VME is used with a new optical sensor for IC package lead inspection. This is done in 3D, including horizontal and coplanarity inspection. The appropriate software is designed for lead inspection, alignment and control tasks in IC package production and handling equipment, like Trim&Form, Tape&Reel and Pick&Place machines.

  11. Doctor, I sprained my ankle.

    PubMed

    How, Choon How; Tan, Ken Jin

    2014-10-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk of fracture through history-taking and physical examination, manage the pain, assess long‑term complications and provide certification for rest and recovery. The Ottawa ankle rules may be useful. Graduated exercises to maintain the ankle's range of motion should be started early, after the resolution of initial pain and swelling. The risk of recurrent ankle injuries is often a combination of both mechanical and functional disabilities. PMID:25631892

  12. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball. A randomized clinical study at West Point.

    PubMed

    Sitler, M; Ryan, J; Wheeler, B; McBride, J; Arciero, R; Anderson, J; Horodyski, M

    1994-01-01

    This randomized clinical study was designed to prospectively determine the efficacy of a semirigid ankle stabilizer in reducing the frequency and severity of acute ankle injuries in basketball. Athletic shoe, playing surface, athlete-exposure, ankle injury history, and brace assignment were either statistically or experimentally controlled. Participants in the study were 1601 United States Military Academy cadets with no preparticipation, clinical, functional, or radiographic evidence of ankle instability. Subjects experienced a total of 13,430 athlete-exposures in the 1990 and 1991 intramural basketball seasons. Ankle injury was defined as acute trauma to the ankle ligaments that resulted in an athlete's inability to participate in basketball 1 day after the injury. Use of ankle stabilizers significantly reduced the frequency of ankle injuries. Reduction in ankle injuries, however, depended on the nature of injury (fewer contact injuries occurred among those who wore braces). Injury severity was not statistically reduced, and wearing the ankle stabilizer did not affect the frequency of knee injuries. Attitude toward ankle stabilizer use improved as use of the stabilizer increased. PMID:7943509

  13. Tools for Supporting Distributed Agile Project Planning

    NASA Astrophysics Data System (ADS)

    Wang, Xin; Maurer, Frank; Morgan, Robert; Oliveira, Josyleuda

    Agile project planning plays an important part in agile software development. In distributed settings, project planning is severely impacted by the lack of face-to-face communication and the inability to share paper index cards amongst all meeting participants. To address these issues, several distributed agile planning tools were developed. The tools vary in features, functions and running platforms. In this chapter, we first summarize the requirements for distributed agile planning. Then we give an overview on existing agile planning tools. We also evaluate existing tools based on tool requirements. Finally, we present some practical advices for both designers and users of distributed agile planning tools.

  14. What Does an Agile Coach Do?

    NASA Astrophysics Data System (ADS)

    Davies, Rachel; Pullicino, James

    The surge in Agile adoption has created a demand for project managers rather than direct their teams. A sign of this trend is the ever-increasing number of people getting certified as scrum masters and agile leaders. Training courses that introduce agile practices are easy to find. But making the transition to coach is not as simple as understanding what agile practices are. Your challenge as an Agile Coach is to support your team in learning how to wield their new Agile tools in creating great software.

  15. How to Tape an Ankle

    MedlinePlus

    ... Decide If You Need to See an Orthopaedic Foot and Ankle Specialist How to Care for a Sprained Ankle How to Be Non-weightbearing After Surgery Footwear All Site Content AOFAS / FootCareMD / How To... / Foot Injury / How to Tape an Ankle How to ...

  16. Relationship Between Reactive Agility and Change of Direction Speed in Amateur Soccer Players.

    PubMed

    Matlák, János; Tihanyi, József; Rácz, Levente

    2016-06-01

    Matlák, J, Tihanyi, J, and Rácz, L. Relationship between reactive agility and change of direction speed in amateur soccer players. J Strength Cond Res 30(6): 1547-1552, 2016-The aim of the study was to assess the relationship between reactive agility and change of direction speed (CODS) among amateur soccer players using running tests with four directional changes. Sixteen amateur soccer players (24.1 ± 3.3 years; 72.4 ± 7.3 kg; 178.7 ± 6 cm) completed CODS and reactive agility tests with four changes of direction using the SpeedCourt™ system (Globalspeed GmbH, Hemsbach, Germany). Countermovement jump (CMJ) height and maximal foot tapping count (completed in 3 seconds) were also measured with the same device. In the reactive agility test, participants had to react to a series of light stimuli projected onto a screen. Total time was shorter in the CODS test than in the reactive agility test (p < 0.001). Nonsignificant correlations were found among variables measured in the CODS, reactive agility, and CMJ tests. Low common variance (r = 0.03-0.18) was found between CODS and reactive agility test variables. The results of this study underscore the importance of cognitive factors in reactive agility performance and suggest that specific methods may be required for training and testing reactive agility and CODS. PMID:26562713

  17. Arthroscopic ankle arthrodesis.

    PubMed

    Elmlund, Anna O; Winson, Ian G

    2015-03-01

    Arthroscopic ankle arthrodesis is a good option for the treatment of end-stage ankle arthritis. The surgical technique involving the use of a standard 4.5-mm arthroscope is described. Standard anteromedial and anterolateral portals are used. Joint surfaces except the lateral gutter are prepared to point bleeding with motorized burr, abraider, and curettes. Rigid fixation is achieved with cannulated screws. The postoperative regime includes 12 weeks protection, staged from non-weight bearing through partial to full weight bearing. Advantages compared with the open procedure include shorter hospital stay and shorter time to union with similar or better union rates. PMID:25726484

  18. 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

  19. Piloted simulator assessments of agility

    NASA Technical Reports Server (NTRS)

    Schneider, Edward T.

    1990-01-01

    NASA has utilized piloted simulators for nearly two decades to study high-angle-of-attack flying qualities, agility, and air-to-air combat. These studies have included assessments of an F-16XL aircraft equipped with thrust vectoring, an assessment of the F-18 HARV maneuvering requirements to assist in thrust vectoring control system design, and an agility assessment of the F-18. The F-18 agility assessment was compared with in-flight testing. Open-loop maneuvers such as 180-deg rolls to measure roll rate showed favorable simulator/in-flight comparison. Closed-loop maneuvers such as rolls to 90 deg with precision stops or certain maximum longitudinal pitching maneuvers showed poorer performance due to reduced aggressiveness of pilot inputs in flight to remain within flight envelope limits.

  20. The AGILE Data Center at ASDC

    NASA Astrophysics Data System (ADS)

    Pittori, Carlotta; AGILE Collaboration

    2013-01-01

    AGILE is a Scientific Mission of the Italian Space Agency (ASI) with INFN, INAF and CIFS participation, devoted to gamma-ray astrophysics. The satellite has been in orbit since April 23rd, 2007. Thanks to its sky monitoring capability and fast ground segment alert system, AGILE produced several important scientific results, among which was the unexpected discovery of strong and rapid gamma-ray flares from the Crab Nebula over daily timescales. This discovery won for the AGILE PI and the AGILE Team the Bruno Rossi Prize for 2012. The AGILE Data Center, located at ASDC, is in charge of all the scientific oriented activities related to the analysis and archiving of AGILE data. I will present the AGILE data center main activities, and I will give an overview of the AGILE scientific highlights after 5 years of operations.

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

    PubMed

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

    2014-04-01

    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

  2. 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

  3. Doctor, I sprained my ankle

    PubMed Central

    How, Choon How; Tan, Ken Jin

    2014-01-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk of fracture through history-taking and physical examination, manage the pain, assess long-term complications and provide certification for rest and recovery. The Ottawa ankle rules may be useful. Graduated exercises to maintain the ankle’s range of motion should be started early, after the resolution of initial pain and swelling. The risk of recurrent ankle injuries is often a combination of both mechanical and functional disabilities. PMID:25631892

  4. [Tuberculosis of ankle].

    PubMed

    Rubio Barbón, S; Rodríguez Cocina, B; Suárez del Villar Acebal, R; Calvo Rodríguez, C E; Villar López, A; Escalada Rodríguez, P; Torreblanca Gil, A

    2004-09-01

    The authors present a case of tuberculous arthritis of ankle with sinovial fluid and sputum aspirate Lowenstein positive (M. tuberculosis) in a patient non inmunocomprometid and review the clinical, diagnosis and treatment aspects of this entity, and show the difficult diagnosis in cases of radiology normal or low suspect. PMID:15476422

  5. Ankle syndesmosis injuries.

    PubMed

    Peña, Fernando A; Coetzee, J Chris

    2006-03-01

    Physician awareness of ankle syndesmosis injuries is improving. The anatomy involved and the mechanism of injury are extremely relevant for the understanding and treatment of this type of injury. Examination under anesthesia may confirm the syndesmosis instability. Based on those findings, stabilization is the recommended approach. PMID:16564452

  6. Osteochondral Allografts in the Ankle Joint

    PubMed Central

    Vannini, Francesca; Buda, Roberto; Ruffilli, Alberto; Cavallo, Marco; Giannini, Sandro

    2013-01-01

    Purpose: The aim of this systematic review is to report about the clinical use of partial and total fresh osteochondral allograft in the ankle joint. The state of the art of allografts with regard to basic science, procurement and storage methods, immunogenicity, generally accepted indications and contraindications, and the rationale of the allografting procedure have been described. Methods: All studies published in PubMed from 2000 to January 2012 addressing fresh osteochondral allograft procedures in the ankle joint were identified, including those that fulfilled the following criteria: (a) level I-IV evidence addressing the areas of interest outlined above; (b) measures of functional, clinical, or imaging outcome; and (c) outcome related to ankle cartilage lesions or ankle arthritis treated by allografts. Results: The analysis showed a progressively increasing number of articles from 2000. The number of selected articles was 14; 9 of those focused on limited dimension allografts (plugs, partial) and 5 on bipolar fresh osteochondral allografts. The evaluation of evidence level showed 14 case series and no randomized studies. Conclusions: Fresh osteochondral allografts are now a versatile and suitable option for the treatment of different degrees of osteochondral disease in the ankle joint and may even be used as total joint replacement. Fresh osteochondral allografts used for total joint replacement are still experimental and might be considered as a salvage procedure in otherwise unsolvable situations. A proper selection of the patients is therefore a key point. Moreover, the patients should be adequately informed about the possible risks, benefits, and alternatives to the allograft procedure. PMID:26069666

  7. Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability

    PubMed Central

    Feger, Mark A.; Snell, Shannon; Handsfield, Geoffrey G.; Blemker, Silvia S.; Wombacher, Emily; Fry, Rachel; Hart, Joseph M.; Saliba, Susan A.; Park, Joseph S.; Hertel, Jay

    2016-01-01

    Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain. Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Five patients with CAI (mean age, 23.0 ± 4 years; 1 male, 4 females) and 5 healthy controls (mean age, 23.8 ± 4.5 years; 1 male, 4 females) volunteered for this study. Novel fast-acquisition magnetic resonance imaging (MRI) was used to scan from above the femoral condyles through the foot and ankle. The perimeter of each muscle was outlined on each axial slice and then the 2-dimensional area was multiplied by the slice thickness (5 mm) to calculate the muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a handheld dynamometer. Patients with CAI were compared with healthy controls on all measures of muscle volume and strength. Extrinsic muscle volumes of patients with CAI were also compared with a normative database of healthy controls (n = 24) by calculating z scores for each muscle individually for each CAI subject. Results: The CAI group had smaller total shank, superficial posterior compartment, soleus, adductor hallucis obliqus, and flexor hallucis brevis muscle volumes compared with healthy controls as indicated by group means and associated 90% CIs that did not overlap. Cohen d effect sizes for the significant group differences were all large and ranged from 1.46 to 3.52, with 90% CIs that did not cross zero. The CAI group had lower eversion, dorsiflexion, and 4-way composite ankle strength, all with group means and associated 90

  8. Update on acute ankle sprains.

    PubMed

    Tiemstra, Jeffrey D

    2012-06-15

    Ankle sprains are a common problem seen by primary care physicians, especially among teenagers and young adults. Most ankle sprains are inversion injuries to the lateral ankle ligaments, although high sprains representing damage to the tibiofibular syndesmosis are becoming increasingly recognized. Physicians should apply the Ottawa ankle rules to determine whether radiography is needed. According to the Ottawa criteria, radiography is indicated if there is pain in the malleolar or midfoot zone, and either bone tenderness over an area of potential fracture (i.e., lateral malleolus, medial malleolus, base of fifth metatarsal, or navicular bone) or an inability to bear weight for four steps immediately after the injury and in the emergency department or physician's office. Patients with ankle sprain should use cryotherapy for the first three to seven days to reduce pain and improve recovery time. Patients should wear a lace-up ankle support or an air stirrup brace combined with an elastic compression wrap to reduce swelling and pain, speed recovery, and protect the injured ligaments as they become more mobile. Early mobilization speeds healing and reduces pain more effectively than prolonged rest. Pain control options for patients with ankle sprain include nonsteroidal anti-inflammatory drugs, acetaminophen, and mild opioids. Because a previous ankle sprain is the greatest risk factor for an acute ankle sprain, recovering patients should be counseled on prevention strategies. Ankle braces and supports, ankle taping, a focused neuromuscular training program, and regular sport-specific warm-up exercises can protect against ankle injuries, and should be considered for patients returning to sports or other high-risk activities. PMID:22962897

  9. What Is a Foot and Ankle Surgeon?

    MedlinePlus

    ... Text Size Print Bookmark What is a Foot & Ankle Surgeon? Foot and ankle surgeons are the surgical specialists of the podiatric ... every age. What education has a foot and ankle surgeon received? After completing undergraduate education, the foot ...

  10. Acute ankle sprain: an update.

    PubMed

    Ivins, Douglas

    2006-11-15

    Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. The initial assessment of an acute ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ankle and Foot Rules provide clinical guidelines for excluding a fracture in adults and children and determining if radiography is indicated at the time of injury. Reexamination three to five days after injury, when pain and swelling have improved, may help with the diagnosis. Therapy for ankle sprains focuses on controlling pain and swelling. PRICE (Protection, Rest, Ice, Compression, and Elevation) is a well-established protocol for the treatment of ankle injury. There is some evidence that applying ice and using nonsteroidal antiinflammatory drugs improves healing and speeds recovery. Functional rehabilitation (e.g., motion restoration and strengthening exercises) is preferred over immobilization. Superiority of surgical repair versus functional rehabilitation for severe lateral ligament rupture is controversial. Treatment using semirigid supports is superior to using elastic bandages. Support devices provide some protection against future ankle sprains, particularly in persons with a history of recurrent sprains. Ankle disk or proprioceptive neuromuscular facilitation exercise regimens also may be helpful, although the literature supporting this is limited. PMID:17137000

  11. Gait Biomechanics in Participants, Six Months after First-time Lateral Ankle Sprain.

    PubMed

    Doherty, C; Bleakley, C; Hertel, J; Caulfield, B; Ryan, J; Delahunt, E

    2016-06-01

    No research currently exists predicating a link between the injury-affiliated sensorimotor deficits of acute ankle sprain and those of chronic ankle instability during gait. This analysis evaluates participants with a 6-month history of ankle sprain injury to affirm this link. 69 participants with a 6-month history of acute first-time lateral ankle sprain were divided into subgroups ('chronic ankle instability' and 'coper') based on their self-reported disability and compared to 20 non-injured participants during a gait task. Lower extremity 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). The 'chronic ankle instability' subgroup (who reported greater disability) displayed increased knee flexion during period 1. During period 2, this subgroup exhibited greater total displacement at their ankle joint and greater extensor dominance at their knee. That many of these features are present, both in individuals with acute ankle sprain and those with chronic ankle instability may advocate a link between acute deficits and long-term outcome. Clinicians must be aware that the sensorimotor deficits of ankle sprain may persevere beyond the acute stage of injury and be cognizant of the capacity for impairments to pervade proximally. PMID:27136507

  12. An Investigation of Agility Issues in Scrum Teams Using Agility Indicators

    NASA Astrophysics Data System (ADS)

    Pikkarainen, Minna; Wang, Xiaofeng

    Agile software development methods have emerged and become increasingly popular in recent years; yet the issues encountered by software development teams that strive to achieve agility using agile methods are yet to be explored systematically. Built upon a previous study that has established a set of indicators of agility, this study investigates what issues are manifested in software development teams using agile methods. It is focussed on Scrum teams particularly. In other words, the goal of the chapter is to evaluate Scrum teams using agility indicators and therefore to further validate previously presented agility indicators within the additional cases. A multiple case study research method is employed. The findings of the study reveal that the teams using Scrum do not necessarily achieve agility in terms of team autonomy, sharing, stability and embraced uncertainty. The possible reasons include previous organizational plan-driven culture, resistance towards the Scrum roles and changing resources.

  13. The AGILE gamma-ray astronomy mission

    NASA Astrophysics Data System (ADS)

    Mereghetti, S.; Tavani, M.; Argan, A.; Barbiellini, G.; Caraveo, P.; Chen, A.; Cocco, V.; Costa, E.; Di Cocco, G.; Feroci, M.; Labanti, C.; Lapshov, I.; Lipari, P.; Longo, F.; Morselli, A.; Perotti, F.; Picozza, P.; Pittori, C.; Prest, M.; Rubini, A.; Soffitta, P.; Vallazza, E.; Vercellone, S.; Zanello, D.

    2001-09-01

    We describe the AGILE satellite: a unique tool for high-energy astrophysics in the 30 MeV - 50 GeV range before GLAST. The scientific performances of AGILE are comparable to those of EGRET, despite the much smaller weight and dimensions. The AGILE mission will be optimized for the imaging capabilities above 30 MeV and for the study of transient phenomena, complemented by simultaneous monitoring in the hard X-ray band (10 - 40 keV).

  14. Agile robotic edge finishing

    SciTech Connect

    Powell, M.

    1996-08-01

    Edge finishing processes have seemed like ideal candidates for automation. Most edge finishing processes are unpleasant, dangerous, tedious, expensive, not repeatable and labor intensive. Estimates place the cost of manual edge finishing processes at 12% of the total cost of fabricating precision parts. For small, high precision parts, the cost of hand finishing may be as high as 305 of the total part cost. Up to 50% of this cost could be saved through automation. This cost estimate includes the direct costs of edge finishing: the machining hours required and the 30% scrap and rework rate after manual finishing. Not included in these estimates are the indirect costs resulting from cumulative trauma disorders and retraining costs caused by the high turnover rate for finishing jobs.. Despite the apparent economic advantages, edge finishing has proven difficult to automate except in low precision and/or high volume production environments. Finishing automation systems have not been deployed successfully in Department of Energy defense programs (DOE/DP) production, A few systems have been attempted but have been subsequently abandoned for traditional edge finishing approaches: scraping, grinding, and filing the edges using modified dental tools and hand held power tools. Edge finishing automation has been an elusive but potentially lucrative production enhancement. The amount of time required for reconfiguring workcells for new parts, the time required to reprogram the workcells to finish new parts, and automation equipment to respond to fixturing errors and part tolerances are the most common reasons cited for eliminating automation as an option for DOE/DP edge finishing applications. Existing automated finishing systems have proven to be economically viable only where setup and reprogramming costs are a negligible fraction of overall production costs.

  15. Assessment of proposed fighter agility metrics

    NASA Technical Reports Server (NTRS)

    Liefer, Randall K.; Valasek, John; Eggold, David P.; Downing, David R.

    1990-01-01

    This paper presents the results of an analysis of proposed metrics to assess fighter aircraft agility. A novel framework for classifying these metrics is developed and applied. A set of transient metrics intended to quantify the axial and pitch agility of fighter aircraft is evaluated with a high fidelity, nonlinear F-18 simulation. Test techniques and data reduction method are proposed, and sensitivities to pilot introduced errors during flight testing is investigated. Results indicate that the power onset and power loss parameters are promising candidates for quantifying axial agility, while maximum pitch up and pitch down rates are for quantifying pitch agility.

  16. 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…

  17. Multiply-agile encryption in high speed communication networks

    SciTech Connect

    Pierson, L.G.; Witzke, E.L.

    1997-05-01

    Different applications have different security requirements for data privacy, data integrity, and authentication. Encryption is one technique that addresses these requirements. Encryption hardware, designed for use in high-speed communications networks, can satisfy a wide variety of security requirements if that hardware is key-agile, robustness-agile and algorithm-agile. Hence, multiply-agile encryption provides enhanced solutions to the secrecy, interoperability and quality of service issues in high-speed networks. This paper defines these three types of agile encryption. Next, implementation issues are discussed. While single-algorithm, key-agile encryptors exist, robustness-agile and algorithm-agile encryptors are still research topics.

  18. Mechanics and energetics of level walking with powered ankle exoskeletons.

    PubMed

    Sawicki, Gregory S; Ferris, Daniel P

    2008-05-01

    Robotic lower limb exoskeletons that can alter joint mechanical power output are novel tools for studying the relationship between the mechanics and energetics of human locomotion. We built pneumatically powered ankle exoskeletons controlled by the user's own soleus electromyography (i.e. proportional myoelectric control) to determine whether mechanical assistance at the ankle joint could reduce the metabolic cost of level, steady-speed human walking. We hypothesized that subjects would reduce their net metabolic power in proportion to the average positive mechanical power delivered by the bilateral ankle exoskeletons. Nine healthy individuals completed three 30 min sessions walking at 1.25 m s(-1) while wearing the exoskeletons. Over the three sessions, subjects' net metabolic energy expenditure during powered walking progressed from +7% to -10% of that during unpowered walking. With practice, subjects significantly reduced soleus muscle activity (by approximately 28% root mean square EMG, P<0.0001) and negative exoskeleton mechanical power (-0.09 W kg(-1) at the beginning of session 1 and -0.03 W kg(-1) at the end of session 3; P=0.005). Ankle joint kinematics returned to similar patterns to those observed during unpowered walking. At the end of the third session, the powered exoskeletons delivered approximately 63% of the average ankle joint positive mechanical power and approximately 22% of the total positive mechanical power generated by all of the joints summed (ankle, knee and hip) during unpowered walking. Decreases in total joint positive mechanical power due to powered ankle assistance ( approximately 22%) were not proportional to reductions in net metabolic power ( approximately 10%). The ;apparent efficiency' of the ankle joint muscle-tendon system during human walking ( approximately 0.61) was much greater than reported values of the ;muscular efficiency' of positive mechanical work for human muscle ( approximately 0.10-0.34). High ankle joint

  19. Arthroscopic Repair of Ankle Instability.

    PubMed

    Sorensen, Matthew D; Baca, John; Arbuckle, Keith

    2016-10-01

    Arthroscopic lateral ankle stabilization procedures have been described for many years. New technological advances and a deeper understanding of the pathobiomechanics involved in chronic lateral ankle instability have allowed an expansion of arthroscopic approaches to this common pathology. As experience is gained and outcomes within the patient profile are understood, the authors feel that the arthroscopic approach to lateral ankle stabilization may prove superior to traditional methods secondary to the risk and traditional complications that are mitigated within minimally invasive arthroscopic approaches. Additionally, the arthroscopic approach may allow a quicker return to ballistic sport and decrease time for rehabilitation. PMID:27599440

  20. An Agile Course-Delivery Approach

    ERIC Educational Resources Information Center

    Capellan, Mirkeya

    2009-01-01

    In the world of software development, agile methodologies have gained popularity thanks to their lightweight methodologies and flexible approach. Many advocates believe that agile methodologies can provide significant benefits if applied in the educational environment as a teaching method. The need for an approach that engages and motivates…

  1. The Introduction of Agility into Albania.

    ERIC Educational Resources Information Center

    Smith-Stevens, Eileen J.; Shkurti, Drita

    1998-01-01

    Describes a plan to introduce and achieve a national awareness of agility (and easy entry into the world market) for Albania through the relatively stable higher-education order. Agility's four strategic principles are enriching the customer, cooperating to enhance competitiveness, organizing to master change and uncertainty, and leveraging the…

  2. Teaching Agile Software Development: A Case Study

    ERIC Educational Resources Information Center

    Devedzic, V.; Milenkovic, S. R.

    2011-01-01

    This paper describes the authors' experience of teaching agile software development to students of computer science, software engineering, and other related disciplines, and comments on the implications of this and the lessons learned. It is based on the authors' eight years of experience in teaching agile software methodologies to various groups…

  3. Fighter agility metrics, research, and test

    NASA Technical Reports Server (NTRS)

    Liefer, Randall K.; Valasek, John; Eggold, David P.

    1990-01-01

    Proposed new metrics to assess fighter aircraft agility are collected and analyzed. A framework for classification of these new agility metrics is developed and applied. A completed set of transient agility metrics is evaluated with a high fidelity, nonlinear F-18 simulation provided by the NASA Dryden Flight Research Center. Test techniques and data reduction methods are proposed. A method of providing cuing information to the pilot during flight test is discussed. The sensitivity of longitudinal and lateral agility metrics to deviations from the pilot cues is studied in detail. The metrics are shown to be largely insensitive to reasonable deviations from the nominal test pilot commands. Instrumentation required to quantify agility via flight test is also considered. With one exception, each of the proposed new metrics may be measured with instrumentation currently available. Simulation documentation and user instructions are provided in an appendix.

  4. Some Findings Concerning Requirements in Agile Methodologies

    NASA Astrophysics Data System (ADS)

    Rodríguez, Pilar; Yagüe, Agustín; Alarcón, Pedro P.; Garbajosa, Juan

    Agile methods have appeared as an attractive alternative to conventional methodologies. These methods try to reduce the time to market and, indirectly, the cost of the product through flexible development and deep customer involvement. The processes related to requirements have been extensively studied in literature, in most cases in the frame of conventional methods. However, conclusions of conventional methodologies could not be necessarily valid for Agile; in some issues, conventional and Agile processes are radically different. As recent surveys report, inadequate project requirements is one of the most conflictive issues in agile approaches and better understanding about this is needed. This paper describes some findings concerning requirements activities in a project developed under an agile methodology. The project intended to evolve an existing product and, therefore, some background information was available. The major difficulties encountered were related to non-functional needs and management of requirements dependencies.

  5. Agile manufacturing from a statistical perspective

    SciTech Connect

    Easterling, R.G.

    1995-10-01

    The objective of agile manufacturing is to provide the ability to quickly realize high-quality, highly-customized, in-demand products at a cost commensurate with mass production. More broadly, agility in manufacturing, or any other endeavor, is defined as change-proficiency; the ability to thrive in an environment of unpredictable change. This report discusses the general direction of the agile manufacturing initiative, including research programs at the National Institute of Standards and Technology (NIST), the Department of Energy, and other government agencies, but focuses on agile manufacturing from a statistical perspective. The role of statistics can be important because agile manufacturing requires the collection and communication of process characterization and capability information, much of which will be data-based. The statistical community should initiate collaborative work in this important area.

  6. CT-assisted agile manufacturing

    NASA Astrophysics Data System (ADS)

    Stanley, James H.; Yancey, Robert N.

    1996-11-01

    The next century will witness at least two great revolutions in the way goods are produced. First, workers will use the medium of virtual reality in all aspects of marketing, research, development, prototyping, manufacturing, sales and service. Second, market forces will drive manufacturing towards small-lot production and just-in-time delivery. Already, we can discern the merging of these megatrends into what some are calling agile manufacturing. Under this new paradigm, parts and processes will be designed and engineered within the mind of a computer, tooled and manufactured by the offspring of today's rapid prototyping equipment, and evaluated for performance and reliability by advanced nondestructive evaluation (NDE) techniques and sophisticated computational models. Computed tomography (CT) is the premier example of an NDE method suitable for future agile manufacturing activities. It is the only modality that provides convenient access to the full suite of engineering data that users will need to avail themselves of computer- aided design, computer-aided manufacturing, and computer- aided engineering capabilities, as well as newly emerging reverse engineering, rapid prototyping and solid freeform fabrication technologies. As such, CT is assured a central, utilitarian role in future industrial operations. An overview of this exciting future for industrial CT is presented.

  7. Agile manufacturing prototyping system (AMPS)

    SciTech Connect

    Garcia, P.

    1998-05-09

    The Agile Manufacturing Prototyping System (AMPS) is being integrated at Sandia National Laboratories. AMPS consists of state of the industry flexible manufacturing hardware and software enhanced with Sandia advancements in sensor and model based control; automated programming, assembly and task planning; flexible fixturing; and automated reconfiguration technology. AMPS is focused on the agile production of complex electromechanical parts. It currently includes 7 robots (4 Adept One, 2 Adept 505, 1 Staubli RX90), conveyance equipment, and a collection of process equipment to form a flexible production line capable of assembling a wide range of electromechanical products. This system became operational in September 1995. Additional smart manufacturing processes will be integrated in the future. An automated spray cleaning workcell capable of handling alcohol and similar solvents was added in 1996 as well as parts cleaning and encapsulation equipment, automated deburring, and automated vision inspection stations. Plans for 1997 and out years include adding manufacturing processes for the rapid prototyping of electronic components such as soldering, paste dispensing and pick-and-place hardware.

  8. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... side of the ankle. This condition often... Barefoot Running Barefoot running is running while barefoot, without wearing any shoes on the feet. Running in thin-soled, flexible shoes is related but ...

  9. [Arthroscopic surgery of the ankle].

    PubMed

    Bojanić, Ivan; Franić, Miljenko; Ivković, Alan

    2007-05-01

    Arthroscopic surgery of the ankle has become indispensable method in the armamentarium of the modern orthopaedic surgeon. Technological advancement and thorough understanding of the anatomy have resulted in improved ability to perform arthroscopy of the ankle. The method is minimally invasive and it allows the direct visualization of intra-articular structures without arthrotomy or malleolar osteotomy. Anterior or posterior approach may be used, and various indications have become generally accepted: anterior soft tissue or bony impingement, loose bodies, osteochondral defects, synovitis (rheumatoid arthritis, infective arthritis, and hemophilic arthropathy), posterior impingement syndrome, posttraumatic conditions, osteoarthritis (arthrosis), ankle arthrodesis, tumor-like lesions (synovial osteochondromatosis, pigmented villonodular synovitis) and many combinations of these pathological entities. In this paper we will discuss technique, indications, complications and future perspective of the ankle arthroscopy. In addition we will review the most recent literature data regarding this appealing technique. PMID:17695197

  10. Foot, leg, and ankle swelling

    MedlinePlus

    ... feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... 51. Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: Diagnosis and management. Am Fam Phys . 2013;88( ...

  11. Effects of ankle balance taping with kinesiology tape for a patient with chronic ankle instability.

    PubMed

    Kim, Byeong-Jo; Lee, Jung-Hoon; Kim, Chang-Tae; Lee, Sun-Min

    2015-07-01

    [Purpose] To report the effects of ankle balance taping for a patient with chronic ankle instability (CAI). [Subject] A 33-year-old man with a 10 year history of chronic ankle stability. [Methods] ABT with kinesiology tape was performed for 2 months (average, 16 h/day) around the right ankle. [Results] At the end of two months, no ankle instability was noted when ascending and descending the stairs, jumping, turning, operating the pedals while driving, and lifting heavy objects. [Conclusion] The repeated use of kinesiology tape in ankle balance taping may be an effective treatment for recovering the ankle stability of patients with chronic ankle instability. PMID:26311206

  12. Effects of ankle balance taping with kinesiology tape for a patient with chronic ankle instability

    PubMed Central

    Kim, Byeong-Jo; Lee, Jung-Hoon; Kim, Chang-Tae; Lee, Sun-Min

    2015-01-01

    [Purpose] To report the effects of ankle balance taping for a patient with chronic ankle instability (CAI). [Subject] A 33-year-old man with a 10 year history of chronic ankle stability. [Methods] ABT with kinesiology tape was performed for 2 months (average, 16 h/day) around the right ankle. [Results] At the end of two months, no ankle instability was noted when ascending and descending the stairs, jumping, turning, operating the pedals while driving, and lifting heavy objects. [Conclusion] The repeated use of kinesiology tape in ankle balance taping may be an effective treatment for recovering the ankle stability of patients with chronic ankle instability. PMID:26311206

  13. Opening up the Agile Innovation Process

    NASA Astrophysics Data System (ADS)

    Conboy, Kieran; Donnellan, Brian; Morgan, Lorraine; Wang, Xiaofeng

    The objective of this panel is to discuss how firms can operate both an open and agile innovation process. In an era of unprecedented changes, companies need to be open and agile in order to adapt rapidly and maximize their innovation processes. Proponents of agile methods claim that one of the main distinctions between agile methods and their traditional bureaucratic counterparts is their drive toward creativity and innovation. However, agile methods are rarely adopted in their textbook, "vanilla" format, and are usually adopted in part or are tailored or modified to suit the organization. While we are aware that this happens, there is still limited understanding of what is actually happening in practice. Using innovation adoption theory, this panel will discuss the issues and challenges surrounding the successful adoption of agile practices. In addition, this panel will report on the obstacles and benefits reported by over 20 industrial partners engaged in a pan-European research project into agile practices between 2006 and 2009.

  14. Social Protocols for Agile Virtual Teams

    NASA Astrophysics Data System (ADS)

    Picard, Willy

    Despite many works on collaborative networked organizations (CNOs), CSCW, groupware, workflow systems and social networks, computer support for virtual teams is still insufficient, especially support for agility, i.e. the capability of virtual team members to rapidly and cost efficiently adapt the way they interact to changes. In this paper, requirements for computer support for agile virtual teams are presented. Next, an extension of the concept of social protocol is proposed as a novel model supporting agile interactions within virtual teams. The extended concept of social protocol consists of an extended social network and a workflow model.

  15. Developing communications requirements for Agile Product Realization

    SciTech Connect

    Forsythe, C.; Ashby, M.R.

    1994-03-01

    Sandia National Laboratories has undertaken the Agile Product Realization for Innovative electroMEchanical Devices (A-PRIMED) pilot project to develop and implement technologies for agile design and manufacturing of electrochemical components. Emphasis on information-driven processes, concurrent engineering and multi-functional team communications makes computer-supported cooperative work critical to achieving significantly faster product development cycles. This report describes analyses conducted in developing communications requirements and a communications plan that addresses the unique communications demands of an agile enterprise.

  16. Agility enabled by the SEMATECH CIM framework

    NASA Astrophysics Data System (ADS)

    Hawker, Scott; Waskiewicz, Fred

    1997-01-01

    The survivor in today's market environment is agile: able to survive and thrive in a market place marked by rapid, continuous change. For manufacturers, this includes an ability to rapidly develop, deploy and reconfigure manufacturing information and control systems. The SEMATECH CIM framework defines an application integration architecture and standard application components that enable agile manufacturing information and control systems. Further, the CIM framework and its evolution process foster virtual organizations of suppliers and manufacturers, combining their products and capabilities into an agile manufacturing information and control system.

  17. The Anatomic Pattern of Injuries in Acute Inversion Ankle Sprains

    PubMed Central

    Khor, Yuet Peng; Tan, Ken Jin

    2013-01-01

    Background: There are little data on the incidence and patterns of injuries seen on magnetic resonance imaging (MRI) in acute inversion ankle sprains. This study may help in the understanding of the pathomechanics, natural history, and outcomes of this common injury. Study Design: Case series; Level of evidence, 4. Methods: From June 2011 to June 2013, a total of 64 consecutive patients had MRI of the ankle performed for acute inversion injury to the ankle. All injuries/pathologies reported were recorded. Results: Only 22% of patients had isolated lateral ligament complex injuries. Twenty-two percent of patients had other pathologies but no lateral ligament injury, and 53% had lateral ligament injuries in combination with other pathologies or injuries. The most common associated finding with lateral ligament injuries was bone bruising (76%) followed by deltoid ligament injury (50%). The overall incidence of bone bruising was 50%. Thirty percent of ankles had tendon pathology, 27% had deltoid ligament injury, and 22% had occult fractures. Conclusion: Isolated lateral ligament ankle injury is not as common as is believed. The pattern of injury seems complex, and most patients appear to have more injuries than expected. MRI reveals additional information that may have significance in terms of diagnosis, treatment, and prognosis in this common injury. PMID:26535261

  18. The origin of the ankle

    NASA Astrophysics Data System (ADS)

    Codino, Antonio; Plouin, Francois

    2007-03-01

    The differential intensity of cosmic radiation shows a sequence of depressions referred to as knees in a large energy band above 1015eV. The global depression entailed in the complete spectrum with respect to the extrapolated intensity based on low energy data, amounts to a maximum factor of 8, occurring at 5×10eV, where flux measurements exhibit a relative minimum, referred to as the ankle. It is demonstrated by a full simulation of cosmic ray trajectories in the Galaxy that the intensity minimum around the ankle energy is primarily due to the nuclear interactions of the cosmic ions with the interstellar matter and to the galactic magnetic field. Ankles signal the onset energies of the rectilinear propagation in the Milky Way at Earth, being for example, 4×10eV for helium and 6×10eV for iron. The ankle, in spite of its notable importance at Earth, is a local perturbation of the universal spectrum which, between the knee and the ankle, decreases by a round factor 109 regaining its unperturbed status above 1019eV.

  19. American Orthopaedic Foot and Ankle Society

    MedlinePlus

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  20. Osteoarthritis of the Foot and Ankle

    MedlinePlus

    ... Size Print Bookmark Osteoarthritis of the Foot and Ankle What Is Osteoarthritis? Osteoarthritis is a condition characterized ... is also often found in the midfoot and ankle. Causes Osteoarthritis is considered a “wear and tear” ...

  1. Agile manufacturing concepts and opportunities in ceramics

    SciTech Connect

    Booth, C.L.; Harmer, M.P.

    1995-08-01

    In 1991 Lehigh University facilitated seminars over a period of 8 months to define manufacturing needs for the 21st century. They concluded that the future will be characterized by rapid changes in technology advances, customer demands, and shifts in market dynamics and coined the term {open_quotes}Agile Manufacturing{close_quotes}. Agile manufacturing refers to the ability to thrive in an environment of constant unpredictable change. Market opportunities are attacked by partnering to form virtual firms to dynamically obtain the required skills for each product opportunity. This paper will describe and compare agile vs. traditional concepts of organization & structure, management policy and ethics, employee environment, product focus, information, and paradigm shift. Examples of agile manufacturing applied to ceramic materials will be presented.

  2. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain

    PubMed Central

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ankle Instability Tool score and reach distances in the Y-Balance and lunge tests were increased. [Conclusion] Repeated ankle eversion taping may be an effective treatment intervention for ankle inversion sprain. PMID:27064668

  3. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

    PubMed

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ankle Instability Tool score and reach distances in the Y-Balance and lunge tests were increased. [Conclusion] Repeated ankle eversion taping may be an effective treatment intervention for ankle inversion sprain. PMID:27064668

  4. Stabilizing effects of ankle bracing under a combination of inversion and axial compression loading.

    PubMed

    Tohyama, Harukazu; Yasuda, Kazunori; Beynnon, Bruce D; Renstrom, Per A

    2006-04-01

    The combined effects of bracing, axial compression and inversion rotation on the ankle-subtalar complexes were evaluated. Ex vivo tests under the load-controlled condition were performed on six cadaver ankle specimens using a six degree-of-freedom fixture. Inversion rotation was measured while subjecting the ankle-subtalar complex to a 2.5 N-m inversion moment and a combination of the testing variables (brace type, no brace, 178 N axial compression load, no compression load, 0 degrees and 20 degrees of plantar flexion) for a total of 16 tests per specimen. Three commercially available braces (two semirigid types and one lace up type) were evaluated. An axial compression load significantly decreased ankle-subtalar motion in unbraced ankles for the tested inversion moment. The contribution of bracing to stabilization of the ankle was smaller in the axial loading condition than in the no axial loading condition. The semirigid braces had greater stabilizing effects in response to the inversion moment than the lace up brace. Stabilizing effects of bracing were significantly greater in 20 degrees of plantar flexion than in 0 degrees of plantar flexion. The most common mechanism for an ankle sprain injury is inversion rotation on a weight-bearing ankle. Therefore, we should not overestimate stabilizing effects of bracing from evaluations of bracing without axial compression loading. PMID:15959767

  5. SuperAGILE Services at ASDC

    SciTech Connect

    Preger, B.; Verrecchia, F.; Pittori, C.; Antonelli, L. A.; Giommi, P.; Lazzarotto, F.; Evangelista, Y.

    2008-05-22

    The Italian Space Agency Science Data Center (ASDC) is a facility with several responsibilities including support to all the ASI scientific missions as for management and archival of the data, acting as the interface between ASI and the scientific community and providing on-line access to the data hosted. In this poster we describe the services that ASDC provides for SuperAGILE, in particular the ASDC public web pages devoted to the dissemination of SuperAGILE scientific results. SuperAGILE is the X-Ray imager onboard the AGILE mission, and provides the scientific community with orbit-by-orbit information on the observed sources. Crucial source information including position and flux in chosen energy bands will be reported in the SuperAGILE public web page at ASDC. Given their particular interest, another web page will be dedicated entirely to GRBs and other transients, where new event alerts will be notified and where users will find all the available informations on the GRBs detected by SuperAGILE.

  6. Subperiosteal Hematoma of the Ankle

    PubMed Central

    Hui, S H; Lui, T H

    2016-01-01

    Introduction: Periosteal reaction has a long list of differential diagnoses ranging from trauma, infection, metabolic disease to malignancy. The morphology of periosteal reaction shown in imaging studies helps to narrow down the list of differential diagnoses. Case report: A 25 year old gentleman had an inversion injury to his left ankle. He complained of lateral ankle and posterior heel pain and swelling after the injury. Radiograph of his left ankle revealed solid, smooth periosteal reaction at posterior aspect of left distal tibia. MRI showed periosteal reaction at the corresponding site, which was better demonstrated in CT scan. Follow up MRI and CT showed maturation of the new bone formation at the site of periosteal reaction. Findings were compatible with subperiosteal hematoma formation from injury, which ossified with time. Conclusion: Smooth, thick periosteal reaction favours benign process, while interrupted pattern is an alarming feature for more aggressive causes. PMID:27299131

  7. The Incidence of Ankle Sprains in Orienteering.

    ERIC Educational Resources Information Center

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  8. Sports Injuries to the Foot and Ankle

    MedlinePlus

    ... Print Bookmark Sports Injuries to the Foot and Ankle Depending on the sport, your feet and ankles can certainly take a beating from repetitive play. ... communities: Copyright © 2016 | American College of Foot and Ankle Surgeons (ACFAS), All Rights Reserved. | Privacy Statement | Disclaimer | ...

  9. Lateral ankle sprains and instability problems.

    PubMed

    Liu, S H; Jason, W J

    1994-10-01

    The lateral ankle complex is the most frequently injured single structure in athletes, consisting of 38% to 45% of all injuries. One-sixth of all sports injury loss time is from ankle sprains. In North America, ankle inversion sprains are considered "de rigeur" for basketball participation. PMID:7805107

  10. Software ``Best'' Practices: Agile Deconstructed

    NASA Astrophysics Data System (ADS)

    Fraser, Steven

    Software “best” practices depend entirely on context - in terms of the problem domain, the system constructed, the software designers, and the “customers” ultimately deriving value from the system. Agile practices no longer have the luxury of “choosing” small non-mission critical projects with co-located teams. Project stakeholders are selecting and adapting practices based on a combina tion of interest, need and staffing. For example, growing product portfolios through a merger or the acquisition of a company exposes legacy systems to new staff, new software integration challenges, and new ideas. Innovation in communications (tools and processes) to span the growth and contraction of both information and organizations, while managing the adoption of changing software practices, is imperative for success. Traditional web-based tools such as web pages, document libraries, and forums are not suf ficient. A blend of tweeting, blogs, wikis, instant messaging, web-based confer encing, and telepresence creates a new dimension of communication “best” practices.

  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. PMID:24365326

  12. Foot and ankle problems in dancers.

    PubMed

    Kadel, Nancy

    2014-11-01

    The dancer's foot and ankle are subjected to high forces and unusual stresses in training and performance. Injuries are common in dancers, and the foot and ankle are particularly vulnerable. Ankle sprains, ankle impingement syndromes, flexor hallucis longus tendonitis, cuboid subluxation, stress fractures, midfoot injuries, heel pain, and first metatarsophalangeal joint problems including hallux valgus, hallux rigidus, and sesamoid injuries will be reviewed. This article will discuss these common foot and ankle problems in dancers and give typical clinical presentation and diagnostic and treatment recommendations. PMID:25442161

  13. Distinguishing ankle and knee articular cartilage.

    PubMed

    Cole, Ada A; Margulis, Arkady; Kuettner, Klaus E

    2003-06-01

    Degenerative changes in the tall and femoral distal cartilages of more than 2,000 tissue donors were graded based on the appearance of articular cartilage and osteophytes. In the ankle and the knee the degenerative changes increased with age; however, the rate of degeneration in the ankle was slower than in the knee. The degenerative changes in the ankle were more severe in men than in women, were predominantly bilateral, and seemed to be correlated with weight. The slower rate of change in the ankle may be caused, in part, by the biochemical and biomechanical tissue properties that distinguish ankle cartilage from that of the knee. PMID:12911243

  14. 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. PMID:27052302

  15. Prevalence of chronic ankle instability and associated symptoms in university dance majors: an exploratory study.

    PubMed

    Simon, Janet; Hall, Emily; Docherty, Carrie

    2014-01-01

    Previous investigations have established that dancers suffer a large number of injuries to the lower leg, foot, and ankle, with a portion of these being significant time loss injuries or in some cases career ending. Lateral ankle sprain is a common injury in dancers and can often lead to recurrent instability and repetitive injuries. Research in other active populations has linked ankle sprains to the development of chronic ankle instability (CAI). Therefore, the purpose of this study was to identify the prevalence of CAI and related symptoms of ankle sprain in a student dance population. Individuals were included if they were currently a modern or ballet dance major at the investigators' university (exclusion criterion: a history of fracture or surgery in the lower extremities). A self-reported demographic questionnaire and the Identification of Functional Ankle Instability survey were used to identify the presence and characteristics of CAI. A total of 83 questionnaires were collected, and after exclusions, 77 participants remained: 43 modern dancers and 34 ballet dancers (10 males and 67 females, mean age 19.61 ± 2.53 years, mean dance experience 13.61 ± 3.16 years). Of all dancers surveyed, 41 (53.2%) had CAI, and of those 24 (58.5%) were modern dancers, and 17 (41.5%) were ballet dancers. When looking only at those dancers who had a previous lateral ankle sprain, 75.9% were identified as having CAI. Chronic Ankle Instability can create long-term problems for anyone but especially female dancers, who place extreme stress on their feet and ankles from being en pointe or demi-pointe. It is important to educate dancers, instructors, and medical staff of the importance of recognizing CAI and seeking medical care for ankle sprains and their residual symptoms. PMID:25474297

  16. Effectiveness of robot-assisted therapy on ankle rehabilitation – a systematic review

    PubMed Central

    2013-01-01

    Objective The aim of this study was to provide a systematic review of studies that investigated the effectiveness of robot-assisted therapy on ankle motor and function recovery from musculoskeletal or neurologic ankle injuries. Methods Thirteen electronic databases of articles published from January, 1980 to June, 2012 were searched using keywords ‘ankle*’, ‘robot*’, ‘rehabilitat*’ or ‘treat*’ and a free search in Google Scholar based on effects of ankle rehabilitation robots was also conducted. References listed in relevant publications were further screened. Eventually, twenty-nine articles were selected for review and they focused on effects of robot-assisted ankle rehabilitation. Results Twenty-nine studies met the inclusion criteria and a total of 164 patients and 24 healthy subjects participated in these trials. Ankle performance and gait function were the main outcome measures used to assess the therapeutic effects of robot-assisted ankle rehabilitation. The protocols and therapy treatments were varied, which made comparison among different studies difficult or impossible. Few comparative trials were conducted among different devices or control strategies. Moreover, the majority of study designs met levels of evidence that were no higher than American Academy for Cerebral Palsy (CP) and Developmental Medicine (AACPDM) level IV. Only one study used a Randomized Control Trial (RCT) approach with the evidence level being II. Conclusion All the selected studies showed improvements in terms of ankle performance or gait function after a period of robot-assisted ankle rehabilitation training. The most effective robot-assisted intervention cannot be determined due to the lack of universal evaluation criteria for various devices and control strategies. Future research into the effects of robot-assisted ankle rehabilitation should be carried out based on universal evaluation criteria, which could determine the most effective method of intervention. It

  17. Neural-mechanical feedback control scheme generates physiological ankle torque fluctuation during quiet stance.

    PubMed

    Vette, Albert H; Masani, Kei; Nakazawa, Kimitaka; Popovic, Milos R

    2010-02-01

    We have recently demonstrated in simulations and experiments that a proportional and derivative (PD) feedback controller can regulate the active ankle torque during quiet stance and stabilize the body despite a long sensory-motor time delay. The purpose of the present study was to: 1) model the active and passive ankle torque mechanisms and identify their contributions to the total ankle torque during standing and 2) investigate whether a neural-mechanical control scheme that implements the PD controller as the neural controller can successfully generate the total ankle torque as observed in healthy individuals during quiet stance. Fourteen young subjects were asked to stand still on a force platform to acquire data for model optimization and validation. During two trials of 30 s each, the fluctuation of the body angle, the electromyogram of the right soleus muscle, and the ankle torque were recorded. Using these data, the parameters of: 1) the active and passive torque mechanisms (Model I) and 2) the PD controller within the neural-mechanical control scheme (Model II) were optimized to achieve potential matching between the measured and predicted ankle torque. The performance of the two models was finally validated with a new set of data. Our results indicate that not only the passive, but also the active ankle torque mechanism contributes significantly to the total ankle torque and, hence, to body stabilization during quiet stance. In addition, we conclude that the proposed neural-mechanical control scheme successfully mimics the physiological control strategy during quiet stance and that a PD controller is a legitimate model for the strategy that the central nervous system applies to regulate the active ankle torque in spite of a long sensory-motor time delay. PMID:20071280

  18. Pseudoaneurysm of peroneal artery after ankle arthroscopy

    PubMed Central

    Battisti, Daniela; Oliva, Francesco; Tarantino, Umberto; Nicola, Maffulli

    2014-01-01

    Summary Background: ankle arthroscopy increased its role in the diagnosis and treatment of pathology of the ankle since 1970s. Although the benefits are well established, ankle arthroscopy is associated with a definite risk of complications, especially neurological. The incidence rate of vascular complication after anterior ankle arthroscopy has been reported. Methods: we review the literature on vascular complications after anterior ankle arthroscopy especially pseudoaneurysm and a case report of a peronal artery pseudoaneurysm was reported. Conclusion: vascular complications after an anterior ankle arthroscopy are extremely rare but orthopaedic surgeons should be wary of this chance. Among vascular complications after an anterior ankle arthroscopy, peroneal artery pseudoaneurysm to our knowledge never has been described until now. PMID:25332946

  19. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player.

    PubMed

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-07-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  20. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player

    PubMed Central

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-01-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  1. Syndesmotic ankle sprains in athletes.

    PubMed

    Williams, Glenn N; Jones, Morgan H; Amendola, Annunziato

    2007-07-01

    Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries have historically been underdiagnosed, and assessment in terms of severity and optimal treatment has not been determined. More recently, a heightened awareness in sports medicine has resulted in more frequent diagnoses of syndesmosis injuries. However, there is a low level of evidence and a paucity of literature on this topic compared with lateral ankle sprains. As a result, no clear guidelines are available to help the clinician assess the severity of injury, choose an imaging modality to visualize the injury, make a decision in terms of operative versus nonoperative treatment, or decide when the athlete may return to play. Increased knowledge and understanding of these injuries by clinicians and researchers are essential to improve the prevention, diagnosis, and treatment of this significant condition. This review will discuss the anatomy, mechanism of injury, diagnosis, and treatment of syndesmosis sprains of the ankle while identifying controversies in management and topics for future research. PMID:17519439

  2. Fighter agility metrics. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Liefer, Randall K.

    1990-01-01

    Fighter flying qualities and combat capabilities are currently measured and compared in terms relating to vehicle energy, angular rates and sustained acceleration. Criteria based on these measurable quantities have evolved over the past several decades and are routinely used to design aircraft structures, aerodynamics, propulsion and control systems. While these criteria, or metrics, have the advantage of being well understood, easily verified and repeatable during test, they tend to measure the steady state capability of the aircraft and not its ability to transition quickly from one state to another. Proposed new metrics to assess fighter aircraft agility are collected and analyzed. A framework for classification of these new agility metrics is developed and applied. A complete set of transient agility metrics is evaluated with a high fidelity, nonlinear F-18 simulation. Test techniques and data reduction methods are proposed. A method of providing cuing information to the pilot during flight test is discussed. The sensitivity of longitudinal and lateral agility metrics to deviations from the pilot cues is studied in detail. The metrics are shown to be largely insensitive to reasonable deviations from the nominal test pilot commands. Instrumentation required to quantify agility via flight test is also considered. With one exception, each of the proposed new metrics may be measured with instrumentation currently available.

  3. Gamma-ray Astrophysics with AGILE

    SciTech Connect

    Longo, Francesco |; Tavani, M.; Barbiellini, G.; Argan, A.; Basset, M.; Boffelli, F.; Bulgarelli, A.; Caraveo, P.; Cattaneo, P.; Chen, A.; Costa, E.; Del Monte, E.; Di Cocco, G.; Di Persio, G.; Donnarumma, I.; Feroci, M.; Fiorini, M.; Foggetta, L.; Froysland, T.; Frutti, M.

    2007-07-12

    AGILE will explore the gamma-ray Universe with a very innovative instrument combining for the first time a gamma-ray imager and a hard X-ray imager. AGILE will be operational in spring 2007 and it will provide crucial data for the study of Active Galactic Nuclei, Gamma-Ray Bursts, unidentified gamma-ray sources. Galactic compact objects, supernova remnants, TeV sources, and fundamental physics by microsecond timing. The AGILE instrument is designed to simultaneously detect and image photons in the 30 MeV - 50 GeV and 15 - 45 keV energy bands with excellent imaging and timing capabilities, and a large field of view covering {approx} 1/5 of the entire sky at energies above 30 MeV. A CsI calorimeter is capable of GRB triggering in the energy band 0.3-50 MeV AGILE is now (March 2007) undergoing launcher integration and testing. The PLSV launch is planned in spring 2007. AGILE is then foreseen to be fully operational during the summer of 2007.

  4. Enterprise Technologies Deployment for Agile Manufacturing

    SciTech Connect

    Neal, R.E.

    1992-11-01

    This report is intended for high-level technical planners who are responsible for planning future developments for their company or Department of Energy/Defense Programs (DOE/DP) facilities. On one hand, the information may be too detailed or contain too much manufacturing technology jargon for a high-level, nontechnical executive, while at the same time an expert in any of the four infrastructure fields (Product Definition/Order Entry, Planning and Scheduling, Shop Floor Management, and Intelligent Manufacturing Systems) will know more than is conveyed here. The purpose is to describe a vision of technology deployment for an agile manufacturing enterprise. According to the 21st Century Manufacturing Enterprise Strategy, the root philosophy of agile manufacturing is that ``competitive advantage in the new systems will belong to agile manufacturing enterprises, capable of responding rapidly to demand for high-quality, highly customized products.`` Such agility will be based on flexible technologies, skilled workers, and flexible management structures which collectively will foster cooperative initiatives in and among companies. The remainder of this report is dedicated to sharpening our vision and to establishing a framework for defining specific project or pre-competitive project goals which will demonstrate agility through technology deployment.

  5. Enterprise Technologies Deployment for Agile Manufacturing

    SciTech Connect

    Neal, R.E.

    1992-11-01

    This report is intended for high-level technical planners who are responsible for planning future developments for their company or Department of Energy/Defense Programs (DOE/DP) facilities. On one hand, the information may be too detailed or contain too much manufacturing technology jargon for a high-level, nontechnical executive, while at the same time an expert in any of the four infrastructure fields (Product Definition/Order Entry, Planning and Scheduling, Shop Floor Management, and Intelligent Manufacturing Systems) will know more than is conveyed here. The purpose is to describe a vision of technology deployment for an agile manufacturing enterprise. According to the 21st Century Manufacturing Enterprise Strategy, the root philosophy of agile manufacturing is that competitive advantage in the new systems will belong to agile manufacturing enterprises, capable of responding rapidly to demand for high-quality, highly customized products.'' Such agility will be based on flexible technologies, skilled workers, and flexible management structures which collectively will foster cooperative initiatives in and among companies. The remainder of this report is dedicated to sharpening our vision and to establishing a framework for defining specific project or pre-competitive project goals which will demonstrate agility through technology deployment.

  6. An investigation of fighter aircraft agility

    NASA Technical Reports Server (NTRS)

    Valasek, John; Downing, David R.

    1993-01-01

    This report attempts to unify in a single document the results of a series of studies on fighter aircraft agility funded by the NASA Ames Research Center, Dryden Flight Research Facility and conducted at the University of Kansas Flight Research Laboratory during the period January 1989 through December 1993. New metrics proposed by pilots and the research community to assess fighter aircraft agility are collected and analyzed. The report develops a framework for understanding the context into which the various proposed fighter agility metrics fit in terms of application and testing. Since new metrics continue to be proposed, this report does not claim to contain every proposed fighter agility metric. Flight test procedures, test constraints, and related criteria are developed. Instrumentation required to quantify agility via flight test is considered, as is the sensitivity of the candidate metrics to deviations from nominal pilot command inputs, which is studied in detail. Instead of supplying specific, detailed conclusions about the relevance or utility of one candidate metric versus another, the authors have attempted to provide sufficient data and analyses for readers to formulate their own conclusions. Readers are therefore ultimately responsible for judging exactly which metrics are 'best' for their particular needs. Additionally, it is not the intent of the authors to suggest combat tactics or other actual operational uses of the results and data in this report. This has been left up to the user community. Twenty of the candidate agility metrics were selected for evaluation with high fidelity, nonlinear, non real-time flight simulation computer programs of the F-5A Freedom Fighter, F-16A Fighting Falcon, F-18A Hornet, and X-29A. The information and data presented on the 20 candidate metrics which were evaluated will assist interested readers in conducting their own extensive investigations. The report provides a definition and analysis of each metric; details

  7. Gamma-ray astrophysics with AGILE

    NASA Astrophysics Data System (ADS)

    Tavani, M.

    2003-09-01

    Gamma-ray astrophysics above 30 MeV will soon be revitalized by a new generation of high-energy detectors in space. We discuss here the AGILE Mission that will be dedicated to gamma-ray astrophysics above 30 MeV during the period 2005-2006. The main characteristics of AGILE are: (1) excellent imaging and monitoring capabilities both in the γ-ray (30 MeV - 30 GeV) and hard X-ray (10-40 keV) energy ranges (reaching an arcminute source positioning), (2) very good timing (improving by three orders of magnitude the instrumental deadtime for γ-ray detection compared to previous instruments), and (3) excellent imaging and triggering capability for Gamma-Ray Bursts. The AGILE scientific program will emphasize a quick response to gamma-ray transients and multiwavelength studies of gamma-ray sources.

  8. SuperAGILE and Gamma Ray Bursts

    SciTech Connect

    Pacciani, Luigi; Costa, Enrico; Del Monte, Ettore; Donnarumma, Immacolata; Evangelista, Yuri; Feroci, Marco; Frutti, Massimo; Lazzarotto, Francesco; Lapshov, Igor; Rubini, Alda; Soffitta, Paolo; Tavani, Marco; Barbiellini, Guido; Mastropietro, Marcello; Morelli, Ennio; Rapisarda, Massimo

    2006-05-19

    The solid-state hard X-ray imager of AGILE gamma-ray mission -- SuperAGILE -- has a six arcmin on-axis angular resolution in the 15-45 keV range, a field of view in excess of 1 steradian. The instrument is very light: 5 kg only. It is equipped with an on-board self triggering logic, image deconvolution, and it is able to transmit the coordinates of a GRB to the ground in real-time through the ORBCOMM constellation of satellites. Photon by photon Scientific Data are sent to the Malindi ground station at every contact. In this paper we review the performance of the SuperAGILE experiment (scheduled for a launch in the middle of 2006), after its first onground calibrations, and show the perspectives for Gamma Ray Bursts.

  9. Minimum reporting standards for copers in chronic ankle instability research.

    PubMed

    Wikstrom, Erik A; Brown, Cathleen N

    2014-02-01

    Lateral ankle sprains (LASs) are among the most common sports-related injuries and a high percentage of individuals who sprain their ankle go on to develop chronic ankle instability (CAI). The condition of CAI is often classified as having pain, loss of function, and a restriction of, or failure to, return to levels of previous activity. Historically, uninjured healthy controls are used as a comparison group to study the biomechanical and neuromuscular consequences of CAI. However, this model is not ideal to determine why a portion of the population experiencing an ankle sprain does not recover. A more appropriate comparison may be individuals who had an ankle sprain, and thus the exposure, but did not go on to develop CAI (i.e., copers). Thus, the purpose of this review was to determine the existing discrepancies and common standards in definitions of, terminology used for, and the inclusionary/exclusionary criteria used to describe copers within the CAI literature. Multiple databases were searched by keywords and specific authors. Potential studies were screened independently by both authors. Inclusion criteria consisted of an explicit definition of copers and explicit inclusionary/exclusionary criteria. A total of 21 studies were included in the current study and had four outcomes extracted: (1) the definition of copers; (2) the terminology used; (3) specific inclusionary/exclusionary criteria; and (4) injury characteristics of the copers. Based on the included operational definitions, it is recommend that future operational definitions of copers include three key components: (1) an initial LAS; (2) subsequent lack of CAI symptoms (i.e., no complaints of disability or giving way); and (3) a time since injury component. The term coper was overwhelming used within the existing literature (n = 15) and is thus recommended to be used in future studies when describing individuals who have suffered an LAS but failed to develop CAI. Minimal inclusionary criteria should

  10. Reference Values for Anaerobic Performance and Agility in Ambulatory Children and Adolescents with Cerebral Palsy

    ERIC Educational Resources Information Center

    Verschuren, Olaf; Bloemen, Manon; Kruitwagen, Cas; Takken, Tim

    2010-01-01

    Aim: The aim of this study was to provide reference values of anaerobic performance and agility in a group of children and adolescents with spastic cerebral palsy (CP). Method: A total of 300 children (184 males, 116 females) with spastic CP were recruited from 26 rehabilitation centres in six different countries. Of these, 215 were classified at…

  11. The prognosis of ankle sprains.

    PubMed

    de Bie, R A; de Vet, H C; van den Wildenberg, F A; Lenssen, T; Knipschild, P G

    1997-05-01

    We developed a new diagnostic tool for predicting the severity of ankle sprains just after injury. Since hard data obtained by diagnostic imaging techniques are still imperfect, we decided to use data from individual medical history and signs and symptoms that are part of the admission routine. During a three month-period data were collected on thirty-five patients with lateral ankle sprains who visited the first aid department of the University Hospital of Maastricht. Assessments took place at admission and at two and four weeks after injury. Assessors were the first-aid physician, a physiotherapist and the patient. Dependent variables were healed ankle in two and four weeks. Predicting variables were the data obtained at admission by the physician, the physiotherapist and the patient. The ability to predict outcome after two and four weeks was determined in a bivariate analysis, followed by logistic modelling. Accurate prediction of recovery time at admission appeared to be possible. Best two weeks predictor was the modified function score, an accuracy of 97% was achieved. Four weeks prediction was most accurate when function score was used together with the report mark from the doctor and the palpation score (accuracy of 81%). PMID:9231846

  12. Outcome of ankle arthrodesis in posttraumatic arthritis

    PubMed Central

    Gowda, BS Narayana; Kumar, J Mohan

    2012-01-01

    Background: Ankle arthrodesis is still a gold standard salvage procedure for the management of ankle arthritis. There are several functional and mechanical benefits of ankle arthrodesis, which make it a viable surgical procedure in the management of ankle arthritis. The functional outcomes following ankle arthrodesis are not very well known. The purpose of this study was to perform a clinical and radiographic evaluation of ankle arthrodesis in posttraumatic arthritis performed using Charnley's compression device. Materials and Methods: Between January 2006 and December 2009 a functional assessment of 15 patients (10 males and 5 females) who had undergone ankle arthrodesis for posttraumatic arthritis and/or avascular necrosis (AVN) talus (n=6), malunited bimalleolar fracture (n=4), distal tibial plafond fractures (n=3), medial malleoli nonunion (n=2). All the patients were assessed clinically and radiologically after an average followup of 2 years 8 months (range 1–5.7 years). Results: All patients had sound ankylosis and no complications related to the surgery. Scoring the patients with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, we found that 11 of the 15 had excellent results, two had good, and two showed fair results. They were all returned to their preinjury activities. Conclusion: We conclude that, the ankle arthrodesis can still be considered as a standard procedure in ankle arthritis. On the basis of these results, patients should be counseled that an ankle fusion will help to relieve pain and to improve overall function. Still, one should keep in mind that it is a salvage procedure that will cause persistent alterations in gait with a potential for deterioration due to the development of subtalar arthritis. PMID:22719119

  13. Find an Orthopaedic Foot and Ankle MD/DO

    MedlinePlus

    ... AOFAS / FootCareMD / Find a Surgeon Find an Orthopaedic Foot & Ankle Surgeon Page Content The Orthopaedic Distinction Who are Orthopaedic Foot & Ankle Surgeons? Orthopaedic foot and ankle surgeons are ...

  14. Lean and Agile: An Epistemological Reflection

    ERIC Educational Resources Information Center

    Browaeys, Marie-Joelle; Fisser, Sandra

    2012-01-01

    Purpose: The aim of the paper is to contribute to the discussion of treating the concepts of lean and agile in isolation or combination by presenting an alternative view from complexity thinking on these concepts, considering an epistemological approach to this topic. Design/methodology/approach: The paper adopts an epistemological approach, using…

  15. Achieving agility through parameter space qualification

    SciTech Connect

    Diegert, K.V.; Easterling, R.G.; Ashby, M.R.; Benavides, G.L.; Forsythe, C.; Jones, R.E.; Longcope, D.B.; Parratt, S.W.

    1995-02-01

    The A-primed (Agile Product Realization of Innovative electro-Mechanical Devices) project is defining and proving processes for agile product realization for the Department of Energy complex. Like other agile production efforts reported in the literature, A-primed uses concurrent engineering and information automation technologies to enhance information transfer. A unique aspect of our approach to agility is the qualification during development of a family of related product designs and their production processes, rather than a single design and its attendant processes. Applying engineering principles and statistical design of experiments, economies of test and analytic effort are realized for the qualification of the device family as a whole. Thus the need is minimized for test and analysis to qualify future devices from this family, thereby further reducing the design-to-production cycle time. As a measure of the success of the A-primed approach, the first design took 24 days to produce, and operated correctly on the first attempt. A flow diagram for the qualification process is presented. Guidelines are given for implementation, based on the authors experiences as members of the A-primed qualification team.

  16. Surgical treatment of the arthritic varus ankle.

    PubMed

    Easley, Mark E

    2012-12-01

    Within the past several years, the arthritic varus ankle has been addressed extensively in Foot and Ankle Clinics, with numerous excellent reviews by particularly knowledgeable authors. To support these outstanding contributions, this article provides a practical approach to this challenging constellation of foot and ankle abnormalities. Varus ankle arthritis exists on a continuum that prompts the treating surgeon to be familiar with a spectrum of surgical solutions, including joint-sparing realignment, arthroplasty, and arthrodesis. Each of these treatment options is addressed with several expanded case examples and supports the management approaches with the available pertinent literature. PMID:23158376

  17. Which ankle fractures require syndesmotic stabilization?

    PubMed

    van den Bekerom, Michel P J; Lamme, Bas; Hogervorst, Mike; Bolhuis, Hugo W

    2007-01-01

    Syndesmotic ruptures associated with ankle fractures are most commonly caused by external rotation of the foot, eversion of the talus within the ankle mortise, and excessive dorsiflexion. The distal tibiofibular syndesmosis consists of the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, and interosseous ligament, and it is essential for stability of the ankle mortise. Despite the numerous biomechanical and clinical studies pertaining to ankle fractures, there are no uniform recommendations regarding the use of the syndesmotic screw for specific injury patterns and fracture types. The objective of this review was to formulate recommendations for clinical practice related to the use of syndesmotic screw placement. PMID:17980843

  18. 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

  19. The relationship between lateral ankle sprain and ankle tendinitis in ballet dancers.

    PubMed

    Ritter, Stephanie; Moore, Marjorie

    2008-01-01

    The lateral ligament complex of the ankle is the most frequently injured structure in the body. Although most simple ankle sprains do not result in long-term disability, a significant number do not completely resolve, leading to residual symptoms that may persist for years. The most commonly reported symptoms, particularly among athletes, include instability, re-injury, and tendinitis. Ballet dancers are a combination of artist and high-performance athlete; consequently, they are subjected to the same types of injuries as other athletes, including lateral ankle sprains and their sequelae. Furthermore, ballet dancers perform in unusual positions such as en pointe, which places the ankle in extreme plantar flexion, requiring stabilization by surrounding muscles. Dancers' extraordinary performance demands place them at risk for other ankle injuries as well, including inflammation ofseveral tendons, especially the peroneals. This report reviews the relevant literature to characterize the scope of lateral ankle sprains and sequelae, discuss the importance of the peroneal muscles in ankle stability, and explore a relationship between lateral ankle sprain and ankle tendinitis in ballet dancers. Informal interviews were conducted with physical therapists who specialize in treating ballet dancers, providing a clinical context for this report. An extensive review of the literature was conducted, including electronic databases, reference lists from papers, and relevant reference texts. Numerous studies have investigated ankle sprains and residual complaints; nearly all report that lateral ankle sprains commonly lead to chronic ankle instability. Studies exploring ankle stability have demonstrated that the peroneal muscles play a crucial role in ankle stabilization; EMG studies confirm they are the first to contract during ankle inversion stress. The dancer's need for exceptional ankle stabilization may lead to peroneal overuse and tendinitis. Studies have linked peroneal

  20. Association of hemoglobin with ankle-brachial index in general population

    PubMed Central

    Chenglong, Zhang; Jing, Lei; Xia, Ke; Yang, Tianlun

    2016-01-01

    OBJECTIVES: Previous studies have demonstrated that both low and high hemoglobin concentrations are predictive of adverse cardiovascular outcomes in various populations. However, an association of hemoglobin with the ankle-brachial index, which is widely used as a screening test for peripheral arterial disease, has not yet been identified. METHODS: We examined 786 subjects (236 women and 550 men) who received routine physical check-ups. The ankle-brachial index and several hematological parameters, including the hemoglobin level, hematocrit and red blood cell count and other demographic and biochemical characteristics were collected. Univariate and multivariate linear regression analyses were performed to assess the relationships between the ankle-brachial index and the independent determinants. Receiver operating characteristic curve analysis was conducted to calculate the cut-off level of hemoglobin for a relatively low ankle-brachial index (less than 20% of all subjects, which was 1.02). RESULTS: The hemoglobin level, hematocrit and red blood cell count were correlated with the ankle-brachial index in the males (r=-0.274, r=-0.224 and r=-0.273, respectively, p<0.001 for all), but these associations were not significant in the females. Multivariate linear regression analysis revealed that the independent determinants of the ankle-brachial index included age, total cholesterol, high-density lipoprotein cholesterol and the white blood cell count for the females and age, hypertension, total cholesterol and hemoglobin (β=-0.001, p<0.001) for the males after adjusting for confounding factors. Receiver operating characteristic curve analysis revealed that the cut-off level of hemoglobin for predicting a low ankle-brachial index was 156.5 g/L in the males. CONCLUSIONS: A high hemoglobin concentration was independently correlated with a low ankle-brachial index in the healthy males, indicating that an elevation in this level may be associated with an increased

  1. Ankle and Other Signatures in Uhecr

    NASA Astrophysics Data System (ADS)

    Berezinsky, Veniamin

    2015-03-01

    The interaction signatures of UHE protons propagating through CMB are discussed. Much attention is given to ankle, which starting from 1963 is usually interpreted as a feature of transition from galactic to extragalactic cosmic rays. We argue here that this interpretation is now excluded. It gives more credit to alternative explanation of the ankle as an intrinsic part of the pair-production dip.

  2. Basketball injuries of the foot and ankle.

    PubMed

    McDermott, E P

    1993-04-01

    Foot and ankle injuries in basketball are discussed in three unrelated categories in this article. This includes a practical differential diagnosis of ankle sprains, acute conditions of the mid and hindfoot, overuse syndromes of nerve entrapment, fascial strain, synovitis, joint subluxation, and inflammation resulting from repetitive stress. The diagnosis and treatment of tendon inflammation of the extrinsic foot musculature is also reviewed. PMID:8097679

  3. Diagnosis and treatment of chronic ankle pain.

    PubMed

    Wukich, Dane K; Tuason, Dominick A

    2011-01-01

    The differential diagnosis for chronic ankle pain is quite broad. Ankle pain can be caused by intra-articular or extra-articular pathology and may be a result of a traumatic or nontraumatic event. A detailed patient history and physical examination, coupled with judicious selection of the appropriate imaging modalities, are vital in making an accurate diagnosis and providing effective treatment. Chronic ankle pain can affect all age groups, ranging from young athletes to elderly patients with degenerative joint and soft-tissue disorders. It has been estimated that 23,000 ankle sprains occur each day in the United States, representing approximately 1 sprain per 10,000 people per day. Because nearly one in five ankle injuries result in chronic symptoms, orthopaedic surgeons are likely to see patients with chronic ankle pain. Many patients with chronic ankle pain do not recall any history of trauma. Reviewing the management of the various disorders that can cause chronic ankle pain will help orthopaedic surgeons provide the best treatment for their patients. PMID:21553785

  4. Assessment of acute foot and ankle sprains.

    PubMed

    Lynam, Louise

    2006-07-01

    Acute ankle and foot trauma is a regular emergency presentation and prompt strategic assessment skills are required to enable nurses to categorise and prioritise these injuries appropriately. This article provides background information on the anatomy and physiology of the lower limb to help nurses to identify various grades of ankle sprain as well as injuries that are limb threatening PMID:16878848

  5. Redefining prosthetic ankle mechanics: non-anthropomorphic ankle design.

    PubMed

    LaPrè, Andrew K; Sup, Frank

    2013-06-01

    The moment transferred at the residual limb socket interface of transtibial amputees can be a limiting factor of the comfort and activity level of lower limb amputees. The high pressures seen can be a significant source of pain, as well as result in deep tissue damage. The compensation of the sound limbs causes an asymmetrical gait which can be a contributor of early onset osteoarthritis in the sound limbs. It has been shown that the moment transferred with conventional passive prostheses can be lowered in magnitude by aligning the tibia with ground reaction forces, but this limits the effectiveness of the device. With recent powered prosthetics designed to mimic the missing limb, power can be injected into the gait cycle, but can also be limited by this pressure threshold. This paper shows the results of calculations that suggest that altering the prosthetic ankle mechanism can reduce the socket interface moments by as much as 50%. This supports the development of an active non-anthropomorphic ankle prosthesis which reduces socket interface moments while still injecting substantial power levels into the gait cycle. PMID:24187257

  6. Normal Foot and Ankle Radiographic Angles, Measurements, and Reference Points.

    PubMed

    Lamm, Bradley M; Stasko, Paul A; Gesheff, Martin G; Bhave, Anil

    2016-01-01

    The limb deformity-based principles originate from a standard set of lower extremity radiographic angles and reference points. Objective radiographic measures are the building blocks for surgical planning. Critical preoperative planning and intraoperative and postoperative evaluation of radiographs are essential for proper deformity planning and correction of all foot and ankle cases. A total of 33 angles and reference points were measured on 24 healthy feet. The radiographic measurements were performed on standard weightbearing anteroposterior, lateral, and axial views of the right foot. A total of 4 measurements were made from the axial view, 12 from the lateral view, and 17 from the anteroposterior view. All angles were measured by both senior authors twice, independent of each other. The radiographic angles and measurements presented in the present study demonstrate a comprehensive and useful set of standard angles, measures, and reference points that can be used in clinical and perioperative evaluation of the foot and ankle. The standard radiographic measures presented in the present study provide the foundation for understanding the osseous foot and ankle position in a normal population. PMID:27320694

  7. Compact, Automated, Frequency-Agile Microspectrofluorimeter

    NASA Technical Reports Server (NTRS)

    Fernandez, Salvador M.; Guignon, Ernest F.

    1995-01-01

    Compact, reliable, rugged, automated cell-culture and frequency-agile microspectrofluorimetric apparatus developed to perform experiments involving photometric imaging observations of single live cells. In original application, apparatus operates mostly unattended aboard spacecraft; potential terrestrial applications include automated or semiautomated diagnosis of pathological tissues in clinical laboratories, biomedical instrumentation, monitoring of biological process streams, and portable instrumentation for testing biological conditions in various environments. Offers obvious advantages over present laboratory instrumentation.

  8. The Role of Shoe Design in Ankle Sprain Rates Among Collegiate Basketball Players

    PubMed Central

    Curtis, Claudia K; Laudner, Kevin G; McLoda, Todd A; McCaw, Steven T

    2008-01-01

    Context: Much of the recent focus in shoe design and engineering has been on improving athletic performance. Currently, this improvement has been in the form of “cushioned column systems,” which are spring-like in design and located under the heel of the shoe in place of a conventional heel counter. Concerns have been raised about whether this design alteration has increased the incidence of ankle sprains. Objective: To examine the incidence of lateral ankle sprains in collegiate basketball players with regard to shoe design. Design: Prospective cohort study. Setting: Certified athletic trainers at 1014 National Collegiate Athletic Association (NCAA)-affiliated schools sponsoring basketball during the 2005–2006 regular season were notified of an online questionnaire. Athletic trainers at 22 of the 1014 schools participated. Patients or Other Participants: A total of 230 basketball players (141 males, 89 females; age  =  20.2 ± 1.5 years) from NCAA Division I–III basketball programs sustained lateral ankle sprains. Main Outcome Measure(s): Ankle sprain information and type of shoe worn (cushioned column or noncushioned column) were collected via online survey. The incidence of lateral ankle sprains and type of shoes worn were compared using a chi-square analysis. Results: No difference was noted in ankle sprain incidence between groups (χ2  =  2.44, P  =  .20, relative risk  =  1.47, 95% confidence interval [CI]  =  0.32, 6.86). The incidence of ankle sprains was 1.33 per 1000 exposures in the cushioned column group (95% CI  =  0.62, 3.51) and 1.96 per 1000 exposures in the noncushioned column group (95% CI  =  0.51, 4.22). Conclusions: No increased incidence of ankle sprains was associated with shoe design. PMID:18523571

  9. Architecture-Centric Methods and Agile Approaches

    NASA Astrophysics Data System (ADS)

    Babar, Muhammad Ali; Abrahamsson, Pekka

    Agile software development approaches have had significant impact on industrial software development practices. Despite becoming widely popular, there is an increasing perplexity about the role and importance of a system’s software architecture in agile approaches [1, 2]. Advocates of the vital role of architecture in achieving quality goals of large-scale-software-intensive-systems are skeptics of the scalability of any development approach that does not pay sufficient attention to architectural issues. However, the proponents of agile approaches usually perceive the upfront design and evaluation of architecture as being of less value to the customers of a system. According to them, for example, re-factoring can help fix most of the problems. Many experiences show that large-scale re-factoring often results in significant defects, which are very costly to address later in the development cycle. It is considered that re-factoring is worthwhile as long as the high-level design is good enough to limit the need for large-scale re-factoring [1, 3, 4].

  10. Agile manufacturing: The factory of the future

    NASA Technical Reports Server (NTRS)

    Loibl, Joseph M.; Bossieux, Terry A.

    1994-01-01

    The factory of the future will require an operating methodology which effectively utilizes all of the elements of product design, manufacturing and delivery. The process must respond rapidly to changes in product demand, product mix, design changes or changes in the raw materials. To achieve agility in a manufacturing operation, the design and development of the manufacturing processes must focus on customer satisfaction. Achieving greatest results requires that the manufacturing process be considered from product concept through sales. This provides the best opportunity to build a quality product for the customer at a reasonable rate. The primary elements of a manufacturing system include people, equipment, materials, methods and the environment. The most significant and most agile element in any process is the human resource. Only with a highly trained, knowledgeable work force can the proper methods be applied to efficiently process materials with machinery which is predictable, reliable and flexible. This paper discusses the affect of each element on the development of agile manufacturing systems.

  11. First GRB detections with the AGILE Minicalorimeter

    SciTech Connect

    Marisaldi, M.; Labanti, C.; Fuschino, F.; Bulgarelli, A.; Gianotti, F.; Trifoglio, M.; Galli, M.; Tavani, M.; Argan, A.

    2008-05-22

    The Minicalorimeter (MCAL) onboard the AGILE satellite is a 1400 cm{sup 2} scintillation detector sensitive in the energy range 0.3-200 MeV. MCAL works both as a slave of the AGILE Silicon Tracker and as an autonomous detector for transient events (BURST mode). A dedicated onboard Burst Search logic scans BURST mode data in search of count rate increase. Peculiar characteristics of the detector are the high energy spectral coverage and a timing resolution of about 2 microseconds. Even if a trigger is not issued, BURST mode data are used to build a broad band energy spectrum (scientific ratemeters) organized in 11 bands for each of the two MCAL detection planes, with a time resolution of 1 second. After the first engineering commissioning phase, following the AGILE launch on 23rd April 2007, between 22nd June and 5th November 2007 eighteen GRBs were detected offline in the scientific ratemeters data, with a detection rate of about one per week. In this paper the capabilities of the detector will be described and an overview of the first detected GRBs will be given.

  12. Can Chronic Ankle Instability Be Prevented? Rethinking Management of Lateral Ankle Sprains

    PubMed Central

    Denegar, Craig R.; Miller, Sayers J.

    2002-01-01

    Objective: To pose the question, “Can chronic ankle instability be prevented?” The evaluation and treatment of chronic ankle instability is a significant challenge in athletic health care. The condition affects large numbers of athletes and is associated with reinjury and impaired performance. The management of acute injuries varies widely but in athletic training has traditionally focused on initial symptom management and rapid return to activity. A review of practice strategies and philosophies suggests that a more detailed evaluation of all joints affected by the injury, correction of hypomobility, and protection of healing structures may lead to a more optimal long-term outcome. Background: Sprains to the lateral ankle are common in athletes, and the reinjury rate is high. These injuries are often perceived as being isolated to the anterior talofibular and calcaneofibular ligaments. It is, however, becoming apparent that a lateral ankle sprain can injure other tissues and result in joint dysfunction throughout the ankle complex. Description: We begin by addressing the relationship between mechanical and functional instability. We then discuss normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics. Finally, tissue healing, joint dysfunction, and the management of acute lateral ankle sprain are reviewed, with an emphasis on restoring normal mechanics of the ankle-joint complex. A treatment model based on assessment of joint function, treatment of hypomobile segments, and protection of healing tissues at hypermobile segments is described. PMID:12937564

  13. The role of ankle bracing for prevention of ankle sprain injuries.

    PubMed

    Gross, Michael T; Liu, Hsin-Yi

    2003-10-01

    Lateral ankle sprains are one of the most common injuries incurred in recreational and competitive athletics. These injuries have a significant impact in terms of cost, athletic participation, and activities of daily living. Prophylactic ankle braces are often used to reduce the risk of injury recurrence when individuals return to athletic participation. The purpose of this clinical commentary is to review the literature and provide our own experience relative to the use of prophylactic ankle bracing. Relatively high incidence rates of ankle sprain injury have been reported for basketball and soccer athletes, military trainees, and individuals with a previous history of ankle sprain injury. Semirigid and laced ankle braces have significantly reduced the incidence of initial and recurrent ankle sprain injuries in athletic and military samples. With few exceptions, these braces do not appear to affect functional performance adversely. The prophylactic use of semirigid ankle braces appears warranted to reduce the incidence of initial and, in particular, recurrent ankle sprain injuries for individuals who participate in activities that have the highest risk for these injuries. Additional research is needed to evaluate the many new braces that are available and in use and their influence on the incidence of ankle sprain injury and functional performance. PMID:14620786

  14. Fatigue characteristics following ankle fractures.

    PubMed

    Behm, D G; St-Pierre, D M

    1997-09-01

    The purpose of the study was to examine the effects of surgical and nonsurgical treatment of previously immobilized ankle fractures on voluntary and evoked contractile properties before and following fatigue. Twelve control and 12 previously immobilized (4-14 wk postfracture) internally fixated and nonfixated ankles were investigated before and following an isometric, intermittent, submaximal, fatigue protocol of the plantar flexors. Before fatigue, fracture groups had significantly lower force output (42.7 vs 78.8 Nm) and muscle activation (78.3 vs 98.7%) than controls. Decreased activation may be attributed to the inhibitory effects of injured muscle and swelling. All groups had similar force and muscle activation decreases (7-10%) following fatigue; however, the internally fixated group performed significantly fewer contractions during the fatigue test (19) than the nonfixated (71) and controls (61). In contrast to the other groups, internally fixated subjects experienced increased (13%) rather than decreased EMG activity (controls: 10.9%, nonfixated: 21.1%). M-waves and twitch torques potentiated to a similar extent in the fracture groups (4.5 and 5.7%) but decreased significantly in the control group (24.2 and 9.8%). The similar fatigue durations of non-fixated subjects compared with controls may be attributed to a lack of impairment in nonfixated neuromuscular propagation and contractile kinetics, while the increased fatigability of fixated subjects with a similar lack of evoked contractile property impairments suggested a greater intrinsic fatigability. PMID:9309620

  15. Search the Foot and Ankle: Interactive Foot Diagram

    MedlinePlus

    ... Text Size Print Bookmark Search the Foot and Ankle Foot conditions in this region: Bunions (Hallux Valgus) » ... Injuries » Posterior Tibial Tendon Dysfunction (PTTD) » Tarsal Coalition » Ankle Fractures » Ankle Sprain » Chronic Ankle Instability » Equinus » Gout » ...

  16. How to Stretch Your Ankle After a Sprain

    MedlinePlus

    ... Decide If You Need to See an Orthopaedic Foot and Ankle Specialist How to Care for a Sprained Ankle How to Be Non- ... 10. Repeat 10 times. ​ Additional Resources How to Care for a Sprained Ankle How to Strengthen Your ... American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site ...

  17. Future Research in Agile Systems Development: Applying Open Innovation Principles Within the Agile Organisation

    NASA Astrophysics Data System (ADS)

    Conboy, Kieran; Morgan, Lorraine

    A particular strength of agile approaches is that they move away from ‘introverted' development and intimately involve the customer in all areas of development, supposedly leading to the development of a more innovative and hence more valuable information system. However, we argue that a single customer representative is too narrow a focus to adopt and that involvement of stakeholders beyond the software development itself is still often quite weak and in some cases non-existent. In response, we argue that current thinking regarding innovation in agile development needs to be extended to include multiple stakeholders outside the business unit. This paper explores the intra-organisational applicability and implications of open innovation in agile systems development. Additionally, it argues for a different perspective of project management that includes collaboration and knowledge-sharing with other business units, customers, partners, and other relevant stakeholders pertinent to the business success of an organisation, thus embracing open innovation principles.

  18. The effect of prosthetic ankle energy storage and return properties on muscle activity in below-knee amputee walking.

    PubMed

    Ventura, Jessica D; Klute, Glenn K; Neptune, Richard R

    2011-02-01

    In an effort to improve amputee gait, energy storage and return (ESAR) prosthetic feet have been developed to provide enhanced function by storing and returning mechanical energy through elastic structures. However, the effect of ESAR feet on muscle activity in amputee walking is not well understood. Previous studies have analyzed commercial prosthetic feet with a wide range of material properties and geometries, making it difficult to associate specific ESAR properties with changes in muscle activity. In contrast, prosthetic ankles offer a systematic way to manipulate ESAR properties while keeping the prosthetic heel and keel geometry intact. In the present study, ESAR ankles were added to a Seattle Lightfoot2 to carefully control the energy storage and return by altering the ankle stiffness and orientation in order to identify its effect on lower extremity muscle activity during below-knee amputee walking. A total of five foot conditions were analyzed: solid ankle (SA), stiff forward-facing ankle (FA), compliant FA, stiff reverse-facing ankle (RA) and compliant RA. The ESAR ankles decreased the activity of muscles that contribute to body forward propulsion and increased the activity of muscles that provide body support. The compliant ankles generally caused a greater change in muscle activity than the stiff ankles, but without a corresponding increase in energy return. Ankle orientation also had an effect, with RA generally causing a lower change in muscle activity than FA. These results highlight the influence of ESAR stiffness on muscle activity and the importance of prescribing appropriate prosthetic foot stiffness to improve rehabilitation outcomes. PMID:21145747

  19. The agile transversal filter - A flexible building block for ICNIA

    NASA Astrophysics Data System (ADS)

    Botha, D. G.; Smead, F. W.

    Integrated Communications, Navigation and Identification Avionics (ICNIA) is an advanced development program to demonstrate an integrated systems approach to the implementation of functions normally performed by a collection of independent black boxes. The system design partitions all CNI functions to optimize modular commonality within the ICNIA system. One function required in many parallel channels is the processing of signals with instantaneous bandwidths of 10 MHz or less. A specific implementation is the Narrow Band Agile Transversal Filter (NBATF), which can be implemented in state-of-the-art technology, can process signals with a variety of algorithms selectable under software control, and can be replicated within the system, as required, to perform the total set of functions. The NBATF constitutes a building block module within the ICNIA system.

  20. The effect of osseous ankle configuration on chronic ankle instability

    PubMed Central

    Frigg, Arno; Magerkurth, Olaf; Valderrabano, Victor; Ledermann, Hans‐Peter; Hintermann, Beat

    2007-01-01

    Background Chronic ankle instability (CAI) is a common orthopaedic entity in sport. Although other risk factors have been studied extensively, little is known about how it is influenced by the osseous joint configuration. Aim To study the effect of osseous ankle configuration on CAI. Design Case–control study, level III. Setting Radiological examination with measurement of lateral x rays by an independent radiologist using a digital DICOM/PACS system. Patients A group of 52 patients who had had at least three recurrent sprains was compared with an age‐matched and sex‐matched control group of 52 healthy subjects. Main outcome measures The radius of the talar surface, the tibial coverage of the talus (tibiotalar sector) and the height of the talar body were measured. Results The talar radius was found to be larger in patients with CAI (21.2 (2.4) mm) than in controls (17.7 (1.9) mm; p<0.001, power >95%). The tibiotalar sector, representing the tibial coverage of the talus, was smaller in patients with CAI (80° (5.1°)) than in controls (88.4° (7.2°); p<0.001, power >95%). No significant difference was observed in the height of the talar body between patients with CAI (28.8 (2.6) mm) and controls (27.5 (4.0) mm; p = 0.055). Conclusion CAI is associated with an unstable osseous joint configuration characterised by a larger radius of the talus and a smaller tibiotalar sector. There is evidence that a higher talus might also play some part, particularly in women. PMID:17261556

  1. Physical Activity Levels in College Students With Chronic Ankle Instability

    PubMed Central

    Hubbard-Turner, Tricia; Turner, Michael J.

    2015-01-01

    Context Ankle sprains are the most common orthopaedic pathologic condition, and more concerning is the high percentage of persons who develop chronic ankle instability (CAI). Researchers have reported that patients with CAI are restricted occupationally, have more functional limitations, and have a poorer health-related quality of life. We do not know if these limitations decrease physical activity levels. Objective To assess total weekly steps taken between persons with CAI and persons with healthy ankles. Design Case-control study. Setting University research laboratory. Patients or Other Participants A total of 20 participants with unilateral CAI (9 men, 11 women; age = 21.2 ± 1.9 years, height = 174.3 ± 6.9 cm, mass = 71.9 ± 11.7 kg) and 20 healthy participants (9 men, 11 women; age = 20.4 ± 2.1 years, height = 172.1 ± 5.5 cm, mass = 73.1 ± 13.4 kg) volunteered. Main Outcome Measure(s) We provided all participants with a pedometer and instructed them to wear it every day for 7 days and to complete a daily step log. They also completed the Foot and Ankle Ability Measure (FAAM), the FAAM Sport version, and the International Physical Activity Questionnaire. A 2-way analysis of variance (group × sex) was used to determine if differences existed in the total number of weekly steps, ankle laxity, and answers on the International Physical Activity Questionnaire between groups and between sexes. Results We found no group × sex interaction for step count (F range = 0.439–2.108, P = .08). A main effect for group was observed (F1,38 = 10.45, P = .04). The CAI group took fewer steps than the healthy group (P = .04). The average daily step count was 6694.47 ± 1603.35 for the CAI group and 8831.01 ± 1290.01 for the healthy group. The CAI group also scored lower on the FAAM (P = .01) and the FAAM Sport version (P = .01). Conclusions The decreased step count that the participants with CAI demonstrated is concerning. This decreased physical activity may be secondary

  2. Charcot neuroarthropathy of the foot and ankle.

    PubMed

    Schon, L C; Easley, M E; Weinfeld, S B

    1998-04-01

    The goal of this study was to characterize Charcot neuroarthropathy of the foot and ankle by specific sites of involvement (ankle, hindfoot, midfoot, and forefoot), modes of presentation, methods of management, and outcome. A summary of treatment and results for 50 ankles, 22 hindfeet, 131 midfeet, and 18 forefeet is presented. Nondisplaced neuropathic ankle fractures typically healed uneventfully with casting and bracing. For displaced ankle fractures, closed reduction and casting generally resulted in loss of reduction and progressive deterioration; better results were obtained with open reduction and internal fixation, using supplemental Kirschner wires and screws. Ankles with Charcot neuroarthropathy and preexisting arthritis typically required arthrodesis. Of the ankles with neuropathic avascular talar necrosis, approximately 1/3 did well with nonoperative intervention and 2/3 required surgery. Chronic, unstable, malaligned Charcot ankles often required arthrodesis. Neuropathic calcaneal fractures were managed successfully nonoperatively. For feet with transverse tarsal joint involvement (Schon Type IV), management was more complex. Nonoperative treatment was successful for less than 1/2. Two thirds of the feet with midtarsus involvement (Schon Types I, II, and III) were managed successfully nonoperatively; 1/3 required surgery for recurrent ulceration, instability, or osteomyelitis. Half of the feet with forefoot neuroarthropathy required surgery for malalignment, ulceration, and/or difficulty with shoewear or braces. This review has established patterns of Charcot involvement of the foot and ankle with corresponding methods of treatment and subsequent responses. From this extensive clinical experience with 221 neuropathic fractures or Charcot joints, recommendations were derived to assist in selecting appropriate management options. PMID:9584374

  3. Applying Agile MethodstoWeapon/Weapon-Related Software

    SciTech Connect

    Adams, D; Armendariz, M; Blackledge, M; Campbell, F; Cloninger, M; Cox, L; Davis, J; Elliott, M; Granger, K; Hans, S; Kuhn, C; Lackner, M; Loo, P; Matthews, S; Morrell, K; Owens, C; Peercy, D; Pope, G; Quirk, R; Schilling, D; Stewart, A; Tran, A; Ward, R; Williamson, M

    2007-05-02

    This white paper provides information and guidance to the Department of Energy (DOE) sites on Agile software development methods and the impact of their application on weapon/weapon-related software development. The purpose of this white paper is to provide an overview of Agile methods, examine the accepted interpretations/uses/practices of these methodologies, and discuss the applicability of Agile methods with respect to Nuclear Weapons Complex (NWC) Technical Business Practices (TBPs). It also provides recommendations on the application of Agile methods to the development of weapon/weapon-related software.

  4. Effect of ankle proprioceptive training on static body balance.

    PubMed

    Karakaya, Mehmet Gürhan; Rutbİl, Hilal; Akpinar, Ercan; Yildirim, Alİ; Karakaya, İlkİm Çitak

    2015-10-01

    [Purpose] This study aimed to investigate the effect of ankle proprioceptive training on static body balance. [Subjects and Methods] In this randomized-controlled, single-blind study, 59 university students (35 females, 24 males) were randomized into study (n=29) and control (n=30) groups. The study group received a foot and ankle proprioceptive exercise program including stretching, strengthening (plantar and dorsi-flexors, invertor and evertor muscles), and balance board exercises, each with 10 repetitions per session, 5 days a week, for a total of 10 sessions. The control group did not receive any intervention. Static body balance was evaluated by a kinesthetic ability trainer, which showed the balance index scores under both single foot and both feet conditions. This evaluation was repeated at the end of two weeks for both groups. [Results] Outcome measures of the groups were similar at the baseline. Balance index scores of both groups improved at the end of two weeks, and the study group had significantly lower index scores than those of the control group, indicating better balance. [Conclusion] Ankle proprioceptive training had positive effects on static body balance parameters in healthy individuals, and it is worth investigating the effects of this type of training in patients with balance disorders. PMID:26644697

  5. Celiac disease manifested by polyneuropathy and swollen ankles

    PubMed Central

    Djuric, Zlatko; Kamenov, Borislav; Katic, Vuka

    2007-01-01

    A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes, whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination, which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy. PMID:17552018

  6. Foot and Ankle Injuries in Runners.

    PubMed

    Tenforde, Adam S; Yin, Amy; Hunt, Kenneth J

    2016-02-01

    Foot and ankle injuries account for nearly one-third of running injuries. Achilles tendinopathy, plantar fasciopathy, and ankle sprains are 3 of the most common types of injuries sustained during training. Other common injuries include other tendinopathies of the foot and ankle, bone stress injuries, nerve conditions including neuromas, and joint disease including osteoarthritis. This review provides an evidence-based framework for the evaluation and optimal management of these conditions to ensure safe return to running participation and reduce risk for future injury. PMID:26616180

  7. Predictors of Adverse Events for Ankle Fractures: An Analysis of 6800 Patients.

    PubMed

    Dodd, Ashley C; Lakomkin, Nikita; Attum, Basem; Bulka, Catherine; Karhade, Aditya V; Douleh, Diana G; Mir, Hassan; Jahangir, A Alex; Obremskey, William T; Sethi, Manish K

    2016-01-01

    Ankle fractures are one of the most common injuries seen by orthopedic surgeons. It is therefore essential to understand the risks associated with their treatment. Using the American College of Surgeons National Surgical Quality Improvement Program(®) database from 2006 to 2013, the patient demographics, comorbidities, and 30-day complications were collected for 5 types of ankle fractures. A bivariate analysis was used to compare the patient demographics, comorbidities, and complications across all Common Procedural Terminology codes. A multivariable logistic regression model was then used to assess the odds of minor and major postoperative complications within 30 days after open treatment. A total of 6865 patients were included in the analysis. Of these patients, 2507 (36.5%) had bimalleolar ankle fractures. The overall rate of adverse events for ankle fractures was low. Bimalleolar fractures had the greatest rate of major (2.6%, n = 64), minor (3.8%, n = 94), and total (5.7%, n = 143) complications. When controlling for individual patient characteristics, bimalleolar fractures were associated with 4.92 times the odds (95% confidence interval 1.80 to 13.5; p = .002) of developing a complication compared with those with a medial malleolar fracture. The risk factors driving postoperative complications for all ankle fractures were age >65 years, obesity, diabetes, American Society of Anesthesiologists score >2, and functional status (p < .05). Although the overall rate of adverse events for ankle fractures was low, bimalleolar fractures were associated with 5 times the odds of developing a complication compared with medial malleolar fractures. Orthopedic surgeons must be aware of the risk factors that increase the rate of ankle fracture complications to improve patients' quality of care. PMID:27086177

  8. Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: A multicentre, randomised, blinded, controlled and non-inferiority trial

    PubMed Central

    González de Vega, C; Speed, C; Wolfarth, B; González, J

    2013-01-01

    Background Acute ankle sprains are common and activity limiting injuries, and topical diclofenac gel has proven efficacy in alleviating pain and restoring function. This trial aimed to compare a topical natural agent, Traumeel with topical diclofenac gel (1%) in the management of acute ankle sprain. Methods This prospective, multicentre, randomised, blinded, active-control and non-inferiority study involved 449 physically active adults sustaining unilateral grade 1 or 2 ankle sprain within the past 24 h. Participants were randomised to receive 2 g of Traumeel ointment (T-O) (n = 152) or Traumeel gel (T-G) (n = 150) or diclofenac gel (D-G) (n = 147), administered topically to the ankle three times a day for 14 days, with 6-weeks follow up. Results Day 7 median percentage reductions in Visual Analogue Scale pain score were 60.6%, 71.1% and 68.9% for the T-O, T-G and D-G groups, respectively. Total pain relief was reported by 12 (8.5%), 7 (5.0%) and 8 (5.9%) participants in each group, respectively. Median improvements in Foot and Ankle Ability Measure Activities of Daily Living subscale score were 26.2, 26.2 and 25.0 points for T-O, T-G and D-G groups, respectively. Mann–Whitney effect sizes and lower bound confidence intervals demonstrated non-inferiority of Traumeel vs. diclofenac for reducing pain and functional improvement. At 6 weeks, participants reported total pain relief and normal functioning. Adverse events (n = 43) were reported by 31/447 participants (6.9%). Treatments were equally well tolerated. Conclusions T-O and T-G decreased pain and improved joint function to the same extent as D-G in acute ankle sprain, and were well tolerated. PMID:23889885

  9. Analysis of the Association Between Motor and Anthropometric Variables with Change of Direction Speed and Reactive Agility Performance

    PubMed Central

    Sattler, Tine; Sekulić, Damir; Spasić, Miodrag; Perić, Mia; Krolo, Ante; Uljević, Ognjen; Kondrič, Miran

    2015-01-01

    There is an evident lack of studies examining the factors associated with reactive agility performances. The aim of this study was to evaluate the association between anthropometrics, body composition, jumping capacity, reactive strength, and balance with a stop-and-go change of direction speed (CODS) and reactive agility. The total sample comprised 39 male (body height: 182.95 ± 5.19 cm; body mass: 80.66 ± 7.69 kg) and 34 female (body height: 171.45 ± 6.81 cm; body mass: 61.95 ± 6.70 kg) college-level athletes (21.9 ± 1.9 years of age). The variables included body height, body mass, the percentage of body fat (BF%), balance as measured by an overall-stability index, the countermovement jump (CMJ), a reactive-strength index (RSI), stop-and-go reactive agility, and stop-and-go CODS. To define the associations between motor and anthropometric variables with CODS and reactive agility, the participants were clustered into three achievement groups based on their CODS and reactive agility performances. The ANOVA showed a significant difference between the CODS-based achievement groups for the CMJ (F test = 3.45 and 3.60 for males and females, respectively; p < 0.05), the RSI (F test = 6.94 and 5.29 for males and females, respectively; p < 0.05), and balance (F test = 3.47; p < 0.05 for males). In females, the reactive agility achievement groups differed significantly in the RSI (F test = 6.46; p < 0.05), the CMJ (F test = 4.35; p < 0.05) and BF% (F test = 4.07; p < 0.05), which is further confirmed by discriminant canonical analysis (Can R = 0.74; p < 0.05). The results confirm the need for independent evaluation and training for both CODS and reactive agility performance in sports. PMID:26557198

  10. Analysis of the Association Between Motor and Anthropometric Variables with Change of Direction Speed and Reactive Agility Performance.

    PubMed

    Sattler, Tine; Sekulić, Damir; Spasić, Miodrag; Perić, Mia; Krolo, Ante; Uljević, Ognjen; Kondrič, Miran

    2015-09-29

    There is an evident lack of studies examining the factors associated with reactive agility performances. The aim of this study was to evaluate the association between anthropometrics, body composition, jumping capacity, reactive strength, and balance with a stop-and-go change of direction speed (CODS) and reactive agility. The total sample comprised 39 male (body height: 182.95 ± 5.19 cm; body mass: 80.66 ± 7.69 kg) and 34 female (body height: 171.45 ± 6.81 cm; body mass: 61.95 ± 6.70 kg) college-level athletes (21.9 ± 1.9 years of age). The variables included body height, body mass, the percentage of body fat (BF%), balance as measured by an overall-stability index, the countermovement jump (CMJ), a reactive-strength index (RSI), stop-and-go reactive agility, and stop-and-go CODS. To define the associations between motor and anthropometric variables with CODS and reactive agility, the participants were clustered into three achievement groups based on their CODS and reactive agility performances. The ANOVA showed a significant difference between the CODS-based achievement groups for the CMJ (F test = 3.45 and 3.60 for males and females, respectively; p < 0.05), the RSI (F test = 6.94 and 5.29 for males and females, respectively; p < 0.05), and balance (F test = 3.47; p < 0.05 for males). In females, the reactive agility achievement groups differed significantly in the RSI (F test = 6.46; p < 0.05), the CMJ (F test = 4.35; p < 0.05) and BF% (F test = 4.07; p < 0.05), which is further confirmed by discriminant canonical analysis (Can R = 0.74; p < 0.05). The results confirm the need for independent evaluation and training for both CODS and reactive agility performance in sports. PMID:26557198

  11. Agile informatics: application of agile project management to the development of a personal health application.

    PubMed

    Chung, Jeanhee; Pankey, Evan; Norris, Ryan J

    2007-01-01

    We describe the application of the Agile method-- a short iteration cycle, user responsive, measurable software development approach-- to the project management of a modular personal health record, iHealthSpace, to be deployed to the patients and providers of a large academic primary care practice. PMID:18694014

  12. Lichen simplex chronicus on the ankle (image)

    MedlinePlus

    Lichen simplex chronicus on the ankle: Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ...

  13. Sports Injuries to the Foot and Ankle

    MedlinePlus

    ... Field Hockey Football Injuries Golf Injuries Lacrosse Rugby Running Soccer Softball Tennis Volleyball Find an ACFAS Physician ... Foot and Ankle Although golf does not involve running or jumping, injuries can occur to the foot ...

  14. Extended indications for foot and ankle arthroscopy.

    PubMed

    Hsu, Andrew R; Gross, Christopher E; Lee, Simon; Carreira, Dominic S

    2014-01-01

    Advances in foot and ankle arthroscopy have allowed surgeons to diagnose and treat a broadening array of disorders that were previously limited to open procedures. Arthroscopy of the posterior ankle, subtalar joint, and first metatarsophalangeal joint and tendoscopy can be used to address common foot and ankle ailments, with the potential benefits of decreased pain, fast recovery, and low complication rates. Posterior ankle and subtalar arthroscopy can be used to manage impingement, arthrofibrosis, synovitis, arthritis, fractures, and osteochondral defects. First metatarsophalangeal joint arthroscopy can address osteophytes, chronic synovitis, osteochondral defects, and degenerative joint disease. Tendoscopy is a minimally invasive alternative for evaluation and débridement of the Achilles, posterior tibial, flexor hallucis longus, and peroneal tendons. PMID:24382875

  15. American College of Foot and Ankle Surgeons

    MedlinePlus

    ... Programs Practice Management Practice Management Education Opportunities Practice Management e-Learning e-Learning CME Transcripts Corporate Relations Faculty Application Research & Publications Journal of Foot and Ankle Surgery ACFAS Update Read ...

  16. A novel dynamic ankle-supinating device.

    PubMed

    Gutierrez, Gregory M; Kaminski, Thomas

    2010-02-01

    Lateral ankle sprains (LAS) are among the most common joint injuries, and although most are resolved with conservative treatment, others develop chronic ankle instability (AI). Considerable attention has been directed toward understanding the underlying causes of this pathology; however, little is known concerning the neuromuscular mechanisms behind AI. A biomechanical analysis of the landing phase of a drop jump onto a device that simulates the mechanism of a LAS may give insight into the dynamic restraint mechanisms of the ankle by individuals with AI. Furthermore, work evaluating subjects who have a history of at least one lateral ankle sprain, yet did not develop AI, may help elucidate compensatory mechanisms following a LAS event. Identifying proper neuromuscular control strategies is crucial in reducing the incidence of AI. PMID:20147765

  17. Agile Development Methods for Space Operations

    NASA Technical Reports Server (NTRS)

    Trimble, Jay; Webster, Chris

    2012-01-01

    Main stream industry software development practice has gone from a traditional waterfall process to agile iterative development that allows for fast response to customer inputs and produces higher quality software at lower cost. How can we, the space ops community, adopt state of the art software development practice, achieve greater productivity at lower cost, and maintain safe and effective space flight operations? At NASA Ames, we are developing Mission Control Technologies Software, in collaboration with Johnson Space Center (JSC) and, more recently, the Jet Propulsion Laboratory (JPL).

  18. Endoscopic Ankle Lateral Ligament Graft Anatomic Reconstruction.

    PubMed

    Michels, Frederick; Cordier, Guillaume; Guillo, Stéphane; Stockmans, Filip

    2016-09-01

    Chronic instability is a common complication of lateral ankle sprains. If nonoperative treatment fails, a surgical repair or reconstruction may be indicated. Today, endoscopic techniques to treat ankle instability are becoming more popular. This article describes an endoscopic technique, using a step-by-step approach, to reconstruct the ATFL and CFL with a gracilis graft. The endoscopic technique is reproducible and safe with regard to the surrounding anatomic structures. Short and midterm results confirm the benefits of this technique. PMID:27524711

  19. Complex ankle arthrodesis: Review of the literature

    PubMed Central

    Rabinovich, Remy V; Haleem, Amgad M; Rozbruch, S Robert

    2015-01-01

    Complex ankle arthrodesis is defined as an ankle fusion that is at high risk of delayed and nonunion secondary to patient comorbidities and/or local ankle/hindfoot factors. Risk factors that contribute to defining this group of patients can be divided into systemic factors and local factors pertaining to co-existing ankle or hindfoot pathology. Orthopaedic surgeons should be aware of these risk factors and their association with patients’ outcomes after complex ankle fusions. Both external and internal fixations have demonstrated positive outcomes with regards to achieving stable fixation and minimizing infection. Recent innovations in the application of biophysical agents and devices have shown promising results as adjuncts for healing. Both osteoconductive and osteoinductive agents have been effectively utilized as biological adjuncts for bone healing with low complication rates. Devices such as pulsed electromagnetic field bone stimulators, internal direct current stimulators and low-intensity pulsed ultrasound bone stimulators have been associated with faster bone healing and improved outcomes scores when compared with controls. The aim of this review article is to present a comprehensive approach to the management of complex ankle fusions, including the use of biophysical adjuncts for healing and a proposed algorithm for their treatment. PMID:26396936

  20. Ankle flexibility and injury patterns in dancers.

    PubMed

    Wiesler, E R; Hunter, D M; Martin, D F; Curl, W W; Hoen, H

    1996-01-01

    Lower-extremity injuries are common among dancers and cause significant absences from rehearsals and performances. For this study of lower-extremity injuries in 101 ballet and 47 modern dance students, injuries requiring medical attention sustained over 1 academic year were associated with the following data obtained at the beginning of the school year: ankle flexibility, sex, dance discipline, previous injury, body mass index, and years of training. Eighty-three of the 148 students (age range, 12 to 28 years) reported prior lower-limb injuries, the most common being ankle sprains (28% of all dancers). Previous leg injuries correlated significantly with lower dorsiflexion measurements and with more new injuries. Female students had greater ankle and first metatarsophalangeal flexibility. Modern dancers had greater ankle inversion. Ninety-four students sustained 177 injuries during the study, including 75 sprains or strains and 71 cases of tendinitis. Thirty-nine percent (N = 69) were ankle injuries; 18% (N = 33) were knee injuries; 23% (N = 40) were foot injuries; and 20% (N = 35) were either hip or thigh injuries. Sixty-seven percent (N = 78) of the injured students were ballet dancers. Age, years of training, body mass index, sex, and ankle range of motion measurement had no predictive value for injury; previous injury and dance discipline both correlated with increased risk of injury. PMID:8947396

  1. Development of an agility assessment module for preliminary fighter design

    NASA Technical Reports Server (NTRS)

    Ngan, Angelen; Bauer, Brent; Biezad, Daniel; Hahn, Andrew

    1996-01-01

    A FORTRAN computer program is presented to perform agility analysis on fighter aircraft configurations. This code is one of the modules of the NASA Ames ACSYNT (AirCraft SYNThesis) design code. The background of the agility research in the aircraft industry and a survey of a few agility metrics are discussed. The methodology, techniques, and models developed for the code are presented. FORTRAN programs were developed for two specific metrics, CCT (Combat Cycle Time) and PM (Pointing Margin), as part of the agility module. The validity of the code was evaluated by comparing with existing flight test data. Example trade studies using the agility module along with ACSYNT were conducted using Northrop F-20 Tigershark and McDonnell Douglas F/A-18 Hornet aircraft models. The sensitivity of thrust loading and wing loading on agility criteria were investigated. The module can compare the agility potential between different configurations and has the capability to optimize agility performance in the preliminary design process. This research provides a new and useful design tool for analyzing fighter performance during air combat engagements.

  2. Agile Methods for Open Source Safety-Critical Software

    PubMed Central

    Enquobahrie, Andinet; Ibanez, Luis; Cheng, Patrick; Yaniv, Ziv; Cleary, Kevin; Kokoori, Shylaja; Muffih, Benjamin; Heidenreich, John

    2011-01-01

    The introduction of software technology in a life-dependent environment requires the development team to execute a process that ensures a high level of software reliability and correctness. Despite their popularity, agile methods are generally assumed to be inappropriate as a process family in these environments due to their lack of emphasis on documentation, traceability, and other formal techniques. Agile methods, notably Scrum, favor empirical process control, or small constant adjustments in a tight feedback loop. This paper challenges the assumption that agile methods are inappropriate for safety-critical software development. Agile methods are flexible enough to encourage the right amount of ceremony; therefore if safety-critical systems require greater emphasis on activities like formal specification and requirements management, then an agile process will include these as necessary activities. Furthermore, agile methods focus more on continuous process management and code-level quality than classic software engineering process models. We present our experiences on the image-guided surgical toolkit (IGSTK) project as a backdrop. IGSTK is an open source software project employing agile practices since 2004. We started with the assumption that a lighter process is better, focused on evolving code, and only adding process elements as the need arose. IGSTK has been adopted by teaching hospitals and research labs, and used for clinical trials. Agile methods have matured since the academic community suggested they are not suitable for safety-critical systems almost a decade ago, we present our experiences as a case study for renewing the discussion. PMID:21799545

  3. Peridigm summary report : lessons learned in development with agile components.

    SciTech Connect

    Salinger, Andrew Gerhard; Mitchell, John Anthony; Littlewood, David John; Parks, Michael L.

    2011-09-01

    This report details efforts to deploy Agile Components for rapid development of a peridynamics code, Peridigm. The goal of Agile Components is to enable the efficient development of production-quality software by providing a well-defined, unifying interface to a powerful set of component-based software. Specifically, Agile Components facilitate interoperability among packages within the Trilinos Project, including data management, time integration, uncertainty quantification, and optimization. Development of the Peridigm code served as a testbed for Agile Components and resulted in a number of recommendations for future development. Agile Components successfully enabled rapid integration of Trilinos packages into Peridigm. A cost of this approach, however, was a set of restrictions on Peridigm's architecture which impacted the ability to track history-dependent material data, dynamically modify the model discretization, and interject user-defined routines into the time integration algorithm. These restrictions resulted in modifications to the Agile Components approach, as implemented in Peridigm, and in a set of recommendations for future Agile Components development. Specific recommendations include improved handling of material states, a more flexible flow control model, and improved documentation. A demonstration mini-application, SimpleODE, was developed at the onset of this project and is offered as a potential supplement to Agile Components documentation.

  4. Agile Bodies: A New Imperative in Neoliberal Governance

    ERIC Educational Resources Information Center

    Gillies, Donald

    2011-01-01

    Modern business discourse suggests that a key bulwark against market fluctuation and the threat of failure is for organizations to become "agile'", a more dynamic and proactive position than that previously afforded by mere "flexibility". The same idea is also directed at the personal level, it being argued that the "agile" individual is better…

  5. Integrated product definition representation for agile numerical control applications

    SciTech Connect

    Simons, W.R. Jr.; Brooks, S.L.; Kirk, W.J. III; Brown, C.W.

    1994-11-01

    Realization of agile manufacturing capabilities for a virtual enterprise requires the integration of technology, management, and work force into a coordinated, interdependent system. This paper is focused on technology enabling tools for agile manufacturing within a virtual enterprise specifically relating to Numerical Control (N/C) manufacturing activities and product definition requirements for these activities.

  6. Agile Methods for Open Source Safety-Critical Software.

    PubMed

    Gary, Kevin; Enquobahrie, Andinet; Ibanez, Luis; Cheng, Patrick; Yaniv, Ziv; Cleary, Kevin; Kokoori, Shylaja; Muffih, Benjamin; Heidenreich, John

    2011-08-01

    The introduction of software technology in a life-dependent environment requires the development team to execute a process that ensures a high level of software reliability and correctness. Despite their popularity, agile methods are generally assumed to be inappropriate as a process family in these environments due to their lack of emphasis on documentation, traceability, and other formal techniques. Agile methods, notably Scrum, favor empirical process control, or small constant adjustments in a tight feedback loop. This paper challenges the assumption that agile methods are inappropriate for safety-critical software development. Agile methods are flexible enough to encourage the rightamount of ceremony; therefore if safety-critical systems require greater emphasis on activities like formal specification and requirements management, then an agile process will include these as necessary activities. Furthermore, agile methods focus more on continuous process management and code-level quality than classic software engineering process models. We present our experiences on the image-guided surgical toolkit (IGSTK) project as a backdrop. IGSTK is an open source software project employing agile practices since 2004. We started with the assumption that a lighter process is better, focused on evolving code, and only adding process elements as the need arose. IGSTK has been adopted by teaching hospitals and research labs, and used for clinical trials. Agile methods have matured since the academic community suggested they are not suitable for safety-critical systems almost a decade ago, we present our experiences as a case study for renewing the discussion. PMID:21799545

  7. Agile manufacturing in Intelligence, Surveillance and Reconnaissance (ISR)

    NASA Astrophysics Data System (ADS)

    DiPadua, Mark; Dalton, George

    2016-05-01

    The objective of the Agile Manufacturing for Intelligence, Surveillance, and Reconnaissance (AMISR) effort is to research, develop, design and build a prototype multi-intelligence (multi-INT), reconfigurable pod demonstrating benefits of agile manufacturing and a modular open systems approach (MOSA) to make podded intelligence, surveillance, and reconnaissance (ISR) capability more affordable and operationally flexible.

  8. A Roadmap for Using Agile Development in a Traditional Environment

    NASA Technical Reports Server (NTRS)

    Streiffert, Barbara; Starbird, Thomas; Grenander, Sven

    2006-01-01

    One of the newer classes of software engineering techniques is called 'Agile Development'. In Agile Development software engineers take small implementation steps and, in some cases, they program in pairs. In addition, they develop automatic tests prior to implementing their small functional piece. Agile Development focuses on rapid turnaround, incremental planning, customer involvement and continuous integration. Agile Development is not the traditional waterfall method or even a rapid prototyping method (although this methodology is closer to Agile Development). At the Jet Propulsion Laboratory (JPL) a few groups have begun Agile Development software implementations. The difficulty with this approach becomes apparent when Agile Development is used in an organization that has specific criteria and requirements handed down for how software development is to be performed. The work at the JPL is performed for the National Aeronautics and Space Agency (NASA). Both organizations have specific requirements, rules and processes for developing software. This paper will discuss some of the initial uses of the Agile Development methodology, the spread of this method and the current status of the successful incorporation into the current JPL development policies and processes.

  9. A Roadmap for Using Agile Development in a Traditional Environment

    NASA Technical Reports Server (NTRS)

    Streiffert, Barbara A.; Starbird, Thomas; Grenander, Sven

    2006-01-01

    One of the newer classes of software engineering techniques is called 'Agile Development'. In Agile Development software engineers take small implementation steps and, in some cases they program in pairs. In addition, they develop automatic tests prior to implementing their small functional piece. Agile Development focuses on rapid turnaround, incremental planning, customer involvement and continuous integration. Agile Development is not the traditional waterfall method or even a rapid prototyping method (although this methodology is closer to Agile Development). At Jet Propulsion Laboratory (JPL) a few groups have begun Agile Development software implementations. The difficulty with this approach becomes apparent when Agile Development is used in an organization that has specific criteria and requirements handed down for how software development is to be performed. The work at the JPL is performed for the National Aeronautics and Space Agency (NASA). Both organizations have specific requirements, rules and procedure for developing software. This paper will discuss the some of the initial uses of the Agile Development methodology, the spread of this method and the current status of the successful incorporation into the current JPL development policies.

  10. DIAGNOSTIC ACCURACY OF PHYSICAL EXAMINATION TESTS OF THE ANKLE/FOOT COMPLEX: A SYSTEMATIC REVIEW

    PubMed Central

    Schwieterman, Braun; Haas, Deniele; Columber, Kirby; Knupp, Darren

    2013-01-01

    Background: Orthopedic special tests of the ankle/foot complex are routinely used during the physical examination process in order to help diagnose ankle/lower leg pathologies. Purpose: The purpose of this systematic review was to investigate the diagnostic accuracy of ankle/lower leg special tests. Methods: A search of the current literature was conducted using PubMed, CINAHL, SPORTDiscus, ProQuest Nursing and Allied Health Sources, Scopus, and Cochrane Library. Studies were eligible if they included the following: 1) a diagnostic clinical test of musculoskeletal pathology in the ankle/foot complex, 2) description of the clinical test or tests, 3) a report of the diagnostic accuracy of the clinical test (e.g. sensitivity and specificity), and 4) an acceptable reference standard for comparison. The quality of included studies was determined by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results: Nine diagnostic accuracy studies met the inclusion criteria for this systematic review; analyzing a total of 16 special tests of the ankle/foot complex. After assessment using the QUADAS-2, only one study had low risk of bias and low concerns regarding applicability. Conclusion: Most ankle/lower leg orthopedic special tests are confirmatory in nature and are best utilized at the end of the physical examination. Most of the studies included in this systematic review demonstrate notable biases, which suggest that results and recommendations in this review should be taken as a guide rather than an outright standard. There is need for future research with more stringent study design criteria so that more accurate diagnostic power of ankle/lower leg special tests can be determined. Level of Evidence: 3a PMID:24175128

  11. Introduction to Stand-up Meetings in Agile Methods

    NASA Astrophysics Data System (ADS)

    Hasnain, Eisha; Hall, Tracy

    2009-05-01

    In recent years, agile methods have become more popular in the software industry. Agile methods are a new approach compared to plan-driven approaches. One of the most important shifts in adopting an agile approach is the central focus given to people in the process. This is exemplified by the independence afforded to developers in the development work they do. This work investigates the opinions of practitioners about daily stand-up meetings in the agile methods and the role of developer in that. For our investigation we joined a yahoo group called "Extreme Programming". Our investigation suggests that although trust is an important factor in agile methods. But stand-ups are not the place to build trust.

  12. Supporting Agile Development of Authorization Rules for SME Applications

    NASA Astrophysics Data System (ADS)

    Bartsch, Steffen; Sohr, Karsten; Bormann, Carsten

    Custom SME applications for collaboration and workflow have become affordable when implemented as Web applications employing Agile methodologies. Security engineering is still difficult with Agile development, though: heavy-weight processes put the improvements of Agile development at risk. We propose Agile security engineering and increased end-user involvement to improve Agile development with respect to authorization policy development. To support the authorization policy development, we introduce a simple and readable authorization rules language implemented in a Ruby on Rails authorization plugin that is employed in a real-world SME collaboration and workflow application. Also, we report on early findings of the language’s use in authorization policy development with domain experts.

  13. A Case Study of Coordination in Distributed Agile Software Development

    NASA Astrophysics Data System (ADS)

    Hole, Steinar; Moe, Nils Brede

    Global Software Development (GSD) has gained significant popularity as an emerging paradigm. Companies also show interest in applying agile approaches in distributed development to combine the advantages of both approaches. However, in their most radical forms, agile and GSD can be placed in each end of a plan-based/agile spectrum because of how work is coordinated. We describe how three GSD projects applying agile methods coordinate their work. We found that trust is needed to reduce the need of standardization and direct supervision when coordinating work in a GSD project, and that electronic chatting supports mutual adjustment. Further, co-location and modularization mitigates communication problems, enables agility in at least part of a GSD project, and renders the implementation of Scrum of Scrums possible.

  14. Frequency-agile wireless sensor networks

    NASA Astrophysics Data System (ADS)

    Arms, Steven W.; Townsend, Christopher P.; Churchill, David L.; Hamel, Michael J.; Galbreath, Jacob H.; Mundell, Steven W.

    2004-07-01

    Our goal was to demonstrate a wireless communications system capable of simultaneous, high speed data communications from a variety of sensors. We have previously reported on the design and application of 2 KHz data logging transceiver nodes, however, only one node may stream data at a time, since all nodes on the network use the same communications frequency. To overcome these limitations, second generation data logging transceivers were developed with software programmable radio frequency (RF) communications. Each node contains on-board memory (2 Mbytes), sensor excitation, instrumentation amplifiers with programmable gains & offsets, multiplexer, 16 bit A/D converter, microcontroller, and frequency agile, bi-directional, frequency shift keyed (FSK) RF serial data link. These systems are capable of continuous data transmission from 26 distinct nodes (902-928 MHz band, 75 kbaud). The system was demonstrated in a compelling structural monitoring application. The National Parks Service requested a means for continual monitoring and recording of sensor data from the Liberty Bell during a move to a new location (Philadelphia, October 2003). Three distinct, frequency agile, wireless sensing nodes were used to detect visible crack shear/opening micromotions, triaxial accelerations, and hairline crack tip strains. The wireless sensors proved to be useful in protecting the Liberty Bell.

  15. Weight-Bearing Ankle Dorsiflexion Range of Motion—Can Side-to-Side Symmetry Be Assumed?

    PubMed Central

    Rabin, Alon; Kozol, Zvi; Spitzer, Elad; Finestone, Aharon S.

    2015-01-01

    Context: In clinical practice, the range of motion (ROM) of the noninvolved side often serves as the reference for comparison with the injured side. Previous investigations of non–weight-bearing (NWB) ankle dorsiflexion (DF) ROM measurements have indicated bilateral symmetry for the most part. Less is known about ankle DF measured under weight-bearing (WB) conditions. Because WB and NWB ankle DF are not strongly correlated, there is a need to determine whether WB ankle DF is also symmetrical in a healthy population. Objective: To determine whether WB ankle DF is bilaterally symmetrical. A secondary goal was to further explore the correlation between WB and NWB ankle DF ROM. Design: Cross-sectional study. Setting: Training facility of the Israeli Defense Forces. Patients or Other Participants: A total of 64 healthy males (age = 19.6 ± 1.0 years, height = 175.0 ± 6.4 cm, and body mass = 71.4 ± 7.7 kg). Main Outcome Measure(s): Dorsiflexion ROM in WB was measured with an inclinometer and DF ROM in NWB was measured with a universal goniometer. All measurements were taken bilaterally by a single examiner. Results: Weight-bearing ankle DF was greater on the nondominant side compared with the dominant side (P < .001). Non–weight-bearing ankle DF was not different between sides (P = .64). The correlation between WB and NWB DF was moderate, with the NWB DF measurement accounting for 30% to 37% of the variance of the WB measurement. Conclusions: Weight-bearing ankle DF ROM should not be assumed to be bilaterally symmetrical. These findings suggest that side-to-side differences in WB DF may need to be interpreted while considering which side is dominant. The difference in bilateral symmetry between the WB and NWB measurements, as well as the only moderate level of correlation between them, suggests that both measurements should be performed routinely. PMID:25329350

  16. 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

  17. The effects of static stretching on speed and agility: One or multiple repetition protocols?

    PubMed

    Avloniti, Alexandra; Chatzinikolaou, Athanasios; Fatouros, Ioannis G; Protopapa, Maria; Athanailidis, Ioannis; Avloniti, Christina; Leontsini, Diamanda; Mavropalias, George; Jamurtas, Athanasios Z

    2016-01-01

    Although static stretching (SS) is utilized during warm-up before training and competition, the results about its effects on performance remain controversial. We examined whether performing a stretch of short-to-moderate duration (<60 sec) in a single repetition produces a similar or different effect on speed and agility performance from the effect which is produced while performing the same stretch in multiple repetitions of the same total duration. According to a repeated measurement design, 40 trained males were randomly assigned to either (1) a single repetition group or (2) a multiple repetition group. The participants in each group performed five trials: a control trial (no stretches were performed) and four experimental trials of SS protocols consisting of five exercises performed at either 20 sec (2 × 10 in the second group), 30 sec (3 × 10 in the second group), 40 sec (4 × 10 in the second group) or 60 sec (6 × 10 in the second group) of total duration. A two-way repeated measures analysis of variance showed that the participants in both group improved their speed performance in response to the 20-sec trial, whereas agility remained unaffected. Data analysis also revealed that the repetition number did not affect speed and agility performance. These data suggest that SS of short duration (<30 sec) may actually improve acute speed performance, whereas SS of moderate duration may not hamper speed and agility performance. Moreover, the effects of SS protocols are related to the total duration of each exercise and not to the number of repetitions in which each exercise is performed. PMID:25849415

  18. Management of High-Energy Foot and Ankle Injuries in the Geriatric Population

    PubMed Central

    Herscovici, Dolfi; Scaduto, Julia M.

    2012-01-01

    By the year 2035 almost 20% of the US population of 389 million people will be 65 years and older. What this group has, compared with aged populations in the past, is better health, more mobility, and more active lifestyles. From January 1989 through December 2010, a total of 494 elderly patients with 536 foot and ankle injuries were identified. Within this group, 237 (48%) patients with 294 injuries were sustained as a result of a high-energy mechanism. These mechanisms consisted of 170 motor vehicle accidents, 30 as a result of high (not ground level) energy falls, 2 from industrial accidents, and 35 classified as other, which included sports, blunt trauma, bicycle, airplane or boating accidents, crush injuries, and injuries resulting from a lawn mower. The injuries produced were 17 metatarsal fractures, 9 Lisfranc injuries, 10 midfoot (navicular, cuneiform, or cuboid) fractures, 23 talus fractures, 63 calcaneal fractures, 73 unimalleolar, bimalleolar, or trimalleolar ankle fractures, 45 pilon fractures, and 3 pure dislocations of the foot or ankle. Overall, 243 (83%) of these injuries underwent surgical fixation and data have shown that when surgery is used to manage high-energy injuries of the foot and ankle in the elderly individuals, the complications and outcomes are similar to those seen in younger patients. Therefore, the decision for surgical intervention for high-energy injuries of the foot and ankle should be based primarily on the injury pattern and not solely on the age of the patient. PMID:23569695

  19. Misdiagnosis of Talar Body or Neck Fractures as Ankle Sprains in Low Energy Traumas

    PubMed Central

    Young, Ki-Won; Kim, Jin-Su; Cho, Hun-Ki; Choo, Ho-Sik; Park, Jang-Ho

    2016-01-01

    Background The talus has a very complex anatomical morphology and is mainly fractured by a major force caused by a fall or a traffic accident. Therefore, a talus fracture is not common. However, many recent reports have shown that minor injuries, such as sprains and slips during sports activities, can induce a talar fracture especially in the lateral or posterior process. Still, fractures to the main parts of the talus (neck and body) after ankle sprains have not been reported as occult fractures. Methods Of the total 102 cases from January 2005 to December 2012, 7 patients had confirmed cases of missed/delayed diagnosis of a talus body or neck fracture and were included in the study population. If available, medical records, X-rays, computed tomography scans, and magnetic resonance imaging of the confirmed cases were retrospectively reviewed and analyzed. Results In the 7-patient population, there were 3 talar neck fractures and 4 talar body fractures (coronal shearing type). The mechanisms of injuries were all low energy trauma episodes. The causes of the injuries included twisting of the ankle during climbing (n = 2), jumping to the ground from a 1-m high wall (n = 2), and twisting of the ankle during daily activities (n = 3). Conclusions A talar body fracture and a talar neck fracture should be considered in the differential diagnosis of patients with acute and chronic ankle pain after a minor ankle injury. PMID:27583114

  20. The Costs of Operative Complications for Ankle Fractures: A Case Control Study

    PubMed Central

    Avilucea, Frank R.; Greenberg, Sarah E.; Grantham, W. Jeffrey; Sathiyakumar, Vasanth; Thakore, Rachel V.; Nwosu, Samuel K.; Archer, Kristin R.; Obremskey, William T.; Mir, Hassan R.; Sethi, Manish K.

    2014-01-01

    As our healthcare system moves towards bundling payments, it is vital to understand the potential financial implications associated with treatment of surgical complications. Considering that surgical treatment of ankle fractures is common, there remains minimal data relating costs to postsurgical intervention. We aimed to identify costs associated with ankle fracture complications through case-control analysis. Using retrospective analysis at a level I trauma center, 28 patients with isolated ankle fractures who developed complications (cases) were matched with 28 isolated ankle fracture patients without complications (controls) based on ASA score, age, surgery type, and fracture type. Patient charts were reviewed for demographics and complications leading to readmission/reoperation and costs were obtained from the financial department. Wilcoxon tests measured differences in the costs between the cases and controls. 28 out of 439 patients (6.4%) developed complications. Length of stay and median costs were significantly higher for cases than controls. Specifically, differences in total costs existed for infection and hardware-related pain. This is the first study to highlight the considerable costs associated with the treatment of complications due to isolated ankle fractures. Physicians must therefore emphasize methods to control surgical and nonsurgical factors that may impact postoperative complications, especially under a global payment system. PMID:25525521

  1. Validity and Reliability of the Achillometer(®): An Ankle Dorsiflexion Measurement Device.

    PubMed

    Kleeblad, Laura J; van Bemmel, Annelies F; Sierevelt, Inger N; Zuiderbaan, Hendrik A; Vergroesen, Diederik A

    2016-01-01

    Limited ankle dorsiflexion is closely related to important foot and ankle pathologies. Various measurement devices and methods have been examined, but these have demonstrated limited validity and reliability. The purpose of the present study was to assess the validity and intra- and interobserver reliability of the Achillometer(®). A total of 22 consecutive subjects with ankle or foot pathologies and 39 healthy participants were included. All participants were measured using the goniometer and the Achillometer(®), a portable device used to assess ankle dorsiflexion in the weightbearing position with knee in extension. The intraclass correlation coefficient, standard error of the mean, and minimal detectable change were determined. The goniometer and Achillometer(®) revealed high intraobserver reliability coefficients with an intraclass correlation coefficient of 0.88 (standard error of the mean 1.49, minimal detectable change 4.12) and 0.85 (standard error of the mean 1.57, minimal detectable change 4.34), respectively. The interobserver reliability of both measurement techniques ranged from 0.63 to 0.67. The Achillometer(®) showed a strong correlation with the goniometer for both observers. In conclusion, the Achillometer(®) is a valid measurement device to assess ankle dorsiflexion range of motion in the weightbearing position with an extended knee in a heterogeneous population. The device has good intraobserver and moderate interobserver reliability and measurement properties comparable to those of the goniometer. PMID:26830445

  2. Mechanical performance of artificial pneumatic muscles to power an ankle-foot orthosis.

    PubMed

    Gordon, Keith E; Sawicki, Gregory S; Ferris, Daniel P

    2006-01-01

    We developed a powered ankle-foot orthosis that uses artificial pneumatic muscles to produce active plantar flexor torque. The purpose of this study was to quantify the mechanical performance of the orthosis during human walking. Three subjects walked at a range of speeds wearing ankle-foot orthoses with either one or two artificial muscles working in parallel. The orthosis produced similar total peak plantar flexor torque and network across speeds independent of the number of muscles used. The orthosis generated approximately 57% of the peak ankle plantar flexor torque during stance and performed approximately 70% of the positive plantar flexor work done during normal walking. Artificial muscle bandwidth and force-length properties were the two primary factors limiting torque production. The lack of peak force and work differences between single and double muscle conditions can be explained by force-length properties. Subjects altered their ankle kinematics between conditions resulting in changes in artificial muscle length. In the double muscle condition greater plantar flexion yielded shorter artificial muscles lengths and decreased muscle forces. This finding emphasizes the importance of human testing in the design and development of robotic exoskeleton devices for assisting human movement. The results of this study outline the mechanical performance limitations of an ankle-foot orthosis powered by artificial pneumatic muscles. This orthosis could be valuable for gait rehabilitation and for studies investigating neuromechanical control of human walking. PMID:16023126

  3. Effects of Tape and Exercise on Dynamic Ankle Inversion

    PubMed Central

    Ricard, Mark D.; Sherwood, Stephen M.; Schulthies, Shane S.; Knight, Kenneth L.

    2000-01-01

    Objective: To compare the effects of tape, with and without prewrap, on dynamic ankle inversion before and after exercise. Design and Setting: Doubly multivariate analyses of variance were used to compare the taping and exercise conditions. Subjects were randomly assigned to a fixed treatment order as determined by a balanced latin square. The independent variables were tape application (no tape, tape with prewrap, tape to skin) and exercise (before and after). The dependent variables were average inversion velocity, total inversion, maximum inversion velocity, and time to maximum inversion. Subjects: Thirty college-age male and female students (17 males, 13 females; mean age = 24.9 ± 4.3 years, range, 19 to 39 years) were tested. Subjects were excluded from the study if they exhibited a painful gait or painful range of motion or had a past history of ankle surgery or an ankle sprain within the past 4 weeks. Measurements: We collected data using electronic goniometers while subjects balanced on the right leg on an inversion platform tilted about the medial-lateral axis to produce 15° of plantar flexion. Sudden ankle inversion was induced by pulling the inversion platform support, allowing the platform support base to rotate 37°. Ten satisfactory trials were recorded on the inversion platform before and after a prescribed exercise bout. We calculated total inversion, time to maximum inversion, average inversion velocity, and maximum inversion velocity after sudden inversion. Results: We found no significant differences between taping to the skin and taping over prewrap for any of the variables measured. There were significant differences between both taping conditions and no-tape postexercise for average inversion velocity, maximum inversion, maximum inversion velocity, and time to maximum inversion. The total inversion mean for no-tape postexercise was 38.8° ± 6.3°, whereas the means for tape and skin and for tape and prewrap were 28.3° ± 4.6° and 29.1°

  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. 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. PMID:26077988

  6. Unsupported standing with minimized ankle muscle fatigue.

    PubMed

    Mihelj, Matjaz; Munih, Marko

    2004-08-01

    In the past, limited unsupported standing has been restored in patients with thoracic spinal cord injury through open-loop functional electrical stimulation of paralyzed knee extensor muscles and the support of intact arm musculature. Here an optimal control system for paralyzed ankle muscles was designed that enables the subject to stand without hand support in a sagittal plane. The paraplegic subject was conceptualized as an underactuated double inverted pendulum structure with an active degree of freedom in the upper trunk and a passive degree of freedom in the paralyzed ankle joints. Control system design is based on the minimization of a cost function that estimates the effort of ankle joint muscles via observation of the ground reaction force position, relative to ankle joint axis. Furthermore, such a control system integrates voluntary upper trunk activity and artificial control of ankle joint muscles, resulting in a robust standing posture. Figures are shown for the initial simulation study, followed by disturbance tests on an intact volunteer and several laboratory trials with a paraplegic person. Benefits of the presented methodology are prolonged standing sessions and in the fact that the subject is able to maintain voluntary control over upper body orientation in space, enabling simple functional standing. PMID:15311817

  7. Sprained Ankle Could Pose Longer-Term Harms to Health

    MedlinePlus

    ... Sprained Ankle Could Pose Longer-Term Harms to Health Study finds link between adult injury, more heart ... or federal policy. Recent Health News Related MedlinePlus Health Topics Ankle Injuries and Disorders Sprains and Strains ...

  8. [Chronic ankle instability in sports -- a review for sports physicians].

    PubMed

    Valderrabano, V; Leumann, A; Pagenstert, G; Frigg, A; Ebneter, L; Hintermann, B

    2006-12-01

    Chronic ankle instability represents a typical sports injury which can mostly be seen in basketball, soccer, orienteering and other high risk sports. 20 to 40 % of the acute ankle sprains develop into chronic ankle instability. From a sports orthopaedic point of view, chronic ankle instability can be subdivided into a lateral, medial or a combination of both so called rotational ankle instability. From a pathophysiological point of view, chronic ankle instability can be either mechanical with a structural ligament lesion or functional with loss of the neuromuscular control. For the sports physician, the chronic ankle instability is a difficult entity as the diagnosis is usually complex and the therapy usually surgical. This review on chronic ankle instability addresses pathomechanism, diagnostics, indications for conservative and surgical treatments, and possible long-term sequelae, as ligamentous osteoarthritis. PMID:17279471

  9. Agile: From Software to Mission System

    NASA Technical Reports Server (NTRS)

    Trimble, Jay; Shirley, Mark H.; Hobart, Sarah Groves

    2016-01-01

    The Resource Prospector (RP) is an in-situ resource utilization (ISRU) technology demonstration mission, designed to search for volatiles at the Lunar South Pole. This is NASA's first near real time tele-operated rover on the Moon. The primary objective is to search for volatiles at one of the Lunar Poles. The combination of short mission duration, a solar powered rover, and the requirement to explore shadowed regions makes for an operationally challenging mission. To maximize efficiency and flexibility in Mission System design and thus to improve the performance and reliability of the resulting Mission System, we are tailoring Agile principles that we have used effectively in ground data system software development and applying those principles to the design of elements of the mission operations system.

  10. Agility and mixed-model furniture production

    NASA Astrophysics Data System (ADS)

    Yao, Andrew C.

    2000-10-01

    The manufacture of upholstered furniture provides an excellent opportunity to analyze the effect of a comprehensive communication system on classical production management functions. The objective of the research is to study the scheduling heuristics that embrace the concepts inherent in MRP, JIT and TQM while recognizing the need for agility in a somewhat complex and demanding environment. An on-line, real-time data capture system provides the status and location of production lots, components, subassemblies for schedule control. Current inventory status of raw material and purchased items are required in order to develop and adhere to schedules. For the large variety of styles and fabrics customers may order, the communication system must provide timely, accurate and comprehensive information for intelligent decisions with respect to the product mix and production resources.

  11. Compact, flexible, frequency agile parametric wavelength converter

    DOEpatents

    Velsko, Stephan P.; Yang, Steven T.

    2002-01-01

    This improved Frequency Agile Optical Parametric Oscillator provides near on-axis pumping of a single QPMC with a tilted periodically poled grating to overcome the necessity to find a particular crystal that will permit collinear birefringence in order to obtain a desired tuning range. A tilted grating design and the elongation of the transverse profile of the pump beam in the angle tuning plane of the FA-OPO reduces the rate of change of the overlap between the pumped volume in the crystal and the resonated and non-resonated wave mode volumes as the pump beam angle is changed. A folded mirror set relays the pivot point for beam steering from a beam deflector to the center of the FA-OPO crystal. This reduces the footprint of the device by as much as a factor of two over that obtained when using the refractive telescope design.

  12. Agile parallel bioinformatics workflow management using Pwrake

    PubMed Central

    2011-01-01

    Background In bioinformatics projects, scientific workflow systems are widely used to manage computational procedures. Full-featured workflow systems have been proposed to fulfil the demand for workflow management. However, such systems tend to be over-weighted for actual bioinformatics practices. We realize that quick deployment of cutting-edge software implementing advanced algorithms and data formats, and continuous adaptation to changes in computational resources and the environment are often prioritized in scientific workflow management. These features have a greater affinity with the agile software development method through iterative development phases after trial and error. Here, we show the application of a scientific workflow system Pwrake to bioinformatics workflows. Pwrake is a parallel workflow extension of Ruby's standard build tool Rake, the flexibility of which has been demonstrated in the astronomy domain. Therefore, we hypothesize that Pwrake also has advantages in actual bioinformatics workflows. Findings We implemented the Pwrake workflows to process next generation sequencing data using the Genomic Analysis Toolkit (GATK) and Dindel. GATK and Dindel workflows are typical examples of sequential and parallel workflows, respectively. We found that in practice, actual scientific workflow development iterates over two phases, the workflow definition phase and the parameter adjustment phase. We introduced separate workflow definitions to help focus on each of the two developmental phases, as well as helper methods to simplify the descriptions. This approach increased iterative development efficiency. Moreover, we implemented combined workflows to demonstrate modularity of the GATK and Dindel workflows. Conclusions Pwrake enables agile management of scientific workflows in the bioinformatics domain. The internal domain specific language design built on Ruby gives the flexibility of rakefiles for writing scientific workflows. Furthermore, readability

  13. Isolated posterior high ankle sprain: a report of three cases.

    PubMed

    Botchu, Rajesh; Allen, Patricia; Rennie, Winston J

    2013-12-01

    High ankle sprains are difficult to diagnose and account for 10% of all ankle sprains. A high index of suspicion is essential for diagnosis. High ankle sprains are managed symptomatically, with prolonged rehabilitation. The posterior inferior tibiofibular ligament is the strongest syndesmotic ligament; isolated injury of it is rare. We present 3 cases of isolated posterior high ankle sprain and discuss the relevant anatomy, mechanism of injury, and management. PMID:24366808

  14. 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. PMID:21305286

  15. Agile rediscovering values: Similarities to continuous improvement strategies

    NASA Astrophysics Data System (ADS)

    Díaz de Mera, P.; Arenas, J. M.; González, C.

    2012-04-01

    Research in the late 80's on technological companies that develop products of high value innovation, with sufficient speed and flexibility to adapt quickly to changing market conditions, gave rise to the new set of methodologies known as Agile Management Approach. In the current changing economic scenario, we considered very interesting to study the similarities of these Agile Methodologies with other practices whose effectiveness has been amply demonstrated in both the West and Japan. Strategies such as Kaizen, Lean, World Class Manufacturing, Concurrent Engineering, etc, would be analyzed to check the values they have in common with the Agile Approach.

  16. Interpretation of the ankle in UHECR

    NASA Astrophysics Data System (ADS)

    Berezinsky, Veniamin

    Ankle is a flattening in CR spectrum observed first in Volcano Ranch experiment in 1963 at E _{a} ˜ 10 EeV, and it was interpreted as transition from galactic to extragalactic CRs. Since that time the ankle was observed in all large UHECR detectors and most recently in HiRes, TA and Auger detectors at E _{a} ˜ 4 - 5 EeV. At present there are two interpretations of the ankle: as transition from galactic to extragalactic CRs (the conventional interpretation) and as a part of the dip, produced by extragalactic protons interacting with the CMB photons. These two interpretations will be discussed in the light of recent observations and models of UHECR origin.

  17. Osteochondral defects in the ankle: why painful?

    PubMed Central

    Reilingh, Mikel L.; Zengerink, Maartje; van Bergen, Christiaan J. A.

    2010-01-01

    Osteochondral defects of the ankle can either heal and remain asymptomatic or progress to deep ankle pain on weight bearing and formation of subchondral bone cysts. The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone plate. The ankle joint has a high congruency. During loading, compressed cartilage forces its water into the microfractured subchondral bone, leading to a localized high increased flow and pressure of fluid in the subchondral bone. This will result in local osteolysis and can explain the slow development of a subchondral cyst. The pain does not arise from the cartilage lesion, but is most probably caused by repetitive high fluid pressure during walking, which results in stimulation of the highly innervated subchondral bone underneath the cartilage defect. Understanding the natural history of osteochondral defects could lead to the development of strategies for preventing progressive joint damage. PMID:20151110

  18. Proprioception and ankle injuries in soccer.

    PubMed

    Ergen, Emin; Ulkar, Bülent

    2008-01-01

    Because soccer attracts many participants and leads to a substantial number of injuries, especially of the lower extremities, it is important to study possibilities for injury prevention and proper rehabilitation to return safely to activities. Ankle sprains can be prevented by external ankle supports and proprioceptive-coordination training, especially in athletes with previous ankle sprains. Proprioception is a broad concept that includes balance and postural control with visual and vestibular contributions, joint kinesthesia, position sense, and muscle reaction time. Proprioceptive feedback is crucial in the conscious and unconscious awareness of a joint or limb in motion. Enhancement of functional joint stability by proprioceptive (or neuromuscular) training is important both in prevention and rehabilitation of athletic injuries. PMID:18206575

  19. Transfer of mechanical energy between ankle and knee joints by gastrocnemius and plantaris muscles during cat locomotion.

    PubMed

    Prilutsky, B I; Herzog, W; Leonard, T

    1996-04-01

    The purposes of this study were (1) to define and estimate the direction and amount of the energy transfer between the knee and ankle through gastrocnemius (GA) and plantaris (PL) muscles during cat locomotion, and (2) to test the assumption that the force and activity patterns of soleus (SO), GA, and PL are mechanically and physiologically advantageous for providing the transfer of energy between these joints. The direction, amount and rate of the energy transfer through a two-joint muscle were defined using a theoretical analysis of movements in two adjacent joints spanned by the two-joint muscle. The energy transferred between the ankle and the knee was calculated using the time integration of the difference between the power developed by the moments of SO, GA, and PL at the ankle joint and the total power of these muscles. The total power of SO, GA, and PL muscles, and the power of their movements about the ankle and knee, were obtained using the experimentally determined muscle forces, the rates of change in muscle length, and the angular velocities at the knee and ankle which were calculated from the kinematics and the geometry of the cat hindlimb. Muscular forces and hindlimb kinematics of the cats were recorded during normal walking and trotting on a treadmill at speeds of 0.4, 0.8, 1.2, 1.5, and 1.8 ms-1 using 'E'-shaped tendon transducers and high-speed video, respectively. It was found that during the early phase of support, there was a transfer of mechanical energy from the ankle to the knee through GA and PL. During the late phase of support, mechanical energy was transferred from the knee to the ankle. The amount of energy transferred increased with increasing speeds of locomotion. The energy transferred from the ankle to the knee was 3-60 mJ (7-22% of the negative work done by the moments of SO, GA, and PL at the ankle), and the energy transferred from the knee to the ankle was 10-67 mJ (7-14% of the positive work done by the moments of SO, GA, and

  20. Ankle pain and peroneal tendon pathology.

    PubMed

    Baumhauer, Judith F; Nawoczenski, Deborah A; DiGiovanni, Benedict F; Flemister, A Samuel

    2004-01-01

    Chronic ankle pain can be due to multiple causes. A thorough review of the patient's history with a physical examination concentrating on anatomic structures surrounding the ankle is imperative. The most common of causes have been presented. The addition of provocative testing and radiographic examinations can aid in elucidating the pathology. After treatment of the injury, attention to training technique, shoe and insert usage as well as individual gait abnormalities are integrated into global patient education to decrease the incidence of injury recurrence. PMID:15062582

  1. Ankle injuries and the family physician.

    PubMed

    Birrer, R B

    1988-01-01

    In transmitting the body's weight, the ankle is subject to frequent static and dynamic injury due to concentrated stresses during standing and movement. The frequency of athletic ankle injuries ranges from 10 to 90 percent, with the highest rate occurring in basketball players. There is prolonged disability and recurrent instability for months to years for 25 to 40 per cent of these patients. Because most of this trauma is handled by primary care physicians, this review presents the mechanism of injury, relevant anatomy, physical examination, and appropriate therapeutic intervention in the acute and rehabilitative phases. PMID:3146894

  2. GRB 070724B: the first Gamma Ray Burst localized by SuperAGILE

    SciTech Connect

    Del Monte, E.; Costa, E.; Donnarumma, I.; Feroci, M.; Lapshov, I.; Lazzarotto, F.; Soffitta, P.; Argan, A.; Pucella, G.; Trois, A.; Vittorini, V.; Evangelista, Y.; Rapisarda, M.; Barbiellini, G.; Longo, F.; Basset, M.; Foggetta, L.; Vallazza, E.; Bulgarelli, A.; Di Cocco, G.

    2008-05-22

    GRB070724B is the first Gamma Ray Burst localized by the SuperAGILE instrument aboard the AGILE space mission. The SuperAGILE localization has been confirmed after the after-glow observation by the XRT aboard the Swift satellite. No significant gamma ray emission above 50 MeV has been detected for this GRB. In this paper we describe the SuperAGILE capabilities in detecting Gamma Ray Burst and the AGILE observation of GRB 070724B.

  3. How do patients with end-stage ankle arthritis decide between two surgical treatments? A qualitative study

    PubMed Central

    Zaidi, Razi; Pfeil, Michael; Macgregor, Alexander J; Goldberg, Andy

    2013-01-01

    Objective To examine how patients decide between ankle fusion and ankle replacement in end-stage ankle arthritis. Design Purposive patient selection, semistructured interviews, thematic analysis. Setting Royal National Orthopaedic Hospital, Stanmore, UK. Participants 14 patients diagnosed with end-stage ankle osteoarthritis. Results We interviewed 6 men and 8 women with a mean age of 58 years (range 41–83). All had opted for surgery after failure of at least 6 months of conservative management, sequentially trading-off daily activities to limit the evolving pain. To decide between two offered treatments of ankle fusion and total ankle replacement (TAR), three major sources informed the patients’ decision-making process: their surgeon, peers and the internet. The treating surgeon was viewed as the most reliable and influential source of information. Information gleaned from other patients was also important, but with questionable reliability, as was information from the internet, both of which invariably required validation by the surgeon and in some cases the general practitioner. Conclusions Patients seek knowledge from a wealth of sources including the internet, web forums and other patients. While they leverage each of these sources to guide decision-making, the most important and influential factor in governing how patients decide on any particular surgical intervention is their surgeon. A high quality doctor–patient relationship, coupled with clear, balanced and complete information is essential to enable shared decision-making to become a standard model of care. PMID:23864209

  4. 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

  5. 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

  6. Modern Enterprise Systems as Enablers of Agile Development

    NASA Astrophysics Data System (ADS)

    Fredriksson, Odd; Ljung, Lennart

    Traditional ES technology and traditional project management methods are supporting and matching each other. But they are not supporting the critical success conditions for ES development in an effective way. Although the findings from one case study of a successful modern ES change project is not strong empirical evidence, we carefully propose that the new modern ES technology is supporting and matching agile project management methods. In other words, it provides the required flexibility which makes it possible to put into practice the agile way of running projects, both for the system supplier and for the customer. In addition, we propose that the combination of modern ES technology and agile project management methods are more appropriate for supporting the realization of critical success conditions for ES development. The main purpose of this chapter is to compare critical success conditions for modern enterprise systems development projects with critical success conditions for agile information systems development projects.

  7. Frequency agile OPO-based transmitters for multiwavelength DIAL

    SciTech Connect

    Velsko, S.P.; Ruggiero, A.; Herman, M.

    1996-09-01

    We describe a first generation mid-infrared transmitter with pulse to pulse frequency agility and both wide and narrow band capability. This transmitter was used to make multicomponent Differential Absorption LIDAR (DIAL) measurements in the field.

  8. Investigation into the impact of agility on conceptual fighter design

    NASA Technical Reports Server (NTRS)

    Engelbeck, R. M.

    1995-01-01

    The Agility Design Study was performed by the Boeing Defense and Space Group for the NASA Langley Research Center. The objective of the study was to assess the impact of agility requirements on new fighter configurations. Global trade issues investigated were the level of agility, the mission role of the aircraft (air-to-ground, multi-role, or air-to-air), and whether the customer is Air force, Navy, or joint service. Mission profiles and design objectives were supplied by NASA. An extensive technology assessment was conducted to establish the available technologies to industry for the aircraft. Conceptual level methodology is presented to assess the five NASA-supplied agility metrics. Twelve configurations were developed to address the global trade issues. Three-view drawings, inboard profiles, and performance estimates were made and are included in the report. A critical assessment and lessons learned from the study are also presented.

  9. Effective speed and agility conditioning methodology for random intermittent dynamic type sports.

    PubMed

    Bloomfield, Jonathan; Polman, Remco; O'Donoghue, Peter; McNaughton, Lars

    2007-11-01

    Different coaching methods are often used to improve performance. This study compared the effectiveness of 2 methodologies for speed and agility conditioning for random, intermittent, and dynamic activity sports (e.g., soccer, tennis, hockey, basketball, rugby, and netball) and the necessity for specialized coaching equipment. Two groups were delivered either a programmed method (PC) or a random method (RC) of conditioning with a third group receiving no conditioning (NC). PC participants used the speed, agility, quickness (SAQ) conditioning method, and RC participants played supervised small-sided soccer games. PC was also subdivided into 2 groups where participants either used specialized SAQ equipment or no equipment. A total of 46 (25 males and 21 females) untrained participants received (mean +/- SD) 12.2 +/- 2.1 hours of physical conditioning over 6 weeks between a battery of speed and agility parameter field tests. Two-way analysis of variance results indicated that both conditioning groups showed a significant decrease in body mass and body mass index, although PC achieved significantly greater improvements on acceleration, deceleration, leg power, dynamic balance, and the overall summation of % increases when compared to RC and NC (p < 0.05). PC in the form of SAQ exercises appears to be a superior method for improving speed and agility parameters; however, this study found that specialized SAQ equipment was not a requirement to observe significant improvements. Further research is required to establish whether these benefits transfer to sport-specific tasks as well as to the underlying mechanisms resulting in improved performance. PMID:18076227

  10. Sprained ankles as they relate to the basketball player.

    PubMed

    Johnson, K A; Teasdall, R D

    1993-04-01

    Concepts based on newer medical information concerning ankle injuries have changed in recent years. With these changing concepts, the method of treatment has also changed. It is the purpose of this article to review some of the commonly known information concerning ankle sprains, to emphasize the association of subtalar injury with the ankle sprain complex, to outline new information concerning the static stabilizers on the lateral aspect of the ankle, and finally, to utilize this information in producing a rationale for a new type of surgical treatment for chronic instability of the ankle. PMID:8481971

  11. An in Silico Analysis of Ankle Joint Loads in Secondary Ankle Osteoarthritis. Case Study.

    PubMed

    Lorkowski, Jacek; Mrzygłód, Mirosław W; Grzegorowska, Oliwia; Kotela, Ireneusz

    2015-01-01

    Secondary, post-traumatic, degenerative lesions of the ankle joint remain a serious clinical challenge. This paper presents the case of a 66-year-old patient with secondary, post-traumatic ankle osteoarthritis and subchondral cysts. The use of rapid computer modelling FEM 2D enabled optimization of surgical treatment. A FEM 2D model of biomechanical changes in bones may help in streamlining treatment as well as improve our understanding of the pathomechanism of osteoarthritis. PMID:26248632

  12. Effectiveness of an outside-the-boot ankle brace in reducing parachuting related ankle injuries

    PubMed Central

    Schmidt, M; Sulsky, S; Amoroso, P

    2005-01-01

    Objectives: To examine the efficacy of an outside-the-boot parachute ankle brace (PAB) in reducing risk of ankle injury to army paratrooper trainees and to identify inadvertent risks associated with PAB use. Design: The authors compared hospitalization rates for ankle, musculoskeletal, and other traumatic injury among 223 172 soldiers trained 1985–2002 in time periods defined by presence/absence of PAB use protocols. Multiple logistic regression analysis estimated adjusted odds ratios (OR) and 95% confidence intervals for injury outcomes, comparing pre and post brace periods to the brace protocol period. Setting: A research database consisting of training rosters from the US Army Airborne training facility (Fort Benning, GA) occupational, demographic, and hospitalization information. Main outcome measures: Injuries were considered training related if they occurred during a five week period starting with first scheduled static line parachute jump and a parachuting cause of injury code appeared in the hospital record. Results: Of 939 parachuting related hospitalizations during the defined risk period, 597 (63.6%) included an ankle injury diagnosis, 198 (21.1%) listed a musculoskeletal (non-ankle) injury, and 69 (7.3%) cited injuries to multiple body parts. Risk of ankle injury hospitalization was higher during both pre-brace (adjusted OR 2.38, 95% CI 1.92 to 2.95) and post-brace (adjusted OR 1.72, 95% CI 1.27 to 2.32) periods compared with the brace protocol period. Odds of musculoskeletal (non-ankle) injury or injury to multiple body parts did not change between the brace and post-brace periods. Conclusion: Use of a PAB during airborne training appears to reduce risk of ankle injury without increasing risk of other types of traumatic injury. PMID:15933409

  13. Ankle Ligament Healing After an Acute Ankle Sprain: An Evidence-Based Approach

    PubMed Central

    Hubbard, Tricia J; Hicks-Little, Charlie A

    2008-01-01

    Objective: To perform a systematic review to determine the healing time of the lateral ankle ligaments after an acute ankle sprain. Data Sources: 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. Study Selection: 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. Data Extraction: 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. Data Synthesis: Ankle laxity improved over a period of 6 weeks to 1 year. One author showed stress talar tilt values of 16.10 ± 8.8° immediately after injury and 3.4 ± 3.6° 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. Conclusions/Recommendations: 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

  14. The impact of flying qualities on helicopter operational agility

    NASA Technical Reports Server (NTRS)

    Padfield, Gareth D.; Lappos, Nick; Hodgkinson, John

    1993-01-01

    Flying qualities standards are formally set to ensure safe flight and therefore reflect minimum, rather than optimum, requirements. Agility is a flying quality but relates to operations at high, if not maximum, performance. While the quality metrics and test procedures for flying, as covered for example in ADS33C, may provide an adequate structure to encompass agility, they do not currently address flight at high performance. This is also true in the fixed-wing world and a current concern in both communities is the absence of substantiated agility criteria and possible conflicts between flying qualities and high performance. AGARD is sponsoring a working group (WG19) title 'Operational Agility' that deals with these and a range of related issues. This paper is condensed from contributions by the three authors to WG19, relating to flying qualities. Novel perspectives on the subject are presented including the agility factor, that quantifies performance margins in flying qualities terms; a new parameter, based on maneuver acceleration is introduced as a potential candidate for defining upper limits to flying qualities. Finally, a probabilistic analysis of pilot handling qualities ratings is presented that suggests a powerful relationship between inherent airframe flying qualities and operational agility.

  15. Supervised exercises for adults with acute lateral ankle sprain: a randomised controlled trial

    PubMed Central

    van Rijn, Rogier M; van Os, Anton G; Kleinrensink, Gert-Jan; Bernsen, Roos MD; Verhaar, Jan AN; Koes, Bart W; Bierma-Zeinstra, Sita MA

    2007-01-01

    Background During the recovery period after acute ankle sprain, it is unclear whether conventional treatment should be supported by supervised exercise. Aim To evaluate the short- and long-term effectiveness of conventional treatment combined with supervised exercises compared with conventional treatment alone in patients with an acute ankle sprain. Design Randomised controlled clinical trial. Setting A total of 32 Dutch general practices and the hospital emergency department. Method Adults with an acute lateral ankle sprain consulting general practices or the hospital emergency department were allocated to either conventional treatment combined with supervised exercises or conventional treatment alone. Primary outcomes were subjective recovery (0–10 point scale) and the occurrence of a re-sprain. Measurements were carried out at intake, 4 weeks, 8 weeks, 3 months, and 1 year after injury. Data were analysed using intention-to-treat analyses. Results A total of 102 patients were enrolled and randomised to either conventional treatment alone or conventional treatment combined with supervised exercise. There was no significant difference between treatment groups concerning subjective recovery or occurrence of re-sprains after 3 months and 1-year of follow-up. Conclusion Conventional treatment combined with supervised exercises compared to conventional treatment alone during the first year after an acute lateral ankle sprain does not lead to differences in the occurrence of re-sprains or in subjective recovery. PMID:17925136

  16. Factors Contributing to Chronic Ankle Instability: A Strength Perspective

    PubMed Central

    Kaminski, Thomas W.; Hartsell, Heather D.

    2002-01-01

    Objective: To examine the concept of dynamic ankle stability and closely critique the relevant research over the past 50+ years focusing on strength as it relates to those with chronic ankle instability (CAI). Data Sources: We reviewed the literature regarding the assessment of strength related to CAI. We searched MEDLINE and ISI Web of Science from 1950 through 2001 using the key words functional ankle instability, chronic ankle instability, strength, ankle stability, chronic ankle dysfunction, and isokinetics. Data Synthesis: An overview of dynamic stability in the ankle is established, followed by a comprehensive discussion involving the variables used to assess ankle strength. Additionally, a historical look at deficits in muscular stability leading to CAI is provided, and a compilation of numerous contemporary approaches examining strength as it relates to CAI is presented. Conclusions/Recommendations: Although strength is an important consideration during ankle rehabilitation, deficits in ankle strength are not highly correlated with CAI. More contemporary approaches involving the examination of reciprocal muscle-group ratios as a measure of strength have recently been investigated and offer an insightful, albeit different, avenue for future exploration. Evidence pertaining to the effects of strength training on those afflicted with CAI is lacking, including what, if any, implication strength training has on the various measures of ankle strength. PMID:12937561

  17. Rehabilitation of the Ankle After Acute Sprain or Chronic Instability

    PubMed Central

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Objective: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice. Background: Important considerations in the rehabilitation of ankle injuries include controlling the acute inflammatory process, regaining full ankle range of motion, increasing muscle strength and power, and improving proprioceptive abilities. These goals can be achieved through various modalities, flexibility exercises, and progressive strength- and balance-training exercises. In this article, we discuss the deleterious effects of ankle injury on ankle-joint proprioception and muscular strength and how these variables can be quantifiably measured to follow progress through a rehabilitation program. Evidence to support the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation is provided, along with recommendations for functional rehabilitation of ankle injuries, including a structured progression of exercises. Recommendations: Early functional rehabilitation of the ankle should include range-of-motion exercises and isometric and isotonic strength-training exercises. In the intermediate stage of rehabilitation, a progression of proprioception-training exercises should be incorporated. Advanced rehabilitation should focus on sport-specific activities to prepare the athlete for return to competition. Although it is important to individualize each rehabilitation program, this well-structured template for ankle rehabilitation can be adapted as needed. PMID:12937563

  18. Assessment of the Injured Ankle in the Athlete

    PubMed Central

    Lynch, Scott A.

    2002-01-01

    Objective: To present appropriate tools to assist in the assessment and evaluation of ankle injuries in athletes. Data Sources: A MEDLINE search was performed for the years 1980–2001 using the terms ankle injuries and ankle sprains. Data Synthesis: Ankle sprains are the most common injuries sustained by athletes. In order to render appropriate treatment, a proper evaluation must be made. Assessment of ankle injuries includes obtaining a good history of the mechanism of injury, a thorough physical examination, and judicious use of radiographic evaluation and special tests. I will outline techniques for diagnosing the most common ankle injuries among athletes. Conclusions/Recommendations: In order to provide appropriate treatment, the examiner must differentiate among injuries to the lateral ankle-ligament complex, subtalar joint, deltoid ligament, and syndesmosis. It is important to realize that injury can occur to any or all of these structures simultaneously. PMID:12937562

  19. X-36 Tailless Fighter Agility Research Aircraft arrival at Dryden

    NASA Technical Reports Server (NTRS)

    1996-01-01

    NASA and McDonnell Douglas Corporation (MDC) personnel remove protective covers from the newly arrived NASA/McDonnell Douglas Corporation X-36 Tailless Fighter Agility Research Aircraft. It arrived at NASA Dryden Flight Research Center, Edwards, California, on July 2, 1996. The NASA/Boeing X-36 Tailless Fighter Agility Research Aircraft program successfully demonstrated the tailless fighter design using advanced technologies to improve the maneuverability and survivability of possible future fighter aircraft. The program met or exceeded all project goals. For 31 flights during 1997 at the Dryden Flight Research Center, Edwards, California, the project team examined the aircraft's agility at low speed / high angles of attack and at high speed / low angles of attack. The aircraft's speed envelope reached up to 206 knots (234 mph). This aircraft was very stable and maneuverable. It handled very well. The X-36 vehicle was designed to fly without the traditional tail surfaces common on most aircraft. Instead, a canard forward of the wing was used as well as split ailerons and an advanced thrust-vectoring nozzle for directional control. The X-36 was unstable in both pitch and yaw axes, so an advanced, single-channel digital fly-by-wire control system (developed with some commercially available components) was put in place to stabilize the aircraft. Using a video camera mounted in the nose of the aircraft and an onboard microphone, the X-36 was remotely controlled by a pilot in a ground station virtual cockpit. A standard fighter-type head-up display (HUD) and a moving-map representation of the vehicle's position within the range in which it flew provided excellent situational awareness for the pilot. This pilot-in-the-loop approach eliminated the need for expensive and complex autonomous flight control systems and the risks associated with their inability to deal with unknown or unforeseen phenomena in flight. Fully fueled the X-36 prototype weighed approximately 1

  20. Imaging of the foot and ankle.

    PubMed

    Pavlov, H

    1990-09-01

    The foot and ankle are subjected to daily stresses and strains ranging from normal walking activities to the excessive forces encountered in the active sports enthusiast. These traumatic events as well as systemic and local arthritic conditions and tumors can be temporarily or permanently disabling. Early, expedited, and cost-efficient diagnosis is the daily challenge for the radiologist, clinician, and patient. PMID:1975109

  1. Treatment algorithm for chronic lateral ankle instability

    PubMed Central

    Giannini, Sandro; Ruffilli, Alberto; Pagliazzi, Gherardo; Mazzotti, Antonio; Evangelisti, Giulia; Buda, Roberto; Faldini, Cesare

    2014-01-01

    Summary Introduction: ankle sprains are a common sports-related injury. A 20% of acute ankle sprains results in chronic ankle instability, requiring surgery. Aim of this paper is to report the results of a series of 38 patients treated for chronic lateral ankle instability with anatomic reconstruction. Materials and methods: thirty-eight patients were enrolled in the study. Seventeen patients underwent a surgical repair using the Brostrom-modified technique, while the remaining underwent anatomic reconstruction with autologous or allogenic graft. Results: at a mean follow-up of 5 years the AOFAS score improved from 66.1 ± 5.3 to 92.2 ± 5.6. Discussion: the findings of this study confirm that anatomic reconstruction is an effective procedure with satisfactory subjective and objective results which persist at long-term follow-up along with a low complication rate. No differences, in term of clinical and functional outcomes, were observed between the Brostrom-modified repair and the anatomic reconstruction technique. Level of evidence: level IV. PMID:25767783

  2. [Ankle sprain during a volleyball game].

    PubMed

    Boersma, Anton R; Munzebrock, Arvid V E

    2015-01-01

    A 27-year old woman was admitted to the emergency room after her left ankle rolled inward during a volleyball game. On physical examination a bony prominence on the lateral side of the left foot was noticeable, without neurovascular injury. An X-ray (anterior-posterior view) showed a subtalar dislocation without associated fractures. PMID:26420145

  3. Biomechanics of foot/ankle trauma with variable energy impacts

    PubMed Central

    Gallenberger, Kathryn; Yoganandan, Narayan; Pintar, Frank

    2013-01-01

    A total of 60 pendulum impacts to the plantar surface of 15 lower limb PMHS specimens were conducted. Impact conditions were chosen to obtain data from high velocity tests without injury. For 19 impacts the specimen was initially positioned in 20-deg of dorsiflexion. The remaining impacts used neutral positioning. The foot-ankle response was investigated based on impact energy and velocity. Response was characterized by heel pad and joint stiffness. For neutral tests, axial force vs compression corridors were developed for 2–3 m/s, 4–6 m/s, and 7–63 J impacts. For dorsiflexion tests corridors of 1–3 m/s, 6–8 m/s, 7–20 J, and 80–100 J were developed. These results indicate foot/ankle response is not more sensitive to impact energy than velocity. Injury risk curves were developed for both neutral and dorsiflexion positioning using logistic regression. Strain gage data were used to obtain uncensored force values for injury analysis. In neutral, 50% probability of injury occurred at 6800 N. In dorsiflexion, 50% probability occurred at 7900 N, but the regression was not statistically significant. These preliminary results indicate dorsiflexed specimens fracture at a higher force than neutral specimens. PMID:24406952

  4. A biomechanical comparison of internal fixation techniques for ankle arthrodesis.

    PubMed

    Clifford, Craig; Berg, Scott; McCann, Kevin; Hutchinson, Byron

    2015-01-01

    The purpose of the present study was to compare the primary bending stiffness characteristics of 5 different ankle arthrodesis fixation techniques: 3 compression screws, an anterior locking plate, a lateral locking plate, an anterior locking plate with a compression screw, and a lateral locking plate with a compression screw. A total of 25 full-scale anatomic models consisting of fourth-generation composite tibiae and tali were tested using an Instron 4505 Universal Testing System. We hypothesized that the use of a compression screw with a locking plate would add considerable stiffness to the fixation construct compared with the use of a locking plate alone. The data have shown that an anterior or lateral plate with a compression screw provides significantly greater stiffness than both a plate and 3 compression screws used individually. No significant difference was seen between the anterior plate with a compression screw and the lateral plate with a compression screw. No significant differences were found among the use of an anterior plate, a lateral plate, or 3 compression screws. We have concluded that when using a locking plate in an anterior or lateral configuration, the addition of a compression screw will considerably increase the primary bending stiffness of ankle arthrodesis. PMID:25116232

  5. Frequency-agile, rapid scanning spectroscopy

    NASA Astrophysics Data System (ADS)

    Truong, G.-W.; Douglass, K. O.; Maxwell, S. E.; van Zee, R. D.; Plusquellic, D. F.; Hodges, J. T.; Long, D. A.

    2013-07-01

    Challenging applications in trace gas measurements require low uncertainty and high acquisition rates. Many cavity-enhanced spectroscopies exhibit significant sensitivity and potential, but their scanning rates are limited by reliance on either mechanical or thermal frequency tuning. Here, we present frequency-agile, rapid scanning spectroscopy (FARS) in which a high-bandwidth electro-optic modulator steps a selected laser sideband to successive optical cavity modes. This approach involves no mechanical motion and allows for a scanning rate of 8 kHz per cavity mode, a rate that is limited only by the cavity response time itself. Unlike rapidly frequency-swept techniques, FARS does not reduce the measurement duty cycle, degrade the spectrum's frequency axis or require an unusual cavity configuration. FARS allows for a sensitivity of ~2 × 10-12 cm-1 Hz-1/2 and a tuning range exceeding 70 GHz. This technique shows promise for fast and sensitive trace gas measurements and studies of chemical kinetics.

  6. APID: Agile Protein Interaction DataAnalyzer.

    PubMed

    Prieto, Carlos; De Las Rivas, Javier

    2006-07-01

    Agile Protein Interaction DataAnalyzer (APID) is an interactive bioinformatics web tool developed to integrate and analyze in a unified and comparative platform main currently known information about protein-protein interactions demonstrated by specific small-scale or large-scale experimental methods. At present, the application includes information coming from five main source databases enclosing an unified sever to explore >35 000 different proteins and 111 000 different proven interactions. The web includes search tools to query and browse upon the data, allowing selection of the interaction pairs based in calculated parameters that weight and qualify the reliability of each given protein interaction. Such parameters are for the 'proteins': connectivity, cluster coefficient, Gene Ontology (GO) functional environment, GO environment enrichment; and for the 'interactions': number of methods, GO overlapping, iPfam domain-domain interaction. APID also includes a graphic interactive tool to visualize selected sub-networks and to navigate on them or along the whole interaction network. The application is available open access at http://bioinfow.dep.usal.es/apid/. PMID:16845013

  7. Distributed agile software development for the SKA

    NASA Astrophysics Data System (ADS)

    Wicenec, Andreas; Parsons, Rebecca; Kitaeff, Slava; Vinsen, Kevin; Wu, Chen; Nelson, Paul; Reed, David

    2012-09-01

    The SKA software will most probably be developed by many groups distributed across the globe and coming from dierent backgrounds, like industries and research institutions. The SKA software subsystems will have to cover a very wide range of dierent areas, but still they have to react and work together like a single system to achieve the scientic goals and satisfy the challenging data ow requirements. Designing and developing such a system in a distributed fashion requires proper tools and the setup of an environment to allow for ecient detection and tracking of interface and integration issues in particular in a timely way. Agile development can provide much faster feedback mechanisms and also much tighter collaboration between the customer (scientist) and the developer. Continuous integration and continuous deployment on the other hand can provide much faster feedback of integration issues from the system level to the subsystem developers. This paper describes the results obtained from trialing a potential SKA development environment based on existing science software development processes like ALMA, the expected distribution of the groups potentially involved in the SKA development and experience gained in the development of large scale commercial software projects.

  8. Parallel optimization methods for agile manufacturing

    SciTech Connect

    Meza, J.C.; Moen, C.D.; Plantenga, T.D.; Spence, P.A.; Tong, C.H.; Hendrickson, B.A.; Leland, R.W.; Reese, G.M.

    1997-08-01

    The rapid and optimal design of new goods is essential for meeting national objectives in advanced manufacturing. Currently almost all manufacturing procedures involve the determination of some optimal design parameters. This process is iterative in nature and because it is usually done manually it can be expensive and time consuming. This report describes the results of an LDRD, the goal of which was to develop optimization algorithms and software tools that will enable automated design thereby allowing for agile manufacturing. Although the design processes vary across industries, many of the mathematical characteristics of the problems are the same, including large-scale, noisy, and non-differentiable functions with nonlinear constraints. This report describes the development of a common set of optimization tools using object-oriented programming techniques that can be applied to these types of problems. The authors give examples of several applications that are representative of design problems including an inverse scattering problem, a vibration isolation problem, a system identification problem for the correlation of finite element models with test data and the control of a chemical vapor deposition reactor furnace. Because the function evaluations are computationally expensive, they emphasize algorithms that can be adapted to parallel computers.

  9. Agile robotic edge finishing system research

    SciTech Connect

    Powell, M.A.

    1995-07-01

    This paper describes a new project undertaken by Sandia National Laboratories to develop an agile, automated, high-precision edge finishing system. The project has a two-year duration and was initiated in October, 1994. This project involves re-designing and adding additional capabilities to an existing finishing workcell at Sandia; and developing intelligent methods for automating process definition and for controlling finishing processes. The resulting system will serve as a prototype for systems that will be deployed into highly flexible automated production lines. The production systems will be used to produce a wide variety of products with limited production quantities and quick turnaround requirements. The prototype system is designed to allow programming, process definition, fixture re-configuration, and process verification to be performed off-line for new products. CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) models of the part will be used to assist with the automated process development and process control tasks. To achieve Sandia`s performance goals, the system will be employ advanced path planning, burr prediction expert systems, automated process definition, statistical process models in a process database, and a two-level control scheme using hybrid position-force control and fuzzy logic control. In this paper, we discuss the progress and the planned system development under this project.

  10. Frequency-agile dual-comb spectroscopy

    NASA Astrophysics Data System (ADS)

    Millot, Guy; Pitois, Stéphane; Yan, Ming; Hovhannisyan, Tatevik; Bendahmane, Abdelkrim; Hänsch, Theodor W.; Picqué, Nathalie

    2016-01-01

    Spectroscopic gas sensing and its applications to, for example, trace detection or chemical kinetics, require ever more demanding measurement times, acquisition rates, sensitivities, precisions and broad tuning ranges. Here, we propose a new approach to near-infrared molecular spectroscopy, utilizing advanced concepts of optical telecommunications and supercontinuum photonics. We generate, without mode-locked lasers, two frequency combs of slightly different repetition frequencies and moderate, but rapidly tunable, spectral span. The output of a frequency-agile continuous-wave laser is split and sent into two electro-optic intensity modulators. Flat-top low-noise frequency combs are produced by wave-breaking in a nonlinear optical fibre of normal dispersion. With a dual-comb spectrometer, we record Doppler-limited spectra spanning 60 GHz within 13 μs and an 80 kHz refresh rate, at a tuning speed of 10 nm s-1. The sensitivity for weak absorption is enhanced by a long gas-filled hollow-core fibre. New opportunities for real-time diagnostics may be opened up, even outside the laboratory.

  11. Ankle positions and exercise intervals effect on the blood flow velocity in the common femoral vein during ankle pumping exercises

    PubMed Central

    Toya, Kaori; Sasano, Ken; Takasoh, Tomomi; Nishimoto, Teppei; Fujimoto, Yuta; Kusumoto, Yasuaki; Yoshimatsu, Tatsuki; Kusaka, Satomi; Takahashi, Tetsuya

    2016-01-01

    [Purpose] The aim of this study was to identify the most effective method of performing ankle pumping exercises. [Subjects and Methods] The study subjects were 10 men. We measured time-averaged maximum flow velocity and peak systolic velocity in the common femoral vein using a pulse Doppler method with a diagnostic ultrasound system during nine ankle pumping exercises (three different ankle positions and three exercise intervals). Changes of blood flow velocity during ankle pumping exercises with different ankle positions and exercise intervals were compared. [Result] Peak systolic velocity of the leg-up position showed significantly lower values than those of the supine and head-up positions. For all exercise intervals, the increased amount of blood flow velocity in the leg-up position was significantly lower than that in the head-up and supine positions. [Conclusion] Ankle positions and exercise intervals must be considered when performing effective ankle pumping exercises. PMID:27065564

  12. A multimodal approach to ankle instability: Interrelations between subjective and objective assessments of ankle status in athletes.

    PubMed

    Golditz, Tobias; Welsch, Goetz H; Pachowsky, Milena; Hennig, Friedrich F; Pfeifer, Klaus; Steib, Simon

    2016-03-01

    The aim of this retrospective cohort study is to investigate the association between different subjective and objective assessments of ankle function in a population of athletes with or without functional ankle instability (FAI). 29 athletes with a history of ankle spraining were divided into two groups according to their ankle status: 16 with FAI (initial ankle sprain with residual functional instability) (age 24.6 ± 3.1 years), and 13 COPERS (initial ankle sprain without residual instability) (age 25.3 ± 4.4 years). The assessment of each individual's ankle function was based on three approaches: The "functional-ankle-ability-measure" (FAAM) assessing subjective ankle functionality, measures of sensorimotor control as objective functional measurements and MRI-based T2-mapping as a quantitative marker of compositional joint status. Pearson's product-moment-correlation coefficient, student's t-test and analysis-of-variance were used for statistical analysis. Significant group differences existed for subjective ankle function (FAAM, p = 0.04) and MRI-data mainly in the medial compartment of the ankle joint (p ≤ 0.05). We found unique associations between T2-mapping results and sensorimotor scores in the COPER (r = -0.756-0.849), and "FAI"-group (r = 0.630-0.657). The location and magnitude differed between groups. No correlations existed between these measures and the FAAM. This exploratory study provides preliminary evidence for potential interrelations between various diagnostic measures of ankle function and structure in individuals with and without FAI. We found associations between MRI-results and selected measures of sensorimotor control, indicating a potential link between loss of ankle function and early joint degeneration. Despite these interrelations, each of the different assessment options appears to contain unique information on ankle functionality important in a clinical assessment. PMID:26309042

  13. The AGILE Alert System for Gamma-Ray Transients

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Parmiggiani, N.; Fioretti, V.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Beneventano, D.; Argan, A.; Trois, A.; Scalise, E.; Longo, F.; Pellizzoni, A.; Pucella, G.; Colafrancesco, S.; Conforti, V.; Tempesta, P.; Cerone, M.; Sabatini, P.; Annoni, G.; Valentini, G.; Salotti, L.

    2014-01-01

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  14. The agile alert system for gamma-ray transients

    SciTech Connect

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Fioretti, V.; Chen, A. W.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Pellizzoni, A.; and others

    2014-01-20

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  15. 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.

  16. Evidence-based treatment for ankle injuries: a clinical perspective

    PubMed Central

    Lin, Chung-Wei Christine; Hiller, Claire E; de Bie, Rob A

    2010-01-01

    The most common ankle injuries are ankle sprain and ankle fracture. This review discusses treatments for ankle sprain (including the management of the acute sprain and chronic instability) and ankle fracture, using evidence from recent systematic reviews and randomized controlled trials. After ankle sprain, there is evidence for the use of functional support and non-steroidal anti-inflammatory drugs. There is weak evidence suggesting that the use of manual therapy may lead to positive short-term effects. Electro-physical agents do not appear to enhance outcomes and are not recommended. Exercise may reduce the occurrence of recurrent ankle sprains and may be effective in managing chronic ankle instability. After surgical fixation for ankle fracture, an early introduction of activity, administered via early weight-bearing or exercise during the immobilization period, may lead to better outcomes. However, the use of a brace or orthosis to enable exercise during the immobilization period may also lead to a higher rate of adverse events, suggesting that this treatment regimen needs to be applied judiciously. After the immobilization period, the focus of treatment for ankle fracture should be on a progressive exercise program. PMID:21655420

  17. 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. PMID:21332435

  18. Brachial-Ankle Pulse Wave Velocity: Background, Method, and Clinical Evidence

    PubMed Central

    Munakata, Masanori

    2016-01-01

    Background The populations of many developed countries are becoming progressively older. In aged societies, assessment of total vascular risk is critically important, because old age is usually associated with multiple risks. In this regard, pulse wave velocity (PWV) could be a global cardiovascular marker, since it increases with advancing age, high blood pressure, hyperglycaemia, and other traditional risks, summating cardiovascular risks. Carotid-femoral PWV has been widely applied in Western countries and has been used as a gold-standard PWV measure. However, this measure has never been implemented by general practitioners in Japan, possibly because of methodological difficulties. The life expectancy of Japanese people is now the highest in the world, and the establishment of an adequate total vascular risk measure is an urgent need. Against this background, brachial-ankle PWV was developed at the beginning of this century. Summary Measurement of this parameter is easy, and its reproducibility is good. Moreover, the generality of the methodology is guaranteed. Brachial-ankle PWV has been reported to consistently increase with most traditional cardiovascular risk factors except dyslipidaemia. A meta-analysis of cohort studies including various levels of risk has shown that a 1 m/s increase in brachial-ankle PWV is associated with a 12% increase in the risk of cardiovascular events. Moreover, simultaneous evaluation of the ankle-brachial index could allow further risk stratification of high-risk individuals, who are common in aged societies. This unique feature is indispensable for the management of aged populations, who usually are exposed to multiple risks and have polyvascular diseases. This evidence, however, is chiefly derived from East Asian countries. The collection of data from Caucasian populations, therefore, remains a task for the future. Key Message Brachial-ankle PWV has the potential to become a measure of arterial stiffness worldwide. PMID:27195241

  19. A contact mechanics model for ankle implants with inclusion of surface roughness effects

    NASA Astrophysics Data System (ADS)

    Hodaei, M.; Farhang, K.; Maani, N.

    2014-02-01

    Total ankle replacement is recognized as one of the best procedures to treat painful arthritic ankles. Even though this method can relieve patients from pain and reproduce the physiological functions of the ankle, an improper design can cause an excessive amount of metal debris due to wear, causing toxicity in implant recipient. This paper develops a contact model to treat the interaction of tibia and talus implants in an ankle joint. The contact model describes the interaction of implant rough surfaces including both elastic and plastic deformations. In the model, the tibia and the talus surfaces are viewed as macroscopically conforming cylinders or conforming multi-cylinders containing micrometre-scale roughness. The derived equations relate contact force on the implant and the minimum mean surface separation of the rough surfaces. The force is expressed as a statistical integral function of asperity heights over the possible region of interaction of the roughness of the tibia and the talus implant surfaces. A closed-form approximate equation relating contact force and minimum separation is used to obtain energy loss per cycle in a load-unload sequence applied to the implant. In this way implant surface statistics are related to energy loss in the implant that is responsible for internal void formation and subsequent wear and its harmful toxicity to the implant recipient.

  20. The Frequency Agile Solar Radiotelescope (FASR)

    NASA Astrophysics Data System (ADS)

    White, S. M.; Gary, D. E.; Bastian, T. S.; Hurford, G. J.; Lanzerotti, L. J.

    2003-04-01

    The Frequency Agile Solar Radiotelescope (FASR) is a radio interferometer designed to make high spatial resolution images of the Sun across a broad range of radio wavelengths simultaneously, allowing the technique of imaging spectroscopy to be exploited on a routine basis. The telescope will cover the frequency range 0.1-30 GHz using several sets of receiving elements that provide full-disk imaging, with of order 100 antennas at highest frequency range. FASR will be optimized for solar radio phenomena and will be the most powerful and versatile radioheliograph ever built, providing an improvement of orders of magnitude in image quality over existing instruments. FASR recently received the top ranking amongst all small projects considered by the decadal survey of the National Academy of Science Committee on Solar and Space Physics. FASR will probe all phenomena in the solar atmosphere from the mid-chromosphere outwards. In particular, FASR will provide direct measurement of coronal magnetic field strengths, will image the nonthermal solar atmosphere and show directly the locations of electrons accelerated by solar flares, will provide images of coronal mass ejections travelling outwwards through the solar corona, and supply extensive data products for forecasting and synoptic studies. A major emphasis in the project is to make FASR data as widely and easily used as possible, i.e., providing the general user with processed, fully-calibrated high-quality images that do not need particular knowledge of radio astronomy for interpretation. This paper will describe the telescope and its science goals, and summarize its current status.

  1. The Southern Argentine Agile Meteor Radar (SAAMER)

    NASA Astrophysics Data System (ADS)

    Janches, Diego

    2014-11-01

    The Southern Argentina Agile Meteor Radar (SAAMER) is a new generation system deployed in Rio Grande, Tierra del Fuego, Argentina (53 S) in May 2008. SAAMER transmits 10 times more power than regular meteor radars, and uses a newly developed transmitting array, which focuses power upward instead of the traditional single-antenna-all-sky configuration. The system is configured such that the transmitter array can also be utilized as a receiver. The new design greatly increases the sensitivity of the radar enabling the detection of large number of particles at low zenith angles. The more concentrated transmitted power enables additional meteor studies besides those typical of these systems based on the detection of specular reflections, such as routine detections of head echoes and non-specular trails, previously only possible with High Power and Large Aperture radars. In August 2010, SAAMER was upgraded to a system capable to determine meteoroid orbital parameters. This was achieved by adding two remote receiving stations approximately 10 km away from the main site in near perpendicular directions. The upgrade significantly expands the science that is achieved with this new radar enabling us to study the orbital properties of the interplanetary dust environment. Because of the unique geographical location, SAAMER allows for additional inter-hemispheric comparison with measurements from Canadian Meteor Orbit Radar, which is geographically conjugate. Initial surveys show, for example, that SAAMER observes a very strong contribution of the South Toroidal Sporadic meteor source, of which limited observational data is available. In addition, SAAMER offers similar unique capabilities for meteor showers and streams studies given the range of ecliptic latitudes that the system enables detailed study of showers at high southern latitudes (e.g July Phoenicids or Puppids complex). Finally, SAAMER is ideal for the deployment of complementary instrumentation in both, permanent

  2. Creativity in Agile Systems Development: A Literature Review

    NASA Astrophysics Data System (ADS)

    Conboy, Kieran; Wang, Xiaofeng; Fitzgerald, Brian

    Proponents of agile methods claim that enabling, fostering and driving creativity is the key motivation that differentiates agile methods from their more traditional, beauraucratic counterparts. However, there is very little rigorous research to support this claim. Like most of their predecessors, the development and promotion of these methods has been almost entirely driven by practitioners and consultants, with little objective validation from the research community. This lack of validation is particularly relevant for SMEs, given that many of their project teams typify the environment to which agile methods are most suited i.e. small, co-located teams with diverse, blended skills in unstructured, sometimes even chaotic surroundings. This paper uses creativity theory as a lens to review the current agile method literature to understand exactly how much we know about the extent to which creativity actually occurs in these agile environments. The study reveals many gaps and conflict of opinion in the body of knowledge in its current state and identifies many avenues for further research.

  3. 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

  4. 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. PMID:26696703

  5. Modulation of ankle stiffness during postural sway.

    PubMed

    Lang, Christopher B; Kearney, Robert E

    2014-01-01

    Ankle stiffness is a nonlinear, time-varying system which contributes to the control of human upright stance. This study sought to examine the nature of the contribution of stiffness to postural control by determining how intrinsic and reflex stiffnesses varied with sway. Subjects were instructed to stand quietly on a bilateral electro-hydraulic actuator while perturbations were applied about the ankle. Subjects performed three types of trials: normal stance, forward lean, and backward lean. Position, torque, and EMGs from the tibialis anterior and triceps surae were recorded. Background torque, intrinsic stiffness and reflex stiffness were calculated for each perturbation. Intrinsic and reflex stiffnesses were heavily modulated by postural sway. Moreover, they were modulated in a complimentary manner; intrinsic stiffness was lowest when reflex gain was highest, and vice versa. These findings suggest that intrinsic stiffness is modulated simultaneously with reflex stiffness to optimize the control of balance. PMID:25570884

  6. Analgesia for people with acute ankle sprain.

    PubMed

    Carter, David; Amblum-Almer, Jeshni

    2015-04-01

    Around 302,000 people with soft-tissue ankle injuries present to UK emergency departments every year (Ferran and Maffulli 2006). These patients are generally treated conservatively with analgesia, ice, compression and elevation, and rest. There is some discussion in the literature about whether or not people with these injuries should be treated with non-steroidal anti-inflammatory drugs (NSAIDs), with some authors claiming that the inflammatory response following injury is part of the healing process and should not be halted. This article examines the literature on the efficacy of administering NSAIDs as the first-line drug management for ankle sprain. It also considers cost of treatment, prescribing practice and contraindications of NSAIDs. PMID:25854742

  7. Surgical treatment of ankle instability in athletes.

    PubMed Central

    Kristiansen, B.

    1982-01-01

    Eighteen athletes with symptoms of recurrent sprain and instability of the ankle during activity were treated by reconstructing the lateral ligament by the Evans technique. Before the operation 55 per cent had given up all athletic activities because of pain, swelling or instability, and 17 per cent had restricted their activities. The average age at operation was 24.6 years and the average follow-up period 3.1 years. Normal stability was achieved in 67 per cent and improved stability in 11 per cent, but only 33 per cent were still engaged in athletic activities without any complaints from the ankle. The results are similar to other methods of surgical repair. Images p40-a Fig. 2a Fig. 2b Fig. 3a Fig. 3b PMID:6802212

  8. Imaging in Foot and Ankle Arthritis.

    PubMed

    Wilkinson, Victoria H; Rowbotham, Emma L; Grainger, Andrew J

    2016-04-01

    The foot and ankle are commonly involved in a range of arthritides that affect the joints, bones, and soft tissues. Accurate plain film interpretation can often aid the diagnosis and monitor disease progression and treatment response. Ultrasound and MRI afford superior depiction of the soft tissues, and advances over recent years have centered on early detection of synovitis, enabling earlier diagnosis and treatment. Advantages and disadvantages of the imaging techniques of radiography, multidetector computed tomography, ultrasound, and MRI are discussed, as is optimization of these modalities for the assessment of the anatomically complex joints of the foot and ankle. Diagnostic features enabling differentiation between rheumatoid arthritis, seronegative spondyloarthropathies, osteoarthritis, gout, crystal deposition disease, pigmented villonodular synovitis, Charcot arthropathy, septic arthritis, synovial osteochondromatosis, hemophilia, and reflex sympathetic dystrophy are also reviewed. PMID:27336451

  9. Biomechanical Evaluation of a Prototype Foot/Ankle Prosthesis

    PubMed Central

    Quesada, P. M.; Pitkin, M.; Colvin, J.

    2016-01-01

    In this paper, we report on our pilot evaluation of a prototype foot/ankle prosthesis. This prototype has been designed and fabricated with the intention of providing decreased ankle joint stiffness during the middle portion of the stance phase of gait, and increased (i.e., more normal) knee range of motion during stance. Our evaluation involved fitting the existing prototype foot/ankle prosthesis, as well as a traditional solid ankle cushioned heel (SACH) foot, to an otherwise healthy volunteer with a below-knee (BK) amputation. We measured this individual’s lower extremity joint kinematics and kinetics during walking using a video motion analysis system and force platform. These measurements permitted direct comparison of prosthetic ankle joint stiffness and involved side knee joint motion, as well as prosthetic ankle joint moment and power. PMID:10779119

  10. 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

  11. [Advances on biomechanics and kinematics of sprain of ankle joint].

    PubMed

    Zhao, Yong; Wang, Gang

    2015-04-01

    Ankle sprains are orthopedic clinical common disease, accounting for joint ligament sprain of the first place. If treatment is not timely or appropriate, the joint pain and instability maybe develop, and even bone arthritis maybe develop. The mechanism of injury of ankle joint, anatomical basis has been fully study at present, and the diagnostic problem is very clear. Along with the development of science and technology, biological modeling and three-dimensional finite element, three-dimensional motion capture system,digital technology study, electromyographic signal study were used for the basic research of sprain of ankle. Biomechanical and kinematic study of ankle sprain has received adequate attention, combined with the mechanism research of ankle sprain,and to explore the the biomechanics and kinematics research progress of the sprain of ankle joint. PMID:26072625

  12. Foot and ankle injuries during the Athens 2004 Olympic Games

    PubMed Central

    Badekas, Thanos; Papadakis, Stamatios A; Vergados, Nikolaos; Galanakos, Spyros P; Siapkara, Angeliki; Forgrave, Mike; Romansky, Nick; Mirones, Steven; Trnka, Hans-Jeorg; Delmi, Marino

    2009-01-01

    Background Major, rare and complex incidents can occur at any mass-gathering sporting event and team medical staff should be appropriately prepared for these. One such event, the Athens Olympic Games in 2004, presented a significant sporting and medical challenge. This study concerns an epidemiological analysis of foot and ankle injuries during the Games. Methods An observational, epidemiological survey was used to analyse injuries in all sport tournaments (men's and women's) over the period of the Games. Results A total of 624 injuries (525 soft tissue injuries and 99 bony injuries) were reported. The most frequent diagnoses were contusions, sprains, fractures, dislocations and lacerations. Significantly more injuries in male (58%) versus female athletes (42%) were recorded. The incidence, diagnosis and cause of injuries differed substantially between the team sports. Conclusion Our experience from the Athens Olympic Games will inform the development of public health surveillance systems for future Olympic Games, as well as other similar mass events. PMID:19361341

  13. Brachial-Ankle Pulse Wave Velocity: Myths, Misconceptions, and Realities

    PubMed Central

    Sugawara, Jun; Tanaka, Hirofumi

    2015-01-01

    A variety of techniques to evaluate central arterial stiffness have been developed and introduced. None of these techniques, however, have been implemented widely in regular clinical settings, except for brachial-ankle pulse wave velocity (baPWV). The most prominent procedural advantage of baPWV is its ease of use, since it only requires the wrapping of blood pressure cuffs on the 4 extremities. There is mounting evidence indicating the ability of baPWV to predict the risk of future cardiovascular events and total mortality. Additionally, the guidelines for the management of hypertension in Japan recommended the measurement of baPWV be included in the assessment of subclinical target organ damage. However, baPWV has not been fully accepted worldwide due to perceived theoretical and methodological issues. In this review, we address the most frequently mentioned questions and concerns regarding baPWV to shed some light on this simple and easy arterial stiffness measurement. PMID:26587459

  14. Diagnostic dilemmas in foot and ankle injuries

    SciTech Connect

    Keene, J.S.; Lange, R.H.

    1986-07-11

    Differential diagnosis of foot and ankle injuries should include (1) stress fractures of the great toe sesamoids, the shaft of the fifth metatarsal, and the tarsal navicular bone; (2) transchondral talar-dome fractures; (3) fractures of the os trigonum; and (4) dislocating peroneal tendons. Diagnosis of these injuries is challenging because the initial roentgenograms often are normal, and special clinical tests and ancillary studies are required.

  15. Forces predicted at the ankle during running.

    PubMed

    Burdett, R G

    1982-01-01

    A biomechanical model of the ankle joint was developed and was used to predict the forces at the ankle during the stance phase of running. Measurements from five cadavers were averaged to obtain insertion points and directions of pull of equivalent tendons with respect to the assumed center of the ankle joint. A minimum joint force solution was obtained by assuming that only two equivalent muscle groups could exert force at one time. Three subjects ran at 4.47 m/s across a force platform that recorded the external forces and moments acting on the foot. Cinematography was used to measure the foot and leg positions during stance. Peak resultant joint forces ranging from 9.0 to 13.3 times body weight and peak Achilles tendon forces ranging from 5.3 to 10.0 times body weight were predicted. Small variations in some cases resulted in large differences in predicted forces. The highest tendon forces predicted exceeded those reported to cause damage to cadaver tendons in other studies. PMID:7132650

  16. Diagnosing syndesmotic instability in ankle fractures

    PubMed Central

    van den Bekerom, Michel PJ

    2011-01-01

    The precise diagnosis of distal tibiofibular syndesmotic ligament injury is challenging and a distinction should be made between syndesmotic ligament disruption and real syndesmotic instability. This article summarizes the available evidence in the light of the author’s opinion. Pre-operative radiographic assessment, standard radiographs, computed tomography scanning and magnetic resonance imaging are of limited value in detecting syndesmotic instability in acute ankle fractures but can be helpful in planning. Intra-operative stress testing, in the sagittal, coronal or exorotation direction, is more reliable in the diagnosis of syndesmotic instability of rotational ankle fractures. The Hook or Cotton test is more reliable than the exorotation stress test. The lateral view is more reliable than the AP mortise view because of the larger displacement in this direction. When the Hook test is used the force should be applied in the sagittal direction. A force of 100 N applied to the fibula seems to be appropriate. In the case of an unstable joint requiring syndesmotic stabilisation, the tibiofibular clear space would exceed 5 mm on the lateral stress test. When the surgeon is able to perform an ankle arthroscopy this technique is useful to detect syndesmotic injury and can guide anatomic reduction of the syndesmosis. Many guidelines formulated in this article are based on biomechanical and cadaveric studies and clinical correlation has to be established. PMID:22474636

  17. Rheumatoid Arthritis of the Foot and Ankle.

    PubMed

    Abdo; Iorio

    1994-11-01

    Rheumatoid arthritis of the foot and ankle can be a debilitating problem, particularly for patients who have undergone successful hip or knee arthroplasty. Optimal medical management, use of orthotic devices, and surgical intervention are essential components of patient care. Forefoot involvement with hallux valgus and lesser metatarsophalangeal joint subluxation and dislocation are the most common findings. Reconstruction usually requires lesser metatarsophalangeal joint excisional arthroplasty and first metatarsophalangeal joint arthrodesis. Midfoot tarsometatarsal and intertarsal involvement is treated with orthotic devices and intertarsal fusion for advanced arthropathy. Hindfoot involvement frequently leads to pes planovalgus deformity, which may require isolated talonavicular arthrodesis if treated early or triple arthrodesis for advanced destruction. Ankle involvement is less frequent; when it is unresponsive to conservative measures, ankle symptoms may be improved by arthrodesis. Although great advances have been made in medical and surgical management of rheumatoid arthritis, the disease remains a serious problem. Through prudent use of medical management, orthotic devices, and other conservative measures as well as surgical intervention, long-term function can be enhanced greatly. PMID:10709025

  18. Rehabilitation of Ankle and Foot Injuries in Athletes

    PubMed Central

    Chinn, Lisa; Hertel, Jay

    2009-01-01

    Foot and ankle injuries are extremely common among athletes and other physically active individuals. Rehabilitation programs that emphasize the use of therapeutic exercise to restore joint range of motion, muscle strength, neuromuscular coordination, and gait mechanics have been shown to have clinical success for patients suffering various foot and ankle pathologies. Rehabilitation programs are discussed for ankle sprains, plantar fasciitis, Achilles tendonitis, and turf toe. PMID:19945591

  19. Reconstructive Osteotomy for Ankle Malunion Improves Patient Satisfaction and Function

    PubMed Central

    Tohyama, Masahiko; Yasuda, Hiroyuki; Konishi, Sadahiko; Waseda, Akeo

    2015-01-01

    Treatment of chronic symptoms caused by a malunion is a difficult problem in orthopedic surgery. We encountered a case of ankle malunion at our hospital about 1 year after the first operation. The patient had been unable to walk with weight-bearing but regained the ability to walk after reconstructive osteotomy of the fibula. Functional scores for the foot and ankle were significantly improved after intervention. Reconstructive osteotomy appears to represent a good option for ankle malunion. PMID:26064743

  20. Developing a Framework for Ankle Function: A Delphi Study

    PubMed Central

    Snyder, Kelli R.; Evans, Todd A.; Neibert, Peter J.

    2014-01-01

    Context: Addressing clinical outcomes is paramount to providing effective health care, yet there is no consensus regarding the appropriate outcomes to address after ankle injuries. Compounding the problem is the repetitive nature of lateral ankle sprains, referred to as functional (FAI) or chronic (CAI) ankle instability. Although they are commonly used terms in practice and research, FAI and CAI are inconsistently defined and assessed. Objective: To establish definitions of a healthy/normal/noninjured ankle, FAI, and CAI, as well as their characteristics and assessment techniques. Design: Delphi study. Setting: Telephone interviews and electronic surveys. Patients or Other Participants: Sixteen experts representing the fields of ankle function and treatment, ankle research, and outcomes assessment and research were selected as panelists. Data Collection and Analysis: A telephone interview produced feedback regarding the definition of, functional characteristics of, and assessment techniques for a healthy/normal/noninjured ankle, an unhealthy/acutely injured ankle, and FAI/CAI. Those data were compiled, reduced, and returned through electronic surveys and were either included by reaching consensus (80% agreement) or excluded. Results: The definitions of a healthy/normal/noninjured ankle and FAI reached consensus. Experts did not agree on a definition of CAI. Eleven functional characteristics of a healthy/normal/noninjured ankle, 32 functional characteristics of an unhealthy/acutely injured ankle, and 13 characteristics of FAI were agreed upon. Conclusions: Although a consensus was reached regarding the definitions and functional characteristics of a healthy/normal/noninjured ankle and FAI, the experts could only agree on 1 characteristic to include in the FAI definition. Several experts did, however, provide additional comments that reinforced the differences in the interpretation of those concepts. Although the experts could not agree on the definition of CAI, its

  1. MRI in acute ligamentous injuries of the ankle.

    PubMed

    Martella, Ilenia; Azzali, Emanuele; Milanese, Gianluca; Praticò, Francesco Emanuele; Ruggirello, Margherita; Trunfio, Vincenzo; Parziale, Raffaele; Corrado, Michele; Della Casa, Giovanni; Capasso, Raffaella; De Filippo, Massimo

    2016-01-01

    Ankle sprains are the most common lower limb injuries and affect more frequently young athletes; imaging is needed for an accurate diagnosis of such traumatic injuries. The purpose of this review is to analyse the magnetic resonance (MR) findings of both normal and pathological ankle's ligaments; indeed, MRI is the gold standard for the diagnosis of acute traumatic injuries and is useful for differentiation of the causes of ankle instability as well as for pre-operative planning. PMID:27467862

  2. Pathways to agility in the production of neutron generators

    SciTech Connect

    Stoltz, R.E.; Beavis, L.C.; Cutchen, J.T.; Garcia, P.; Gurule, G.A.; Harris, R.N.; McKey, P.C.; Williams, D.W.

    1994-02-01

    This report is the result of a study team commissioned to explore pathways for increased agility in the manufacture of neutron generators. As a part of Sandia`s new responsibility for generator production, the goal of the study was to identify opportunities to reduce costs and increase flexibility in the manufacturing operation. Four parallel approaches (or pathways) were recommended: (1) Know the goal, (2) Use design leverage effectively, (3) Value simplicity, and (4) Configure for flexibility. Agility in neutron generator production can be enhanced if all of these pathways are followed. The key role of the workforce in achieving agility was also noted, with emphasis on ownership, continuous learning, and a supportive environment.

  3. Comparison of conventional and microlens-array agile beam steerers

    NASA Astrophysics Data System (ADS)

    McDearmon, Graham F.; Flood, Kevin M.; Finlan, J. Michael

    1995-05-01

    We analyzed the optical and mechanical performance of several designs of agile beam steerers based on refractive microlens arrays for sensing and imaging applications in the visible and infrared wavebands. Ray-trace analyses showed that the best design is capable of steering narrowband illumination +/- 25 degree(s) in two dimensions with nearly diffraction-limited performance. The maximum steering angle depends on the materials. We found that imaging the field of regard takes significantly more time than scanning it unless cameras with very high frame-rates are used. We performed many parametric studies that can be used to optimize the design for any application. We compared optimal designs for microlens-array and conventional galvanometric agile beam steerers. The microlens-array agile beam steerer provides significant improvements in scanning speed, random access pointing, energy consumption, mass reduction, and volume reduction.

  4. A study of a proposed modified torsional agility metric

    NASA Technical Reports Server (NTRS)

    Valasek, John; Eggold, David P.; Downing, David R.

    1991-01-01

    A new candidate lateral agility metric, the modified torsional agility parameter, is proposed and tested through generic, nonlinear, non-real-time flight simulation programs of the F-18 and F-5A. The metric is aimed at quantifying high subsonic loaded roll capabilities which might be useful in modern air combat. The metric is considered to be straightforward for testing and measuring based on nonreal-time unmanned flight simulation. The metric is found to be sensitive to pilot input errors of less than full lateral stick to capture bank angle, when tested using unmanned flight simulations. It is suggested that, for redesigned configurations of both aircraft with improved lateral agility, the major benefit would be provided by fast and highly effective rudders, and a high level of pitch, roll, and yaw damping at moderate to high normal load factor levels.

  5. Onshore and Offshore Outsourcing with Agility: Lessons Learned

    NASA Astrophysics Data System (ADS)

    Kussmaul, Clifton

    This chapter reflects on case study based an agile distributed project that ran for approximately three years (from spring 2003 to spring 2006). The project involved (a) a customer organization with key personnel distributed across the US, developing an application with rapidly changing requirements; (b) onshore consultants with expertise in project management, development processes, offshoring, and relevant technologies; and (c) an external offsite development team in a CMM-5 organization in southern India. This chapter is based on surveys and discussions with multiple participants. The several years since the project was completed allow greater perspective on both the strengths and weaknesses, since the participants can reflect on the entire life of the project, and compare it to subsequent experiences. Our findings emphasize the potential for agile project management in distributed software development, and the importance of people and interactions, taking many small steps to find and correct errors, and matching the structures of the project and product to support implementation of agility.

  6. Development of a Computer Program for Analyzing Preliminary Aircraft Configurations in Relationship to Emerging Agility Metrics

    NASA Technical Reports Server (NTRS)

    Bauer, Brent

    1993-01-01

    This paper discusses the development of a FORTRAN computer code to perform agility analysis on aircraft configurations. This code is to be part of the NASA-Ames ACSYNT (AirCraft SYNThesis) design code. This paper begins with a discussion of contemporary agility research in the aircraft industry and a survey of a few agility metrics. The methodology, techniques and models developed for the code are then presented. Finally, example trade studies using the agility module along with ACSYNT are illustrated. These trade studies were conducted using a Northrop F-20 Tigershark aircraft model. The studies show that the agility module is effective in analyzing the influence of common parameters such as thrust-to-weight ratio and wing loading on agility criteria. The module can compare the agility potential between different configurations. In addition, one study illustrates the module's ability to optimize a configuration's agility performance.

  7. Analysis and optimization of preliminary aircraft configurations in relationship to emerging agility metrics

    NASA Technical Reports Server (NTRS)

    Sandlin, Doral R.; Bauer, Brent Alan

    1993-01-01

    This paper discusses the development of a FORTRAN computer code to perform agility analysis on aircraft configurations. This code is to be part of the NASA-Ames ACSYNT (AirCraft SYNThesis) design code. This paper begins with a discussion of contemporary agility research in the aircraft industry and a survey of a few agility metrics. The methodology, techniques and models developed for the code are then presented. Finally, example trade studies using the agility module along with ACSYNT are illustrated. These trade studies were conducted using a Northrop F-20 Tigershark aircraft model. The studies show that the agility module is effective in analyzing the influence of common parameters such as thrust-to-weight ratio and wing loading on agility criteria. The module can compare the agility potential between different configurations. In addition one study illustrates the module's ability to optimize a configuration's agility performance.

  8. Foot and ankle surgery in Australia: a descriptive analysis of the Medicare Benefits Schedule database, 1997–2006

    PubMed Central

    Menz, Hylton B; Gilheany, Mark F; Landorf, Karl B

    2008-01-01

    Background Foot and ankle problems are highly prevalent in the general community and a substantial proportion of people seek surgical treatment to alleviate foot pain and deformity. However, the epidemiology of foot and ankle surgery has not been examined in detail. Therefore, the aim of this study was to examine patterns and costs of private sector foot surgery provision in Australia. Methods Data pertaining to all foot and ankle surgical procedures for the calendar years 1997–2006 were extracted from the Australian Medicare Benefits Schedule (MBS) database and were cross-tabulated by sex and age. Descriptive analyses were undertaken to assess sex and age differences in the number and type of procedures performed and to assess for temporal trends over the ten year assessment period. The total cost to Medicare of subsiding surgeons' fees in 2006 was also determined. Results During the 1997–2006 period, 996,477 surgical procedures were performed on the foot and ankle by private surgeons in Australia. Approximately equal numbers of procedures were performed on males (52%) and females (48%). However, males were more likely to undergo toenail, ankle, clubfoot, tarsal coalition and congenital vertical talus surgery, whereas females were more likely to undergo lesser toe, first metatarsophalangeal joint (MPJ), neuroma, heel, rearfoot and lesser MPJ surgery. The total number of procedures was stable over the assessment period, however there was a relative increase in the number of procedures performed on people aged over 55 years. The total contribution of Medicare to subsiding surgeons' fees for procedures performed in 2006 was $14 M. Conclusion Foot and ankle surgery accounts for a considerable degree of healthcare expenditure in Australia, and the number of procedures in those aged over 55 years is increasing. Given the ageing demographics of the Australian population, the future public health and economic impact of foot morbidity is likely to be substantial

  9. [Measurement ofthe ankle-brachial pressure index (ABPI)].

    PubMed

    Kulisić, Sandra Marinović

    2012-10-01

    Measurement of the ankle-brachial pressure index, also known as ankle-brachial index or ankle-arm index is a ratio of the ankle blood pressure and brachial blood pressure. It is easy to perform and allows for diagnosis and further definition of the severity of peripheral arterial disease with sensitivity 90% and specificity 98%. The test is not appropriate for mild arterial changes as in case of comorbidity. Its further objectives are to identify patients at an higher risk of cardiovascular events. PMID:23193828

  10. Increased Ligament Thickness in Previously Sprained Ankles as Measured by Musculoskeletal Ultrasound

    PubMed Central

    Liu, Kathy; Gustavsen, Geoff; Royer, Todd; Wikstrom, Erik A.; Glutting, Joseph; Kaminski, Thomas W.

    2015-01-01

    Context: Lateral ankle sprains are among the most common injuries in sport, with the anterior talofibular ligament (ATFL) most susceptible to damage. Although we understand that after a sprain, scar tissue forms within the ligament, little is known about the morphologic changes in a ligament after injury. Objective: To examine whether morphologic differences exist in the thickness of the ATFL in healthy, coper, and unstable-ankle groups. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 80 National Collegiate Athletic Association Division I collegiate athletes (43 women, 37 men, age = 18.2 ± 1.1 years, height = 175.8 ± 11.1 cm, body mass = 75.0 ± 16.9 kg) participated in this study. They were categorized into the healthy, coper, or unstable group by history of ankle sprains and score on the Cumberland Ankle Instability Tool. Main Outcome Measure(s): A musculoskeletal sonographic image of the ATFL was obtained from each ankle. Thickness of the ATFL was measured at the midpoint of the ligament between the attachments on the lateral malleolus and talus. Results: A group-by-limb interaction was evident (P = .038). The ATFLs of the injured limb for the coper group (2.20 ± 0.47 mm) and the injured limb for the unstable group (2.28 ± 0.53 mm) were thicker than the ATFL of the “injured” limb of the healthy group (1.95 ± 0.29 mm) at P = .015 and P = .015, respectively. No differences were seen in the uninjured limbs among groups. Conclusions: Because ATFL thicknesses of the healthy group's uninjured ankles were similar, we contend that lasting morphologic changes occurred in those with a previous injury to the ankle. Similar differences were seen between the injured limbs of the coper and unstable groups, so there must be another explanation for the sensations of instability and the reinjuries in the unstable group. PMID:25384002

  11. 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

  12. Biorobotics: using robots to emulate and investigate agile locomotion.

    PubMed

    Ijspeert, Auke J

    2014-10-10

    The graceful and agile movements of animals are difficult to analyze and emulate because locomotion is the result of a complex interplay of many components: the central and peripheral nervous systems, the musculoskeletal system, and the environment. The goals of biorobotics are to take inspiration from biological principles to design robots that match the agility of animals, and to use robots as scientific tools to investigate animal adaptive behavior. Used as physical models, biorobots contribute to hypothesis testing in fields such as hydrodynamics, biomechanics, neuroscience, and prosthetics. Their use may contribute to the design of prosthetic devices that more closely take human locomotion principles into account. PMID:25301621

  13. Lean and Agile Development of the AITS Ground Software System

    NASA Astrophysics Data System (ADS)

    Richters, Mark; Dutruel, Etienne; Mecredy, Nicolas

    2013-08-01

    We present the ongoing development of a new ground software system used for integrating, testing and operating spacecraft. The Advanced Integration and Test Services (AITS) project aims at providing a solution for electrical ground support equipment and mission control systems in future Astrium Space Transportation missions. Traditionally ESA ground or flight software development projects are conducted according to a waterfall-like process as specified in the ECSS-E-40 standard promoted by ESA in the European industry. In AITS a decision was taken to adopt an agile development process. This work could serve as a reference for future ESA software projects willing to apply agile concepts.

  14. Association of Diabetes and Hemodialysis With Ankle Pressure and Ankle-Brachial Index in Japanese Patients With Critical Limb Ischemia

    PubMed Central

    Takahara, Mitsuyoshi; Kaneto, Hideaki; Iida, Osamu; Katakami, Naoto; Matsuoka, Taka-aki; Ikeda, Masahiko; Shimomura, Iichiro

    2012-01-01

    OBJECTIVE To investigate whether diabetes and regular hemodialysis are associated with false elevation of ankle systolic blood pressure and ankle-brachial systolic pressure index (ABI) because of their arterial calcification in patients with critical limb ischemia (CLI). RESEARCH DESIGN AND METHODS We recruited 269 Japanese patients who underwent endovascular therapy for CLI. Ankle systolic blood pressure and ABI were assessed before endovascular therapy. Arterial stenosis and calcification were evaluated angiographically. We investigated the associations among clinical comorbidities, arterial calcification, and measurements of ankle systolic blood pressure and ABI. RESULTS Ankle systolic blood pressure was 85 ± 56 mmHg, and ABI was 0.59 ± 0.37. Arterial calcification was observed in 69% of the patients. The prevalence of diabetes and regular hemodialysis was 71 and 47%. Diabetes and regular hemodialysis were both significantly associated with the presence of arterial calcification; their adjusted odds ratios were 2.33 (P = 0.01) and 7.40 (P < 0.01), respectively. However, there was no significant difference in ankle systolic blood pressure or ABI level between those with and without these comorbidities. Furthermore, the presence of arterial calcification was not associated with ankle systolic blood pressure or ABI level, whereas arterial stenoses of all segments in the lower body had independent associations with reduced ankle systolic blood pressure and ABI level. CONCLUSIONS Diabetes and regular hemodialysis were significantly associated with arterial calcification, but not with elevated measurements of ankle systolic blood pressure or ABI, in CLI patients. PMID:22723344

  15. Ultrasonography in the Assessment of Lateral Ankle Ligament Injury, Instability, and Anterior Ankle Impingement: A Diagnostic Case Report

    PubMed Central

    Battaglia, Patrick J.; Craig, Kate; Kettner, Norman W.

    2015-01-01

    Objective The purpose of this case report is to describe the diagnostic value of ultrasonography (US) in a patient with injury to the lateral ligaments of the ankle with concomitant ankle joint osteoarthritis and anterior impingement. Clinical Features A 28-year-old male had a history of an inversion injury of the left ankle. Diagnostic US of the left ankle using an 8- to 15-MHz linear array transducer demonstrated a full thickness tear of the anterior talofibular ligament, partial thickness tearing of the calcaneofibular ligament, and laxity of the ankle with varus stress testing. In addition, US was able to demonstrate degeneration of the ankle and talonavicular joints and anterior impingement with dorsiflexion. Osteoarthritic changes were confirmed with radiography. Other US findings included remote deltoid ligamentous complex injury, multiple sites of tenosynovitis, and a large ankle joint effusion with synovial hypertrophy and synovitis. Intervention and Outcome Using US, an accurate diagnosis was established with respect to the pathology and functional impairments of the patient’s ankle. Conclusion This case report exemplifies the value and utility of US in diagnosing derangement in ligamentous, tendinous, articular, and osseous injuries of the ankle. PMID:26793038

  16. 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

  17. X-36 Tailless Fighter Agility Research Aircraft in flight

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The tailless X-36 technology demonstrator research aircraft cruises over the California desert at low altitude during a 1997 research flight. The NASA/Boeing X-36 Tailless Fighter Agility Research Aircraft program successfully demonstrated the tailless fighter design using advanced technologies to improve the maneuverability and survivability of possible future fighter aircraft. The program met or exceeded all project goals. For 31 flights during 1997 at the Dryden Flight Research Center, Edwards, California, the project team examined the aircraft's agility at low speed / high angles of attack and at high speed / low angles of attack. The aircraft's speed envelope reached up to 206 knots (234 mph). This aircraft was very stable and maneuverable. It handled very well. The X-36 vehicle was designed to fly without the traditional tail surfaces common on most aircraft. Instead, a canard forward of the wing was used as well as split ailerons and an advanced thrust-vectoring nozzle for directional control. The X-36 was unstable in both pitch and yaw axes, so an advanced, single-channel digital fly-by-wire control system (developed with some commercially available components) was put in place to stabilize the aircraft. Using a video camera mounted in the nose of the aircraft and an onboard microphone, the X-36 was remotely controlled by a pilot in a ground station virtual cockpit. A standard fighter-type head-up display (HUD) and a moving-map representation of the vehicle's position within the range in which it flew provided excellent situational awareness for the pilot. This pilot-in-the-loop approach eliminated the need for expensive and complex autonomous flight control systems and the risks associated with their inability to deal with unknown or unforeseen phenomena in flight. Fully fueled the X-36 prototype weighed approximately 1,250 pounds. It was 19 feet long and three feet high with a wingspan of just over 10 feet. A Williams International F112 turbofan engine

  18. X-36 Tailless Fighter Agility Research Aircraft in flight

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The X-36 technology demonstrator shows off its distinctive shape as the remotely piloted aircraft flies a research mission over the Southern California desert on October 30, 1997. The NASA/Boeing X-36 Tailless Fighter Agility Research Aircraft program successfully demonstrated the tailless fighter design using advanced technologies to improve the maneuverability and survivability of possible future fighter aircraft. The program met or exceeded all project goals. For 31 flights during 1997 at the Dryden Flight Research Center, Edwards, California, the project team examined the aircraft's agility at low speed / high angles of attack and at high speed / low angles of attack. The aircraft's speed envelope reached up to 206 knots (234 mph). This aircraft was very stable and maneuverable. It handled very well. The X-36 vehicle was designed to fly without the traditional tail surfaces common on most aircraft. Instead, a canard forward of the wing was used as well as split ailerons and an advanced thrust-vectoring nozzle for directional control. The X-36 was unstable in both pitch and yaw axes, so an advanced, single-channel digital fly-by-wire control system (developed with some commercially available components) was put in place to stabilize the aircraft. Using a video camera mounted in the nose of the aircraft and an onboard microphone, the X-36 was remotely controlled by a pilot in a ground station virtual cockpit. A standard fighter-type head-up display (HUD) and a moving-map representation of the vehicle's position within the range in which it flew provided excellent situational awareness for the pilot. This pilot-in-the-loop approach eliminated the need for expensive and complex autonomous flight control systems and the risks associated with their inability to deal with unknown or unforeseen phenomena in flight. Fully fueled the X-36 prototype weighed approximately 1,250 pounds. It was 19 feet long and three feet high with a wingspan of just over 10 feet. A Williams

  19. X-36 Tailless Fighter Agility Research Aircraft in flight

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The lack of a vertical tail on the X-36 technology demonstrator is evident as the remotely piloted aircraft flies a low-altitude research flight above Rogers Dry Lake at Edwards Air Force Base in the California desert on October 30, 1997. The NASA/Boeing X-36 Tailless Fighter Agility Research Aircraft program successfully demonstrated the tailless fighter design using advanced technologies to improve the maneuverability and survivability of possible future fighter aircraft. The program met or exceeded all project goals. For 31 flights during 1997 at the Dryden Flight Research Center, Edwards, California, the project team examined the aircraft's agility at low speed / high angles of attack and at high speed / low angles of attack. The aircraft's speed envelope reached up to 206 knots (234 mph). This aircraft was very stable and maneuverable. It handled very well. The X-36 vehicle was designed to fly without the traditional tail surfaces common on most aircraft. Instead, a canard forward of the wing was used as well as split ailerons and an advanced thrust-vectoring nozzle for directional control. The X-36 was unstable in both pitch and yaw axes, so an advanced, single-channel digital fly-by-wire control system (developed with some commercially available components) was put in place to stabilize the aircraft. Using a video camera mounted in the nose of the aircraft and an onboard microphone, the X-36 was remotely controlled by a pilot in a ground station virtual cockpit. A standard fighter-type head-up display (HUD) and a moving-map representation of the vehicle's position within the range in which it flew provided excellent situational awareness for the pilot. This pilot-in-the-loop approach eliminated the need for expensive and complex autonomous flight control systems and the risks associated with their inability to deal with unknown or unforeseen phenomena in flight. Fully fueled the X-36 prototype weighed approximately 1,250 pounds. It was 19 feet long and three

  20. Current State of Agile User-Centered Design: A Survey

    NASA Astrophysics Data System (ADS)

    Hussain, Zahid; Slany, Wolfgang; Holzinger, Andreas

    Agile software development methods are quite popular nowadays and are being adopted at an increasing rate in the industry every year. However, these methods are still lacking usability awareness in their development lifecycle, and the integration of usability/User-Centered Design (UCD) into agile methods is not adequately addressed. This paper presents the preliminary results of a recently conducted online survey regarding the current state of the integration of agile methods and usability/UCD. A world wide response of 92 practitioners was received. The results show that the majority of practitioners perceive that the integration of agile methods with usability/UCD has added value to their adopted processes and to their teams; has resulted in the improvement of usability and quality of the product developed; and has increased the satisfaction of the end-users of the product developed. The top most used HCI techniques are low-fidelity prototyping, conceptual designs, observational studies of users, usability expert evaluations, field studies, personas, rapid iterative testing, and laboratory usability testing.

  1. The influence of agility training on physiological and cognitive performance.

    PubMed

    Lennemann, Lynette M; Sidrow, Kathryn M; Johnson, Erica M; Harrison, Catherine R; Vojta, Christopher N; Walker, Thomas B

    2013-12-01

    Agility training (AT) has recently been instituted in several military communities in hopes of improving combat performance and general fitness. The purpose of this study was to determine how substituting AT for traditional military physical training (PT) influences physical and cognitive performance. Forty-one subjects undergoing military technical training were divided randomly into 2 groups for 6 weeks of training. One group participated in standard military PT consisting of calisthenics and running. A second group duplicated the amount of exercise of the first group but used AT as their primary mode of training. Before and after training, subjects completed a physical and cognitive battery of tests including V[Combining Dot Above]O2max, reaction time, Illinois Agility Test, body composition, visual vigilance, dichotic listening, and working memory tests. There were significant improvements within the AT group in V[Combining Dot Above]O2max, Illinois Agility Test, visual vigilance, and continuous memory. There was a significant increase in time-to-exhaustion for the traditional group. We conclude that AT is as effective or more effective as PT in enhancing physical fitness. Further, it is potentially more effective than PT in enhancing specific measures of physical and cognitive performance, such as physical agility, memory, and vigilance. Consequently, we suggest that AT be incorporated into existing military PT programs as a way to improve war-fighter performance. Further, it seems likely that the benefits of AT observed here occur in various other populations. PMID:23442271

  2. On the Biomimetic Design of Agile-Robot Legs

    PubMed Central

    Garcia, Elena; Arevalo, Juan Carlos; Muñoz, Gustavo; Gonzalez-de-Santos, Pablo

    2011-01-01

    The development of functional legged robots has encountered its limits in human-made actuation technology. This paper describes research on the biomimetic design of legs for agile quadrupeds. A biomimetic leg concept that extracts key principles from horse legs which are responsible for the agile and powerful locomotion of these animals is presented. The proposed biomimetic leg model defines the effective leg length, leg kinematics, limb mass distribution, actuator power, and elastic energy recovery as determinants of agile locomotion, and values for these five key elements are given. The transfer of the extracted principles to technological instantiations is analyzed in detail, considering the availability of current materials, structures and actuators. A real leg prototype has been developed following the biomimetic leg concept proposed. The actuation system is based on the hybrid use of series elasticity and magneto-rheological dampers which provides variable compliance for natural motion. From the experimental evaluation of this prototype, conclusions on the current technological barriers to achieve real functional legged robots to walk dynamically in agile locomotion are presented. PMID:22247667

  3. Agile Software Development Methods: A Comparative Review1

    NASA Astrophysics Data System (ADS)

    Abrahamsson, Pekka; Oza, Nilay; Siponen, Mikko T.

    Although agile software development methods have caught the attention of software engineers and researchers worldwide, scientific research still remains quite scarce. The aim of this study is to order and make sense of the different agile approaches that have been proposed. This comparative review is performed from the standpoint of using the following features as the analytical perspectives: project management support, life-cycle coverage, type of practical guidance, adaptability in actual use, type of research objectives and existence of empirical evidence. The results show that agile software development methods cover, without offering any rationale, different phases of the software development life-cycle and that most of these methods fail to provide adequate project management support. Moreover, quite a few methods continue to offer little concrete guidance on how to use their solutions or how to adapt them in different development situations. Empirical evidence after ten years of application remains quite limited. Based on the results, new directions on agile methods are outlined.

  4. Network configuration management : paving the way to network agility.

    SciTech Connect

    Maestas, Joseph H.

    2007-08-01

    Sandia networks consist of nearly nine hundred routers and switches and nearly one million lines of command code, and each line ideally contributes to the capabilities of the network to convey information from one location to another. Sandia's Cyber Infrastructure Development and Deployment organizations recognize that it is therefore essential to standardize network configurations and enforce conformance to industry best business practices and documented internal configuration standards to provide a network that is agile, adaptable, and highly available. This is especially important in times of constrained budgets as members of the workforce are called upon to improve efficiency, effectiveness, and customer focus. Best business practices recommend using the standardized configurations in the enforcement process so that when root cause analysis results in recommended configuration changes, subsequent configuration auditing will improve compliance to the standard. Ultimately, this minimizes mean time to repair, maintains the network security posture, improves network availability, and enables efficient transition to new technologies. Network standardization brings improved network agility, which in turn enables enterprise agility, because the network touches all facets of corporate business. Improved network agility improves the business enterprise as a whole.

  5. Tailoring Agility: Promiscuous Pair Story Authoring and Value Calculation

    NASA Astrophysics Data System (ADS)

    Tendon, Steve

    This chapter describes how a multi-national software organization created a business plan involving business units from eight countries that followed an agile way, after two previously failed attempts with traditional approaches. The case is told by the consultant who initiated implementation of agility into requirements gathering, estimation and planning processes in an international setting. The agile approach was inspired by XP, but then tailored to meet the peculiar requirements. Two innovations were critical. The first innovation was promiscuous pair story authoring, where user stories were written by two people (similarly to pair programming), and the pairing changed very often (as frequently as every 15-20 minutes) to achieve promiscuity and cater for diverse point of views. The second innovation was an economic value evaluation (and not the cost) which was attributed to stories. Continuous recalculation of the financial value of the stories allowed to assess the projects financial return. In this case implementation of agility in the international context allowed the involved team members to reach consensus and unanimity of decisions, vision and purpose.

  6. Wavelength-Agile External-Cavity Diode Laser for DWDM

    NASA Technical Reports Server (NTRS)

    Pilgrim, Jeffrey S.; Bomse, David S.

    2006-01-01

    A prototype external-cavity diode laser (ECDL) has been developed for communication systems utilizing dense wavelength- division multiplexing (DWDM). This ECDL is an updated version of the ECDL reported in Wavelength-Agile External- Cavity Diode Laser (LEW-17090), NASA Tech Briefs, Vol. 25, No. 11 (November 2001), page 14a. To recapitulate: The wavelength-agile ECDL combines the stability of an external-cavity laser with the wavelength agility of a diode laser. Wavelength is modulated by modulating the injection current of the diode-laser gain element. The external cavity is a Littman-Metcalf resonator, in which the zeroth-order output from a diffraction grating is used as the laser output and the first-order-diffracted light is retro-reflected by a cavity feedback mirror, which establishes one end of the resonator. The other end of the resonator is the output surface of a Fabry-Perot resonator that constitutes the diode-laser gain element. Wavelength is selected by choosing the angle of the diffracted return beam, as determined by position of the feedback mirror. The present wavelength-agile ECDL is distinguished by design details that enable coverage of all 60 channels, separated by 100-GHz frequency intervals, that are specified in DWDM standards.

  7. Agile manufacturing and constraints management: a strategic perspective

    NASA Astrophysics Data System (ADS)

    Stratton, Roy; Yusuf, Yahaya Y.

    2000-10-01

    The definition of the agile paradigm has proved elusive and is often viewed as a panacea, in contention with more traditional approaches to operations strategy development and Larkin its own methodology and tools. The Theory of Constraints (TOC) is also poorly understood, as it is commonly solely associated with production planning and control systems and bottleneck management. This paper will demonstrate the synergy between these two approaches together with the Theory of Inventive Problem Solving (TRIZ), and establish how the systematic elimination of trade-offs can support the agile paradigm. Whereas agility is often seen as a trade-off free destination, both TOC and TRIZ may be considered to be route finders, as they comprise methodologies that focus on the identification and elimination of the trade-offs that constrain the purposeful improvement of a system, be it organizational or mechanical. This paper will also show how the TOC thinking process may be combined with the TRIZ knowledge based approach and used in breaking contradictions within agile logistics.

  8. Agent-based scheduling system to achieve agility

    NASA Astrophysics Data System (ADS)

    Akbulut, Muhtar B.; Kamarthi, Sagar V.

    2000-12-01

    Today's competitive enterprises need to design, develop, and manufacture their products rapidly and inexpensively. Agile manufacturing has emerged as a new paradigm to meet these challenges. Agility requires, among many other things, scheduling and control software systems that are flexible, robust, and adaptive. In this paper a new agent-based scheduling system (ABBS) is developed to meet the challenges of an agile manufacturing system. In ABSS, unlike in the traditional approaches, information and decision making capabilities are distributed among the system entities called agents. In contrast with the most agent-based scheduling systems which commonly use a bidding approach, the ABBS employs a global performance monitoring strategy. A production-rate-based global performance metric which effectively assesses the system performance is developed to assist the agents' decision making process. To test the architecture, an agent-based discrete event simulation software is developed. The experiments performed using the simulation software yielded encouraging results in supporting the applicability of agent-based systems to address the scheduling and control needs of an agile manufacturing system.

  9. Impact of Agile Software Development Model on Software Maintainability

    ERIC Educational Resources Information Center

    Gawali, Ajay R.

    2012-01-01

    Software maintenance and support costs account for up to 60% of the overall software life cycle cost and often burdens tightly budgeted information technology (IT) organizations. Agile software development approach delivers business value early, but implications on software maintainability are still unknown. The purpose of this quantitative study…

  10. A Capstone Course on Agile Software Development Using Scrum

    ERIC Educational Resources Information Center

    Mahnic, V.

    2012-01-01

    In this paper, an undergraduate capstone course in software engineering is described that not only exposes students to agile software development, but also makes it possible to observe the behavior of developers using Scrum for the first time. The course requires students to work as Scrum Teams, responsible for the implementation of a set of user…

  11. Prospective epidemiological study of basketball injuries during one competitive season: ankle sprains and overuse knee injuries.

    PubMed

    Cumps, Elke; Verhagen, Evert; Meeusen, Romain

    2007-01-01

    This prospective cohort study aims to assess the overall incidence of acute and overuse basketball injuries and identifies risk factors associated with ankle sprains and knee overuse injuries. In total, 164 senior players (23.7 years ± 7.0) of all levels of play, and including both men and women, participated voluntarily during one season. A total of 139 acute and 87 overuse injuries were reported, resulting in an overall injury incidence of 9.8 (8.5 to 11.1) per 1,000 hours. The incidence of acute injuries was 6.0/1,000 hours. Ankle sprains (n = 34) accounted for most acute injuries, and 52.9% of all players with ankle sprains reported a previous ankle sprain. Relative Risks (RR) and Odds Ratio (OR) with their 95% Confidence Intervals (CI) were calculated to determine significant differences. Landing on an opponent's foot was the major inciting event, significantly more so than non contact mechanisms (RR=2.1 [95% CI: 1.0-4.2]). Acute knee injuries resulted in the highest playing absence (7 weeks 2 days ± 9 weeks 1 day). Overuse injury incidence was 3.8/1,000 hours. The knee (1.5/1,000 hours) was the most common site. Forward players sustained less knee overuse injuries than players of all other playing positions, and significantly less than center players (OR=0.5 [95% CI: 0.2-0.9]). This study showed that ankle sprains and overuse knee injuries are the most common injuries in basketball, both accounting for 14.8%. Injury prevention programmes however should not concentrate on those injuries only, but might one to consider that acute knee injuries, in spite of the fact that they occur less frequently, also merit further research. Key pointsAnkle sprains are the most common acute injuries in basketball with the inciting event being landing on an opponent's foot or changing direction.Anterior knee pain is the most common overuse injury. Etiologic factors are well described in literature, but prevention strategies are lacking.Acute knee injuries account for the

  12. AGILE integration into APC for high mix logic fab

    NASA Astrophysics Data System (ADS)

    Gatefait, M.; Lam, A.; Le Gratiet, B.; Mikolajczak, M.; Morin, V.; Chojnowski, N.; Kocsis, Z.; Smith, I.; Decaunes, J.; Ostrovsky, A.; Monget, C.

    2015-09-01

    For C040 technology and below, photolithographic depth of focus control and dispersion improvement is essential to secure product functionality. Critical 193nm immersion layers present initial focus process windows close to machine control capability. For previous technologies, the standard scanner sensor (Level sensor - LS) was used to map wafer topology and expose the wafer at the right Focus. Such optical embedded metrology, based on light reflection, suffers from reading issues that cannot be neglected anymore. Metrology errors are correlated to inspected product area for which material types and densities change, and so optical properties are not constant. Various optical phenomena occur across the product field during wafer inspection and have an effect on the quality and position of the reflected light. This can result in incorrect heights being recorded and exposures possibly being done out of focus. Focus inaccuracy associated to aggressive process windows on critical layers will directly impact product realization and therefore functionality and yield. ASML has introduced an air gauge sensor to complement the optical level sensor and lead to optimal topology metrology. The use of this new sensor is managed by the AGILE (Air Gauge Improved process LEveling) application. This measurement with no optical dependency will correct for optical inaccuracy of level sensor, and so improve best focus dispersion across the product. Due to the fact that stack complexity is more and more important through process steps flow, optical perturbation of standard Level sensor metrology is increasing and is becoming maximum for metallization layers. For these reasons AGILE feature implementation was first considered for contact and all metal layers. Another key point is that standard metrology will be sensitive to layer and reticle/product density. The gain of Agile will be enhanced for multiple product contribution mask and for complex System on Chip. Into ST context (High

  13. 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.

  14. Rehabilitation of the Ankle after Acute Sprain or Chronic Instability.

    ERIC Educational Resources Information Center

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Outlines rehabilitation concepts applicable to acute and chronic ankle injury, providing evidence for current techniques used in ankle rehabilitation and describing a functional rehabilitation program that progresses from basic to advanced, while taking into account empirical data from the literature and clinical practice. The article notes that…

  15. Review on design and control aspects of ankle rehabilitation robots.

    PubMed

    Jamwal, Prashant K; Hussain, Shahid; Xie, Sheng Q

    2015-03-01

    Ankle rehabilitation robots can play an important role in improving outcomes of the rehabilitation treatment by assisting therapists and patients in number of ways. Consequently, few robot designs have been proposed by researchers which fall under either of the two categories, namely, wearable robots or platform-based robots. This paper presents a review of both kinds of ankle robots along with a brief analysis of their design, actuation and control approaches. While reviewing these designs it was observed that most of them are undesirably inspired by industrial robot designs. Taking note of the design concerns of current ankle robots, few improvements in the ankle robot designs have also been suggested. Conventional position control or force control approaches, being used in the existing ankle robots, have been reviewed. Apparently, opportunities of improvement also exist in the actuation as well as control of ankle robots. Subsequently, a discussion on most recent research in the development of novel actuators and advanced controllers based on appropriate physical and cognitive human-robot interaction has also been included in this review. Implications for Rehabilitation Ankle joint functions are restricted/impaired as a consequence of stroke or injury during sports or otherwise. Robots can help in reinstating functions faster and can also work as tool for recording rehabilitation data useful for further analysis. Evolution of ankle robots with respect to their design and control aspects has been discussed in the present paper and a novel design with futuristic control approach has been proposed. PMID:24320195

  16. Direct measurement of the intrinsic ankle stiffness during standing.

    PubMed

    Vlutters, M; Boonstra, T A; Schouten, A C; van der Kooij, H

    2015-05-01

    Ankle stiffness contributes to standing balance, counteracting the destabilizing effect of gravity. The ankle stiffness together with the compliance between the foot and the support surface make up the ankle-foot stiffness, which is relevant to quiet standing. The contribution of the intrinsic ankle-foot stiffness to balance, and the ankle-foot stiffness amplitude dependency remain a topic of debate in the literature. We therefore developed an experimental protocol to directly measure the bilateral intrinsic ankle-foot stiffness during standing balance, and determine its amplitude dependency. By applying fast (40 ms) ramp-and-hold support surface rotations (0.005-0.08 rad) during standing, reflexive contributions could be excluded, and the amplitude dependency of the intrinsic ankle-foot stiffness was investigated. Results showed that reflexive activity could not have biased the torque used for estimating the intrinsic stiffness. Furthermore, subjects required less recovery action to restore balance after bilateral rotations in opposite directions compared to rotations in the same direction. The intrinsic ankle-foot stiffness appears insufficient to ensure balance, ranging from 0.93±0.09 to 0.44±0.06 (normalized to critical stiffness 'mgh'). This implies that changes in muscle activation are required to maintain balance. The non-linear stiffness decrease with increasing rotation amplitude supports the previous published research. With the proposed method reflexive effects can be ruled out from the measured torque without any model assumptions, allowing direct estimation of intrinsic stiffness during standing. PMID:25843262

  17. Ankle moment generation and maximum-effort curved sprinting performance.

    PubMed

    Luo, Geng; Stefanyshyn, Darren

    2012-11-15

    Turning at high speed along acute curves is crucial for athletic performance. One determinant of curved sprinting speed is the ground reaction force that can be created by the supporting limb; the moment generated at the ankle joint may influence such force generation. Body lean associated with curved sprints positions the ankle joints in extreme in-/eversion, and may hinder the ankle moment generation. To examine the influence of ankle moment generation on curved sprinting performance, 17 male subjects performed maximum-effort curved sprints in footwear with and without a wedge. The wedged footwear was constructed with the intention to align the ankle joints closer to their neutral frontal-plane configuration during counter-clockwise curved sprints so greater joint moments might be generated. We found, with the wedged footwear, the average eversion angle of the inside leg ankle was reduced, and the plantarflexion moment generation increased significantly. Meanwhile, the knee extension moment remained unchanged. With the wedged footwear, stance-average centripetal ground reaction force increased significantly while no difference in the vertical ground reaction force was detected. The subjects created a greater centripetal ground reaction impulse in the wedged footwear despite a shortened stance phase when compared to the control. Stance-average curved sprinting speed improved by 4.3% with the wedged footwear. The changes in ankle moment and curved sprinting speed observed in the current study supports the notion that the moment generation at the ankle joint may be a performance constraint for curved sprinting. PMID:23022207

  18. Systematic review of chronic ankle instability in children

    PubMed Central

    2014-01-01

    Background Chronic ankle instability (CAI) is a disabling condition often encountered after ankle injury. Three main components of CAI exist; perceived instability; mechanical instability (increased ankle ligament laxity); and recurrent sprain. Literature evaluating CAI has been heavily focused on adults, with little attention to CAI in children. Hence, the objective of this study was to systematically review the prevalence of CAI in children. Methods Studies were retrieved from major databases from earliest records to March 2013. References from identified articles were also examined. Studies involving participants with CAI, classified by authors as children, were considered for inclusion. Papers investigating traumatic instability or instability arising from fractures were excluded. Two independent examiners undertook all stages of screening, data extraction and methodological quality assessments. Screening discrepancies were resolved by reaching consensus. Results Following the removal of duplicates, 14,263 papers were screened for eligibility against inclusion and exclusion criteria. Nine full papers were included in the review. Symptoms of CAI evaluated included perceived and mechanical ankle instability along with recurrent ankle sprain. In children with a history of ankle sprain, perceived instability was reported in 23-71% whilst mechanical instability was found in 18-47% of children. A history of recurrent ankle sprain was found in 22% of children. Conclusion Due to the long-lasting impacts of CAI, future research into the measurement and incidence of ankle instability in children is recommended. PMID:24641786

  19. Kinematics of ankle taping after a training session.

    PubMed

    Meana, M; Alegre, L M; Elvira, J L L; Aguado, X

    2008-01-01

    This study aimed to test the effectiveness of ankle taping on the limitation of forced supination during a change of direction, as well as the losses of effectiveness after a 30-minute training session. Fifteen young men with no ankle injury volunteered for the study. The static and dynamic ranges of movement (ROM) were measured before and after a training session. The dynamic measurements were recorded using high-speed 3D photogrammetry. The differences between static and dynamic measures of ankle supination and plantar flexion were significant. The losses of effectiveness during supination and ankle plantar flexion restriction were 42.3 % and 47.6 %, respectively. Ankle taping was effective in restricting the maximal static ROMs before a training session, but the effectiveness decreased after 30 min of training. The present study shows the necessity of performing dynamic ROM analysis of sports techniques involved in the ankle sprain mechanism in order to determine the degree of tape restriction after a training session, because there were differences between static and dynamic ankle ROMs. The lack of effects on the restriction of the dynamic plantar flexion would bring into question the necessity of ankle taping in subjects without previous injuries. PMID:17614032

  20. Recycling Energy to Restore Impaired Ankle Function during Human Walking

    PubMed Central

    Collins, Steven H.; Kuo, Arthur D.

    2010-01-01

    Background Humans normally dissipate significant energy during walking, largely at the transitions between steps. The ankle then acts to restore energy during push-off, which may be the reason that ankle impairment nearly always leads to poorer walking economy. The replacement of lost energy is necessary for steady gait, in which mechanical energy is constant on average, external dissipation is negligible, and no net work is performed over a stride. However, dissipation and replacement by muscles might not be necessary if energy were instead captured and reused by an assistive device. Methodology/Principal Findings We developed a microprocessor-controlled artificial foot that captures some of the energy that is normally dissipated by the leg and “recycles” it as positive ankle work. In tests on subjects walking with an artificially-impaired ankle, a conventional prosthesis reduced ankle push-off work and increased net metabolic energy expenditure by 23% compared to normal walking. Energy recycling restored ankle push-off to normal and reduced the net metabolic energy penalty to 14%. Conclusions/Significance These results suggest that reduced ankle push-off contributes to the increased metabolic energy expenditure accompanying ankle impairments, and demonstrate that energy recycling can be used to reduce such cost. PMID:20174659

  1. 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

  2. Orthobiologics in Foot and Ankle Surgery.

    PubMed

    Lin, Sheldon S; Montemurro, Nicholas J; Krell, Ethan S

    2016-02-01

    Exploration into the molecular aspects of the healing process has led to the development of autologous and recombinant biologic agents. These products, collectively known as orthobiologics, have the potential to optimize favorable outcomes with respect to bone and soft-tissue restoration and to maximize the natural healing response. These orthobiologics include platelet-derived growth factor, bone morphogenetic proteins, and platelet-rich plasma. Although the usefulness of these growth factors is well described in various fields of surgery, few data exist to support or oppose the specific application of growth factors in foot and ankle surgery. PMID:26803546

  3. Arthroscopic Approach to Posterior Ankle Impingement.

    PubMed

    Theodoulou, Michael H; Bohman, Laura

    2016-10-01

    Posterior ankle pain can occur for many reasons. If it is produced by forced plantarflexion of the foot, it is often a result of impingement from an enlarged posterior talar process or an os trigonum. This condition may present in an acute or chronic state. Management is initially nonoperative, but surgical treatments are available. This condition is often seen in athletes, so procedures that limit surgical trauma and allow early return to activity are ideal. An arthroscopic approach for this disorder produces good outcomes with limited complications. Understanding the indications, local anatomy, and surgical technique, allows good, reproducible outcomes. PMID:27599438

  4. Clinical assessment and management of ankle sprains.

    PubMed

    Myrick, Karen M

    2014-01-01

    Ankle sprains are a common occurrence and are frequently either undertreated or overtreated. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the United States alone, this is an orthopaedic injury that providers should be acutely aware of and successfully able to evaluate and treat. This clinical feature will provide a thorough review of the mechanism of injury, the history and physical examination, and the classification and management of these injuries. Clinical red flags are discussed. PMID:25233201

  5. Robotic Ankle for Omnidirectional Rock Anchors

    NASA Technical Reports Server (NTRS)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

    Future robotic exploration of near-Earth asteroids and the vertical and inverted rock walls of lava caves and cliff faces on Mars and other planetary bodies would require a method of gripping their rocky surfaces to allow mobility without gravitational assistance. In order to successfully navigate this terrain and drill for samples, the grippers must be able to produce anchoring forces in excess of 100 N. Additionally, the grippers must be able to support the inertial forces of a moving robot, as well gravitational forces for demonstrations on Earth. One possible solution would be to use microspine arrays to anchor to rock surfaces and provide the necessary load-bearing abilities for robotic exploration of asteroids. Microspine arrays comprise dozens of small steel hooks supported on individual suspensions. When these arrays are dragged along a rock surface, the steel hooks engage with asperities and holes on the surface. The suspensions allow for individual hooks to engage with asperities while the remaining hooks continue to drag along the surface. This ensures that the maximum possible number of hooks engage with the surface, thereby increasing the load-bearing abilities of the gripper. Using the microspine array grippers described above as the end-effectors of a robot would allow it to traverse terrain previously unreachable by traditional wheeled robots. Furthermore, microspine-gripping robots that can perch on cliffs or rocky walls could enable a new class of persistent surveillance devices for military applications. In order to interface these microspine grippers with a legged robot, an ankle is needed that can robotically actuate the gripper, as well as allow it to conform to the large-scale irregularities in the rock. The anchor serves three main purposes: deploy and release the anchor, conform to roughness or misalignment with the surface, and cancel out any moments about the anchor that could cause unintentional detachment. The ankle design contains a

  6. Data transfer through beam steering using agile lensing

    NASA Astrophysics Data System (ADS)

    Arshad, Muhammad Assad; Reza, Syed Azer; Muhammad, Ahsan

    2016-04-01

    This paper presents a data transfer scheme using multi-focus tunable lenses. The design involves the use of a standard laser source and a variable focus agile lens to steer to the laser beam that passes through the lens. In our proposed system, the beam steer angle depends on an input electrical signal which drives the tunable lens. Therefore the beam steer angle is made to follow the variations in the input electrical drive signal. This is extremely interesting for data transfer applications as the data signal can be used as the input drive signal to the lens. The laser beam is steered according to the input data voltage levels and when the beam is incident on a photo-detector of a finite size, only a fraction of its total incident optical power is received by the photo-detector. This power contribution is proportional to the fraction of the total number of photons per unit area which are incident on the active area of the detector. The remaining photons which are not incident on the photo-detector do not contribute to the received power at the photo-detector. We present the theory of beam steering through a tunable lens and present a theoretical framework which governs data transfer through the proposed method. We also present the transfer function of the proposed system which helps us to calculate its essential theoretical performance parameters such as modulation depth and bit error rates. We also present experimental results to demonstrate efficient data transfer through the proposed method. As tunable lenses are primarily deployed in motion-free multi-focus cameras hence most of the modern portable devices such as cellphones and tablets use these lenses to operate the in-built variable focus cameras that are part of these devices. Because tunable lenses are commonly present in several different portable devices, the proposed method of data transfer between two devices is highly promising as it expands the use of the already deployed tunable lenses with

  7. Finite element analysis of a composite artificial ankle

    NASA Technical Reports Server (NTRS)

    Perkins, Leigh Ann; Johnston, Lawrence; Denniston, Charles; Czekalski, Blaise E.

    1993-01-01

    Ultra-light carbon fiber composite materials are being utilized in artificial limbs with increasing frequency in recent years. Dr. Arthur Copes, an orthotist from Baton Rouge, Louisiana, has developed a graphite expoxy composite material artificial ankle (Copes/Bionic Ankle) that is intended to be used by amputees who require the most advanced above-and-below-the-knee prosthetic devices. The Copes/Bionic Ankle is designed to reproduce the function of the natural ankle joint by allowing the composite material to act as a spring mechanism without the use of metal mechanical parts. NASA Marshall Space Flight Center has agreed to participate in the design effort by providing the structural analysis of the artificial ankle design.

  8. Functional Design in Rehabilitation: Modular Mechanisms for Ankle Complex

    PubMed Central

    2016-01-01

    This paper is aimed at presenting an innovative ankle rehabilitation device based on a parallel mechanism. A functional analysis and design are described to obtain a device able to guarantee ankle movement while patient's body remains stationary. Human ankle is a challenging context where a series of joints are highly integrated. The proposed rehabilitation device permits a patient with walking defects to improve his or her gait. The research focuses on plantar-flexion-dorsiflexion movement. The robust design starts from an accurate modelling of ankle movements during walking, assessing motion data from healthy individuals and patients. The kinematics analysis and functional evaluations lead the study and development of the articulated system. In particular, results of simulations support the effectiveness of the current design. A 3D prototype is presented highlighting that the ankle motion is successfully demonstrated. PMID:27524881

  9. Foot and ankle injuries in the barefoot sports.

    PubMed

    Vormittag, Kara; Calonje, Ronald; Briner, William W

    2009-01-01

    Playing sports barefoot has been contested since the very beginnings of athletic competition. Even today, some data suggest that shoes may limit the adaptive pronation that occurs after footstrike during running gait. This pronation likely protects runners from injury. Boardsport participants who perform their sports barefoot on the water seem to be at risk for foot and ankle injuries. The high-impact forces in gymnastics place participants at risk for foot and ankle injuries, as well. Swimming and diving have a low rate of foot and ankle injuries. The risk of ankle sprain in beach volleyball, which is played barefoot, seems to be lower than that for indoor volleyball, played wearing shoes. Martial arts place competitors at risk for injuries to the foot and ankle from torsional and impact mechanisms. Athletes who hope to return to barefoot competition after injury should perform their rehabilitation in their bare feet. PMID:19741354

  10. IINCIDENCE OF ANKLE SPRAINS IN SOCCER PLAYERS WITH JOINT HYPERMOBILITY SYNDROME

    PubMed Central

    Vieira, Rodrigo Barreiros; Bertolini, Fabricio Melo; Vieira, Tallys Campos; Aguiar, Rodrigo Manso; Pinheiro, Guilherme Baldez; Lasmar, Rodrigo Campos Pace

    2015-01-01

    Objective: Eighty-three soccer players aged between 14 and 19 years, in the basic category of a professional soccer club in the city of Belo Horizonte, were followed up during the 2009 season. Methods: A prospective observational cohort study was conducted, in which these soccer players were divided randomly into two groups. The first consisted of individuals with joint hypermobility syndrome (JHS), totaling 22 players, and the second was a control group with 61 players without this syndrome, determined through a physical examinati. Results: Both groups were studied with regard to incidence of ankle sprains. At the end of this period, the data were compiled and statistical analysis was performed. A total of 43 cases of ankle injury due to sprains were recorded, of which nine episodes were in players with JHS, thus making p = 0.106. The significance level was 5%. Conclusion: We were able to conclude that in our study there was insufficient evidence to assert that there is an association with increased incidence of ankle sprains among patients with JHS. PMID:27047888

  11. Organizational Agility and Complex Enterprise System Innovations: A Mixed Methods Study of the Effects of Enterprise Systems on Organizational Agility

    ERIC Educational Resources Information Center

    Kharabe, Amol T.

    2012-01-01

    Over the last two decades, firms have operated in "increasingly" accelerated "high-velocity" dynamic markets, which require them to become "agile." During the same time frame, firms have increasingly deployed complex enterprise systems--large-scale packaged software "innovations" that integrate and automate…

  12. 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

  13. Syndesmosis and lateral ankle sprains in the National Football League.

    PubMed

    Osbahr, Daryl C; Drakos, Mark C; O'Loughlin, Padhraig F; Lyman, Stephen; Barnes, Ronnie P; Kennedy, John G; Warren, Russell F

    2013-11-01

    Syndesmosis sprains in the National Football League (NFL) can be a persistent source of disability, especially compared with lateral ankle injuries. This study evaluated syndesmosis and lateral ankle sprains in NFL players to allow for better identification and management of these injuries. Syndesmosis and lateral ankle sprains from a single NFL team database were reviewed over a 15-year period, and 32 NFL team physicians completed a questionnaire detailing their management approach. A comparative analysis was performed analyzing several variables, including diagnosis, treatment methods, and time lost from sports participation. Thirty-six syndesmosis and 53 lateral ankle sprains occurred in the cohort of NFL players. The injury mechanism typically resulted from direct impact in the syndesmosis and torsion in the lateral ankle sprain group (P=.034). All players were managed nonoperatively. The mean time lost from participation was 15.4 days in the syndesmosis and 6.5 days in the lateral ankle sprain groups (P⩽.001). National Football League team physicians varied treatment for syndesmosis sprains depending on the category of diastasis but recommended nonoperative management for lateral ankle sprains. Syndesmosis sprains in the NFL can be a source of significant disability compared with lateral ankle sprains. Successful return to play with nonoperative management is frequently achieved for syndesmosis and lateral ankle sprains depending on injury severity. With modern treatment algorithms for syndesmosis sprains, more aggressive nonoperative treatment is advocated. Although the current study shows that syndesmosis injuries require longer rehabilitation periods when compared with lateral ankle sprains, the time lost from participation may not be as prolonged as previously reported. PMID:24200441

  14. Mechanical energy profiles of the combined ankle-foot system in normal gait: insights for prosthetic designs.

    PubMed

    Takahashi, Kota Z; Stanhope, Steven J

    2013-09-01

    Over the last half-century, the field of prosthetic engineering has continuously evolved with much attention being dedicated to restoring the mechanical energy properties of ankle joint musculatures during gait. However, the contributions of 'distal foot structures' (e.g., foot muscles, plantar soft tissue) have been overlooked. Therefore, the purpose of this study was to quantify the total mechanical energy profiles (e.g., power, work, and work-ratio) of the natural ankle-foot system (NAFS) by combining the contributions of the ankle joint and all distal foot structures during stance in level-ground steady state walking across various speeds (0.4, 0.6, 0.8 and 1.0 statures/s). The results from eleven healthy subjects walking barefoot indicated ankle joint and distal foot structures generally performed opposing roles: the ankle joint performed net positive work that systematically increased its energy generation with faster walking speeds, while the distal foot performed net negative work that systematically increased its energy absorption with faster walking speeds. Accounting for these simultaneous effects, the combined ankle-foot system exhibited increased work-ratios with faster walking. Most notably, the work-ratio was not significantly greater than 1.0 during the normal walking speed of 0.8 statures/s. Therefore, a prosthetic design that strategically exploits passive-dynamic properties (e.g., elastic energy storage and return) has the potential to replicate the mechanical energy profiles of the NAFS during level-ground steady-state walking. PMID:23628408

  15. Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation.

    PubMed

    Carmichael, Kelly D; Maxwell, Seth C; Calhoun, Jason H

    2005-01-01

    The purpose of this study was to determine recurrence rates of pediatric foot and ankle burn deformities treated with the Ilizarov method. A total of 19 patients with 29 foot and ankle deformities were studied. The most common deformity treated was equinus (23). Rocker-bottom and cavus foot deformities were each treated three times. The average age of the patient at the time of the burn injury was 3.2 years, and the average age at the time of fixation was 9.4 years. Equinus contractures averaged -34 degrees (34 degrees of plantarflexion) before surgery and +7 degrees (7 degrees of dorsiflexion) after treatment with the Ilizarov fixator. The recurrence rate for all 29 ankles and feet was 69% (20/29). The recurrence rate for equinus contractures was 74% (17/23). The average time to recurrence was 17.3 months. Only short-term follow-up was available on four of the six feet and ankles that did not recur. Deformity correction in burned feet and ankles is difficult to obtain by any means. The authors recommend using the Ilizarov method to obtain correction of moderate to severe foot and ankle deformities in pediatric burn patients, but the correction obtained is not stable and deformity will likely recur. Parents and patients should anticipate adjunctive nonoperative and operative procedures to keep their feet plantigrade as they grow. In young children, the possibility of having additional surgeries, including repeat Ilizarov procedures, should be discussed. Even older children should expect additional surgeries to prevent recurrent deformities. PMID:15958908

  16. Reliability and criterion-related validity of a new repeated agility test.

    PubMed

    Fessi, M S; Makni, E; Jemni, M; Elloumi, M; Chamari, K; Nabli, M A; Padulo, J; Moalla, W

    2016-06-01

    The study aimed to assess the reliability and the criterion-related validity of a new repeated sprint T-test (RSTT) that includes intense multidirectional intermittent efforts. The RSTT consisted of 7 maximal repeated executions of the agility T-test with 25 s of passive recovery rest in between. Forty-five team sports players performed two RSTTs separated by 3 days to assess the reliability of best time (BT) and total time (TT) of the RSTT. The intra-class correlation coefficient analysis revealed a high relative reliability between test and retest for BT and TT (>0.90). The standard error of measurement (<0.50) showed that the RSTT has a good absolute reliability. The minimal detectable change values for BT and TT related to the RSTT were 0.09 s and 0.58 s, respectively. To check the criterion-related validity of the RSTT, players performed a repeated linear sprint (RLS) and a repeated sprint with changes of direction (RSCD). Significant correlations between the BT and TT of the RLS, RSCD and RSTT were observed (p<0.001). The RSTT is, therefore, a reliable and valid measure of the intermittent repeated sprint agility performance. As this ability is required in all team sports, it is suggested that team sports coaches, fitness coaches and sports scientists consider this test in their training follow-up. PMID:27274109

  17. Reliability and criterion-related validity of a new repeated agility test

    PubMed Central

    Makni, E; Jemni, M; Elloumi, M; Chamari, K; Nabli, MA; Padulo, J; Moalla, W

    2016-01-01

    The study aimed to assess the reliability and the criterion-related validity of a new repeated sprint T-test (RSTT) that includes intense multidirectional intermittent efforts. The RSTT consisted of 7 maximal repeated executions of the agility T-test with 25 s of passive recovery rest in between. Forty-five team sports players performed two RSTTs separated by 3 days to assess the reliability of best time (BT) and total time (TT) of the RSTT. The intra-class correlation coefficient analysis revealed a high relative reliability between test and retest for BT and TT (>0.90). The standard error of measurement (<0.50) showed that the RSTT has a good absolute reliability. The minimal detectable change values for BT and TT related to the RSTT were 0.09 s and 0.58 s, respectively. To check the criterion-related validity of the RSTT, players performed a repeated linear sprint (RLS) and a repeated sprint with changes of direction (RSCD). Significant correlations between the BT and TT of the RLS, RSCD and RSTT were observed (p<0.001). The RSTT is, therefore, a reliable and valid measure of the intermittent repeated sprint agility performance. As this ability is required in all team sports, it is suggested that team sports coaches, fitness coaches and sports scientists consider this test in their training follow-up. PMID:27274109

  18. [Unexpected revision procedures treating ankle fractures].

    PubMed

    Richter, J; Pommer, A; Breuer, R; Hullmann, S; Heyde, D V; Dávid, A

    2012-06-01

    The purpose of the present study was to analyze the risk factors associated with unexpected second procedures and strategies of revision surgery. Within a 5 year period 647 patients with closed ankle fractures AO type 44 were identified of which 77 (11.9%) needed revision surgery. Complications were addressed to 4 main groups: deep infections (IG) were seen in 29 patients (4.5%), problems with primary wound closure (WG) in 22 patients (3.4%), insufficient reduction (KG) in 22 patients (3.4%) and other causes (RG) included 4 patients (0.6%). Significant predictive factors for soft tissue complications were higher age, comorbidities with peripheral arteriosclerosis, high American Society of Anesthesiologists (ASA) score and diabetes mellitus. AO 44 type B2 and B3 fractures were often associated with soft tissue problems. The more complex fracture types AO 44 C1-C3 and A2-A3 were significantly associated with problems of insufficient congruency post-surgery. The distribution of the mean revision rate was significantly different (p<0.01) for all groups: IG 4.59, WG 3.5, KG 1.55, RG 1.25. In summary, we strongly recommend immediate reduction of displaced fractures and to consider a more detailed fracture classification. To reduce the amount of unexpected ankle procedures individual risk factors should be weighed against the advantages of optimal open reduction and internal fixation. PMID:21165587

  19. Lyme arthritis of the pediatric ankle.

    PubMed

    Aiyer, Amiethab; Walrath, Jessica; Hennrikus, William

    2014-10-01

    Lyme arthritis results from acute inflammation caused by the spirochete Borrelia burgdorferi. The number of cases per year has been rising since 2006, with a majority of patients being affected in the northeastern United States. Development of Lyme arthritis is of particular importance to the orthopedic surgeon because Lyme arthritis often presents as an acute episode of joint swelling and tenderness and may be confused with bacterial septic arthritis. Considering the vast difference in treatment management between these 2 pathologies, differentiating between them is of critical importance. Septic arthritis often needs to be addressed surgically, whereas Lyme arthritis can be treated with oral antibiotics alone. Laboratory testing for Lyme disease often results in a delay in diagnosis because many laboratories batch-test Lyme specimens only a few times per week because of increased expense. The authors present a case of Lyme arthritis in the pediatric ankle in an endemic region. No clear algorithm exists to delineate between septic arthritis and Lyme arthritis of the joint. Improved clinical guidelines for the identification and diagnosis of Lyme arthritis of the ankle are important so that appropriate antibiotics can be used and surgery can be avoided. PMID:25275987

  20. Arthroscopic Anatomy of the Ankle Joint.

    PubMed

    Ray, Ronald G

    2016-10-01

    There are a number of variations in the intra-articular anatomy of the ankle which should not be considered pathological under all circumstances. The anteromedial corner of the tibial plafond (between the anterior edge of the tibial plafond and the medial malleolus) can have a notch, void of cartilage and bone. This area can appear degenerative arthroscopically; it is actually a normal variant of the articular surface. The anterior inferior tibiofibular ligament (AITF) can possess a lower, accessory band which can impinge on the anterolateral edge of the talar dome. In some cases it can cause irritation along this area of the talus laterally. If it is creating local irritation it can be removed since it does not provide any additional stabilization to the syndesmosis. There is a beveled region at the anterior leading edge of the lateral and dorsal surfaces of the talus laterally. This triangular region is void of cartilage and subchondral bone. The lack of talar structure in this region allows the lower portion of the AITF ligament to move over the talus during end range dorsiflexion of the ankle, preventing impingement. The variation in talar anatomy for this area should not be considered pathological. PMID:27599433

  1. The foot and ankle of Australopithecus sediba.

    PubMed

    Zipfel, Bernhard; DeSilva, Jeremy M; Kidd, Robert S; Carlson, Kristian J; Churchill, Steven E; Berger, Lee R

    2011-09-01

    A well-preserved and articulated partial foot and ankle of Australopithecus sediba, including an associated complete adult distal tibia, talus, and calcaneus, have been discovered at the Malapa site, South Africa, and reported in direct association with the female paratype Malapa Hominin 2. These fossils reveal a mosaic of primitive and derived features that are distinct from those seen in other hominins. The ankle (talocrural) joint is mostly humanlike in form and inferred function, and there is some evidence for a humanlike arch and Achilles tendon. However, Au. sediba is apelike in possessing a more gracile calcaneal body and a more robust medial malleolus than expected. These observations suggest, if present models of foot function are correct, that Au. sediba may have practiced a unique form of bipedalism and some degree of arboreality. Given the combination of features in the Au. sediba foot, as well as comparisons between Au. sediba and older hominins, homoplasy is implied in the acquisition of bipedal adaptations in the hominin foot. PMID:21903807

  2. Ankle Bracing and the Neuromuscular Factors Influencing Joint Stiffness

    PubMed Central

    Zinder, Steven M; Granata, Kevin P; Shultz, Sandra J; Gansneder, Bruce M

    2009-01-01

    Context: Health care professionals commonly prescribe external stabilization to decrease the incidence and severity of ankle sprains. The mechanism for this decrease is not clearly understood. Examining the effects of ankle bracing on biomechanical stability and influencing factors may provide important information regarding the neuromuscular effects of bracing. Objective: To study the effects of 2 different ankle braces on the neuromuscular factors influencing ankle stiffness. Design: Mixed-model repeated-measures design. Setting: Research laboratory. Patients or Other Participants: Twenty-eight physically active participants composing 2 groups: 14 with unilateral functional ankle instability (age  =  26.19 ± 6.46 years, height  =  166.07 ± 12.90 cm, mass  =  69.90 ± 13.46 kg) and 14 with bilaterally stable ankles (age  =  23.76 ± 5.82 years, height  =  174.00 ± 11.67 cm, mass  =  68.60 ± 13.12 kg). Intervention(s): Participants were fitted with surface electromyography electrodes over the peroneus longus, peroneus brevis, tibialis anterior, and soleus muscles. Each participant received transient motion oscillations to his or her ankle on a custom-built medial-lateral swaying cradle in each of 3 conditions: no ankle brace (NB), lace-up brace (LU), and semirigid brace (SR). Main Outcome Measure(s): Ankle stiffness as measured by the cradle and preactivation levels (percentage of maximal voluntary isometric contraction) of the 4 test muscles. Results: Stiffness levels increased across brace conditions (NB  =  24.79 ± 6.59 Nm/rad, LU  =  28.29 ± 7.05 Nm/rad, SR  =  33.22 ± 8.78 Nm/rad; F2,52  =  66.185, P < .001). No differences were found between groups for rotational stiffness (stable  =  27.36 ± 6.17 Nm/rad, unstable  =  30.18 ± 8.21 Nm/rad; F1,26  =  1.084, P  =  .307). Preactivation levels did not change for any of the tested muscles with the application of an ankle brace (F2,52  =  1.326, P

  3. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint... ankle joint. The device limits translation and rotation: in one or more planes via the geometry of...

  4. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint... ankle joint. The device limits translation and rotation: in one or more planes via the geometry of...

  5. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint... ankle joint. The device limits translation and rotation: in one or more planes via the geometry of...

  6. 21 CFR 888.3100 - Ankle joint metal/composite semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ankle joint metal/composite semi-constrained... Ankle joint metal/composite semi-constrained cemented prosthesis. (a) Identification. An ankle joint... ankle joint. The device limits translation and rotation: in one or more planes via the geometry of...

  7. Imaging evaluation of traumatic ligamentous injuries of the ankle and foot.

    PubMed

    Nazarenko, Anna; Beltran, Luis S; Bencardino, Jenny T

    2013-05-01

    Sports ankle injuries are very common worldwide. In the United States, it is estimated that 2 million acute ankle sprains occur each year, averaging to $318 to $914 per sprain. Magnetic resonance imaging is excellent for depicting normal ankle anatomy and can elegantly demonstrate ligamentous injuries of the ankle and associated conditions after ankle sprain. This article encompasses epidemiology, biomechanics, normal anatomy, and pathologic conditions of the ankle and foot ligaments. The specific ligaments discussed include the syndesmotic ligaments, lateral ligament complex of the ankle, deltoid ligament, spring ligament, ligaments of the sinus tarsi, and the Lisfranc ligament. PMID:23622094

  8. Bone alterations are associated with ankle osteoarthritis joint pain

    PubMed Central

    Nakamura, Yukio; Uchiyama, Shigeharu; Kamimura, Mikio; Komatsu, Masatoshi; Ikegami, Shota; Kato, Hiroyuki

    2016-01-01

    The etiology of ankle osteoarthritis (OA) is largely unknown. We analyzed 24 ankle OA of 21 patients diagnosed by plain radiographs using magnetic resonance imaging (MRI). Ankle joint pain disappeared in 22 out of 24 joints by conservative treatment. MRI bone signal changes in and around the ankle joints were observed in 22 of 24 joints. Bone signal changes along the joint line were seen in 10 of 11 joints as a Kellgren-Lawrence (KL) grade of II to IV. Such signal changes were witnessed in only 4 of 13 joints with KL grade 0 or I. In the talocrural joint, bone alterations occurred in both tibia and talus bones through the joint line in cases of KL grade III or IV, while focal bone alterations were present in the talus only in KL grade I or II cases. Sixteen of 24 joints exhibited intraosseous bone signal changes, which tended to correspond to joint pain of any ankle OA stage. Our results suggest that bone alterations around the ankle joint might be one of the etiologies of OA and associated with ankle joint pain. PMID:26776564

  9. Ankle motion after external fixation of tibial fractures.

    PubMed Central

    Taylor, G J; Allum, R L

    1988-01-01

    Loss of ankle movement is a complication of severe tibial fractures. This can be exacerbated if the foot is allowed to drop into equinus, particularly when an external fixator is employed. The range of ankle motion following external fixation of tibial fractures as compared to the opposite normal ankle was studied in 40 of 55 patients treated over a ten-year period. Nine were excluded due to other causes of ankle stiffness, leaving 31 cases for analysis. The mean follow up was 2 years 7 months (range 1 year to 8 years 3 months), and union had occurred by a mean of 35 weeks (range 9-100 weeks). The mean loss of ankle movement was 8 degrees of plantar-flexion and 12 degrees of dorsiflexion (overall loss 20 degrees), the difference between the two being highly significant (P greater than 0.001, t test). Loss of ankle motion closely paralleled the degree of soft tissue trauma, being 6 degrees for closed fractures and 22 degrees for open fractures (0.05 greater than P greater than 0.02). Ankle function is therefore at risk when a severe tibial fracture is treated by external fixation, and appropriate measures should be taken to preserve movement and prevent an equinus contracture. Images Figure 1. Figure 2. Figure 3. PMID:3343667

  10. Managing ankle ligament sprains and tears: current opinion

    PubMed Central

    McGovern, Ryan P; Martin, RobRoy L

    2016-01-01

    The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected structures should be obtained through history and objective assessment. From this information, an individualized evidence-based intervention plan can be developed to enable recovery while decreasing the risk of reinjury. An appropriate evaluation is needed not only to determine the correct diagnosis but also to allow for grading and determining the prognosis of the injury in those with an acute lateral ankle sprain. Examination should include an assessment of impairments as well as a measure of activity and participation. Evidence-based interventions for those with an acute lateral ankle sprain should include weight bearing with bracing, manual therapy, progressive therapeutic exercises, and cryotherapy. For those with chronic ankle instability (CAI), interventions should include manual therapy and a comprehensive rehabilitation program. It is essential to understand the normal clinical course for athletes who sustain a lateral ankle sprain as well as risk factors for an acute injury and CAI. Risk factors for both an acute lateral ankle sprain and CAI include not using an external support and not participating in an appropriate exercise program. Incorporating the latest evidence-based rehabilitation techniques provides the best course of treatment for athletes with an acute ankle sprain or CAI. PMID:27042147

  11. The Anatomy and Mechanisms of Syndesmotic Ankle Sprains

    PubMed Central

    Floyd, R. T.

    2001-01-01

    Objective: To present a comprehensive review of the anatomy, biomechanics, and mechanisms of tibiofibular syndesmosis ankle sprains. Data Sources: MEDLINE (1966–1998) and CINAHL (1982–1998) searches using the key words syndesmosis, tibiofibular, ankle injuries, and ankle injuries–etiology. Data Synthesis: Stability of the distal tibiofibular syndesmosis is necessary for proper functioning of the ankle and lower extremity. Much of the ankle's stability is provided by the mortise formed around the talus by the tibia and fibula. The anterior and posterior inferior tibiofibular ligaments, the interosseous ligament, and the interosseous membrane act to statically stabilize the joint. During dorsiflexion, the wider portion anteriorly more completely fills the mortise, and contact between the articular surfaces is maximal. The distal structures of the lower leg primarily prevent lateral displacement of the fibula and talus and maintain a stable mortise. A variety of mechanisms individually or combined can cause syndesmosis injury. The most common mechanisms, individually and particularly in combination, are external rotation and hyperdorsiflexion. Both cause a widening of the mortise, resulting in disruption of the syndesmosis and talar instability. Conclusions and Recommendation: Syndesmosis ankle injuries are less common than lateral ankle injuries, are difficult to evaluate, have a long recovery period, and may disrupt normal joint functioning. To effectively evaluate and treat this injury, clinicians should have a full understanding of the involved structures, functional anatomy, and etiologic factors. PMID:16404437

  12. Multivariable Dynamic Ankle Mechanical Impedance With Active Muscles

    PubMed Central

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

    2015-01-01

    Multivariable dynamic ankle mechanical impedance in two coupled degrees-of-freedom (DOFs) was quantified when muscles were active. Measurements were performed at five different target activation levels of tibialis anterior and soleus, from 10% to 30% of maximum voluntary contraction (MVC) with increments of 5% MVC. Interestingly, several ankle behaviors characterized in our previous study of the relaxed ankle were observed with muscles active: ankle mechanical impedance in joint coordinates showed responses largely consistent with a second-order system consisting of inertia, viscosity, and stiffness; stiffness was greater in the sagittal plane than in the frontal plane at all activation conditions for all subjects; and the coupling between dorsiflexion–plantarflexion and inversion–eversion was small—the two DOF measurements were well explained by a strictly diagonal impedance matrix. In general, ankle stiffness increased linearly with muscle activation in all directions in the 2-D space formed by the sagittal and frontal planes, but more in the sagittal than in the frontal plane, resulting in an accentuated “peanut shape.” This characterization of young healthy subjects’ ankle mechanical impedance with active muscles will serve as a baseline to investigate pathophysiological ankle behaviors of biomechanically and/or neurologically impaired patients. PMID:25203497

  13. Managing ankle ligament sprains and tears: current opinion.

    PubMed

    McGovern, Ryan P; Martin, RobRoy L

    2016-01-01

    The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected structures should be obtained through history and objective assessment. From this information, an individualized evidence-based intervention plan can be developed to enable recovery while decreasing the risk of reinjury. An appropriate evaluation is needed not only to determine the correct diagnosis but also to allow for grading and determining the prognosis of the injury in those with an acute lateral ankle sprain. Examination should include an assessment of impairments as well as a measure of activity and participation. Evidence-based interventions for those with an acute lateral ankle sprain should include weight bearing with bracing, manual therapy, progressive therapeutic exercises, and cryotherapy. For those with chronic ankle instability (CAI), interventions should include manual therapy and a comprehensive rehabilitation program. It is essential to understand the normal clinical course for athletes who sustain a lateral ankle sprain as well as risk factors for an acute injury and CAI. Risk factors for both an acute lateral ankle sprain and CAI include not using an external support and not participating in an appropriate exercise program. Incorporating the latest evidence-based rehabilitation techniques provides the best course of treatment for athletes with an acute ankle sprain or CAI. PMID:27042147

  14. Preparing your Offshore Organization for Agility: Experiences in India

    NASA Astrophysics Data System (ADS)

    Srinivasan, Jayakanth

    Two strategies that have significantly changed the way we conventionally think about managing software development and sustainment are the family of development approaches collectively referred to as agile methods, and the distribution of development efforts on a global scale. When you combine the two strategies, organizations have to address not only the technical challenges that arise from introducing new ways of working, but more importantly have to manage the 'soft' factors that if ignored lead to hard challenges. Using two case studies of distributed agile software development in India we illustrate the areas that organizations need to be aware of when transitioning work to India. The key issues that we emphasize are the need to recruit and retain personnel; the importance of teaching, mentoring and coaching; the need to manage customer expectations; the criticality of well-articulated senior leadership vision and commitment; and the reality of operating in a heterogeneous process environment.

  15. Agile Data Management with the Global Change Information System

    NASA Astrophysics Data System (ADS)

    Duggan, B.; Aulenbach, S.; Tilmes, C.; Goldstein, J.

    2013-12-01

    We describe experiences applying agile software development techniques to the realm of data management during the development of the Global Change Information System (GCIS), a web service and API for authoritative global change information under development by the US Global Change Research Program. Some of the challenges during system design and implementation have been : (1) balancing the need for a rigorous mechanism for ensuring information quality with the realities of large data sets whose contents are often in flux, (2) utilizing existing data to inform decisions about the scope and nature of new data, and (3) continuously incorporating new knowledge and concepts into a relational data model. The workflow for managing the content of the system has much in common with the development of the system itself. We examine various aspects of agile software development and discuss whether or how we have been able to use them for data curation as well as software development.

  16. Pulsar timing and the Fermi and AGILE missions

    NASA Astrophysics Data System (ADS)

    Weltevrede, Patrick; Possenti, Andrea; Manchester, Dick; Johnston, Simon; Kramer, Michael; Hobbs, George; Keith, Michael; Romani, Roger W.; Thompson, David J.; Thorsett, Stephen; Roberts, Mallory

    2009-10-01

    We request time to observe 160 pulsars on a regular basis in order to provide accurate ephemerides necessary for the detection of gamma-ray pulsars with the Fermi and AGILE satellites. The main science goals are to increase the number of known gamma-ray pulsars (both radio loud and radio quiet), to determine accurate pulse profiles, to characterise their high energy spectra and phase resolved spectroscopy of the brightest pulsars. In the radio, the observations will also allow us to find glitches, characterise timing noise, investigate dispersion and rotation measure variability and enhance our knowledge of single pulse phenomenology. To date, we are (co-)authors on 2 Agile papers, 4 Fermi papers, 3 radio papers and authors on 3 papers in submission. The data are contributing to the PhD theses of Lucas Guillemot and Damien Parent from the Bordeaux Fermi group.

  17. A comparison of ankle block and spinal anesthesia for foot surgery

    PubMed Central

    Urfalioglu, Aykut; Gokdemir, Onur; Hanbeyoglu, Onur; Bilal, Bora; Oksuz, Gozen; Toker, Melike; Gungor, Leyla

    2015-01-01

    Regional anesthesia methods in the lower extremity include central blocks where spinal and epidural anesthesia are performed as well as peripheral nerve blocks, which are performed by injecting anesthetics locally to nerves. The study aimed to provide a retrospective comparison of unilateral spinal block and ankle block methods in foot operations. Some 60 ASA I-III patients who underwent operation under regional anesthesia were retrospectively examined. Two groups, known as the Unilateral Spinal Block Group (Group S) (n=30) and the Ankle Block Group (Group A) (n=30), were designed. Average blood pressure (ABP), heart rate (HR), block formation time (BFT), time for being ready for operation (TBRFO), total operation duration (TOD), visual analogue scale (VAS), first analgesic need time (FANT) and any complications were all recorded. The BFTs were longer in Group A than Group S, while the FANTs were longer in Group A postoperatively. When these decreases in Group A and Group S were compared with the basal values before the block, all decreases in Group S following the block were considered statistically significant (P<0.05), while the decreases in Group A in the 5th and 15th minutes were not considered statistically significant. The VASs measured postoperatively at the 6th, 12th and 24th hours of Group A were lower than those of Group S (P≤0.05). Despite the longer block formation, the ankle block is safer when compared to the spinal anesthesia, which involves risky hemodynamic changes in patients with associated diseases. PMID:26770580

  18. Utility of Fresh Frozen Section Analysis in Foot and Ankle Surgery: A Pilot Study.

    PubMed

    Monaco, Spencer J; Manway, Jeffery M; Burns, Patrick R

    2016-01-01

    The use of intraoperative fresh frozen section (FFS) analysis to determine the presence of infection has been well reported in orthopedic studies. Specifically, the number of polymorphonuclear leukocytes per high-power field has been used to diagnose total joint arthroplasty-related infection. Less commonly, reconstructive surgeons have extended the use of FFS analysis for intraoperative evaluation when suspicion of deep infection with or without hardware is high. The purpose of the present study was to retrospectively review the data from 11 patients undergoing foot and ankle reconstruction in the setting of possible deep infection and determine the usefulness of FFS analysis. A retrospective review of the medical records of patients who had undergone reconstructive foot and ankle revision surgery with intraoperative FFS analysis and tissue/swab cultures available was performed. A positive FFS was defined as >5 polymorphonuclear leukocytes per high-power field. A positive frozen section was associated with a positive tissue culture 4 of 7 times (57%). The sensitivity and specificity of FFS analysis for infection was 80% and 50%, respectively. The positive and negative predictive value of the FFS result was 57.1% and 75%, respectively. In conclusion, FFS analysis and intraoperative cultures correlated only 57% of the time in the present series. This test had moderate sensitivity for detecting infection at 80%, but the specificity was poor (50%). More research is needed to further evaluate the role of FFS analysis in foot and ankle surgery. PMID:27068638

  19. Ultrasound-guided interventions of the foot and ankle.

    PubMed

    Yablon, Corrie M

    2013-02-01

    Ultrasound (US) provides excellent delineation of tendons and ligaments in the foot and ankle and provides real-time visualization of a needle during interventions, yielding greater accuracy and efficacy than the traditional blind approach using anatomical landmarks. For this reason, US is rapidly gaining acceptance as the preferred modality for guiding interventions in the foot and ankle where the anatomy is complex, neurovascular structures should be identified, and precise technique is demanded. In the foot and ankle, US is especially useful to guide tendon sheath, bursal, and Achilles paratenon injections, Morton neuroma injections, plantar fascial injections, and joint aspirations and injections. PMID:23487336

  20. Diabetic charcot neuroarthropathy of the foot and ankle with osteomyelitis.

    PubMed

    Ramanujam, Crystal L; Stapleton, John J; Zgonis, Thomas

    2014-10-01

    One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis. PMID:25281510

  1. Ankle-foot orthosis function in low-level myelomeningocele.

    PubMed

    Hullin, M G; Robb, J E; Loudon, I R

    1992-01-01

    Six children with low-level myelomeningocele underwent gait analysis. All showed excessive ankle dorsiflexion and knee flexion when walking barefoot. A rigid thermoplastic ankle-foot orthosis (AFO) improved gait by preventing ankle dorsiflexion and reducing knee flexion. Biomechanically, the AFO caused a reduction in external knee moment by aligning the knee with the ground reaction force. Small changes in the foot-shank angle of the orthosis had profound effects on knee mechanics. Knee hyperextension could be controlled by a rocker sole. Kinetic gait analysis permits understanding of the biomechanical effects of orthoses. PMID:1613099

  2. Return to Play Following Ankle Sprain and Lateral Ligament Reconstruction.

    PubMed

    Shawen, Scott B; Dworak, Theodora; Anderson, Robert B

    2016-10-01

    Ankle sprains are the most common musculoskeletal injury occurring during athletics. Proper initial treatment with supportive pain control, limited immobilization, early return to weight bearing and range of motion, and directed physical therapy are essential for preventing recurrent injury. Reconstruction of the lateral ligaments is indicated for patients with continued instability and dysfunction despite physical therapy. Return to athletic activity should be reserved for athletes who have regained strength, proprioception, and range of motion of the injured ankle. Athletes with a history of an ankle sprain should be prophylactically braced or tapped to reduce risk of recurrent injury. PMID:27543408

  3. Seasonality of Ankle Swelling: Population Symptom Reporting Using Google Trends.

    PubMed

    Liu, Fangwei; Allan, G Michael; Korownyk, Christina; Kolber, Michael; Flook, Nigel; Sternberg, Harvey; Garrison, Scott

    2016-07-01

    In our experience, complaints of ankle swelling are more common in summer, typically from patients with no obvious cardiovascular disease. Surprisingly, this observation has never been reported. To objectively establish this phenomenon, we sought evidence of seasonality in the public's Internet searches for ankle swelling. Our data, obtained from Google Trends, consisted of all related Google searches in the United States from January 4, 2004, to January 26, 2016. Consistent with our expectations and confirmed by similar data for Australia, Internet searches for information on ankle swelling are highly seasonal (highest in midsummer), with seasonality explaining 86% of search volume variability. PMID:27401424

  4. ROADM architectures and technologies for agile optical networks

    NASA Astrophysics Data System (ADS)

    Eldada, Louay A.

    2007-02-01

    We review the different optoelectronic component and module technologies that have been developed for use in ROADM subsystems, and describe their principles of operation, designs, features, advantages, and challenges. We also describe the various needs for reconfigurable optical add/drop switching in agile optical networks. For each network need, we present the different ROADM subsystem architecture options with their pros and cons, and describe the optoelectronic technologies supporting each architecture.

  5. Sprint, agility, strength and endurance capacity in wheelchair basketball players

    PubMed Central

    Granados, C; Otero, M; Badiola, A; Olasagasti, J; Bidaurrazaga-Letona, I; Iturricastillo, A; Gil, SM

    2014-01-01

    The aims of the present study were, firstly, to determine the reliability and reproducibility of an agility T-test and Yo-Yo 10 m recovery test; and secondly, to analyse the physical characteristics measured by sprint, agility, strength and endurance field tests in wheelchair basketball (WB) players. 16 WB players (33.06 ± 7.36 years, 71.89 ± 21.71 kg and sitting body height 86.07 ± 6.82 cm) belonging to the national WB league participated in this study. Wheelchair sprint (5 and 20 m without ball, and 5 and 20 m with ball) agility (T-test and pick-up test) strength (handgrip and maximal pass) and endurance (Yo-Yo 10 m recovery test) were performed. T-test and Yo-Yo 10 m recovery test showed good reproducibility values (intraclass correlation coefficient, ICC = 0.74-0.94). The WB players’ results in 5 and 20 m sprints without a ball were 1.87 ± 0.21 s and 5.70 ± 0.43 s and with a ball 2.10 ± 0.30 s and 6.59 ± 0.61 s, being better than those reported in the literature. Regarding the pick-up test results (16.05 ± 0.52 s) and maximal pass (8.39 ± 1.77 m), players showed worse values than those obtained in elite players. The main contribution of the present study is the characterization of the physical performance profile of WB players using a field test battery. Furthermore, we demonstrated that the agility T-test and the aerobic Yo-Yo 10 m recovery test are reliable; consequently they may be appropriate instruments for measuring physical fitness in WB. PMID:25729153

  6. AGILE detection of a flare from PKS 1510-089

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Tavani, M.; Fioretti, V.; Gianotti, F.; Trifoglio, M.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Vercellone, S.; Piano, G.; Donnarumma, I.; Striani, E.; Cardillo, M.; Giuliani, A.; Mereghetti, S.; Caraveo, P.; Perotti, F.; Chen, A.; Colafrancesco, S.; Del Monte, E.; Evangelista, Y.; Feroci, M.; Lazzarotto, F.; Pacciani, L.; Soffitta, P.; Costa, E.; Lapshov, I.; Rapisarda, M.; Argan, A.; Pucella, G.; Sabatini, S.; Trois, A.; Vittorini, V.; Fuschino, F.; Galli, M.; Labanti, C.; Marisaldi, M.; Di Cocco, G.; Pellizzoni, A.; Pilia, M.; Barbiellini, G.; Vallazza, E.; Longo, F.; Morselli, A.; Picozza, P.; Prest, M.; Lipari, P.; Zanello, D.; Cattaneo, P. W.; Rappoldi, A.; Giommi, P.; Salotti, L.; Valentini, G.

    2014-08-01

    AGILE is now detecting transient gamma-ray emission above 100 MeV from a source positionally consistent with PKS 1510-089. Integrating from 2014-07-31 00:43 UT to 2014-08-02 02:15 UT, a preliminary maximum likelihood analysis yields a detection above 100 MeV positioned at Galactic coordinates (l,b) = (350.96, 40.12) +/- 0.9 (stat.) +/- 0.1 (syst.).

  7. AGILE Observations of the Gravitational-wave Event GW150914

    NASA Astrophysics Data System (ADS)

    Tavani, M.; Pittori, C.; Verrecchia, F.; Bulgarelli, A.; Giuliani, A.; Donnarumma, I.; Argan, A.; Trois, A.; Lucarelli, F.; Marisaldi, M.; Del Monte, E.; Evangelista, Y.; Fioretti, V.; Zoli, A.; Piano, G.; Munar-Adrover, P.; Antonelli, L. A.; Barbiellini, G.; Caraveo, P.; Cattaneo, P. W.; Costa, E.; Feroci, M.; Ferrari, A.; Longo, F.; Mereghetti, S.; Minervini, G.; Morselli, A.; Pacciani, L.; Pellizzoni, A.; Picozza, P.; Pilia, M.; Rappoldi, A.; Sabatini, S.; Vercellone, S.; Vittorini, V.; Giommi, P.; Colafrancesco, S.; Cardillo, M.; Galli, M.; Fuschino, F.

    2016-07-01

    We report the results of an extensive search through the AGILE data for a gamma-ray counterpart to the LIGO gravitational-wave (GW) event GW150914. Currently in spinning mode, AGILE has the potential of cover 80% of the sky with its gamma-ray instrument, more than 100 times a day. It turns out that AGILE came within a minute of the event time of observing the accessible GW150914 localization region. Interestingly, the gamma-ray detector exposed ∼65% of this region during the 100 s time intervals centered at ‑100 and +300 s from the event time. We determine a 2σ flux upper limit in the band 50 MeV–10 GeV, UL = 1.9 × 10‑8 erg cm‑2 s‑1, obtained ∼300 s after the event. The timing of this measurement is the fastest ever obtained for GW150914, and significantly constrains the electromagnetic emission of a possible high-energy counterpart. We also carried out a search for a gamma-ray precursor and delayed emission over five timescales ranging from minutes to days: in particular, we obtained an optimal exposure during the interval ‑150/‑30 s. In all these observations, we do not detect a significant signal associated with GW150914. We do not reveal the weak transient source reported by Fermi-GBM 0.4 s after the event time. However, even though a gamma-ray counterpart of the GW150914 event was not detected, the prospects for future AGILE observations of GW sources are decidedly promising.

  8. Epidemiology of foot and ankle injuries in the workplace.

    PubMed

    Conti, Stephen F; Silverman, Lance

    2002-06-01

    Injuries to the ankle, foot, and toes of injured workers are common. Although the workers' compensation system attempts to collect information about these injuries and report them in a meaningful way, the process is somewhat inconsistent, inaccurate, and provides information relevant to government agencies but not to physician organizations seeking to improve the prevention and treatment of work-related injuries. Several improvements in data collection could greatly increase the system's efficiency and usefulness. The first is to establish a national system of uniform data collection from each State. The second improvement involves standardization of the forms and means that the data are collected from the worker including a system to retrieve information that has been omitted during the initial encounter. The third, and most important, refinement is to change the reporting of the illness to match currently accepted medical diagnosis codes (ICD-9). Using the current system and making these improvements, the United States would be able to collect more meaningful data on work injuries in this country. From that point forward medical interventions could then be created and their effects more meaningfully analyzed. All those involved in the care and treatment of the injured worker must recognize not only the limitations of the collected data but also how this information can be manipulated. For example, whereas the total cost of benefits paid by employers increased during one decade the average cost per covered employee decreased. Employers and insurers can argue that their total costs have consistently risen but only by knowing that the cost per covered employee had decreased during that same time period can that argument be countered. Similarly, implementation of certain safety practices during a given time period may be accompanied by a reduction in the number of injuries. Changes in the laws that altered injury reporting and reduced the coverage for certain

  9. Effects of hip and head position on ankle range of motion, ankle passive torque, and passive gastrocnemius tension.

    PubMed

    Andrade, R J; Lacourpaille, L; Freitas, S R; McNair, P J; Nordez, A

    2016-01-01

    Ankle joint range of motion (ROM) is notably influenced by the position of the hip joint. However, this result remains unexplained. Thus, the aim of this study was to test if the ankle passive torque and gastrocnemius muscle tension are affected by the hip and the head positions. The torque and the muscle shear elastic modulus (measured by elastography to estimate muscle tension) were collected in nine participants during passive ankle dorsiflexions performed in four conditions (by combining hip flexion at 90 or 150°, and head flexed or neutral). Ankle maximum dorsiflexion angle significantly decreased by flexing the hip from 150 to 90° (P < 0.001; mean difference 17.7 ± 2.5°), but no effect of the head position was observed (P > 0.05). Maximal passive torque and shear elastic modulus were higher with the hip flexed at 90° (P < 0.001). During submaximal ROM, no effects of the head and hip positioning (P > 0.05) were found for both torque and shear elastic modulus at a given common ankle angle among conditions. Shifts in maximal ankle angle due to hip angle manipulation are not related neither to changes in passive torque nor tension of the gastrocnemius. Further studies should be addressed to better understand the functional role of peripheral nerves and fasciae in the ankle ROM limits. PMID:25676048

  10. Agile Science Operations: A New Approach for Primitive Exploration Bodies

    NASA Technical Reports Server (NTRS)

    Chien, Steve A.; Thompson, David R.; Castillo-Rogez, Julie C.; Doyle, Richard; Estlin, Tara; Mclaren, David

    2012-01-01

    Primitive body exploration missions such as potential Comet Surface Sample Return or Trojan Tour and Rendezvous would challenge traditional operations practices. Earth-based observations would provide only basic understanding before arrival and many science goals would be defined during the initial rendezvous. It could be necessary to revise trajectories and observation plans to quickly characterize the target for safe, effective observations. Detection of outgassing activity and monitoring of comet surface activity are even more time constrained, with events occurring faster than round-trip light time. "Agile science operations" address these challenges with contingency plans that recognize the intrinsic uncertainty in the operating environment and science objectives. Planning for multiple alternatives can significantly improve the time required to repair and validate spacecraft command sequences. When appropriate, time-critical decisions can be automated and shifted to the spacecraft for immediate access to instrument data. Mirrored planning systems on both sides of the light-time gap permit transfer of authority back and forth as needed. We survey relevant science objectives, identifying time bottlenecks and the techniques that could be used to speed missions' reaction to new science data. Finally, we discuss the results of a trade study simulating agile observations during flyby and comet rendezvous scenarios. These experiments quantify instrument coverage of key surface features as a function of planning turnaround time. Careful application of agile operations techniques can play a significant role in realizing the Decadal Survey plan for primitive body exploration

  11. Clustering-based urbanisation to improve enterprise information systems agility

    NASA Astrophysics Data System (ADS)

    Imache, Rabah; Izza, Said; Ahmed-Nacer, Mohamed

    2015-11-01

    Enterprises are daily facing pressures to demonstrate their ability to adapt quickly to the unpredictable changes of their dynamic in terms of technology, social, legislative, competitiveness and globalisation. Thus, to ensure its place in this hard context, enterprise must always be agile and must ensure its sustainability by a continuous improvement of its information system (IS). Therefore, the agility of enterprise information systems (EISs) can be considered today as a primary objective of any enterprise. One way of achieving this objective is by the urbanisation of the EIS in the context of continuous improvement to make it a real asset servicing enterprise strategy. This paper investigates the benefits of EISs urbanisation based on clustering techniques as a driver for agility production and/or improvement to help managers and IT management departments to improve continuously the performance of the enterprise and make appropriate decisions in the scope of the enterprise objectives and strategy. This approach is applied to the urbanisation of a tour operator EIS.

  12. Integrating a distributed, agile, virtual enterprise in the TEAM program

    NASA Astrophysics Data System (ADS)

    Cobb, C. K.; Gray, W. Harvey; Hewgley, Robert E.; Klages, Edward J.; Neal, Richard E.

    1997-01-01

    The technologies enabling agile manufacturing (TEAM) program enhances industrial capability by advancing and deploying manufacturing technologies that promote agility. TEAM has developed a product realization process that features the integration of product design and manufacturing groups. TEAM uses the tools it collects, develops, and integrates in support of the product realization process to demonstrate and deploy agile manufacturing capabilities for three high- priority processes identified by industry: material removal, forming, and electromechanical assembly. In order to provide a proof-of-principle, the material removal process has been addressed first and has been successfully demonstrate din an 'interconnected' mode. An internet-accessible intersite file manager (IFM) application has been deployed to allow geographically distributed TEAM participants to share and distribute information as the product realization process is executed. An automated inspection planning application has been demonstrated, importing a solid model form the IFM, generating an inspection plan and a part program to be used in the inspection process, and then distributing the part program to the inspection site via the IFM. TEAM seeks to demonstrate the material removal process in an integrated mode in June 1997 complete with an object-oriented framework and infrastructure. The current status and future plans for this project are presented here.

  13. An agile mask data preparation and writer dispatching approach

    NASA Astrophysics Data System (ADS)

    Hsu, Chih-tung; Chen, Y. S.; Hsin, S. C.; Tuo, Laurent C.; Schulze, Steffen F.

    2004-08-01

    An agile mask data preparation (MDP) approach is proposed to cut re-fracture cycle time as incurred by mask writer dispatching policy changes. Shorter re-fracture cycle time increases the flexibility of mask writer dispatching, as a result, mask writer's capacity can be utilized to its optimum. Preliminary results demonstrate promising benefits in MDP cycle time reduction and writer dispatching flexibility improvement. The agile MDP can save up to 40% of re-fracture cycle time. OASIS (Open Artwork System Interchange Standard) was proposed to address the GDSII file size explosion problem. However, OASIS has yet to gain wide acceptance in the mask industry. The authors envision OASIS adoption by the mask industry as a three-phase process and identify key issues of each phase from the mask manufacturer's perspective. As a long-term MDP flow reengineering project, an agile MDP and writer dispatching approach based on OASIS is proposed. The paper describes the results of an extensive evaluation on OASIS performance compared to that of GDSII, both original GDSII and post-OPC GDSII files. The file size of eighty percent of the original GDSII files is more than ten times larger compared to that of its OASIS counterpart.

  14. Observing peculiar γ-ray pulsars with AGILE

    NASA Astrophysics Data System (ADS)

    Pilia, M.; Pellizzoni, A.

    2011-08-01

    The AGILE γ-ray satellite provides large sky exposure levels (>=109 cm2 s per year on the Galactic Plane) with sensitivity peaking at E ~100 MeV where the bulk of pulsar energy output is typically released. Its ~1 μs absolute time tagging capability makes it perfectly suited for the study of γ-ray pulsars. AGILE collected a large number of γ-ray photons from EGRET pulsars (>=40,000 pulsed counts for Vela) in two years of observations unveiling new interesting features at sub-millisecond level in the pulsars' high-energy light-curves, γ-ray emission from pulsar glitches and Pulsar Wind Nebulae. AGILE detected about 20 nearby and energetic pulsars with good confidence through timing and/or spatial analysis. Among the newcomers we find pulsars with very high rotational energy losses, such as the remarkable PSR B1509-58 with a magnetic field in excess of 1013 Gauss, and PSR J2229+6114 providing a reliable identification for the previously unidentified EGRET source 3EG2227+6122. Moreover, the powerful millisecond pulsar B1821-24, in the globular cluster M28, is detected during a fraction of the observations.

  15. Effect of fence height on joint angles of agility dogs.

    PubMed

    Birch, Emily; Leśniak, Kirsty

    2013-12-01

    The Kennel Club (KC) and United Kingdom Agility (UKA) govern major dog agility competitions in the UK. Dogs are categorised into different jump heights depending on their height at the withers, with fence heights ranging from 300 to 650 mm for both organisations. Dogs fall into one of three height categories when competing under KC rules and one of four height categories under UKA rules. The aim of this study was to investigate the influence of an additional height category for agility dogs measuring over 430 mm at the withers. Jump heights were selected that related to the percentage of body height that dogs of 430 mm (7% lower) and 431 mm (51% higher) height at the withers would be encouraged to jump under UKA regulations without the addition of their fourth ('standard height') category. Joint angles were determined from anatomical markers placed on the forelimb and hind limb joints, and at six points along the vertebral column. As fence height increased, flexion of the scapulohumeral joint increased significantly for both the take-off and bascule (arc) phases of the jump. The increase in flexion as a consequence of the increase in fence height is likely to result in intensified stretching of the biceps brachii and supraspinatus muscles. In addition, increasing fence high resulted in an increase in the sacroiliac joint angle during take-off. PMID:24360736

  16. Agile Data Curation at a State Geological Survey

    NASA Astrophysics Data System (ADS)

    Hills, D. J.

    2015-12-01

    State agencies, including geological surveys, are often the gatekeepers for myriad data products essential for scientific research and economic development. For example, the Geological Survey of Alabama (GSA) is mandated to explore for, characterize, and report Alabama's mineral, energy, water, and biological resources in support of economic development, conservation, management, and public policy for the betterment of Alabama's citizens, communities, and businesses. As part of that mandate, the GSA has increasingly been called upon to make our data more accessible to stakeholders. Even as demand for greater data accessibility grows, budgets for such efforts are often small, meaning that agencies must do more for less. Agile software development has yielded efficient, effective products, most often at lower cost and in shorter time. Taking guidance from the agile software development model, the GSA is working towards more agile data management and curation. To date, the GSA's work has been focused primarily on data rescue. By using workflows that maximize clear communication while encouraging simplicity (e.g., maximizing the amount of work not done or that can be automated), the GSA is bringing decades of dark data into the light. Regular checks by the data rescuer with the data provider (or their proxy) provides quality control without adding an overt burden on either party. Moving forward, these workflows will also allow for more efficient and effective data management.

  17. [Ankle fractures in the elderly patient].

    PubMed

    Crevoisier, Xavier; Baalbaki, Rayan; Dos Santos, Tiago; Assal, Mathieu

    2014-12-17

    Ankle fractures in adults are usually managed by open reduction internal fixation. In elderly patients the surgical dilemma relates to bone quality. Osteoporosis is the enemy of internal fixation, and secure purchase of screws in osteopenic bone may be difficult to achieve. Insufficient screw purchase may lead to loss of reduction, wound breakdown, and infection. Postoperative management after osteosynthesis usually requires an extended period of restricted weight bearing. However, this is not feasible in older patients as a result of their lack of strength in the upper extremities and frequent comorbidities. Therefore, augmen- ted methods of internal fixation and specific surgical techniques have been developed using metal and bone cement. This permits this fragile population to begin early full weight bearing in a removable brace. PMID:25752013

  18. Optimal management of ankle syndesmosis injuries

    PubMed Central

    Porter, David A; Jaggers, Ryan R; Barnes, Adam Fitzgerald; Rund, Angela M

    2014-01-01

    Syndesmosis injuries occur when there is a disruption of the distal attachment of the tibia and fibula. These injuries occur commonly (up to 18% of ankle sprains), and the incidence increases in the setting of athletic activity. Recognition of these injuries is key to preventing long-term morbidity. Diagnosis and treatment of these injuries requires a thorough understanding of the normal anatomy and the role it plays in the stability of the ankle. A complete history and physical examination is of paramount importance. Patients usually experience an external rotation mechanism of injury. Key physical exam features include detailed documentation about areas of focal tenderness (syndesmosis and deltoid) and provocative maneuvers such as the external rotation stress test. Imaging workup in all cases should consist of radiographs with the physiologic stress of weight bearing. If these images are inconclusive, then further imaging with external rotation stress testing or magnetic resonance imaging are warranted. Nonoperative treatment is appropriate for stable injuries. Unstable injuries should be treated operatively. This consists of stabilizing the syndesmosis with either trans-syndesmotic screw or tightrope fixation. In the setting of a concomitant Weber B or C fracture, the fibula is anatomically reduced and stabilized with a standard plate and screw construct. Proximal fibular fractures, as seen in the Maisonneuve fracture pattern, are not repaired operatively. Recent interest is moving toward repair of the deltoid ligament, which may provide increased stability, especially in rehabilitation protocols that involve early weight bearing. Rehabilitation is focused on allowing patients to return to their pre-injury activities as quickly and safely as possible. Protocols initially focus on controlling swelling and recovery from surgery. The protocols then progress to restoration of motion, early protected weight bearing, restoration of strength, and eventually a

  19. Recent Advances in Foot and Ankle Surgery in Mainland China: Correction of Severe Foot and Ankle Deformities.

    PubMed

    Zhu, Yuan; Xu, Xiang-Yang; Wang, Bi-Bo

    2016-06-01

    Foot and ankle physicians in China encounter quite a large amount of severe and complex deformities. The main cause of severe ankle and foot deformity is trauma, while the other causes may be neuromuscular diseases, improper reduction and fixation and so on. Staged procedure may sometimes be a safer way to correct deformities in the presence of severe soft tissue contracture. Periarticular osteotomy combined with soft tissue balancing can be used in treating severe varus ankle arthritis, including stage IIIb cases and patients with talar tilt of more than 10 degrees. PMID:27261804

  20. Final Report of the NASA Office of Safety and Mission Assurance Agile Benchmarking Team

    NASA Technical Reports Server (NTRS)

    Wetherholt, Martha

    2016-01-01

    To ensure that the NASA Safety and Mission Assurance (SMA) community remains in a position to perform reliable Software Assurance (SA) on NASAs critical software (SW) systems with the software industry rapidly transitioning from waterfall to Agile processes, Terry Wilcutt, Chief, Safety and Mission Assurance, Office of Safety and Mission Assurance (OSMA) established the Agile Benchmarking Team (ABT). The Team's tasks were: 1. Research background literature on current Agile processes, 2. Perform benchmark activities with other organizations that are involved in software Agile processes to determine best practices, 3. Collect information on Agile-developed systems to enable improvements to the current NASA standards and processes to enhance their ability to perform reliable software assurance on NASA Agile-developed systems, 4. Suggest additional guidance and recommendations for updates to those standards and processes, as needed. The ABT's findings and recommendations for software management, engineering and software assurance are addressed herein.

  1. Towards a Framework for Using Agile Approaches in Global Software Development

    NASA Astrophysics Data System (ADS)

    Hossain, Emam; Ali Babar, Muhammad; Verner, June

    As agile methods and Global Software Development (GSD) are become increasingly popular, GSD project managers have been exploring the viability of using agile approaches in their development environments. Despite the expected benefits of using an agile approach with a GSD project, the overall combining mechanisms of the two approaches are not clearly understood. To address this challenge, we propose a conceptual framework, based on the research literature. This framework is expected to aid a project manager in deciding what agile strategies are effective for a particular GSD project, taking into account project context. We use an industry-based case study to explore the components of our conceptual framework. Our case study is planned and conducted according to specific published case study guidelines. We identify the agile practices and agile supporting practices used by a GSD project manager in our case study and conclude with future research directions.

  2. High-Speed Time-Series CCD Photometry with Agile

    NASA Astrophysics Data System (ADS)

    Mukadam, Anjum S.; Owen, R.; Mannery, E.; MacDonald, N.; Williams, B.; Stauffer, F.; Miller, C.

    2011-12-01

    We have assembled a high-speed time-series CCD photometer named Agile for the 3.5 m telescope at Apache Point Observatory, based on the design of a photometer called Argos at McDonald Observatory. Instead of a mechanical shutter, we use the frame-transfer operation of the CCD to end an exposure and initiate the subsequent new exposure. The frame-transfer operation is triggered by the negative edge of a GPS pulse; the instrument timing is controlled directly by hardware, without any software intervention or delays. This is the central pillar in the design of Argos that we have also used in Agile; this feature makes the accuracy of instrument timing better than a millisecond. Agile is based on a Princeton Instruments Acton VersArray camera with a frame-transfer CCD, which has 1K × 1K active pixels, each of size 13 μm × 13 μm. Using a focal reducer at the Nasmyth focus of the 3.5 m telescope at Apache Point Observatory, we yield a field of view of 2.2 × 2.2 arcmin2 with an unbinned plate scale of 0.13'' pixel-1. The CCD is back-illuminated and thinned for improved blue sensitivity and provides a quantum efficiency >=80% in the wavelength range of 4500-7500 Å. The unbinned full-frame readout time can be as fast as 1.1 s this is achieved using a low-noise amplifier operating at 1 MHz with an average read noise of the order of 6.6 e rms. At the slow read rate of 100 kHz to be used for exposure times longer than a few seconds, we determine an average read noise of the order of 3.7 e rms. Agile is optimized to observe variability at short timescales from one-third of a second to several hundred seconds. The variable astronomical sources routinely observed with Agile include pulsating white dwarfs, cataclysmic variables, flare stars, planetary transits, and planetary satellite occultations.

  3. Flexible Conveyance Control System for Agile Manufacturing

    NASA Astrophysics Data System (ADS)

    Uchiyama, Kazuhisa; Uchimura, Keiichi; Yoshikawa, Takeru; Shishino, Satoru; Hu, Zhencheng

    The control of conveyance between processes still relies on the engineer's experience. It is difficult to correspond to the change in the conveyance layout due to the expansion and reduction of production and the breakdown of conveyance devices. In this paper, we propose a conveyance control system that can adapt to changes in the conveyance layout and we aim at the improvement of the amount of total conveyance. First of all, the system is divided into the part where the conveyance layout is made a data base and the part where the conveyance control that uses the congestion index is done. Therefore, it is possible to deal flexibly by changing the data base part without changing the conveyance control part when it is necessary to change the conveyance layout suddenly. In all the combinations of the conveyance layout and the turning on pattern used as a result of the simulation, the proposed conveyance control method became a great result by the amount of total conveyance.

  4. Efficacy and Safety of Split Peroneal Tendon Lateral Ankle Stabilization.

    PubMed

    Shibuya, Naohiro; Bazán, D Issac; Evans, Andrew M; Agarwal, Monica R; Jupiter, Daniel C

    2016-01-01

    Chronic lateral ankle instability is a common condition. Split peroneal tendon lateral ankle stabilization, a modification of the Chrisman-Snook procedure, is biomechanically stable and often used for severe and/or recurrent chronic lateral ankle instability. The purpose of the present study was to evaluate the efficacy and safety of this technique. Specifically, the midterm recurrence of instability and postoperative complications, such as stiffness, neurologic pain, and wound healing complications, were evaluated. We evaluated 30 consecutive procedures with a minimal follow-up period of 1 year. The mean follow-up period was 25 ± 13 (median 19, range 13 to 62) months. Five patients (17%) developed recurrent ankle instability, of whom 4 underwent revision surgery. One superficial infection and two wound disruptions developed. Two patients experienced stiffness and eight (27%) surgically induced neurologic complaints, such as sural neuritis. Finally, 2 patients developed complex regional pain syndrome. PMID:26364699

  5. How to Strengthen Your Ankle After a Sprain

    MedlinePlus

    ... back to the starting position. Repeat 10 times. Tie the resistance bands around a fixed object and ... starting position and cycle your ankle 10 times. Tie the bands around an object to the outer ...

  6. Design of a portable hydraulic ankle-foot orthosis.

    PubMed

    Neubauer, Brett C; Nath, Jonathan; Durfee, William K

    2014-01-01

    Small-scale hydraulics is ideal for powered human assistive devices including powered ankle foot orthoses because a large torque can be generated with an actuator that is small and light. A portable hydraulic ankle foot orthosis has been designed and is undergoing preliminary prototyping and engineering bench test evaluation. The device provides 90 Nm of ankle torque and has an operating pressure of 138 bar (2,000 psi). The battery-operated hydraulic power supply weighs about 3 kg and is worn at the waist. The ankle component weighs about 1.2 Kg and connects to the power supply with two hoses. Performance simulation and preliminary bench testing suggests that the device could be useful in certain rehabilitation applications. PMID:25570175

  7. Argon beam coagulation in foot and ankle surgery.

    PubMed

    Adams, Melissa L; Steinberg, John S

    2011-01-01

    In this brief report, we introduce the principles, indications, advantages, disadvantages, and surgical techniques involved in the use of argon beam coagulation in foot and ankle surgery. PMID:21907597

  8. Ankle Injuries and Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Ankle Injuries and Disorders URL of this page: https://medlineplus.gov/languages/ankleinjuriesanddisorders.html Other topics A-Z A B ...

  9. Open and Arthroscopic Surgical Anatomy of the Ankle

    PubMed Central

    Frank, Rachel M.; Hsu, Andrew R.; Gross, Christopher E.; Walton, David M.

    2013-01-01

    Ankle-related complaints are among the most commonly encountered problems for musculoskeletal clinicians. Ankle pathology is widely variable, including, but not limited to, fractures, deformity, infection, oncologic diseases, neuromuscular conditions, and arthritis. While nonoperative management with activity modification, bracing and/or shoe modifications, and medications is usually indicated as first line of treatment, surgical intervention may become necessary. A thorough understanding of the complex anatomy and biomechanics of the ankle, and in particular, the potential neurovascular structures that may be encountered, is important to reduce complications and obtain good surgical outcomes. The purpose of this review is to discuss the most common open and arthroscopic exposures to the ankle with a focus on surgically relevant anatomy for each approach. PMID:24288614

  10. Clinical anatomy and biomechanics of the ankle in dance.

    PubMed

    Russell, Jeffrey A; McEwan, Islay M; Koutedakis, Yiannis; Wyon, Matthew A

    2008-01-01

    The ankle is an important joint to understand in the context of dance because it is the connection between the leg and the foot that establishes lower extremity stability. Its function coordinates with the leg and foot and, thus, it is crucial to the dancer's ability to perform. Furthermore, the ankle is one of the most commonly injured body regions in dance. An understanding of ankle anatomy and biomechanics is not only important for healthcare providers working with dancers, but for dance scientists, dance instructors, and dancers themselves. The bony architecture, the soft tissue restraints, and the locomotive structures all integrate to allow the athletic artistry of dance. Yet, there is still much research to be carried out in order to more completely understand the ankle of the dancer. PMID:19618582

  11. Management of Syndesmotic Ankle Injuries in Children and Adolescents.

    PubMed

    Shore, Benjamin J; Kramer, Dennis E

    2016-06-01

    Pediatric ankle injuries are common, especially in athletes; however, the incidence of syndesmosis injuries in children has been scarcely reported. Injuries to the ankle syndesmosis, termed "high ankle sprains," can affect high-level and recreational athletes and have been related to delayed return to play, persistent pain, and adult injuries have been associated with long-term disability. Syndesmotic injuries do occur in children, especially those who participate in sports that involve cutting and pivoting (football, soccer) or sports with rigid immobilization of the ankle (skiing, hockey). Unstable pediatric syndesmosis injuries requiring surgical fixation are often associated with concomitant fibular fracture in skeletally mature children. Physician vigilance and careful clinical examination coupled with appropriate radiographs can determine the extent of the injury in the majority of circumstances. PMID:27100034

  12. Ankle Injuries and Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Ankle Injuries and Disorders URL ... this page: https://www.nlm.nih.gov/medlineplus/languages/ankleinjuriesanddisorders.html Other topics A-Z A B ...

  13. The efficacy of the tourniquet in foot and ankle surgery? A systematic review and meta-analysis.

    PubMed

    Smith, T O; Hing, C B

    2010-03-01

    Tourniquets are commonly used during foot and ankle surgery. The purpose of this study was to compare the peri- and post-operative outcomes of tourniquet-assisted to non-tourniquet-assisted ankle and foot surgery. A systematic review was undertaken assessing the electronic databases Medline, CINAHL, AMED and EMBASE, in addition to a review of unpublished material and a hand search of pertinent orthopaedic journals. The evidence-base was critically appraised using the Cochrane Bone, Joint and Muscle Trauma Group quality assessment tool. Study heterogeneity was measured using chi(2) and I(2) statistics. Where appropriate, a random-effects meta-analysis was undertaken to pool results of primary studies, assessing mean difference or relative risk of each outcome. A total of four studies were identified. The findings of this study would suggest that hospital length of stay was significantly shorter, and that the post-operative period was less painful, with reduced swelling from the fifth post-operative day, in surgeries undertaken without a tourniquet, compared to tourniquet-assisted procedures. There may be a greater incidence of wound infection and deep vein thrombosis in tourniquet-assisted foot and ankle procedures. The methodological quality of the evidence base is limited. Further study is required to address these limitations, after which we may be able to determine whether a tourniquet should be used during ankle or foot procedures. PMID:20152747

  14. Distraction-free ankle arthroscopy for anterolateral impingement.

    PubMed

    Rouvillain, Jean Louis; Daoud, Wael; Donica, Adrian; Garron, Emmanuel; Uzel, André Pierre

    2014-08-01

    The origin of chronic pain after external ankle sprain is better known with arthroscopy's contribution. Chronic hypertrophic synovitis of the anterolateral ankle region is seemingly the cause, resulting in "anterolateral ankle impingement." But is partial synovectomy with fibrosis resection under arthroscopy always possible without any distraction? Are results affected? This retrospective study concerned only patients with soft tissue ankle impingement. All cases with bone and joint diseases were excluded. The final sample of 24 patients had a mean age of 35 years (21-54 years) and presented anterolateral mechanical pain associated with oedema following external ankle sprain. Medical and rehabilitative treatment was undertaken for more than 6 months before arthroscopy. Average time between trauma and arthroscopy was 21 months (5-60 months). Clinical examination revealed no ankle instability or laxity. Debridement with joint lavage was systematically performed under arthroscopy without any distraction. Average patient follow-up was 22 months (12-92 months). All patients had a good Kitaoka score, with 22 patients registering excellent results. There were no septic complications or algodystrophy. Two transient hypoesthesias were observed in the dorsal surface and lateral border of the foot with full postoperative recovery at 6 months. Distraction was never used and simple dorsiflexion was sufficient to perform arthroscopic debridement. In this study, anterolateral ankle impingement diagnosis was primarily clinical. Arthroscopic treatment yielded significant benefits on pain, oedema and resumption of sport activities. Arthroscopic treatment of anterolateral ankle impingements is thus possible with simple dorsiflexion and no distraction, resulting in a possible decrease in complication rates. Level of evidence Retrospective cohort study, Level IV. PMID:24220747

  15. Supramalleolar Osteotomies for the Treatment of Ankle Arthritis.

    PubMed

    Hintermann, Beat; Knupp, Markus; Barg, Alexej

    2016-07-01

    Supramalleolar osteotomy is a joint-preserving surgical treatment for patients with asymmetric valgus or varus ankle arthritis. The primary goal of the procedure is to realign the spatial relationship between the talus and tibia and thereby normalize joint loading within the ankle. Procedures to balance the soft tissues, as well as hindfoot osteotomy and arthrodesis, may also be necessary. Clinical studies of supramalleolar osteotomy demonstrate that correction of the altered biomechanics associated with asymmetric arthritis improves functional outcomes. PMID:27195382

  16. Ultrasound-guided intervention in the ankle and foot.

    PubMed

    Drakonaki, Eleni E; Allen, Gina M; Watura, Roland

    2016-01-01

    In this comprehensive review, we discuss the main interventions performed in the foot and ankle for Achilles tendinopathy, Morton's neuromas and Plantar fasciitis as well as techniques for intra-articular and peritendinous injections. We present the different imaging techniques and injectable agents that can be used in clinical practice, trying to help the reader decide the most appropriate way of managing the patient with a problem in the ankle and foot. PMID:26537692

  17. 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

  18. Imaging of Common Arthroscopic Pathology of the Ankle.

    PubMed

    Grambart, Sean T

    2016-10-01

    Arthroscopy of the ankle is used in the treatment and diagnosis of a spectrum of intra-articular pathology including soft tissue and osseous impingement, osteochondral lesions, arthrofibrosis, and synovitis. To help identify the correct pathology, imaging techniques are often used to aid the surgeon in diagnosing pathology and determining best treatment options. This article discusses the use of imaging in various ankle pathologies. PMID:27599435

  19. Mechanics and energetics of incline walking with robotic ankle exoskeletons.

    PubMed

    Sawicki, Gregory S; Ferris, Daniel P

    2009-01-01

    We examined healthy human subjects wearing robotic ankle exoskeletons to study the metabolic cost of ankle muscle-tendon work during uphill walking. The exoskeletons were powered by artificial pneumatic muscles and controlled by the user's soleus electromyography. We hypothesized that as the demand for net positive external mechanical work increased with surface gradient, the positive work delivered by ankle exoskeletons would produce greater reductions in users' metabolic cost. Nine human subjects walked at 1.25 m s(-1) on gradients of 0%, 5%, 10% and 15%. We compared rates of O(2) consumption and CO(2) production, exoskeleton mechanics, joint kinematics, and surface electromyography between unpowered and powered exoskeleton conditions. On steeper inclines, ankle exoskeletons delivered more average positive mechanical power (P<0.0001; +0.37+/-0.03 W kg(-1) at 15% grade and +0.23+/-0.02 W kg(-1) at 0% grade) and reduced subjects' net metabolic power by more (P<0.0001; -0.98+/-0.12 W kg(-1) at 15% grade and -0.45+/-0.07 W kg(-1) at 0% grade). Soleus muscle activity was reduced by 16-25% when wearing powered exoskeletons on all surface gradients (P<0.0008). The ;apparent efficiency' of ankle muscle-tendon mechanical work decreased from 0.53 on level ground to 0.38 on 15% grade. This suggests a decreased contribution from previously stored Achilles' tendon elastic energy and an increased contribution from actively shortening ankle plantar flexor muscle fibers to ankle muscle-tendon positive work during walking on steep uphill inclines. Although exoskeletons delivered 61% more mechanical work at the ankle up a 15% grade compared with level walking, relative reductions in net metabolic power were similar across surface gradients (10-13%). These results suggest a shift in the relative distribution of mechanical power output to more proximal (knee and hip) joints during inclined walking. PMID:19088208

  20. Deep Vein Thrombosis in Foot and Ankle Surgery.

    PubMed

    Chao, John

    2016-04-01

    The routine use of venous thromboembolism prophylaxis in patients undergoing foot and ankle procedures is not well supported in the literature. Multiple studies draw conclusions from heterogeneous populations, and specific studies have small numbers of specific pathologic conditions. Depending on the study, recommendations for and against venous thromboembolism prophylaxis in foot and ankle surgery can be made. The identification of risk factors for venous thromboembolism is paramount in the decision making of postoperative venous thromboembolism prophylaxis. PMID:26772954

  1. 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

  2. Team-based work and work system balance in the context of agile manufacturing.

    PubMed

    Yauch, Charlene A

    2007-01-01

    Manufacturing agility is the ability to prosper in an environment characterized by constant and unpredictable change. The purpose of this paper is to analyze team attributes necessary to facilitate agile manufacturing, and using Balance Theory as a framework, it evaluates the potential positive and negative impacts related to these team attributes that could alter the balance of work system elements and resulting "stress load" experienced by persons working on agile teams. Teams operating within the context of agile manufacturing are characterized as multifunctional, dynamic, cooperative, and virtual. A review of the literature relevant to each of these attributes is provided, as well as suggestions for future research. PMID:16631101

  3. A surgical ankle sprain pain model in the rat: Effects of morphine and indomethacin

    PubMed Central

    Young Kim, Hee; Wang, Jigong; Chung, Kyungsoon; Mo Chung, Jin

    2008-01-01

    Ankle sprain is a frequent injury in humans that results in pain, swelling and difficulty in walking on the affected ankle. Currently a suitable animal model resembling human ankle sprain is lacking. Here, we describe an animal ankle sprain model induced by ankle ligament injury (ALI) in rats. Cutting combinations of the lateral ankle ligament complex produced pain, edema and difficulty of weight bearing, thereby mimicking severe (grade III) ankle sprain in humans. Analgesic compounds, morphine and indomethacin, significantly reversed the reduced weight bearing, thus indicating that reduction of weight bearing is partially due to pain. The ALI model is a new ankle sprain model that may be useful for the study of ankle sprain pain mechanisms and treatments and for the screening of new analgesic drugs. PMID:18620022

  4. Conservative management of posterior ankle impingement: a case report

    PubMed Central

    Senécal, Isabelle; Richer, Nadia

    2016-01-01

    Objective: To describe the pain and functional improvements of a patient with posterior ankle impingement following a treatment plan incorporating soft tissue therapy, chiropractic adjustment and a progressive rehabilitation program. Clinical Features: A 37-year- old male presented with posterolateral ankle pain exacerbated by plantar flexion two weeks after sustaining an inversion ankle sprain. Oedema was present and the patient was describing a sensation of instability while walking. The initial diagnosis of lateral ankle sprain was found to be complicated by a posterior ankle impingement caused by a tenosynovitis of the flexor hallucis longus sheath suspected during the physical examination and confirmed by MRI. Intervention and Outcome: The patient was treated over a 14-week period. Soft tissue therapy, a rehabilitation program and cortisone injection were used to treat this condition. A precise description of the rehabilitation program that contains open kinetic chain, closed kinetic chain, proprioception, and conditioning exercises prescribed to the patient is given. After the treatment plan, the patient returned to play pain free and had no daily living restrictions. Summary: A protocol including rest, soft tissue therapy, open and closed kinetic chain exercises, sport-specific exercises and cortisone injection appeared to facilitate complete recovery of this patient’s posterior ankle impingement. PMID:27385836

  5. Biomechanical and Neuromuscular Effects of Ankle Taping and Bracing

    PubMed Central

    Wilkerson, Gary B.

    2002-01-01

    Objective: An extensive review of clinically relevant research is provided to assist clinicians in understanding the underlying mechanisms by which various ankle-support systems may provide beneficial effects. Strategies for management of different types of ankle ligament conditions are also discussed. Background: Much of the literature pertaining to ankle instability and external support has focused on assessment of inward displacement of the hindfoot within the frontal plane. Some researchers have emphasized the importance of (1) pathologic rotary displacement of the talus within the transverse plane, (2) the frequent presence of subtalar joint ligament lesions, and (3) the interrelated effects of ankle support on deceleration of inversion velocity and facilitation of neuromuscular response. Description: The traditional method for application of adhesive tape to the ankle primarily restricts inward displacement of the hindfoot within the frontal plane. The biomechanical rationale for a method of ankle taping that restricts lower leg rotation and triplanar displacement of the foot associated with subtalar motion is presented. Clinical Advantages: The lateral subtalar-sling taping procedure may limit strain on the anterior talofibular ligament associated with subtalar inversion, restrain anterolateral rotary subluxation of the talus in the presence of ligament laxity, and protect the subtalar ligaments from excessive loading. The medial subtalar sling may reduce strain on the anterior-inferior tibiofibular syndesmosis and enhance hindfoot-to-forefoot force transfer during the push-off phase of the gait cycle. PMID:12937565

  6. A novel assessment technique for measuring ankle orientation and stiffness.

    PubMed

    Zhang, Mingming; Davies, T Claire; Nandakumar, Anoop; Quan Xie, Sheng

    2015-09-18

    The measurement of ankle orientation and stiffness can provide insight into improvements and allows for effective monitoring during a rehabilitation program. Existing assessment techniques have a variety of limitations. Dynamometer based methods rely on manual manipulation. The use of torque meter is usually for single degree-of-freedom (DOF) devices. This study proposes a novel ankle assessment technique that can be used for multiple DOFs devices working in both manual and automatic modes using the position sensor and the multi-axis load cell. As a preliminary evaluation, an assessment device for ankle dorsiflexion and plantarflexion was constructed. Nine subjects participated to evaluate the effectiveness of the assessment device in determining ankle orientation and stiffness. The measured ankle orientation was consistent with that from the NDI Polaris optical tracking system. The measured ankle torque and stiffness compared well with published data. The test-retest reliability was high with intraclass correlation coefficient (ICC2, 1) values greater than 0.846 and standard error of measurement (SEM) less than 1.38. PMID:26159061

  7. Side-Alternating Vibration Training for Balance and Ankle Muscle Strength in Untrained Women

    PubMed Central

    Spiliopoulou, Styliani I.; Amiridis, Ioannis G.; Tsigganos, Georgios; Hatzitaki, Vassilia

    2013-01-01

    Context: Side-alternating vibration (SAV) may help reduce the risk of falling by improving body balance control. Such training has been promoted as a strength-training intervention because it can increase muscle activation through an augmented excitatory input from the muscle spindles. Objective: To determine the effect of SAV training on static balance during 3 postural tasks of increasing difficulty and lower limb strength. Design: Randomized controlled clinical trial. Setting: Laboratory. Patients or Other Participants: A total of 21 healthy women were divided into training (n = 11; age = 43.35 ± 4.12 years, height = 169 ± 6.60 cm, mass = 68.33 ± 11.90 kg) and control (n = 10; age = 42.31 ± 3.73 years, height = 167 ± 4.32 cm, mass = 66.29 ± 10.74 kg) groups. Intervention(s): The training group completed a 9-week program during which participants performed 3 sessions per week of ten 15-second isometric contractions with a 30-second active rest of 3 exercises (half-squat, wide-stance squat, 1-legged half-squat) on an SAV plate (acceleration = 0.91–16.3g). The control group did not participate in any form of exercise over the 9-week period. Main Outcome Measure(s): We evaluated isokinetic and isometric strength of the knee extensors and flexors and ankle plantar flexors, dorsiflexors, and evertors. Static balance was assessed using 3 tasks of increasing difficulty (quiet bipedal stance, tandem stance, 1-legged stance). The electromyographic activity of the vastus lateralis, semitendinosus, medial gastrocnemius, tibialis anterior, and peroneus longus was recorded during postural task performance, baseline and pretraining, immediately posttraining, and 15 days posttraining. Results: After training in the training group, ankle muscle strength improved (P = .03), whereas knee muscle strength remained unaltered (P = .13). Improved ankle-evertor strength was observed at all angular velocities (P = .001). Postural sway decreased in both directions but was greater

  8. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

    PubMed Central

    Nilsson, Gertrud M; Jonsson, Kjell; Ekdahl, Charlotte S; Eneroth, Magnus

    2009-01-01

    Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group) versus usual care (control group) after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS) which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36), timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028), muscle strength in the plantar flexors (p = 0.029) and dorsiflexors (p = 0.030). Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three out of nine outcome

  9. Evaluating fracture risk in acute ankle sprains: Any news since the Ottawa Ankle Rules? A systematic review.

    PubMed

    Jonckheer, Pascale; Willems, Tine; De Ridder, Roel; Paulus, Dominique; Holdt Henningsen, Kirsten; San Miguel, Lorena; De Sutter, An; Roosen, Philip

    2016-03-01

    Background Ankle sprain is frequently encountered, both in primary care and in emergency departments. Since 1992, the Ottawa ankle rules (OAR) can assist clinicians in determining whether an X-ray should be performed to exclude a fracture. Several guidelines recommend the use of OAR based on a systematic review from 2003. Ten years later, one can wonder if this recommendation should be changed. Objective To review systematically the current evidence on the most accurate method to assess the fracture risk after an ankle sprain in adults. Methods A methodical search for systematic reviews, meta-analyses and primary studies was carried out in Medline, Cochrane Database of systematic reviews, Embase, Pedro, CINAHL, Medion and specific guideline search engines. At least two independent researchers performed selection, quality appraisal (with validated checklists) and data extraction. Results One systematic review and 21 primary studies were selected. Sensitivity and specificity of the OAR range from 92-100% and from 16-51%, respectively. To improve the OAR specificity, other tools are proposed such as the Bernese ankle rules. Vibrating tuning fork test and ultrasound could be useful in patient with OAR positive to decrease the need for radiographs. No evidence was found in favour of the use of magnetic resonance imaging (MRI) or computed tomography (CT) in the acute phase of ankle sprain. Conclusion The findings confirm the value of the OAR at ruling out fractures after an ankle sprain and propose other or additional tools to decrease the need for X-rays. PMID:26691309

  10. Quantitative analysis of human ankle characteristics at different gait phases and speeds for utilizing in ankle-foot prosthetic design

    PubMed Central

    2014-01-01

    Background Ankle characteristics vary in terms of gait phase and speed change. This study aimed to quantify the components of ankle characteristics, including quasi-stiffness and work in different gait phases and at various speeds. Methods The kinetic and kinematic data of 20 healthy participants were collected during normal gait at four speeds. Stance moment-angle curves were divided into three sub-phases including controlled plantarflexion, controlled dorsiflexion and powered plantarflexion. The slope of the moment-angle curves was quantified as quasi-stiffness. The area under the curves was defined as work. Results The lowest quasi-stiffness was observed in the controlled plantarflexion. The fitted line to moment-angle curves showed R2 > 0.8 at controlled dorsiflexion and powered plantarflexion. Quasi-stiffness was significantly different at different speeds (P = 0.00). In the controlled dorsiflexion, the ankle absorbed energy; by comparison, energy was generated in the powered plantarflexion. A negative work value was recorded at slower speeds and a positive value was observed at faster speeds. Ankle peak powers were increased with walking speed (P = 0.00). Conclusions Our findings suggested that the quasi-stiffness and work of the ankle joint can be regulated at different phases and speeds. These findings may be clinically applicable in the design and development of ankle prosthetic devices that can naturally replicate human walking at various gait speeds. PMID:24568175

  11. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal.

    PubMed

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  12. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal

    PubMed Central

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  13. Relationships Between Reactive Agility Movement Time and Unilateral Vertical, Horizontal, and Lateral Jumps.

    PubMed

    Henry, Greg J; Dawson, Brian; Lay, Brendan S; Young, Warren B

    2016-09-01

    Henry, GJ, Dawson, B, Lay, BS, and Young, WB. Relationships between reactive agility movement time and unilateral vertical, horizontal, and lateral jumps. J Strength Cond Res 30(9): 2514-2521, 2016-This study compared reactive agility movement time and unilateral (vertical, horizontal, and lateral) jump performance and kinetics between dominant and nondominant legs in Australian rules footballers (n = 31) to investigate the role of leg strength characteristics in reactive agility performance. Jumps involved jumping forward on 1 leg, then for maximum height or horizontal or lateral distance. Agility and movement time components of reactive agility were assessed using a video-based test. Correlations between each of the jumps were strong (r = -0.62 to -0.77), but between the jumps and agility movement time the relationships were weak (r = -0.25 to -0.33). Dominant leg performance was superior in reactive agility movement time (4.5%; p = 0.04), lateral jump distance (3%; p = 0.008), and lateral reactive strength index (4.4%; p = 0.03) compared with the nondominant leg. However, when the subjects were divided into faster and slower performers (based on their agility movement times) the movement time was significantly quicker in the faster group (n = 15; 12%; p < 0.001), but no differences in jump performance or kinetics were observed. Therefore, although the capacity for jumps to predict agility performance seems limited, factors involved in producing superior lateral jump performance in the dominant leg may also be associated with advantages in agility performance in that leg. However, because reactive strength as measured by unilateral jumps seems to play a limited role in reactive agility performance and other factors such as skill, balance, and coordination, and also cognitive and decision-making factors, are likely to be more important. PMID:23820562

  14. SU-E-T-610: Comparison of Treatment Times Between the MLCi and Agility Multileaf Collimators

    SciTech Connect

    Ramsey, C; Bowling, J

    2014-06-01

    Purpose: The Agility is a new 160-leaf MLC developed by Elekta for use in their Infinity and Versa HD linacs. As compared to the MLCi, the Agility increased the maximum leaf speed from 2 cm/s to 3.5 cm/s, and the maximum primary collimator speed from 1.5 cm/s to 9.0 cm/s. The purpose of this study was to determine if the Agility MLC resulted in improved plan quality and/or shorter treatment times. Methods: An Elekta Infinity that was originally equipped with a 80 leaf MLCi was upgraded to an 160 leaf Agility. Treatment plan quality was evaluated using the Pinnacle planning system with SmartArc. Optimization was performed once for the MLCi and once for the Agility beam models using the same optimization parameters and the same number of iterations. Patient treatment times were measured for all IMRT, VMAT, and SBRT patients treated on the Infinity with the MLCi and Agility MLCs. Treatment times were extracted from the EMR and measured from when the patient first walked into the treatment room until exiting the treatment room. Results: 11,380 delivery times were measured for patients treated with the MLCi, and 1,827 measurements have been made for the Agility MLC. The average treatment times were 19.1 minutes for the MLCi and 20.8 minutes for the Agility. Using a t-test analysis, there was no difference between the two groups (t = 0.22). The dose differences between patients planned with the MLCi and the Agility MLC were minimal. For example, the dose difference for the PTV, GTV, and cord for a head and neck patient planned using Pinnacle were effectively equivalent. However, the dose to the parotid glands was slightly worse with the Agility MLC. Conclusion: There was no statistical difference in treatment time, or any significant dosimetric difference between the Agility MLC and the MLCi.

  15. Validity, reliability, and responsiveness of the Korean version of American Academy of Orthopedic Surgeons Foot and Ankle questionnaire.

    PubMed

    Kim, Ji-Beom; Kim, Je Kyun; Seo, Sang Gyo; Lee, Dong Yeon

    2015-01-01

    The American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire (AFAQ) reflects patients' subjective disorder due to foot and ankle conditions. We evaluated the validity, reliability, and responsiveness of the Korean version of the AFAQ, after translation and transcultural adaptation of the original AFAQ into the Korean language. A total of 206 patients were enrolled, including 152 with chronic problems (experimental group) and 54 with acute problems (control group). We used the intraclass correlation coefficient to assess the test-retest reliability and Cronbach's α to assess internal reliability. Pearson's correlation coefficient was used to assess the criterion validity by correlating the Korean AFAQ scores with those from other validated scales (American Orthopaedic Foot and Ankle Society Hallux-Metatarsophalangeal-Interphalangeal scale, American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale, and visual analog scale for pain). To analyze discriminant validity, we evaluated the difference between the experimental and control groups using the Student t test. Of the 152 patients in the experimental group, 29 revisited our clinic postoperatively and repeated the Korean AFAQ. To analyze responsiveness, we used paired t tests to evaluate postoperative changes. In terms of test-retest reliability, the intraclass correlation coefficient ranged from 0.979 to 0.999. In terms of internal reliability, Cronbach's α was 0.528 for the stiffness and swelling subscale and greater than 0.7 for all other subscales. In terms of criterion validity, Pearson's correlation coefficient ranged from 0.492 to 0.699. The probability of the null hypothesis for discriminant validity and responsiveness was statistically significant (p < .001 and p = .021, respectively). These results showed that the Korean version of the AFAQ had the same concept and intention as the original version and is reliable, valid, and responsive. PMID:25441847

  16. Wired Widgets: Agile Visualization for Space Situational Awareness

    NASA Astrophysics Data System (ADS)

    Gerschefske, K.; Witmer, J.

    2012-09-01

    Continued advancement in sensors and analysis techniques have resulted in a wealth of Space Situational Awareness (SSA) data, made available via tools and Service Oriented Architectures (SOA) such as those in the Joint Space Operations Center Mission Systems (JMS) environment. Current visualization software cannot quickly adapt to rapidly changing missions and data, preventing operators and analysts from performing their jobs effectively. The value of this wealth of SSA data is not fully realized, as the operators' existing software is not built with the flexibility to consume new or changing sources of data or to rapidly customize their visualization as the mission evolves. While tools like the JMS user-defined operational picture (UDOP) have begun to fill this gap, this paper presents a further evolution, leveraging Web 2.0 technologies for maximum agility. We demonstrate a flexible Web widget framework with inter-widget data sharing, publish-subscribe eventing, and an API providing the basis for consumption of new data sources and adaptable visualization. Wired Widgets offers cross-portal widgets along with a widget communication framework and development toolkit for rapid new widget development, giving operators the ability to answer relevant questions as the mission evolves. Wired Widgets has been applied in a number of dynamic mission domains including disaster response, combat operations, and noncombatant evacuation scenarios. The variety of applications demonstrate that Wired Widgets provides a flexible, data driven solution for visualization in changing environments. In this paper, we show how, deployed in the Ozone Widget Framework portal environment, Wired Widgets can provide an agile, web-based visualization to support the SSA mission. Furthermore, we discuss how the tenets of agile visualization can generally be applied to the SSA problem space to provide operators flexibility, potentially informing future acquisition and system development.

  17. Architecture and performances of the AGILE Telemetry Preprocessing System (TMPPS)

    NASA Astrophysics Data System (ADS)

    Trifoglio, M.; Bulgarelli, A.; Gianotti, F.; Lazzarotto, F.; Di Cocco, G.; Fuschino, F.; Tavani, M.

    2008-07-01

    AGILE is an Italian Space Agency (ASI) satellite dedicated to high energy Astrophysics. It was launched successfully on 23 April 2007, and it has been operated by the AGILE Ground Segment, consisting of the Ground Station located in Malindi (Kenia), the Mission Operations Centre (MOC) and the AGILE Data Centre (ADC) established in Italy, at Telespazio in Fucino and at the ASI Science Data Centre (ASDC) in Frascati respectively. Due to the low equatorial orbit at ~ 530 Km. with inclination angle of ~ 2.5°, the satellite passes over the Ground Station every ~ 100'. During the visibility period of . ~ 12', the Telemetry (TM) is down linked through two separated virtual channels, VC0 and VC1. The former is devoted to the real time TM generated during the pass at the average rate of 50 Kbit/s and is directly relayed to the Control Centre. The latter is used to downlink TM data collected on the satellite on-board mass memory during the non visibility period. This generates at the Ground Station a raw TM file of up to 37 MByte. Within 20' after the end of the contact, both the real time and mass memory TM arrive at ADC through the dedicated VPN ASINet. Here they are automatically detected and ingested by the TMPPS pipeline in less than 5 minutes. The TMPPS archives each TM file and sorts its packets into one stream for each of the different TM layout. Each stream is processed in parallel in order to unpack the various telemetry field and archive them into suitable FITS files. Each operation is tracked into a MySQL data base which interfaces the TMPPS pipeline to the rest of the scientific pipeline running at ADC. In this paper the architecture and the performance of the TMPPS will be described and discussed.

  18. An agile enterprise regulation architecture for health information security management.

    PubMed

    Chen, Ying-Pei; Hsieh, Sung-Huai; Cheng, Po-Hsun; Chien, Tsan-Nan; Chen, Heng-Shuen; Luh, Jer-Junn; Lai, Jin-Shin; Lai, Feipei; Chen, Sao-Jie

    2010-09-01

    Information security management for healthcare enterprises is complex as well as mission critical. Information technology requests from clinical users are of such urgency that the information office should do its best to achieve as many user requests as possible at a high service level using swift security policies. This research proposes the Agile Enterprise Regulation Architecture (AERA) of information security management for healthcare enterprises to implement as part of the electronic health record process. Survey outcomes and evidential experiences from a sample of medical center users proved that AERA encourages the information officials and enterprise administrators to overcome the challenges faced within an electronically equipped hospital. PMID:20815748

  19. Perspectives on Industrial Innovation from Agilent, HP, and Bell Labs

    NASA Astrophysics Data System (ADS)

    Hollenhorst, James

    2014-03-01

    Innovation is the life blood of technology companies. I will give perspectives gleaned from a career in research and development at Bell Labs, HP Labs, and Agilent Labs, from the point of view of an individual contributor and a manager. Physicists bring a unique set of skills to the corporate environment, including a desire to understand the fundamentals, a solid foundation in physical principles, expertise in applied mathematics, and most importantly, an attitude: namely, that hard problems can be solved by breaking them into manageable pieces. In my experience, hiring managers in industry seldom explicitly search for physicists, but they want people with those skills.

  20. Planning and scheduling for agile manufacturers: The Pantex Process Model

    SciTech Connect

    Kjeldgaard, E.A.; Jones, D.A.; List, G.F.; Tumquist, M.A.

    1998-02-01

    Effective use of resources that are shared among multiple products or processes is critical for agile manufacturing. This paper describes the development and implementation of a computerized model to support production planning in a complex manufacturing system at the Pantex Plant, a US Department of Energy facility. The model integrates two different production processes (nuclear weapon disposal and stockpile evaluation) that use common facilities and personnel at the plant. The two production processes are characteristic of flow-shop and job shop operations. The model reflects the interactions of scheduling constraints, material flow constraints, and the availability of required technicians and facilities. Operational results show significant productivity increases from use of the model.

  1. Production planning tools and techniques for agile manufacturing

    SciTech Connect

    Kjeldgaard, E.A.; Jones, D.A.; List, G.F.; Turnquist, M.A.

    1996-10-01

    Effective use of resources shared among multiple products or processes is critical for agile manufacturing. This paper describes development and implementation of a computerized model to support production planning in a complex manufacturing system at Pantex Plant. The model integrates two different production processes (nuclear weapon dismantlement and stockpile evaluation) which use common facilities and personnel, and reflects the interactions of scheduling constraints, material flow constraints, and resource availability. These two processes reflect characteristics of flow-shop and job-shop operations in a single facility. Operational results from using the model are also discussed.

  2. Development of EarthCube Governance: An Agile Approach

    NASA Astrophysics Data System (ADS)

    Pearthree, G.; Allison, M. L.; Patten, K.

    2013-12-01

    Governance of geosciences cyberinfrastructure is a complex and essential undertaking, critical in enabling distributed knowledge communities to collaborate and communicate across disciplines, distances, and cultures. Advancing science with respect to 'grand challenges," such as global climate change, weather prediction, and core fundamental science, depends not just on technical cyber systems, but also on social systems for strategic planning, decision-making, project management, learning, teaching, and building a community of practice. Simply put, a robust, agile technical system depends on an equally robust and agile social system. Cyberinfrastructure development is wrapped in social, organizational and governance challenges, which may significantly impede progress. An agile development process is underway for governance of transformative investments in geosciences cyberinfrastructure through the NSF EarthCube initiative. Agile development is iterative and incremental, and promotes adaptive planning and rapid and flexible response. Such iterative deployment across a variety of EarthCube stakeholders encourages transparency, consensus, accountability, and inclusiveness. A project Secretariat acts as the coordinating body, carrying out duties for planning, organizing, communicating, and reporting. A broad coalition of stakeholder groups comprises an Assembly (Mainstream Scientists, Cyberinfrastructure Institutions, Information Technology/Computer Sciences, NSF EarthCube Investigators, Science Communities, EarthCube End-User Workshop Organizers, Professional Societies) to serve as a preliminary venue for identifying, evaluating, and testing potential governance models. To offer opportunity for broader end-user input, a crowd-source approach will engage stakeholders not involved otherwise. An Advisory Committee from the Earth, ocean, atmosphere, social, computer and library sciences is guiding the process from a high-level policy point of view. Developmental

  3. A Roadmap for using Agile Development in a Traditional System

    NASA Technical Reports Server (NTRS)

    Streiffert, Barbara; Starbird, Thomas

    2006-01-01

    I. Ensemble Development Group: a) Produces activity planning software for in spacecraft; b) Built on Eclipse Rich Client Platform (open source development and runtime software); c) Funded by multiple sources including the Mars Technology Program; d) Incorporated the use of Agile Development. II. Next Generation Uplink Planning System: a) Researches the Activity Planning and Sequencing Subsystem for Mars Science Laboratory (APSS); b) APSS includes Ensemble, Activity Modeling, Constraint Checking, Command Editing and Sequencing tools plus other uplink generation utilities; c) Funded by the Mars Technology Program; d) Integrates all of the tools for APSS.

  4. Impact of emerging technologies on future combat aircraft agility

    NASA Technical Reports Server (NTRS)

    Nguyen, Luat T.; Gilert, William P.

    1990-01-01

    The foreseeable character of future within-visual-range air combat entails a degree of agility which calls for the integration of high-alpha aerodynamics, thrust vectoring, intimate pilot/vehicle interfaces, and advanced weapons/avionics suites, in prospective configurations. The primary technology-development programs currently contributing to these goals are presently discussed; they encompass the F-15 Short Takeoff and Landing/Maneuver Technology Demonstrator Program, the Enhanced Fighter Maneuverability Program, the High Angle-of-Attack Technology Program, and the X-29 Technology Demonstrator Program.

  5. Lateral ankle ligament anesthesia significantly alters single limb postural control.

    PubMed

    McKeon, P O; Booi, M J; Branam, B; Johnson, D L; Mattacola, C G

    2010-07-01

    Lateral ankle anesthesia has been used as a model to explore effects of ligament deafferentation related to ankle sprain on single limb postural control with conflicting results. Time-to-boundary (TTB) is a postural control measurement technique found to be sensitive in detecting subtle deficits in postural control in those with chronic ankle instability. The objective of this study was to determine the effects of lateral ankle ligament anesthesia on TTB measures of single limb postural control in healthy adults. Twenty-two healthy adults with no history of lower extremity injury within the past 6 months or balance disorders participated in the study. All subjects received a lidocaine injection to the lateral ankle structures on one of two testing days. On both testing days, subjects performed 3 eyes open and 3 eyes closed, 10-s trials of barefoot single limb stance on a forceplate. The dependent variables were the mean of TTB minima(s) and standard deviation of TTB minima(s) in mediolateral (ML) and anteroposterior (AP) directions. Separate condition (anesthesia, control) by vision (eyes open, eyes closed) ANOVAs with repeated measures were used for each TTB variable to determine the effects of anesthesia on postural control. Alpha level was set a priori at p≤0.05. The anesthesia day TTBAP magnitude (p=0.008) and variability (p=0.044) measures were significantly lower than the control day, regardless of vision. Anesthesia of the lateral ankle ligamentous structures significantly reduced the magnitude and variability of TTBAP measures. These findings are similar to deficits found in those with chronic ankle instability. PMID:20663671

  6. Prophylactic Ankle Taping and Bracing: A Numbers-Needed-to-Treat and Cost-Benefit Analysis.

    PubMed

    Olmsted, Lauren C.; Vela, Luzita I.; Denegar, Craig R.; Hertel, Jay

    2004-03-01

    OBJECTIVE: Taping and bracing are thought to decrease the incidence of ankle sprains; however, few investigators have addressed the effect of preventive measures on the rate of ankle sprains. Our purpose was to examine the effectiveness of ankle taping and bracing in reducing ankle sprains by applying a numbers-needed-to-treat (NNT) analysis to previously published studies. DATA SOURCES: We searched PubMed, CINAHL, SPORT Discus, and PEDro for original research from 1966 to 2002 with key words ankle taping, ankle sprains, injury incidence, prevention, ankle bracing, ankle prophylaxis, andnumbers needed to treat. We eliminated articles that did not address the effects of ankle taping or bracing on ankle injury rates using an experimental design. DATA SYNTHESIS: The search produced 8 articles, of which 3 permitted calculation of NNT, which addresses the clinical usefulness of an intervention by providing estimates of the number of treatments needed to prevent 1 injury occurrence. In a study of collegiate intramural basketball players, the prevention of 1 ankle sprain required the taping of 26 athletes with a history of ankle sprain and 143 without a prior history. In a military academy intramural basketball program, prevention of 1 sprain required bracing of 18 athletes with a history of ankle sprain and 39 athletes with no history. A study of ankle bracing in competitive soccer players produced an NNT of 5 athletes with a history of previous sprain and 57 without a prior injury. A cost- benefit analysis of ankle taping versus bracing revealed taping to be approximately 3 times more expensive than bracing. CONCLUSIONS/RECOMMENDATIONS: Greater benefit is achieved in applying prophylactic ankle taping or bracing to athletes with a history of ankle sprain, compared with those without previous sprains. The generalizability of these results to other physically active populations is unknown. PMID:15085217

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

    PubMed

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

    2011-05-01

    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

  8. Range of Motion of the Ankle According to Pushing Force, Gender and Knee Position

    PubMed Central

    Cho, Kang Hee; Lee, Hyunkeun

    2016-01-01

    Objective To investigate the difference of range of motion (ROM) of ankle according to pushing force, gender and knee position. Methods One hundred and twenty-eight healthy adults (55 men, 73 women) between the ages of 20 and 51, were included in the study. One examiner measured the passive range of motion (PROM) of ankle by Dualer IQ Inclinometers and Commander Muscle Testing. ROM of ankle dorsiflexion (DF) and plantarflexion (PF) according to change of pushing force and knee position were measured at prone position. Results There was significant correlation between ROM and pushing force, the more pushing force leads the more ROM at ankle DF and ankle PF. Knee flexion of 90° position showed low PF angle and high ankle DF angle, as compared to the at neutral position of knee joint. ROM of ankle DF for female was greater than for male, with no significant difference. ROM of ankle PF for female was greater than male regardless of the pushing force. Conclusion To our knowledge, this is the first study to assess the relationship between pushing force and ROM of ankle joint. There was significant correlation between ROM of ankle and pushing force. ROM of ankle PF for female estimated greater than male regardless of the pushing force and the number of measurement. The ROM of the ankle is measured differently according to the knee joint position. Pushing force, gender and knee joint position are required to be considered when measuring the ROM of ankle joint. PMID:27152277

  9. The NERV Methodology: Non-Functional Requirements Elicitation, Reasoning and Validation in Agile Processes

    ERIC Educational Resources Information Center

    Domah, Darshan

    2013-01-01

    Agile software development has become very popular around the world in recent years, with methods such as Scrum and Extreme Programming (XP). Literature suggests that functionality is the primary focus in Agile processes while non-functional requirements (NFR) are either ignored or ill-defined. However, for software to be of good quality both…

  10. Impact of Business Intelligence and IT Infrastructure Flexibility on Competitive Advantage: An Organizational Agility Perspective

    ERIC Educational Resources Information Center

    Chen, Xiaofeng

    2012-01-01

    There is growing use of business intelligence (BI) for better management decisions in industry. However, empirical studies on BI are still scarce in academic research. This research investigates BI from an organizational agility perspective. Organizational agility is the ability to sense and respond to market opportunities and threats with speed,…

  11. Renewed gamma-ray activity of the Blazar 3C 454.3 detected by AGILE

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Parmiggiani, N.; Fioretti, V.; Zoli, A.; Lucarelli, F.; Verrecchia, F.; Pittori, C.; Vercellone, S.; Piano, G.; Munar-Adrover, P.; Tavani, M.; Donnarumma, I.; Striani, E.; Cardillo, M.; Gianotti, F.; Trifoglio, M.; Giuliani, A.; Mereghetti, S.; Caraveo, P.; Perotti, F.; Chen, A.; Argan, A.; Costa, E.; Del Monte, E.; Evangelista, Y.; Feroci, M.; Lazzarotto, F.; Lapshov, I.; Pacciani, L.; Soffitta, P.; Sabatini, S.; Vittorini, V.; Pucella, G.; Rapisarda, M.; Di Cocco, G.; Fuschino, F.; Galli, M.; Labanti, C.; Marisaldi, M.; Pellizzoni, A.; Pilia, M.; Trois, A.; Barbiellini, G.; Vallazza, E.; Longo, F.; Morselli, A.; Picozza, P.; Prest, M.; Lipari, P.; Zanello, D.; Cattaneo, P. W.; Rappoldi, A.; Colafrancesco, S.; Ferrari, A.; Antonelli, A.; Giommi, P.; Salotti, L.; Valentini, G.; D'Amico, F.

    2016-06-01

    The AGILE satellite is detecting a significant enhancement in gamma-ray activity from the FSRQ 3C 454.3 (known as 1AGLR J2254+1609) since the recent AGILE ATel #9157, and the optical activity reported in ATel #9150.

  12. Project-Method Fit: Exploring Factors That Influence Agile Method Use

    ERIC Educational Resources Information Center

    Young, Diana K.

    2013-01-01

    While the productivity and quality implications of agile software development methods (SDMs) have been demonstrated, research concerning the project contexts where their use is most appropriate has yielded less definitive results. Most experts agree that agile SDMs are not suited for all project contexts. Several project and team factors have been…

  13. Agile methods in biomedical software development: a multi-site experience report

    PubMed Central

    Kane, David W; Hohman, Moses M; Cerami, Ethan G; McCormick, Michael W; Kuhlmman, Karl F; Byrd, Jeff A

    2006-01-01

    Background Agile is an iterative approach to software development that relies on strong collaboration and automation to keep pace with dynamic environments. We have successfully used agile development approaches to create and maintain biomedical software, including software for bioinformatics. This paper reports on a qualitative study of our experiences using these methods. Results We have found that agile methods are well suited to the exploratory and iterative nature of scientific inquiry. They provide a robust framework for reproducing scientific results and for developing clinical support systems. The agile development approach also provides a model for collaboration between software engineers and researchers. We present our experience using agile methodologies in projects at six different biomedical software development organizations. The organizations include academic, commercial and government development teams, and included both bioinformatics and clinical support applications. We found that agile practices were a match for the needs of our biomedical projects and contributed to the success of our organizations. Conclusion We found that the agile development approach was a good fit for our organizations, and that these practices should be applicable and valuable to other biomedical software development efforts. Although we found differences in how agile methods were used, we were also able to identify a set of core practices that were common to all of the groups, and that could be a focus for others seeking to adopt these methods. PMID:16734914

  14. The Impacts of Agile Development Methodology Use on Project Success: A Contingency View

    ERIC Educational Resources Information Center

    Tripp, John F.

    2012-01-01

    Agile Information Systems Development Methods have emerged in the past decade as an alternative manner of managing the work and delivery of information systems development teams, with a large number of organizations reporting the adoption & use of agile methods. The practitioners of these methods make broad claims as to the benefits of their…

  15. Utilization of an agility assessment module in analysis and optimization of preliminary fighter configuration

    NASA Technical Reports Server (NTRS)

    Ngan, Angelen; Biezad, Daniel

    1996-01-01

    A study has been conducted to develop and to analyze a FORTRAN computer code for performing agility analysis on fighter aircraft configurations. This program is one of the modules of the NASA Ames ACSYNT (AirCraft SYNThesis) design code. The background of the agility research in the aircraft industry and a survey of a few agility metrics are discussed. The methodology, techniques, and models developed for the code are presented. The validity of the existing code was evaluated by comparing with existing flight test data. A FORTRAN program was developed for a specific metric, PM (Pointing Margin), as part of the agility module. Example trade studies using the agility module along with ACSYNT were conducted using a McDonnell Douglas F/A-18 Hornet aircraft model. Tile sensitivity of thrust loading, wing loading, and thrust vectoring on agility criteria were investigated. The module can compare the agility potential between different configurations and has capability to optimize agility performance in the preliminary design process. This research provides a new and useful design tool for analyzing fighter performance during air combat engagements in the preliminary design.

  16. Ankle Deformity Secondary to Acquired Fibular Segmental Defect in Children

    PubMed Central

    Kang, Soo Hwan; Song, Seok Whan; Chung, Jin Wha; Kim, Yoon Chung; Suhl, Kyung Hwan

    2010-01-01

    Background The authors report the long-term effect of acquired pseudoarthrosis of the fibula on ankle development in children during skeletal growth, and the results of a long-term follow-up of Langenskiold's supramalleolar synostosis to correct an ankle deformity induced by an acquired fibular segmental defect in children. Methods Since 1980, 19 children with acquired pseudoarthrosis of the fibula were treated and followed up for an average of 11 years. Pseudoarthrosis was the result of a fibulectomy for tumor surgery, osteomyelitis of the fibula and traumatic segmental loss of the fibula in 10, 6, and 3 cases, respectively. Initially, a Langenskiold's operation (in 4 cases) and fusion of the lateral malleolus to the distal tibial epiphysis (in 1 case) were performed, whereas only skeletal growth was monitored in the other 14 cases. After a mean follow-up of 11 years, the valgus deformity and external tibial torsion of the ankle joint associated with proximal migration of the lateral malleolus needed to be treated with a supramallolar osteotomy in 12 cases (63%). These ankle deformities were evaluated using the serial radiographs and limb length scintigraphs. Results In all cases, early closure of the lateral part of the distal tibial physis, upward migration of the lateral malleolus, unstable valgus deformity and external tibial torsion of the ankle joint developed during a mean follow-up of 11 years (range, 5 to 21 years). The mean valgus deformity and external tibial torsion of the ankle at the final follow-up were 15.2° (range, 5° to 35°) and 10° (range, 5° to 12°), respectively. In 12 cases (12/19, 63%), a supramalleolar corrective osteotomy was performed but three children had a recurrence requiring an additional supramalleolar corrective osteotomy 2-4 times. Conclusions A valgus deformity and external tibial torsion are inevitable after acquired pseudoarthrosis of the fibula in children. Both Langenskiöld supramalleolar synostosis to prevent these

  17. Mechanical Joint Laxity Associated With Chronic Ankle Instability

    PubMed Central

    Cordova, Mitchell L.; Sefton, JoEllen M.; Hubbard, Tricia J.

    2010-01-01

    Context: Lateral ankle sprains can manifest into chronic mechanical joint laxity when not treated effectively. Joint laxity is often measured through the use of manual stress tests, stress radiography, and instrumented ankle arthrometers. Purpose: To systematically review the literature to establish the influence of chronic ankle instability (CAI) on sagittal and frontal plane mechanical joint laxity. Data Sources: Articles were searched with MEDLINE (1966 to October 2008), CINAHL (1982 to October 2008), and the Cochrane Database of Systematic Reviews (to October 2008) using the key words chronic ankle instability and joint laxity, functional ankle instability and joint laxity, and lateral ankle sprains and joint laxity. Study Selection: To be included, studies had to employ a case control design; mechanical joint laxity had to be measured via a stress roentogram, an instrumented ankle arthrometer, or ankle/foot stress-testing device; anteroposterior inversion or eversion ankle-subtalar joint complex laxity had to be measured; and means and standard deviations of CAI and control groups had to be provided. Data Extraction: One investigator assessed each study based on the criteria to ensure its suitability for analysis. The initial search yielded 1378 potentially relevant articles, from which 8 were used in the final analysis. Once the study was accepted for inclusion, its quality was assessed with the PEDro scale. Data Synthesis: Twenty-one standardized effect sizes and their 95% confidence intervals were computed for each group and dependent variable. CAI produced the largest effect on inversion joint laxity; 45% of the effects ranged from 0.84 to 2.61. Anterior joint laxity measures were influenced second most by CAI (effects, 0.32 to 1.82). CAI had similar but less influence on posterior joint laxity (effects, −0.06 to 0.68) and eversion joint laxity (effects, 0.03 to 0.69). Conclusion: CAI has the largest effect with the most variability on anterior and

  18. [Ankle sprains: from diagnosis to management. the physiatric view].

    PubMed

    Moreira, Vítor; Antunes, Filipe

    2008-01-01

    Ankle injuries are the most frequently encountered injuries in clinical practice. They are often managed by general practicians, and not only by orthopaedic or physiatric physicians. This injury is usually non-complicated, but some care should be taken to assure an adequate management and to exclude severe lesions. The stability of the ankle is necessary for functional activity of lower extremity, allowing walking and participation in other high demanding activities like running or jumping. There is a constant concern in adopting the best diagnostic and treatment procedures to enhance the recovery and to prevent the chronic joint instability. According to this, there should be proposed comprehensive strategies focusing the rehabilitation view. The ankle is a complex articular structure with contributions from the talocrural, subtalar, and inferior tibiofibular joints. The full understanding of the functional anatomy and biomechanics is the first step for the evaluation of the etiologic factors. The recognition of the mechanism of injury, and the risk factors, should be carefully addressed to make an accurate diagnosis, proper management and to implement prophylactic measures, knowing that the lateral ligamentous complex is the most commonly injured. As always, diagnosis can be made taking an adequate history, performing a thorough physical examination, and when necessary, requesting complementary studies. The priority in initial assessment it's to clear out some severe complications, like fractures, that can mimic or that can be associated with ankle sprains. Although the conventional radiology is suitable for most cases, that has been greatly improved through the institution of the Ottawa Rules, in selected patients the severity of the damage is best evaluated with other imaging resources. Treatment of acute ankle sprains depends on the severity of the injury. Most acute lateral ligament injuries are best treated nonsurgically and will regain satisfactory ankle

  19. The Effects of Kinesiotape Applied to the Lateral Aspect of the Ankle: Relevance to Ankle Sprains – A Systematic Review

    PubMed Central

    Wilson, Brendan; Bialocerkowski, Andrea

    2015-01-01

    Objective To identify, evaluate and synthesise evidence on the effect of kinesiotape applied to the lateral aspect of the ankle, through a systematic review of quantitative studies. Data Sources A search for quantitative studies was undertaken using key terms of “kinesiotape” and “ankle” in seven electronic databases, using the maximum date ranges. Databases included: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Physiotherapy Evidence Database, Scopus, SPORTDiscus and Web of Science. Study Selection Database hits were evaluated against explicit inclusion criteria. From 107 database hits, 8 quantitative studies were included. Data Extraction Two independent reviewers appraised the methodological rigour of the studies using the McMaster Critical Review Form for Quantitative Studies. Data were extracted on participant characteristics, kinesiotape parameters, comparison interventions, outcome measures and findings. Data Syntheses Most studies (n=7) had good to very good methodological rigour. Meta-analysis was not possible due to heterogeneity in participants, interventions and outcome measures. No adverse events were reported. Kinesiotape may produce different effects in healthy and injured ankles. In healthy ankles, kinesiotape may increase postural control, whereas in injured ankles it may improve proprioception, plantarflexor endurance and the performance of activities. These trends were identified from a small body of evidence including 276 participants. Conclusions It is recommended that kinesiotape may be used in clinical practice to prevent lateral ankle injuries (through its effects on postural control) and manage lateral ankle injuries due to its positive effects on proprioception, muscle endurance and activity performance. It appears that kinesiotape may not provide sufficient mechanical support to improve postural control in unstable ankles. Adverse events associated with kinseiotape are unlikely. PMID

  20. RFID-Based Critical Path Expert System for Agility Manufacture Process Management

    NASA Astrophysics Data System (ADS)

    Cheng, Haifang; Xiang, Yuli

    This paper presents a critical path expert system for the agility manufacture process management based on radio frequency identification (RFID) technology. The paper explores that the agility manufacture processes can be visible and controllable with RFID. The critical paths or activities can be easily found out and tracked by the RFID tracing technology. And the expert system can optimize the bottle neck of the task process of the agility management with the critical path adjusting and reforming method. Finally, the paper gives a simple application example of the system to discuss how to adjust the critical paths and how to make the process more agility and flexibility with the critical path expert system. With an RFID-based critical path expert system, the agility manufacture process management will be more effective and efficient.

  1. Autonomous Guidance of Agile Small-scale Rotorcraft

    NASA Technical Reports Server (NTRS)

    Mettler, Bernard; Feron, Eric

    2004-01-01

    This report describes a guidance system for agile vehicles based on a hybrid closed-loop model of the vehicle dynamics. The hybrid model represents the vehicle dynamics through a combination of linear-time-invariant control modes and pre-programmed, finite-duration maneuvers. This particular hybrid structure can be realized through a control system that combines trim controllers and a maneuvering control logic. The former enable precise trajectory tracking, and the latter enables trajectories at the edge of the vehicle capabilities. The closed-loop model is much simpler than the full vehicle equations of motion, yet it can capture a broad range of dynamic behaviors. It also supports a consistent link between the physical layer and the decision-making layer. The trajectory generation was formulated as an optimization problem using mixed-integer-linear-programming. The optimization is solved in a receding horizon fashion. Several techniques to improve the computational tractability were investigate. Simulation experiments using NASA Ames 'R-50 model show that this approach fully exploits the vehicle's agility.

  2. Candidate control design metrics for an agile fighter

    NASA Technical Reports Server (NTRS)

    Murphy, Patrick C.; Bailey, Melvin L.; Ostroff, Aaron J.

    1991-01-01

    Success in the fighter combat environment of the future will certainly demand increasing capability from aircraft technology. These advanced capabilities in the form of superagility and supermaneuverability will require special design techniques which translate advanced air combat maneuvering requirements into design criteria. Control design metrics can provide some of these techniques for the control designer. Thus study presents an overview of control design metrics and investigates metrics for advanced fighter agility. The objectives of various metric users, such as airframe designers and pilots, are differentiated from the objectives of the control designer. Using an advanced fighter model, metric values are documented over a portion of the flight envelope through piloted simulation. These metric values provide a baseline against which future control system improvements can be compared and against which a control design methodology can be developed. Agility is measured for axial, pitch, and roll axes. Axial metrics highlight acceleration and deceleration capabilities under different flight loads and include specific excess power measurements to characterize energy meneuverability. Pitch metrics cover both body-axis and wind-axis pitch rates and accelerations. Included in pitch metrics are nose pointing metrics which highlight displacement capability between the nose and the velocity vector. Roll metrics (or torsion metrics) focus on rotational capability about the wind axis.

  3. PDS4 - Some Principles for Agile Data Curation

    NASA Astrophysics Data System (ADS)

    Hughes, J. S.; Crichton, D. J.; Hardman, S. H.; Joyner, R.; Algermissen, S.; Padams, J.

    2015-12-01

    PDS4, a research data management and curation system for NASA's Planetary Science Archive, was developed using principles that promote the characteristics of agile development. The result is an efficient system that produces better research data products while using less resources (time, effort, and money) and maximizes their usefulness for current and future scientists. The key principle is architectural. The PDS4 information architecture is developed and maintained independent of the infrastructure's process, application and technology architectures. The information architecture is based on an ontology-based information model developed to leverage best practices from standard reference models for digital archives, digital object registries, and metadata registries and capture domain knowledge from a panel of planetary science domain experts. The information model provides a sharable, stable, and formal set of information requirements for the system and is the primary source for information to configure most system components, including the product registry, search engine, validation and display tools, and production pipelines. Multi-level governance is also allowed for the effective management of the informational elements at the common, discipline, and project level. This presentation will describe the development principles, components, and uses of the information model and how an information model-driven architecture exhibits characteristics of agile curation including early delivery, evolutionary development, adaptive planning, continuous improvement, and rapid and flexible response to change.

  4. Gamma-ray blazars: The view from AGILE

    NASA Astrophysics Data System (ADS)

    D'Ammando, F.; Bulgarelli, A.; Chen, A. W.; Donnarumma, I.; Giuliani, A.; Longo, F.; Pacciani, L.; Pucella, G.; Striani, E.; Tavani, M.; Vercellone, S.; Vittorini, V.; Covino, S.; Krimm, H. A.; Raiteri, C. M.; Romano, P.; Villata, M.

    2011-07-01

    During the first 3 years of operation the Gamma-Ray Imaging Detector onboard the AGILE satellite detected several blazars in a high γ-ray activity: 3C 279, 3C 454.3, PKS 1510-089, S5 0716+714, 3C 273, W Comae, Mrk 421, PKS 0537-441 and 4C +21.35. Thanks to the rapid dissemination of our alerts, we were able to obtain multiwavelength data from other observatories such as Spitzer, Swift, RXTE, Suzaku, INTEGRAL, MAGIC, VERITAS, and ARGO as well as radio-to-optical coverage by means of the GASP Project of the WEBT and the REM Telescope. This large multifrequency coverage gave us the opportunity to study the variability correlations between the emission at different frequencies and to obtain simultaneous Spectral Energy Distributions of these sources from radio to γ-ray energy bands, investigating the different mechanisms responsible for their emission and uncovering in some cases a more complex behavior with respect to the standard models. We present a review of the most interesting AGILE results on these γ-ray blazars and their multifrequency data.

  5. A review of the Technologies Enabling Agile Manufacturing program

    SciTech Connect

    Gray, W.H.; Neal, R.E.; Cobb, C.K.

    1996-10-01

    Addressing a technical plan developed in consideration with major US manufacturers, software and hardware providers, and government representatives, the Technologies Enabling Agile Manufacturing (TEAM) program is leveraging the expertise and resources of industry, universities, and federal agencies to develop, integrate, and deploy leap-ahead manufacturing technologies. One of the TEAM program`s goals is to transition products from design to production faster, more efficiently, and at less cost. TEAM`s technology development strategy also provides all participants with early experience in establishing and working within an electronic enterprise that includes access to high-speed networks and high-performance computing and storage systems. The TEAM program uses the cross-cutting tools it collects, develops, and integrates to demonstrate and deploy agile manufacturing capabilities for three high-priority processes identified by industry: material removal, sheet metal forming, electro-mechanical assembly. This paper reviews the current status of the TEAM program with emphasis upon TEAM`s information infrastructure.

  6. The Test Equipment of the AGILE Minicalorimeter Prototype

    NASA Astrophysics Data System (ADS)

    Trifoglio, M.; Bulgarelli, A.; Gianotti, F.; Celesti, E.; Di Cocco, G.; Labanti, C.; Mauri, A.; Prest, M.; Vallazza, E.; Froysland, T.

    2004-09-01

    AGILE is an ASI (Italian Space Agency) Small Space Mission for high energy astrophysics in the range 30 MeV - 50 GeV. The AGILE satellite is currently in the C phase and is planned to be launched in 2005. The Payload shall consist of a Tungsten-Silicon Tracker, a CsI Minicalorimeter, an anticoincidence system and a X-Ray detector sensitive in the 10-40 KeV range. The purpose of the Minicalorimeter (MCAL) is twofold. It shall work in conjunction with the Tracker in order to evaluate the energy of the interacting photons, and it shall operate autonomously in the energy range 250KeV-250 MeV for detection of transients and gamma ray burst events and for the measurement of gamma ray background fluctuations. We present the architecture of the Test Equipment we have designed and developed in order to test and verify the MCAL Simplified Electrical Model prototype which has been manufactured in order to validate the design of the MCAL Proto Flight Model.

  7. Discovery of New Gamma-Ray Pulsars with AGILE

    NASA Astrophysics Data System (ADS)

    Pellizzoni, A.; Pilia, M.; Possenti, A.; Chen, A.; Giuliani, A.; Trois, A.; Caraveo, P.; Del Monte, E.; Fornari, F.; Fuschino, F.; Mereghetti, S.; Tavani, M.; Argan, A.; Burgay, M.; Cognard, I.; Corongiu, A.; Costa, E.; D'Amico, N.; De Luca, A.; Esposito, P.; Evangelista, Y.; Feroci, M.; Johnston, S.; Kramer, M.; Longo, F.; Marisaldi, M.; Theureau, G.; Weltevrede, P.; Barbiellini, G.; Boffelli, F.; Bulgarelli, A.; Cattaneo, P. W.; Cocco, V.; D'Ammando, F.; DeParis, G.; Di Cocco, G.; Donnarumma, I.; Fiorini, M.; Froysland, T.; Galli, M.; Gianotti, F.; Labanti, C.; Lapshov, I.; Lazzarotto, F.; Lipari, P.; Mineo, T.; Morselli, A.; Pacciani, L.; Perotti, F.; Piano, G.; Picozza, P.; Prest, M.; Pucella, G.; Rapisarda, M.; Rappoldi, A.; Sabatini, S.; Soffitta, P.; Trifoglio, M.; Vallazza, E.; Vercellone, S.; Vittorini, V.; Zambra, A.; Zanello, D.; Pittori, C.; Verrecchia, F.; Preger, B.; Santolamazza, P.; Giommi, P.; Salotti, L.; Bignami, G. F.

    2009-04-01

    Using gamma-ray data collected by the Astro-rivelatore Gamma ad Immagini LEggero (AGILE) satellite over a period of almost one year (from 2007 July to 2008 June), we searched for pulsed signals from 35 potentially interesting radio pulsars, ordered according to F_{γ}∝ √{\\dot{E}} d^{-2} and for which contemporary or recent radio data were available. AGILE detected three new top-ranking nearby and Vela-like pulsars with good confidence both through timing and spatial analysis. Among the newcomers we find pulsars with very high rotational energy losses, such as the remarkable PSR B1509 - 58 with a magnetic field in excess of 1013 Gauss, and PSR J2229 + 6114 providing a reliable identification for the previously unidentified EGRET source 3EG 2227 + 6122. Moreover, the powerful millisecond pulsar B1821 - 24, in the globular cluster M28, is detected during a fraction of the observations. Four other promising gamma-ray pulsar candidates, among which is the notable J2043 + 2740 with an age in excess of 1 million years, show a possible detection in the timing analysis only and deserve confirmation.

  8. Enhanced detection of Terrestrial Gamma-Ray Flashes by AGILE

    NASA Astrophysics Data System (ADS)

    Marisaldi, M.; Argan, A.; Ursi, A.; Gjesteland, T.; Fuschino, F.; Labanti, C.; Galli, M.; Tavani, M.; Pittori, C.; Verrecchia, F.; D'Amico, F.; Ostgaard, N.; Mereghetti, S.; Campana, R.; Cattaneo, P.; Bulgarelli, A.; Colafrancesco, S.; Dietrich, S.; Longo, F.; Gianotti, F.; Giommi, P.; Rappoldi, A.; Trifoglio, M.; Trois, A.

    2015-12-01

    At the end of March 2015 the onboard configuration of the AGILE satellite was modified in order to disable the veto signal of the anticoincidence shield for the minicalorimeter instrument. The motivation for such a change was the understanding that the dead time induced by the anticoincidence prevented the detection of a large fraction of Terrestrial Gamma-ray Flashes (TGFs), especially the short duration ones. We present here the characteristics of the new TGF sample after several months of stable operations with the new configuration. The configuration change was highly successful resulting in the detection of about 100 TGFs/month, an increase of a factor about 11 in TGFs detection rate with respect to previous configuration. As expected, the largest fraction of the new events has short duration, with a median duration of 80 microseconds. We also obtain a sample of events with simultaneous association, within 100 microseconds, with lightning sferics detected by the World Wide Lightning Location Network (WWLLN), confirming previous results reported by the Fermi mission. Given the high detection rate and the AGILE very low (+/-2.5°) orbital inclination, the new configuration provides the largest TGF detection rate surface density (TGFs / km2 / year) to date, opening space for correlation studies with lightning and atmospheric parameters on short spatial and temporal scales along the equatorial region. Eventually, the events with associated simultaneous WWLLN sferics provide a highly reliable sample to probe the long-standing issue of the TGF maximal energy.

  9. Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities.

    PubMed

    van Bergen, Christiaan Ja; Gerards, Rogier M; Opdam, Kim Tm; Terra, Maaike P; Kerkhoffs, Gino Mmj

    2015-12-18

    This current concepts review outlines the role of different imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone (usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography (CT) and magnetic resonance imaging (MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available. PMID:26716090

  10. Human hip-ankle coordination emerging from multisensory feedback control.

    PubMed

    Hettich, Georg; Assländer, Lorenz; Gollhofer, Albert; Mergner, Thomas

    2014-10-01

    Human sensorimotor control involves inter-segmental coordination to cope with the complexity of a multi-segment system. The combined activation of hip and ankle muscles during upright stance represents the hip-ankle coordination. This study postulates that the coordination emerges from interactions on the sensory levels in the feedback control. The hypothesis was tested in a model-based approach that compared human experimental data with model simulations. Seven subjects were standing with eyes closed on an anterior-posterior tilting motion platform. Postural responses in terms of angular excursions of trunk and legs with respect to vertical were measured and characterized using spectral analysis. The presented control model consists of separate feedback modules for the hip and ankle joints, which exchange sensory information with each other. The feedback modules utilize sensor-derived disturbance estimates rather than 'raw' sensory signals. The comparison of the human data with the simulation data revealed close correspondence, suggesting that the model captures important aspects of the human sensory feedback control. For verification, the model was re-embodied in a humanoid robot that was tested in the human laboratory. The findings show that the hip-ankle coordination can be explained by interactions between the feedback control modules of the hip and ankle joints. PMID:25150802

  11. Adaptation to walking with an exoskeleton that assists ankle extension.

    PubMed

    Galle, S; Malcolm, P; Derave, W; De Clercq, D

    2013-07-01

    The goal of this study was to investigate adaptation to walking with bilateral ankle-foot exoskeletons with kinematic control that assisted ankle extension during push-off. We hypothesized that subjects would show a neuromotor and metabolic adaptation during a 24min walking trial with a powered exoskeleton. Nine female subjects walked on a treadmill at 1.36±0.04ms(-1) during 24min with a powered exoskeleton and 4min with an unpowered exoskeleton. Subjects showed a metabolic adaptation after 18.5±5.0min, followed by an adapted period. Metabolic cost, electromyography and kinematics were compared between the unpowered condition, the beginning of the adaptation and the adapted period. In the beginning of the adaptation (4min), a reduction in metabolic cost of 9% was found compared to the unpowered condition. This reduction was accompanied by reduced muscular activity in the plantarflexor muscles, as the powered exoskeleton delivered part of the necessary ankle extension moment. During the adaptation this metabolic reduction further increased to 16%, notwithstanding a constant exoskeleton assistance. This increased reduction is the result of a neuromotor adaptation in which subjects adapt to walking with the exoskeleton, thereby reducing muscular activity in all leg muscles. Because of the fast adaptation and the significant reductions in metabolic cost we want to highlight the potential of an ankle-foot exoskeleton with kinematic control that assists ankle extension during push-off. PMID:23465319

  12. Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities

    PubMed Central

    van Bergen, Christiaan JA; Gerards, Rogier M; Opdam, Kim TM; Terra, Maaike P; Kerkhoffs, Gino MMJ

    2015-01-01

    This current concepts review outlines the role of different imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone (usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography (CT) and magnetic resonance imaging (MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available. PMID:26716090

  13. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    PubMed

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients. PMID:27089717

  14. 78 FR 68908 - Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... AFFAIRS Agency Information Collection (Ankle Conditions Disability Benefits Questionnaire) Under OMB... Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records... Disability Benefits Questionnaire)''. SUPPLEMENTARY INFORMATION: Title: Ankle Conditions Disability...

  15. 78 FR 34708 - Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ... AFFAIRS Proposed Information Collection (Ankle Conditions Disability Benefits Questionnaire) Activity... Control No. 2900--NEW (Ankle Conditions Disability Benefits Questionnaire)'' in any correspondence. During... Conditions Disability Benefits Questionnaire, VA Form 21-0960M-2. OMB Control Number: 2900--NEW...

  16. Risk factors for lateral ankle sprain: a prospective study among military recruits.

    PubMed

    Milgrom, C; Shlamkovitch, N; Finestone, A; Eldad, A; Laor, A; Danon, Y L; Lavie, O; Wosk, J; Simkin, A

    1991-08-01

    In a prospective study of risk factors for lateral ankle sprain among 390 male Israeli infantry recruits, a 18% incidence of lateral ankle sprains was found in basic training. There was no statistically significant difference in the incidence of lateral ankle sprains between recruits who trained in modified basketball shoes or standard lightweight infantry boots. By multivariate stepwise logistic regression a statistically significant relationship was found between body weight x height (a magnitude which is proportional to the mass moment of inertia of the body around a horizontal axis through the ankle), a previous history of ankle sprain, and the incidence of lateral ankle sprains. Recruits who were taller and heavier and thus had larger mass moments of inertia (P = 0.004), and those with a prior history of ankle sprain (P = 0.01) had higher lateral ankle sprain morbidity in basic training. PMID:1959831

  17. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types.

    PubMed

    Kemler, Ellen; van de Port, Ingrid; Backx, Frank; van Dijk, C Niek

    2011-03-01

    Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of taping the ankle. The purpose of this review is to evaluate the effectiveness of ankle braces as a treatment for acute ankle sprains compared with other types of functional treatments such as ankle tape and elastic bandages. A computerized literature search was conducted using PubMed, EMBASE, CINAHL and the Cochrane Clinical Trial Register. This review includes randomized controlled trials in English, German and Dutch, published between 1990 and April 2009 that compared ankle braces as a treatment for lateral ankle sprains with other functional treatments. The inclusion criteria for this systematic review were (i) individuals (sports participants as well as non-sports participants) with an acute injury of the ankle (acute ankle sprains); (ii) use of an ankle brace as primary treatment for acute ankle sprains; (iii) control interventions including any other type of functional treatment (e.g. Tubigrip™, elastic wrap or ankle tape); and (iv) one of the following reported outcome measures: re-injuries, symptoms (pain, swelling, instability), functional outcomes and/or time to resumption of sports, daily activities and/or work. Eight studies met all inclusion criteria. Differences in outcome measures, intervention types and patient characteristics precluded pooling of the results, so best evidence syntheses were conducted. A few individual studies reported positive outcomes after treatment with an ankle brace compared with other functional methods, but our best evidence syntheses only demonstrated a better treatment result in terms of functional outcome. Other studies have suggested that ankle brace treatment is a more cost-effective method, so the use of braces after acute

  18. 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

  19. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial

    PubMed Central

    2010-01-01

    Background Ankle sprains are common within the general population and can result in prolonged disablement. Limited talocrural dorsiflexion range of motion (DF ROM) is a common consequence of ankle sprain. Limited talocrural DF ROM may contribute to persistent symptoms, disability, and an elevated risk for re-injury. As a result, many health care practitioners use hands-on passive procedures with the intention of improving talocrural joint DF ROM in individuals following ankle sprains. Dosage of passive hands-on procedures involves a continuum of treatment speeds. Recent evidence suggests both slow- and fast-speed treatments may be effective to address disablement following ankle sprains. However, these interventions have yet to be longitudinally compared against a placebo study condition. Methods/Design We developed a randomized, placebo-controlled clinical trial designed to test the hypotheses that hands-on treatment procedures administered to individuals following ankle sprains during the post-acute injury period can improve short-, intermediate-, and long-term disablement, as well as reduce the risk for re-injury. Discussion This study is designed to measure the clinical effects of hands-on passive stretching treatment procedures directed to the talocrural joint that vary in treatment speed during the post-acute injury period, compared to hands-on placebo control intervention. Trial Registration http://www.clinicaltrials.gov identifier NCT00888498. PMID:20958995

  20. Thromboembolism after foot and ankle surgery. A multicenter study.

    PubMed

    Mizel, M S; Temple, H T; Michelson, J D; Alvarez, R G; Clanton, T O; Frey, C C; Gegenheimer, A P; Hurwitz, S R; Lutter, L D; Mankey, M G; Mann, R A; Miller, R A; Richardson, E G; Schon, L C; Thompson, F M; Yodlowski, M L

    1998-03-01

    Thromboembolic disease presents a potentially fatal complication to patients undergoing orthopaedic surgery. Although the incidence after hip and knee surgery has been studied and documented, its incidence after surgery of the foot and ankle is unknown. For this reason, a prospective multicenter study was undertaken to identify patients with clinically evident thromboembolic disease to evaluate potential risk factors. Two thousand seven hundred thirty-three patients were evaluated for preoperative risk factors and postoperative thromboembolic events. There were six clinically significant thromboembolic events, including four nonfatal pulmonary emboli, after foot and ankle surgery. The incidence of deep vein thrombosis was six of 2733 (0.22%) and that of nonfatal pulmonary emboli was four of 2733 (0.15%). Factors found to correlate with an increased incidence of deep vein thrombosis were nonweightbearing status and immobilization after surgery. On the basis of these results, routine prophylaxis for thromboembolic disease after foot and ankle surgery probably is not warranted. PMID:9553551