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Sample records for agility total ankle

  1. Agility to INBONE: anterior and posterior approaches to the difficult revision total ankle replacement.

    PubMed

    DeVries, J George; Scott, Ryan T; Berlet, Gregory C; Hyer, Christopher F; Lee, Thomas H; DeOrio, James K

    2013-01-01

    Total ankle replacement is now acknowledged as a viable alternative to ankle arthrodesis for end-stage ankle arthritis. The authors present a series of 14 patients who were converted from the Agility total ankle replacement to an INBONE total ankle replacement. This report is unique in that anterior and posterior approaches are discussed and detailed. Although the authors present successful conversion of the Agility total ankle replacement to an INBONE total ankle replacement, the difficulty of this procedure is demonstrated by the high complication rate and 2 early failures.

  2. Total ankle joint replacement.

    PubMed

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  3. Stresses in the ankle joint and total ankle replacement design.

    PubMed

    Kakkar, Rahul; Siddique, M S

    2011-06-01

    The ankle is a highly congruent joint with a surface area of 11-13 cm(2). Total ankle replacements have been attempted since the early 1970s and design has continually evolved as the early designs were a failure. This was because the stresses involved and the mutiaxial motion of the ankle has not been understood until recently. It has been shown that the talus slides as well as rolls during the ankle arc of motion from plantarflexion to dorsiflexion. Furthermore, the articular surfaces and the calcaneofibular and tibiocalcaneal ligaments have been shown to form a four bar linkage dictating ankle motion. A new design ankle replacement has been suggested recently which allows multiaxial motion at the ankle while maintaining congruency throughout the arc of motion. The early results of this ankle replacement have been encouraging without any reported failures due to mechanical loosening.

  4. Modified Evans peroneus brevis lateral ankle stabilization for balancing varus ankle contracture during total ankle replacement.

    PubMed

    Roukis, Thomas S

    2013-01-01

    Lateral ankle instability is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, I have described a modification of the Evans peroneus brevis tendon lateral ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis is then transferred either to the anterior distal tibia concomitantly with total ankle replacement or through the tibia when performed after total ankle replacement and secured with plate and screw fixation. This modified Evans peroneus brevis tendon is useful in providing lateral ankle stability during or after primary and revision total ankle replacement.

  5. Total ankle replacement. Design evolution and results.

    PubMed

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  6. Fusion following failed total ankle replacement.

    PubMed

    Wünschel, Markus; Leichtle, Ulf G; Leichtle, Carmen I; Walter, Christian; Mittag, Falk; Arlt, Eva; Suckel, Andreas

    2013-04-01

    Although mid- to long-term results after total ankle replacement have improved because of available second- and third-generation devices, failure of total ankle replacement is still more common compared with total hip replacement and total knee replacement. The portfolio of available total ankle replacement revision component options is small. Furthermore, the bone stock of the tibiotalar region is scarce making it difficult and in some situations impossible to perform revision total ankle replacement. In these cases tibiotalar and tibiotalocalcaneal fusions are valuable options. This article describes which surgical procedures should be performed depending on the initial situation and gives detailed advice on surgical technique, postoperative care, and clinical results.

  7. Effects of ankle braces upon agility course performance in high school athletes.

    PubMed

    Beriau, M R; Cox, W B; Manning, J

    1994-09-01

    The purpose of this study was to compare the effects of wearing the Aircast(TM) Sports Stirrup, Aircast(TM) Training brace, Swede-O(TM) brace, and DonJoy(TM) Ankle Ligament Protector while running an agility course. Eighty-five high school athletes with no history of ankle injury and no experience in wearing any ankle support served as subjects. Each subject participated in four separate testing sessions. During sessions 1 and 4, subjects ran the agility course under the control (unbraced) conditions. Sessions 2 and 3 consisted of randomly wearing the ankle braces while running the agility course. A questionnaire concerning support, comfort, and restriction was completed by each subject after wearing each of the braces. An analysis of variance (ANOVA) with repeated measures revealed that a significant difference existed between the agility times. Tukey's post hoc test indicated that a significant difference existed between each ankle brace and the control 2 agility times as well as a control 1 and control 2 time difference. The control time difference was attributed to a learning effect. An ANOVA with repeated measures of only the four braces revealed that a significant difference existed between the agility times. Tukey's post hoc test showed the only difference was between the DonJoy Ankle Ligament Protector and the Aircast Training brace. We concluded: 1) there is limited practical performance effect upon agility while wearing an ankle brace; and 2) an athlete's perceived comfort, support, and performance restriction are contributing factors that may directly influence the effectiveness of ankle bracing.

  8. Total ankle replacement - surgical treatment and rehabilitation.

    PubMed

    Prusinowska, Agnieszka; 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.

  9. 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

  10. Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.

    PubMed

    Roukis, Thomas S; Prissel, Mark A

    2014-01-01

    Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.

  11. Revision of the aseptic and septic total ankle replacement.

    PubMed

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  12. Arthroscopic Management of Complications Following Total Ankle Replacement.

    PubMed

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  13. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements

    PubMed Central

    Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban

    2016-01-01

    The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met. PMID:26955224

  14. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements.

    PubMed

    Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban

    2016-03-01

    The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met.

  15. Failure modes of current total ankle replacement systems.

    PubMed

    Pappas, Michael J; Buechel, Frederick F

    2013-04-01

    Methodology for evaluation of total ankle replacements is described. Fusion and its problems are discussed as are those of total ankle joint replacement. Fusion is an imperfect solution because it reduces ankle functionality and has significant complications. Early fixed-bearing total ankles were long-term failures and abandoned. Currently available fixed-bearing ankles have proved inferior to fusion or are equivalent to earlier devices. Only mobile-bearing devices have been shown reasonably safe and effective. One such device, the STAR, has been approved by the Food and Drug Administration after a rigorous controlled clinical trial and is available for use in the United States.

  16. Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series.

    PubMed

    Barg, A; Elsner, A; Hefti, D; Hintermann, B

    2010-07-01

    The standard treatment for end-stage osteoarthritis of the ankle joint in haemophilic patients has been fusion of the ankle joint. Total ankle replacement is still controversial as a treatment option. The objective of this prospective study was to evaluate the mid-term outcome in patients treated with total ankle replacement using an unconstrained three-component ankle implant. Ten haemophilic ankles in eight patients (mean age: 43.2 years, range 26.7-57.5) treated with total ankle replacement were followed up for a minimum of 2.7 years (mean: 5.6, range 2.7-7.6). The outcome was measured with clinical and radiological evaluations. There were no intra- or peri-operative complications. The AOFAS-hindfoot-score increased from 38 (range 8-57) preoperatively to 81 (range 69-95) postoperatively. All patients were satisfied with the results. Four patients became pain free; in the whole patient cohort pain level decreased from 7.1 (range 4-9) preoperatively to 0.8 (range 0-3) postoperatively. All categories of SF-36 score showed significant improvements in quality of life. In one patient, open ankle arthrolysis was performed because of painful arthrofibrosis. For patients with haemophilic osteoarthritis of the ankle joint, total ankle replacement is a valuable alternative treatment to ankle fusion.

  17. 10-year survival of total ankle arthroplasties

    PubMed Central

    2011-01-01

    Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551

  18. 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.

  19. Biomechanics of the ankle joint and clinical outcomes of total ankle replacement.

    PubMed

    Michael, Junitha M; Golshani, Ashkahn; Gargac, Shawn; Goswami, Tarun

    2008-10-01

    Until the 1970s ankle arthrodesis was considered to be the "gold-standard" to treat arthritis. But the low fusion rate of ankle arthrodeses along with the inability to achieve normal range of motion led to the growing interest in the development of total ankle replacements. Though the short-term outcomes were good, their long-term outcomes were not as promising. To date, most models do not exactly mimic the anatomical functionality of a natural ankle joint. Therefore, research is being conducted worldwide to either enhance the existing models or develop new models while understanding the intricacies of the joint more precisely. This paper reviews the anatomical and biomechanical aspects of the ankle joint. Also, the evolution and comparison of clinical outcomes of various total ankle replacements are presented.

  20. 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

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

    PubMed

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

    2015-12-01

    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 pointsAnkle taping

  2. A brief history of total ankle replacement and a review of the current status.

    PubMed

    Vickerstaff, John A; Miles, Anthony W; Cunningham, James L

    2007-12-01

    Total ankle replacement (TAR) was first attempted in the early 1970s, but poor early results lead to it being abandoned in favour of arthrodesis. Arthrodesis is not totally satisfactory, often causing further hindfoot arthritis and this has lead to a resurgence of interest in joint replacement. New designs which more closely approximated the natural anatomy of the ankle and associated biomechanics have produced more encouraging results and led to renewed interest in total ankle replacement. Three prostheses dominate the market: Agility, Buechel-Pappas and STAR, and improving clinical results with these devices have led to more designs appearing on the market. Modern designs of prosthetic ankles almost exclusively consist of three part prostheses with a mobile bearing component, similar to the Buechel-Pappas and STAR. Clinical results of these newer designs are limited and short-term and have often been carried out by the designers of the implants. This paper presents a brief history of the development of total ankle replacement and a review of the current status.

  3. 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

  4. Management of Osseous and Soft-Tissue Ankle Equinus During Total Ankle Replacement.

    PubMed

    Roukis, Thomas S; Simonson, Devin C

    2015-10-01

    Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These techniques include anterior tibiotalar joint cheilectomy, posterior superficial muscle compartment lengthening, posterior ankle capsule release, and release of the posterior portions of the medial and lateral collateral ligament complexes. The rationale for these procedures and the operative sequence of events for these procedures are presented.

  5. Registry data trends of total ankle replacement use.

    PubMed

    Roukis, Thomas S; Prissel, Mark A

    2013-01-01

    Joint arthroplasty registry data are meaningful when evaluating the outcomes of total joint replacement, because they provide unbiased objective information regarding survivorship and incidence of use. Critical evaluation of the registry data information will benefit the surgeon, patient, and industry. However, the implementation and acceptance of registry data for total ankle replacement has lagged behind that of hip and knee implant arthroplasty. Currently, several countries have national joint arthroplasty registries, with only some procuring information for total ankle replacement. We performed an electronic search to identify publications and worldwide registry databanks with pertinent information specific to total ankle replacement to determine the type of prostheses used and usage trends over time. We identified worldwide registry data from 33 countries, with details pertinent to total ankle replacement identified in only 6 countries. The obtained information was arbitrarily stratified into 3 distinct periods: 2000 to 2006, 2007 to 2010, and 2011. Within these study periods, the data from 13 total ankle replacement systems involving 3,980 ankles were identified. The vast majority (97%) of the reported ankle replacements were 3-component, mobile-bearing, uncemented prostheses. Three usage trends were identified: initial robust embracement followed by abrupt disuse, minimal use, and initial embracement followed by sustained growth in implantation. Before the widespread acceptance of new total ankle replacements, the United States should scrutinize and learn from the international registry data and develop its own national joint registry that would include total ankle replacement. Caution against the adoption of newly released prostheses, especially those without readily available revision components, is recommended.

  6. Salto Talaris fixed-bearing total ankle replacement system.

    PubMed

    Rush, Shannon M; Todd, Nicholas

    2013-01-01

    The Salto Talaris total ankle replacement is an anatomically designed fixed bearing prosthesis available in the United States based on the successful design of the mobile-bearing Salto prosthesis available outside the United States. The original mobile-bearing design was modified and the mobile-bearing was transferred to the precision instrumentation at the trial phase evaluation. Instrumentation and technique allow the surgeon to determine the functional joint axis before final implantation. The Salto Talaris total ankle replacement design blends minimal bone resection and optimizes surface area, cortical contact, and ultra-high molecular weight polyethylene conformity. The authors present an overview of the Salto Talaris total ankle replacement surgical technique and pearls for successful application.

  7. 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.

  8. [Arthrodesis versus total joint replacement of the ankle].

    PubMed

    Mittlmeier, T

    2013-06-01

    In general, for the treatment of end-stage osteoarthritis of the ankle joint arthrodesis is considered to be the gold standard based on its versatility and eligibility for numerous indications. Nowadays, total ankle arthroplasty represents a viable alternative to ankle arthrodesis taking into account distinct premises as both procedures provide a calculable reduction of the preoperative pain level and a comparable functional gain. Furthermore, current 10-year-survival rates of total ankle replacement are reported to range between 76 % and 89 %. Revision rates of up to 10 % for both techniques have been reported with manifest differences within the respective spectrum of complications. Due to the fact that more than two thirds of patients suffer from post-traumatic osteoarthritis with a relatively low average of age concomitant malalignment, soft tissue damage or instability may frequently occur. A restoration of anatomic axes and an adequate centering of the talus under the tibia appear to be crucial for the outcome as well as an adequate soft tissue balancing, in particular in total ankle replacement. Thus, the selection of the correct indication and the right choice of treatment on the basis of complete preoperative diagnostics considering necessary additive surgical measures are of paramount importance for the final outcome.

  9. 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.

  10. The painful total ankle arthroplasty: a diagnostic and treatment algorithm.

    PubMed

    Vulcano, E; Myerson, M S

    2017-01-01

    The last decade has seen a considerable increase in the use of in total ankle arthroplasty (TAA) to treat patients with end-stage arthritis of the knee. However, the longevity of the implants is still far from that of total knee and hip arthroplasties. The aim of this review is to outline a diagnostic and treatment algorithm for the painful TAA to be used when considering revision surgery. Cite this article: Bone Joint J 2017;99-B:5-11.

  11. Use of a trabecular metal implant in ankle arthrodesis after failed total ankle replacement

    PubMed Central

    2010-01-01

    Background and purpose Arthrodesis after failed total ankle replacement is complicated and delayed union, nonunion, and shortening of the leg often occur—especially with large bone defects. We investigated the use of a trabecular metal implant and a retrograde intramedullary nail to obtain fusion. Patients and methods 13 patients with a migrated or loose total ankle implant underwent arthrodesis with the use of a retrograde intramedullary nail through a trabecular metal Tibial Cone. The mean follow-up time was 1.4 (0.6–3.4) years. Results At the last examination, 7 patients were pain-free, while 5 had some residual pain but were satisfied with the procedure. 1 patient was dissatisfied and experienced pain and swelling when walking. The implant-bone interfaces showed no radiographic zones or gaps in any patient, indicating union. Interpretation The method is a new way of simplifying and overcoming some of the problems of performing arthrodesis after failed total ankle replacement. PMID:21067435

  12. TOTAL ANKLE ARTHROPLASTY: BRAZILIAN EXPERIENCE WITH THE HINTEGRA PROSTHESIS.

    PubMed

    Nery, Caio; Fernandes, Túlio Diniz; Réssio, Cibele; Fuchs, Mauro Luiz; Godoy Santos, Alexandre Leme de; Ortiz, Rafael Trevisan

    2010-01-01

    Ankle arthrosis is becoming more and more common. The search for solutions that preserve joint function has led to a new generation of prosthesis with three components and more degrees of freedom. This paper presents the results achieved for ten patients treated with the HINTEGRA Prosthesis (Integra, New Deal), through collaborative action between the Foot and Ankle Groups of the Orthopedics and Traumatology divisions of Escola Paulista de Medicina, Unifesp, and the School of Medicine of the University of São Paulo (USP). The ten patients (six women and four men, aged between 29 and 66 years), underwent a surgical procedure consisting of Hintermann's technique, between January and June 2005. They were evaluated at prearranged intervals, and the data were subjected to statistical analysis. The surgery led to a significant improvement in ankle mobility. Radiological evaluation showed no signs of loosening or failure in the prosthetic components in any of the patients studied. Although the complication rate in our sample was high, it was equivalent to the rates found by other authors, and directly represents the learning curve associate with this kind of procedure. Four years after the procedure, it was found that the patients pain levels had significantly decreased, and that their functional patterns had significantly improved, with AOFAS and Hintermann scores indicating results that were excellent for 20%, good for 70% and poor for 10%. Treatment of ankle arthritis by means of total arthroplasty using the HINTEGRA prosthesis was capable of providing good results over an average observation period of four years.

  13. Outcome of unilateral ankle arthrodesis and total ankle replacement in terms of bilateral gait mechanics.

    PubMed

    Chopra, Swati; Rouhani, Hossein; Assal, Mathieu; Aminian, Kamiar; Crevoisier, Xavier

    2014-03-01

    Previous studies assessed the outcome of ankle arthrodesis (AA) and total ankle replacement (TAR) surgeries; however, the extent of postoperative recovery towards bilateral gait mechanics (BGM) is unknown. We evaluated the outcome of the two surgeries at least 2 years post rehabilitation, focusing on BGM. 36 participants, including 12 AA patients, 12 TAR patients, and 12 controls were included. Gait assessment over 50 m distance was performed utilizing pressure insoles and 3D inertial sensors, following which an intraindividual comparison was performed. Most spatiotemporal and kinematic parameters in the TAR group were indicative of good gait symmetry, while the AA group presented significant differences. Plantar pressure symmetry among the AA group was also significantly distorted. Abnormality in biomechanical behavior of the AA unoperated, contralateral foot was observed. In summary, our results indicate an altered BGM in AA patients, whereas a relatively fully recovered BGM is observed in TAR patients, despite the quantitative differences in several parameters when compared to a healthy population. Our study supports a biomechanical assessment and rehabilitation of both operated and unoperated sides after major surgeries for ankle osteoarthrosis.

  14. TOTAL ANKLE ARTHROPLASTY: BRAZILIAN EXPERIENCE WITH THE HINTEGRA PROSTHESIS

    PubMed Central

    Nery, Caio; Fernandes, Túlio Diniz; Réssio, Cibele; Fuchs, Mauro Luiz; Godoy Santos, Alexandre Leme de; Ortiz, Rafael Trevisan

    2015-01-01

    Ankle arthrosis is becoming more and more common. The search for solutions that preserve joint function has led to a new generation of prosthesis with three components and more degrees of freedom. This paper presents the results achieved for ten patients treated with the HINTEGRA Prosthesis (Integra, New Deal), through collaborative action between the Foot and Ankle Groups of the Orthopedics and Traumatology divisions of Escola Paulista de Medicina, Unifesp, and the School of Medicine of the University of São Paulo (USP). The ten patients (six women and four men, aged between 29 and 66 years), underwent a surgical procedure consisting of Hintermann's technique, between January and June 2005. They were evaluated at prearranged intervals, and the data were subjected to statistical analysis. The surgery led to a significant improvement in ankle mobility. Radiological evaluation showed no signs of loosening or failure in the prosthetic components in any of the patients studied. Although the complication rate in our sample was high, it was equivalent to the rates found by other authors, and directly represents the learning curve associate with this kind of procedure. Four years after the procedure, it was found that the patients pain levels had significantly decreased, and that their functional patterns had significantly improved, with AOFAS and Hintermann scores indicating results that were excellent for 20%, good for 70% and poor for 10%. Treatment of ankle arthritis by means of total arthroplasty using the HINTEGRA prosthesis was capable of providing good results over an average observation period of four years. PMID:27022527

  15. Total ankle replacement--evolution of the technology and future applications.

    PubMed

    Yu, John J; Sheskier, Steven

    2014-01-01

    Total ankle arthroplasty was developed to reduce pain and retain motion of the ankle joint in patients with osteoarthritis much like its total hip and knee counterparts. Orthopaedic surgeons are well equipped to evaluate and treat patients with end-stage hip or knee arthritis; however, the management of patients with ankle arthritis represents a challenge to both general orthopaedic surgeons and to the foot and ankle surgeons to whom these patients are often referred. Although techniques for both hip and knee arthroplasty have evolved to provide long-term pain relief and functional improvement, neither ankle arthrodesis nor arthroplasty has demonstrated comparably favorable outcomes in long-term follow-up studies. Early ankle arthroplasty designs with highly constrained cemented components were abandoned due to unacceptably high failure rates and complications. While arthrodesis is still considered the "gold standard" for treatment of end-stage ankle arthritis, progression of adjacent joint arthrosis and diminished gait efficiency has led to a resurgence of interest in ankle arthroplasty. Long-term outcome studies for total ankle replacement found excellent or good results in 82% of patients who received a newer generation ankle device compared with 72% if undergoing ankle fusion. Continued long-term follow-up studies are necessary, but total ankle arthroplasty has become a viable option for surgical treatment of ankle arthritis.

  16. Total ankle replacement through a lateral approach: surgical tips

    PubMed Central

    Usuelli, Federico Giuseppe; Indino, Cristian; Maccario, Camilla; Manzi, Luigi; Salini, Vincenzo

    2016-01-01

    Purpose: Recently, the Zimmer Trabecular Metal Total Ankle Replacement (Zimmer TM TAR) was developed to be used through a lateral transfibular approach. The purpose of this paper is to describe the surgical technique and early outcomes of the TAR via the lateral approach using the Zimmer TM TARs. Methods: Sixty-seven patients underwent primary TAR using the Zimmer TM TAR between May 2013 and May 2015. Patients were clinically evaluated preoperatively and postoperatively at six and twelve months and annually using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot scores, visual analogue scale (VAS) pain score, and the Short Form Health Survey (SF-12) questionnaire. The minimum follow-up was 12 months. Results: The mean AOFAS hindfoot score increased from 32.8 preoperatively to 85.0 at the latest follow-up (p-value < 0.001). The mean VAS pain score decreased from 8.0 to 2.0 at the latest follow-up (p-value < 0.001). The Physical and Mental Health Composite Scale scores (PCS and MCS) of the SF-12 passed from a mean value of 30.2 preoperatively to 43.1 (p-value < 0.001) and from a mean value of 44.6 to 53.5 at the latest follow-up (p-value < 0.001), respectively. Conclusions: We present our surgical tips and the early results of this prosthetic design which are encouraging. They could be useful as an adjunct to the manufacturer’s surgical technique guidance for surgeons who utilize these implants. PMID:27855774

  17. Midterm results of the Salto Total Ankle Prosthesis.

    PubMed

    Bonnin, M; Judet, T; Colombier, J A; Buscayret, F; Graveleau, N; Piriou, P

    2004-07-01

    The Salto Total Ankle Prosthesis is noncemented with mobile bearings and is characterized by an anatomic design and a dual Ti-HA coating. Between 1997 and 2000, 98 consecutive Salto prostheses were implanted. At last followup, two patients were deceased, one patient was lost to followup, and two prostheses were removed in two patients. Ninety-three implants in 91 patients were available with a mean followup of 35 months (range, 24-68 months). Survivorship at 68 months, with the end point implant removal, then was 98% (favorable scenario) to 94.9% (unfavorable scenario). The American Orthopaedic Foot and Ankle Society score was 32.3 points preoperatively and 83.1 points at followup. Seventy-two patients are pain-free, 54 patients walk unlimited distances, and 25 patients have limitation but walk more than 1 km. Sixty-seven patients have no limp but seven need walking aids. Fifty-eight patients can walk on tiptoes, 49 patients can walk on uneven ground, 14 patients can run, 76 patients ascend stairs normally, and 63 patients descend stairs normally. Range of motion as measured on stress radiographs improved from 15.2 degrees preoperatively to 28.3 degrees at followup. Preliminary results of the Salto prosthesis are encouraging and validate the concept of anatomic replacement.

  18. Techniques for managing varus and valgus malalignment during total ankle replacement.

    PubMed

    Choi, Woo Jin; Yoon, Hang Seob; Lee, Jin Woo

    2013-01-01

    The ultimate goal of primary total ankle replacement is to provide a well-balanced soft-tissue envelope around a well-aligned, well-fixated implant. Some surgeons have emphasized that good outcomes in total ankle replacement are more dependent on ligament balancing, along with the procedure itself, than the extent of preoperative coronal deformity in the ankle. Thus, it is imperative that the surgeon be familiar with additional procedures to address the varus, valgus, and other associated deformities commonly encountered in primary total ankle replacement.

  19. Ballooning osteolysis in 71 failed total ankle arthroplasties

    PubMed Central

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

    2016-01-01

    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

  20. RANKL in the osteolysis of AES total ankle replacement implants.

    PubMed

    Koivu, H; Mackiewicz, Z; Takakubo, Y; Trokovic, N; Pajarinen, J; Konttinen, Y T

    2012-09-01

    Peri-implant tissue reactions in failed total ankle replacement (TAR) are characterized by early developing peri-implant osteolysis. The hypothesis of the study was that this reaction is mediated by receptor activator of nuclear factor kappa B ligand (RANKL). Samples of peri-prosthetic tissues from failed TAR implants were stained for macrophages, RANKL, its receptor RANK and osteoprotegerin (OPG), and compared to control samples. The failed TAR implants were surrounded by implant capsule, synovial lining-like interface membrane or necrotic tissues. Infiltrating scavenger receptor I positive CD163(+) macrophages were frequent, in particular around necrotic soft tissues or bone sequestrate, and possibly in part formed due to ischemia and mechanical factors. In contrast, implant-derived wear debris was scanty. Still many RANK(+) macrophages were often seen in close contact with RANKL(+) mesenchymal cells, whereas OPG was mostly located at a distance in vascular endothelial cells. Foreign body giant cells were frequent. RANKL seems to stimulate locally accumulated CD163(+) RANK-expressing cells to fusion, which leads to the local formation of multinuclear foreign body giant cells (and probably of osteoclasts). Therefore, peri-implant osteolysis in early TAR implant failure seems to be caused by the RANKL-driven chronic foreign body inflammation directed against, not implant-derived particles, but against necrotic autologous tissues.

  1. Total ankle replacement using HINTEGRA, an unconstrained, three-component system: surgical technique and pitfalls.

    PubMed

    Barg, Alexej; Knupp, Markus; Henninger, Heath B; Zwicky, Lukas; Hintermann, Beat

    2012-12-01

    Total ankle replacement (TAR) has become a valuable treatment option in patients with end-stage ankle osteoarthritis. One popular 3-component system, the HINTEGRA TAR, is an unconstrained system that provides inversion-eversion stability. More natural biomechanics of the replaced ankle may be expected when anatomic considerations drive prosthesis design. The HINTEGRA prosthesis includes 2 anatomically contoured metal components and a polyethylene insert, providing axial rotation and physiologic flexion-extension mobility. This article describes the HINTEGRA TAR design and surgical technique. Use of the prosthesis for complex hindfoot reconstruction in patients with an osteoarthritic, varus, or valgus ankle deformity is described.

  2. In vivo kinematics and articular surface congruency of total ankle arthroplasty during gait.

    PubMed

    Yamaguchi, Satoshi; Tanaka, Yasuhito; Banks, Scott; Kosugi, Shinichi; Sasho, Takahisa; Takahashi, Kazuhisa; Takakura, Yoshinori

    2012-08-09

    Relatively high rates of loosening and implant failure have been reported after total ankle arthroplasty. Abnormal kinematics and incongruency of the articular surface may cause increased contact pressure and rotational torque applied to the implant, leading to loosening and implant failure. We measured in vivo kinematics of two-component total ankle arthroplasty (TNK ankle), and assessed congruency of the articular surface during the stance phase of gait. Eighteen ankles of 15 patients with a mean age of 75±6 years (mean±standard deviation) and follow-up of 44±38 months were enrolled. Lateral fluoroscopic images were taken during the stance phase of gait. 3D-2D model-image registration was performed using the fluoroscopic image and the implant models, and three-dimensional kinematics of the implant and incongruency of the articular surface were determined. The mean ranges of motion were 11.1±4.6°, 0.8±0.4°, and 2.6±1.5° for dorsi-/plantarflexion, inversion/eversion, and internal/external rotation, respectively. At least one type of incongruency of the articular surface occurred in eight of 18 ankles, including anterior hinging in one ankle, medial or lateral lift off in four ankles, and excessive axial rotation in five ankles. Among the four ankles in which lift off occurred during gait, only one ankle showed lift off in the static weightbearing radiograph. Our observations will provide useful data against which kinematics of other implant designs, such as three-component total ankle arthroplasty, can be compared. Our results also showed that evaluation of lift off in the standard weightbearing radiograph may not predict its occurrence during gait.

  3. Combined total ankle replacement and modified bridle tendon transfer for end-stage ankle joint arthrosis with paralytic dropfoot: report of an unusual case.

    PubMed

    Bibbo, Christopher; Baronofsky, Hyim J; Jaffe, Leland

    2011-01-01

    In recent years, total ankle replacement has become a reasonable option for many patients with end-stage ankle arthrosis. In order to be successful, total ankle replacement requires a relatively balanced alignment of the foot in relation to the leg. Such alignment is traditionally achieved surgically by means of stabilization of the hindfoot in conjunction with relocation osteotomy of the calcaneus and/or tibia. In this report, we describe the unconventional combination of total ankle replacement in an adult patient with concomitant paralysis that was addressed by means of tendon transfer.

  4. Tri-component, mobile bearing, total ankle replacement: mid-term functional outcome and survival.

    PubMed

    Dhawan, Rohit; Turner, Jake; Sharma, Vikas; Nayak, Ramesh K

    2012-01-01

    Tri-component, mobile bearing, uncemented, total ankle replacements were introduced after the high failure rates of cemented, highly constrained, first-generation, total ankle replacement implants. A total of 30 primary total ankle replacements in 29 patients (20 males and 9 females) were followed up in the present retrospective study for up to 13 (mean 5.1 ± 4) years. The postoperative functional and radiographic outcomes were measured. Failure was defined as revision of either of the components for any reason or conversion of the total ankle replacement to arthrodesis because of debilitating pain that did not resolve after surgery. Of the 29 patients, 2 underwent revision and 1 underwent arthrodesis. All 3 patients had the malpositioned talar implant revised. The mean American Orthopaedic Foot and Ankle Society score was 81 at 1 year postoperatively. Revision of the tibial or talar component for any reason or conversion of the ankle replacement to arthrodesis was considered failure for the survival analysis. Kaplan-Meier analysis showed a 5-year survival rate of 87.6%. The last failure occurred 23.3 months after surgery.

  5. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    PubMed Central

    2011-01-01

    Background Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient. PMID:21995682

  6. Partial transmalleolar approach for lateral impingement after total ankle arthroplasty: a case report.

    PubMed

    Matsumoto, Takumi; Nakamura, Ichiro; Miura, Ayumi; Momoyama, Gen; Ito, Katsumi

    2015-01-01

    Advances in implant technology have made total ankle arthroplasty an increasingly popular alternative to arthrodesis for the management of ankle arthritis. However, a frequent complication of the procedure is nerve impingement related to either to heterotrophic bone growth or the prosthesis itself. Successful resolution of this complication presents a challenge to clinicians. We present a case of lateral impingement following total ankle arthroplasty that was successfully treated using a partial transmalleolar approach to effect a partial osteotomy of the lateral malleolus and create a fragment attached to the anterior talofibular and calcaneofibular ligaments. This approach provides a good operative field in the lateral gutter with minimal soft tissue impairment. It also facilitates curettage, and resolution of tissue impingement. The osteotomy site healed fully by 3 months postoperative, and the pain around the lateral malleolus resolved. Furthermore, the patient's score on the Japanese Society for Surgery of the Foot Ankle/Hindfoot Scale improved from 33 preoperatively to 82 at 6 months postoperative.

  7. Total ankle replacement versus arthrodesis (TARVA): protocol for a multicentre randomised controlled trial

    PubMed Central

    Goldberg, Andrew J; Zaidi, Razi; Thomson, Claire; Doré, Caroline J; Cro, Suzie; Round, Jeff; Molloy, Andrew; Davies, Mark; Karski, Michael; Kim, Louise; Cooke, Paul

    2016-01-01

    Introduction Total ankle replacement (TAR) or ankle arthrodesis (fusion) is the main surgical treatments for end-stage ankle osteoarthritis (OA). The popularity of ankle replacement is increasing while ankle fusion rates remain static. Both treatments have efficacy but to date all studies comparing the 2 have been observational without randomisation, and there are no published guidelines as to the most appropriate management. The TAR versus arthrodesis (TARVA) trial aims to compare the clinical and cost-effectiveness of TAR against ankle arthrodesis in the treatment of end-stage ankle OA in patients aged 50–85 years. Methods and analysis TARVA is a multicentre randomised controlled trial that will randomise 328 patients aged 50–85 years with end-stage ankle arthritis. The 2 arms of the study will be TAR or ankle arthrodesis with 164 patients in each group. Up to 16 UK centres will participate. Patients will have clinical assessments and complete questionnaires before their operation and at 6, 12, 26 and 52 weeks after surgery. The primary clinical outcome of the study is a validated patient-reported outcome measure, the Manchester Oxford foot questionnaire, captured preoperatively and 12 months after surgery. Secondary outcomes include quality-of-life scores, complications, revision, reoperation and a health economic analysis. Ethics and dissemination The protocol has been approved by the National Research Ethics Service Committee (London, Bloomsbury 14/LO/0807). This manuscript is based on V.5.0 of the protocol. The trial findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration number NCT02128555. PMID:27601503

  8. Anterior Approach Total Ankle Arthroplasty: Superficial Peroneal Nerve Branches at Risk.

    PubMed

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

    2016-01-01

    In ankle arthroplasty, little attention has been given to intraoperative nerve injury and its postoperative sequelae. The aim of the present anatomic study was to determine the relationship of the superficial peroneal nerve to the standard anterior approach for total ankle arthroplasty. The superficial peroneal nerve was dissected in 10 below-the-knee cadaver specimens. The medial and intermediate dorsal cutaneous branches were identified. A needle was placed at the ankle joint. The following measurements were recorded: bifurcation into the medial and intermediate dorsal cutaneous branches, reference needle to the branches of the medial and intermediate superficial peroneal nerve, and the crossing branches of the medial dorsal cutaneous nerve. Two specimens (20%) had a medial dorsal cutaneous branch cross from medially to laterally. Eight specimens (80%) had a crossing branch of the medial dorsal cutaneous branch within 5 cm of the incision. No intermediate dorsal cutaneous branches were within the incision. The results from the present cadaver study suggest that during an anterior ankle approach, aberrant branches of the superficial peroneal nerve could require transection in 20% of patients at the joint level and ≤80% of patients with distal extension >35 mm from the ankle joint. The risk of injury to branches of the superficial peroneal nerve is substantial. The risk of nerve injury can be decreased with meticulous operative technique, smaller incisions, and the avoidance of aggressive retraction.

  9. Preoperative and Postoperative Range of Motion: A Retrospective Comparison of Two Total Ankle Replacement Systems.

    PubMed

    Brigido, Stephen A; Mulhern, Jennifer L; Wobst, Garrett M; Protzman, Nicole M

    2015-01-01

    The purpose of the present report was to compare the range of motion between a total ankle replacement requiring arched bony resection and a total ankle replacement requiring a flat cut for implantation. We hypothesized that the arched contour would more closely mimic the patient's pre-existing anatomy and increase the range of motion. Pain was evaluated as a secondary outcome. Twenty-eight patients (age 55.95 ± 15.29 years) were included. Of the 28 patients, 14 were treated with an arch cut and 14 with a flat cut. Although no significant difference was found in dorsiflexion between the 2 implant groups (p = .38), preoperative dorsiflexion, body mass index, implant type, and preoperative plantarflexion emerged as significant predictors of postoperative plantarflexion (p = .04). This finding indicates that postoperative plantarflexion was significantly greater in patients treated with an arch cut (30.43° ± 10.01°) than a flat cut (21.79° ± 15.70°, p = .02), when controlling for the other explanatory variables. A statistically significant improvement in pain was observed after total ankle replacement (p < .001). The mean change in pain was similar for the 2 implant groups when statistically controlling for the follow-up duration (p = .09). The findings from the present report suggest that plantarflexion significantly improves after total ankle replacement requiring an arched cut for implantation. Future studies should be designed to control for potentially confounding variables and assess the differences in range of motion after total ankle replacement.

  10. Comparative study of the quality of life between arthrodesis and total arthroplasty substitution of the ankle.

    PubMed

    Esparragoza, Luis; Vidal, Carlos; Vaquero, Javier

    2011-01-01

    Our goal was to compare the health status of patients with primary and secondary arthrosis of the ankle before and after arthrodesis or total substitution arthroplasty, and to determine the improvement in quality of life and whether there is any difference between these techniques. A prospective comparative study of clinical-functional evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) scale and quality of life with the short form (SF)-36 questionnaire in patients who underwent arthrodesis (16 cases) or total substitution arthroplasty of the ankle (14 cases) after 2 years (mean, 25.2 months) of follow-up after surgery, in comparison with the baseline preoperative status. In this series of comparable patients, both techniques showed a statistically significant improvement with regard to the clinical evaluation and quality of life after 2 years of follow-up; the arthrodesis group increased from mean AOFAS values of 37.12 to 45.62 (P = .055) and mean SF-36 values of 32.96 to 46.25 (P = .008), whereas in the arthroplasty group the mean values of AOFAS increased from 33 to 62 (P = .024) and SF-36 from 33.62 to 59.84 (P = .001). Nevertheless, in all cases the improvement was statistically greater in patients who underwent arthroplasty than in those who underwent arthrodesis (P = .048 for AOFAS, and P = .026 for SF-36). In conclusion, arthrodesis and arthroplasty represent good options in the surgical treatment of ankle arthrosis, providing both a significant improvement in function and in the health perception and quality of life of the patient. New-generation total ankle substitution arthroplasty provides an improvement in the quality of life and perception of general health of the patient with arthrosis of this joint, when this technique is compared with surgical fusion.

  11. Finite element analysis of a total ankle replacement during the stance phase of gait.

    PubMed

    Reggiani, B; Leardini, A; Corazza, F; Taylor, M

    2006-01-01

    Total ankle replacement (TAR) designs have still several important issues to be addressed before the treatment becomes fully acceptable clinically. Very little is known about the performance, in terms of the contact pressures and kinematics of TAR when subjected to daily activities such as level gait. For this purpose, an explicit finite element model of a novel 3-component TAR was developed, which incorporated a previously validated mechanical model of the ankle ligament apparatus. The intermediate mobile polyethylene meniscal bearing was modelled as an elastic-plastic continuum while the articulating surfaces of the tibial and talar metal components as rigid bodies. Overall kinematics, contact pressures and ligament forces were analysed during passive, i.e. virtually unloaded, and active, i.e. stance phase of gait, conditions. Simulation of passive motion predicted similar kinematics as reported previously in an analytical four-bar linkage model. The meniscal bearing was observed to move 5.6 mm posteriorly during the simulated stance and the corresponding antero-posterior displacement of the talar component was 8.3 mm. The predicted pattern and the amount (10.6 degrees ) of internal-external rotation of the ankle complex were found to be in good agreement with corresponding in vivo measurements on normal ankles. A peak contact pressure of 16.8 MPa was observed, with majority of contact pressures below 10 MPa. For most ligaments, reaction forces remain within corresponding physiological ranges. A first realistic representation of the biomechanical behaviour of the human ankle when replaced by prosthetic joints is provided. The applied methodology can potentially be applied to other TAR designs.

  12. The Bologna-Oxford total ankle replacement: a mid-term follow-up study.

    PubMed

    Bianchi, A; Martinelli, N; Sartorelli, E; Malerba, F

    2012-06-01

    The Bologna-Oxford (BOX) total ankle replacement (TAR) was developed with the aim of achieving satisfactory pain-free movement of the ankle. To date, only one single multicentre study has reported its clinical results. The aim of this study was to conduct an independent review of its mid-term results. We retrospectively reviewed a total of 60 prospectively followed patients in whom 62 BOX TARs had been implanted between 2004 and 2008. We used the American Orthopedic Foot and Ankle Society (AOFAS) score to assess the clinical results. Standardised radiographs taken at the time of final follow-up were analysed by two observers. The overall survival was 91.9% at a mean follow-up of 42.5 months (24 to 71). The mean AOFAS score had improved from 35.1 points (sd 16.6; 4 to 73) pre-operatively to 78.0 (sd 10.7; 57 to 100) at final follow-up (p < 0.01). Tibial radiolucencies < 2 mm in width were seen around 16 TARs. Talar radiolucencies < 2 mm were seen around four TARs. A total of 47 patients (78.3%) were very satisfied or satisfied with the outcome. Five patients required revision for functional limitation or continuing pain.

  13. 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.

  14. Three-dimensional computer graphics-based ankle morphometry with computerized tomography for total ankle replacement design and positioning.

    PubMed

    Kuo, Chien-Chung; Lu, Hsuan-Lun; Leardini, Alberto; Lu, Tung-Wu; Kuo, Mei-Ying; Hsu, Horng-Chaung

    2014-05-01

    Morphometry of the bones of the ankle joint is important for the design of joint replacements and their surgical implantations. However, very little three-dimensional (3D) data are available and not a single study has addressed the Chinese population. Fifty-eight fresh frozen Chinese cadaveric ankle specimens, 26 females, and 32 males, were CT-scanned in the neutral position and their 3D computer graphics-based models were reconstructed. The 3D morphology of the distal tibia/fibula segment and the full talus was analyzed by measuring 31 parameters, defining the relevant dimensions, areas, and volumes from the models. The measurements were compared statistically between sexes and with previously reported data from Caucasian subjects. The results showed that, within a general similarity of ankle morphology between the current Chinese and previous Caucasian subjects groups, there were significant differences in 9 out of the 31 parameters analyzed. From a quantitative comparison with available prostheses designed for the Caucasian population, few of these designs have both tibial and talar components suitable in dimension for the Chinese population. The current data will be helpful for the sizing, design, and surgical positioning of ankle replacements and for surgical instruments, especially for the Chinese population.

  15. The outcome of total ankle replacement: a systematic review and meta-analysis.

    PubMed

    Zaidi, R; Cro, S; Gurusamy, K; Siva, N; Macgregor, A; Henricson, A; Goldberg, A

    2013-11-01

    We performed a systematic review and meta-analysis of modern total ankle replacements (TARs) to determine the survivorship, outcome, complications, radiological findings and range of movement, in patients with end-stage osteoarthritis (OA) of the ankle who undergo this procedure. We used the methodology of the Cochrane Collaboration, which uses risk of bias profiling to assess the quality of papers in favour of a domain-based approach. Continuous outcome scores were pooled across studies using the generic inverse variance method and the random-effects model was used to incorporate clinical and methodological heterogeneity. We included 58 papers (7942 TARs) with an interobserver reliability (Kappa) for selection, performance, attrition, detection and reporting bias of between 0.83 and 0.98. The overall survivorship was 89% at ten years with an annual failure rate of 1.2% (95% confidence interval (CI) 0.7 to 1.6). The mean American Orthopaedic Foot and Ankle Society score changed from 40 (95% CI 36 to 43) pre-operatively to 80 (95% CI 76 to 84) at a mean follow-up of 8.2 years (7 to 10) (p < 0.01). Radiolucencies were identified in up to 23% of TARs after a mean of 4.4 years (2.3 to 9.6). The mean total range of movement improved from 23° (95% CI 19 to 26) to 34° (95% CI 26 to 41) (p = 0.01). Our study demonstrates that TAR has a positive impact on patients' lives, with benefits lasting ten years, as judged by improvement in pain and function, as well as improved gait and increased range of movement. However, the quality of evidence is weak and fraught with biases and high quality randomised controlled trials are required to compare TAR with other forms of treatment such as fusion.

  16. Development and experimental validation of a finite element model of total ankle replacement.

    PubMed

    Terrier, Alexandre; Larrea, Xabier; Guerdat, Jonas; Crevoisier, Xavier

    2014-02-07

    Total ankle replacement remains a less satisfactory solution compared to other joint replacements. The goal of this study was to develop and validate a finite element model of total ankle replacement, for future testing of hypotheses related to clinical issues. To validate the finite element model, an experimental setup was specifically developed and applied on 8 cadaveric tibias. A non-cemented press fit tibial component of a mobile bearing prosthesis was inserted into the tibias. Two extreme anterior and posterior positions of the mobile bearing insert were considered, as well as a centered one. An axial force of 2kN was applied for each insert position. Strains were measured on the bone surface using digital image correlation. Tibias were CT scanned before implantation, after implantation, and after mechanical tests and removal of the prosthesis. The finite element model replicated the experimental setup. The first CT was used to build the geometry and evaluate the mechanical properties of the tibias. The second CT was used to set the implant position. The third CT was used to assess the bone-implant interface conditions. The coefficient of determination (R-squared) between the measured and predicted strains was 0.91. Predicted bone strains were maximal around the implant keel, especially at the anterior and posterior ends. The finite element model presented here is validated for future tests using more physiological loading conditions.

  17. Perioperative Physiotherapy for Total Ankle Replacement in Patients with Inherited Bleeding Disorders: Outline of an Algorithm

    PubMed Central

    Kotela, Andrzej; Wilk-Frańczuk, Magdalena; Jaczewska, Joanna; Żbikowski, Piotr; Łęgosz, Paweł; Ambroziak, Paweł; Kotela, Ireneusz

    2017-01-01

    The treatment of end-stage hemophilic arthropathy of the ankle joint remains a controversial problem, and total ankle replacement (TAR) is considered to be a valuable management option. Physiotherapy continues to be an extremely important part of TAR and has a tremendous impact on the outcomes of this procedure. Given the lack of data on the latter, this study details a protocol of perioperative physiotherapy in TAR in patients with inherited bleeding disorders (IBD). The protocol outlined in this paper was devised via consultations within an interdisciplinary group, the authors’ own experiences with TAR in hemophilic and non-hemophilic patients, previous reports on this issue in the literature, and patient opinions. Our working group followed the criteria of the International Classification of Functioning, Disability and Health. The algorithm includes 4 physiotherapy phases with specified time frames, aims, interventions, and examples of exercises for each phase. We emphasize the importance of preoperative rehabilitation, and recommend introducing intensive physiotherapy immediately after the surgery, with regard to the wound protection and avoiding full weight-bearing in the first weeks. The intensity of physiotherapy should be adjusted individually depending on individual patient progress. This study details a rehabilitation protocol for TAR in patients with IBDs, which can be equally applicable to clinicians and researchers. Further scientific studies are required to investigate the beneficial effect of different protocols as well as to clarify the effectiveness of various frequencies, durations, and intensities of selected interventions. PMID:28129322

  18. Interval changes in postoperative range of motion of Salto-Talaris total ankle replacement.

    PubMed

    Schuberth, John M; McCourt, Michael J; Christensen, Jeffrey C

    2011-01-01

    The purpose of the present study was to identify changes in the range of motion during the first year after placement of the Salto-Talaris total ankle implant. The first 97 cases were assessed throughout the year at 6 weeks and 3, 6, and 12 months. Data were extracted through retrospective chart review, operative reports, and electronic goniometry of the implant in maximal dorsiflexion and plantarflexion. The range of motion incrementally improved through the treatment course, with the greatest increases occurring between 6 weeks and 6 months. The mean range of motion at 6 weeks was 11.85° ± 0.824° standard error, which had increased by 3.07° ± 0.862° to 14.92° (p < .0001) at 3 months postoperatively. From 3 to 6 months, it increased 3.96° ± 0.981° to 18.88° (p < .0001) at 6 months postoperatively. From 6 to 12 months, the mean range of motion increased to 20.11° ± 1.243° (p = .3765). The overall mean increase in the range of motion from 6 weeks to 12 months was 8.25° (p < .0001). These results have demonstrated a predictable incremental increase in motion over time, with the largest percentage of improvement occurring from 6 weeks to 6 months. This information will aid surgeons in guiding patient expectations after implant arthroplasty of the ankle.

  19. Perioperative Physiotherapy for Total Ankle Replacement in Patients with Inherited Bleeding Disorders: Outline of an Algorithm.

    PubMed

    Kotela, Andrzej; Wilk-Frańczuk, Magdalena; Jaczewska, Joanna; Żbikowski, Piotr; Łęgosz, Paweł; Ambroziak, Paweł; Kotela, Ireneusz

    2017-01-27

    The treatment of end-stage hemophilic arthropathy of the ankle joint remains a controversial problem, and total ankle replacement (TAR) is considered to be a valuable management option. Physiotherapy continues to be an extremely important part of TAR and has a tremendous impact on the outcomes of this procedure. Given the lack of data on the latter, this study details a protocol of perioperative physiotherapy in TAR in patients with inherited bleeding disorders (IBD). The protocol outlined in this paper was devised via consultations within an interdisciplinary group, the authors' own experiences with TAR in hemophilic and non-hemophilic patients, previous reports on this issue in the literature, and patient opinions. Our working group followed the criteria of the International Classification of Functioning, Disability and Health. The algorithm includes 4 physiotherapy phases with specified time frames, aims, interventions, and examples of exercises for each phase. We emphasize the importance of preoperative rehabilitation, and recommend introducing intensive physiotherapy immediately after the surgery, with regard to the wound protection and avoiding full weight-bearing in the first weeks. The intensity of physiotherapy should be adjusted individually depending on individual patient progress. This study details a rehabilitation protocol for TAR in patients with IBDs, which can be equally applicable to clinicians and researchers. Further scientific studies are required to investigate the beneficial effect of different protocols as well as to clarify the effectiveness of various frequencies, durations, and intensities of selected interventions.

  20. 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.

  1. 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.

  2. Long-term follow-up of mobile-bearing total ankle replacement in patients with inflammatory joint disease.

    PubMed

    Kraal, T; van der Heide, H J L; van Poppel, B J; Fiocco, M; Nelissen, R G H H; Doets, H C

    2013-12-01

    Little is known about the long-term outcome of mobile-bearing total ankle replacement (TAR) in the treatment of end-stage arthritis of the ankle, and in particular for patients with inflammatory joint disease. The aim of this study was to assess the minimum ten-year outcome of TAR in this group of patients. We prospectively followed 76 patients (93 TARs) who underwent surgery between 1988 and 1999. No patients were lost to follow-up. At latest follow-up at a mean of 14.8 years (10.7 to 22.8), 30 patients (39 TARs) had died and the original TAR remained in situ in 28 patients (31 TARs). The cumulative incidence of failure at 15 years was 20% (95% confidence interval (CI) 11 to 28). The mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of the surviving patients at latest follow-up was 80.4 (95% CI 72 to 88). In total, 21 patients (23 TARs) underwent subsequent surgery: three implant exchanges, three bearing exchanges and 17 arthrodeses. Neither design of TAR described in this study, the LCS and the Buechel-Pappas, remains currently available. However, based both on this study and on other reports, we believe that TAR using current mobile-bearing designs for patients with end-stage arthritis of the ankle due to inflammatory joint disease remains justified.

  3. Incidence of revision after primary implantation of the Salto ® mobile version and Salto Talaris ™ total ankle prostheses: a systematic review.

    PubMed

    Roukis, Thomas S; Elliott, Andrew D

    2015-01-01

    The incidence of revision of total ankle replacement prostheses remains unclear. We undertook a systematic review to identify the material relating to the incidence of revision after implantation of the Salto(®) mobile version and Salto Talaris™ total ankle prostheses. Studies were eligible for inclusion only if they had involved primary total ankle replacement with these prostheses and had included the incidence of revision. Eight studies involving 1,209 Salto(®) mobile version prostheses, with a weighted mean follow-up period of 55.2 months, and 5 studies involving 212 Salto Talaris™ total ankle prostheses, with a weighted mean follow-up period of 34.9 months, were included. Forty-eight patients with Salto(®) mobile version prostheses (4%) underwent revision, of whom 24 (70.5%) underwent ankle arthrodesis, 9 (26.5%) metallic component replacement, and 1 (3%) below-the-knee amputation. Five (2.4%) Salto Talaris™ total ankle prostheses underwent revision (3 metallic component replacement and 2 ankle arthrodeses). Restricting the data to the inventor, design team, or disclosed consultants, the incidence of revision was 5.2% for the Salto(®) mobile version and 2.6% for the Salto Talaris™ total ankle prostheses. In contrast, data that excluded these individuals had an incidence of revision of 2.8% for the Salto(®) mobile version and 2.0% for the Salto Talaris™ total ankle prostheses. We could not identify any obvious difference in the etiology responsible for the incidence of revision between these mobile- and fixed-bearing prostheses. The incidence of revision for the Salto(®) mobile version and Salto Talaris™ total ankle prostheses was lower than those reported through systematic review for the Agility™ and Scandinavian Total Ankle Replacement™ systems without obvious selection (inventor) or publication (conflict of interest) bias.

  4. Ankle pain

    MedlinePlus

    Pain - ankle ... Ankle pain is often due to an ankle sprain. An ankle sprain is an injury to the ligaments, which ... the joint. In addition to ankle sprains, ankle pain can be caused by: Damage or swelling of ...

  5. In vivo kinematics of two-component total ankle arthroplasty during non-weightbearing and weightbearing dorsiflexion/plantarflexion.

    PubMed

    Yamaguchi, Satoshi; Tanaka, Yasuhito; Kosugi, Shinichi; Takakura, Yoshinori; Sasho, Takahisa; Banks, Scott A

    2011-04-07

    Relatively high rates of loosening and implant failure have been reported after total ankle arthroplasty, especially in first and second generation implants. Abnormal kinematics and incongruency of the articular surface may cause increased loads applied to the implant with concomitant polyethylene wear, resulting in loosening and implant failure. The purpose of this study was to measure three-dimensional kinematics of two-component total ankle arthroplasty during non-weightbearing and weightbearing activities, and to investigate incongruency of the articular surfaces during these activities. Forty-seven patients with a mean age of 71 years were enrolled. Radiographs were taken at non-weightbearing maximal dorsiflexion and plantarflexion, and weightbearing maximal dorsiflexion, plantarflexion, and neutral position. 3D-2D model-image registration was performed using the radiographs and the three-dimensional implant models, and three-dimensional joint angles were determined. The implanted ankles showed 18.1±8.6° (mean±standard deviation) of plantarflexion, 0.1±0.7° of inversion, 1.2±2.0° of internal rotation, and 0.8±0.6mm of posterior translation of the talar component in the non-weightbearing activity, and 17.8±7.5° of plantarflexion, 0.4±0.5° of inversion, 1.8±2.0° of internal rotation, and 0.7±0.5mm of posterior translation in the weightbearing activity. There were no significant differences between the non-weightbearing and weightbearing kinematics except for the plantarflexion angle. Incongruency of the articular surface occurred in more than 75% of the ankles. Our observations will provide useful data against which kinematics of other implant designs, such as three-component total ankle arthroplasty, can be compared.

  6. Impact of Active Ankle Movement Frequency on Velocity of Lower Limb Venous Flow following Total Hip Arthroplasty

    PubMed Central

    Nakayama, Tsutomu; Hiyama, Takayuki; Yamada, Tatsuya; Hirasawa, Naoyuki

    2016-01-01

    Background. Although active ankle movement plays a predominant role in mechanical thromboprophylaxis following total hip arthroplasty (THA), the most effective frequency of movement remains unclear. Materials and Methods. In 29 consecutive patients undergoing THA, the velocity of blood flow in the profunda femoris was measured after various frequencies of ankle movement two days after THA using a pulse wave Doppler ultrasound system. To test the interobserver reliabilities for the velocity measured with Doppler ultrasound system, the intraclass correlation coefficient was calculated based on the measurement in 10 limbs of healthy volunteers. Results. At 0, 1, and 2 minutes after ankle movement, the velocity after movement at 60 contractions per minute was significantly faster than that after movement at 40 or 80 contractions per minute (p = 0.0007, repeated-measures analysis of variance). The intraclass correlation coefficient score in two investigators was 0.849 (95% confidence interval, 0.428 to 0.962). Conclusions. Active ankle movement at 60 contractions per minute is recommended in patients receiving THA to obtain optimal venous blood flow. PMID:27999685

  7. Time trends in total ankle arthroplasty in the USA: a study of the National Inpatient Sample.

    PubMed

    Singh, Jasvinder A; Ramachandran, Rekha

    2016-01-01

    The objective of this study was to assess the time trends in utilization, clinical characteristics, and outcomes of patients undergoing total ankle arthroplasty (TAA) in the USA. 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 (2009-2010). 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 period, those undergoing TAA in 2009-2010 were older (41% fewer patients <50 years, p < 0.0001), less likely to have rheumatoid arthritis as the underlying diagnosis (55% fewer patients, p = 0.0001), more likely to have Deyo-Charlson index of 2 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 from 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). The utilization rate of TAA increased rapidly in the USA 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.

  8. Evaluating component migration after modular stem fixed-bearing total ankle replacement.

    PubMed

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

    2015-01-01

    To date, no studies have evaluated implant migration after implantation of a modular stem fixed-bearing total ankle replacement. The purpose of the present report was to determine the inter-rater and intrarater reliability of our proposed measurement technique and to assess implant migration over time. Twenty consecutive patients (aged 59.3 ± 12.2 years) who had undergone implantation with this modern, third-generation prosthetic were included. To assess implant migration, measurements were made from non-weightbearing, postoperative radiographs immediately after surgery and again at 1 year and 2 years. Implant migration was defined as a change in implant location from the immediate postoperative radiograph. The proposed measurement technique appears to be a reliable method of assessing implant migration, evidenced by the high inter-rater reliability and intrarater reliability (intraclass correlation [2,1] 0.993 and intraclass correlation [1,1] 0.997, respectively). The mean implant migration was 0.7 mm at 1 year and 1.0 mm at 2 years. Time (r = 0.42) and gender (r = 0.31) were significant predictors of implant migration (R(2) = 0.27, p = .008). Therefore, we confirmed our hypothesis that implant migration would significantly increase over time and discovered that implant migration was greater in males (1.2 ± 1.1 mm) than females (0.1 ± 0.8 mm). Given the gross stability of the implant and lack of revision within the follow-up period, the measurements obtained could serve as clinical guidelines for acceptable implant migration in the short term. To determine the thresholds correlated with implant failure, future studies with long-term follow-up are warranted.

  9. Agile Mythbusting

    DTIC Science & Technology

    2015-01-01

    does not fit all Scrum : The most adopted Agile method Scaling Agile Methods: Going beyond the team level methods Challenges to Agile Adoption: What’s...Arsenal Lapham, Wrubel Jan 2015 © 2015 Carnegie Mellon University. Myth: You Must Choose Agile or Waterfall – you can’t do both What about “water- scrum ...used in multiple environments, including DoD programs.1 1Start with “Agile EVM in Scrum Projects” from AGILE 2006 to get started learning about Agile

  10. SU-E-T-191: Commissioning and Dosimetric Characteristics of Elekta Agility for Total Skin Electron Beam (TSEB) Therapy

    SciTech Connect

    Sayler, E; Charpentier, P; Micaily, B; Miyamoto, C; Li, S

    2015-06-15

    Purpose The purpose of this work is to publish beam data from Elekta Synergy(R) linear accelerators with Agility(TM) MLC for total skin electron beam (TSEB) therapy using the HDRE1 (High Dose Rate Electron 6MeV) energy. Method & Materials The optimal gantry angles for TSEB were determined using ion chamber measurements along a vertical profile at 450cm SSD. After gantry angles were chosen, field uniformity was measured over the entire treatment area. Uniformity was measured with and without the patient support device, allowing the dosimetric effect of the support device to be determined. Beam output and PDD were measured at the calibration point (450cm SSD) for a dual beam using a parallel plate chamber in solid water. These measurements were repeated with the chamber and phantom rotated about the patient isocenter at various angles, in order to measure the contribution from oblique beams. This technique provides a precise measurement of the treatment skin dose (TSD). Lastly, ion chamber measurements were verified by film and diodes. Results The optimal gantry angle for 450 cm SSD was determined to be 90±16°. This achieved uniformity better than 96% on the vertical axis, and 92% along the horizontal axis. HDRE1 was calibrated to deliver 10 cGy/MU at standard geometry (100 cm SSD, 1.2 cm depth). Thus at TSEB geometry (450 cm SSD, 0.1 cm depth) the output of the AP dual field was measured to be 0.35 cGy/MU. The TSD of a 20 cm radius cylinder for six (equally, 60° spaced) dual fields was measured to be 1.19 cGy/MU. Percent Depth Dose data for the AP dual field and TSD are shown in Figure 2. Conclusion This paper provides a modern procedure for commissioning TSEB therapy on a linear accelerator, and clinical beam data for the Elekta Synergy(R) with Agility(TM) MLC.

  11. Failure to restore sagittal tibiotalar alignment in total ankle arthroplasty: Its relationship to the axis of the tibia and the positioning of the talar component.

    PubMed

    Cho, J; Yi, Y; Ahn, T K; Choi, H J; Park, C H; Chun, D I; Lee, J S; Lee, W C

    2015-11-01

    The purpose of this study was to evaluate the change in sagittal tibiotalar alignment after total ankle arthroplasty (TAA) for osteoarthritis and to investigate factors affecting the restoration of alignment. This retrospective study included 119 patients (120 ankles) who underwent three component TAA using the Hintegra prosthesis. A total of 63 ankles had anterior displacement of the talus before surgery (group A), 49 had alignment in the normal range (group B), and eight had posterior displacement of the talus (group C). Ankles in group A were further sub-divided into those in whom normal alignment was restored following TAA (41 ankles) and those with persistent displacement (22 ankles). Radiographic and clinical results were assessed. Pre-operatively, the alignment in group A was significantly more varus than that in group B, and the posterior slope of the tibial plafond was greater (p < 0.01 in both cases). The posterior slope of the tibial component was strongly associated with restoration of alignment: ankles in which the alignment was restored had significantly less posterior slope (p < 0.001). An anteriorly translated talus was restored to a normal position after TAA in most patients. We suggest that surgeons performing TAA using the Hintegra prosthesis should aim to insert the tibial component at close to 90° relative to the axis of the tibia, hence reducing posterior soft-tissue tension and allowing restoration of normal tibiotalar alignment following surgery.

  12. Empirical Agility

    DTIC Science & Technology

    2014-06-01

    documented the fact that Unmanned Aerial Vehicles (now more commonly called drones ) added substantially to the quality of surveillance, resulting in better...Battalions. CACI Inc.-Federal, Arlington, Virginia. 1977. DTIC Accession Number ADA123481. Olmstead, Joseph A., B. Leon Elder, and John M...greater agility – Drones improved agility in ground and air operations – Nelson’s C2 at Trafalgar demonstrated agility. Theater Level C2 During WW II

  13. Total Ankle Replacement Survival Rates Based on Kaplan-Meier Survival Analysis of National Joint Registry Data.

    PubMed

    Bartel, Annette F P; Roukis, Thomas S

    2015-10-01

    National joint registry data provides unique information about primary total ankle replacement (TAR) survival. We sought to recreate survival curves among published national joint registry data sets using the Kaplan-Meier estimator. Overall, 5152 primary and 591 TAR revisions were included over a 2- to 13-year period with prosthesis survival for all national joint registries of 0.94 at 2-years, 0.87 at 5-years and 0.81 at 10-years. National joint registry datasets should strive for completion of data presentation including revision definitions, modes and time of failure, and patients lost to follow-up or death for complete accuracy of the Kaplan-Meier estimator.

  14. A Review of 399 Total Ankle Replacements: Analysis of Ipsilateral Subtalar Joint Arthrodesis and Associated Talar Component Subsidence.

    PubMed

    Prissel, Mark A; Hyer, Christopher F; Berlet, Gregory C

    Total ankle replacement (TAR) is an accepted treatment for end-stage ankle arthritis. When concurrent subtalar joint pathologic features exist, ipsilateral subtalar joint arthrodesis (STJA) can be performed either simultaneous with TAR or as a staged procedure. Limited data exist on the effect of talar component subsidence and prosthesis survivorship. The present study purpose was to evaluate the effect of STJA on talar component subsidence after primary TAR and its effect on TAR survivorship. All patients, a minimum of 18 years old, from a single institution with modern-generation TAR and 1-year minimum follow-up data available were evaluated. The study group included patients who had also undergone STJA, and the control group (no STJA) was matched 1:1 by age, gender, and prosthesis. The initial postoperative weightbearing and most recent weightbearing radiographs were compared for talar component subsidence. We reviewed 399 primary TARs from 2004 to 2012. A total of 33 patients with ipsilateral STJA met the inclusion criteria and had an appropriate control group match. In the study group, 8 patients required a return to the operating room for 4 revisions and 4 reoperations at a median follow-up point of 24.3 months. Of the controls, 9 patients required a return to the operating room, with 4 revisions and 5 reoperations at a median follow-up point of 38.4 months. No statistically significant radiographic differences were found between the 2 groups. Primary TAR and ipsilateral STJA were infrequently required (41 of 399; 10.3%). TAR did not result in decreased survivorship when performed with ipsilateral STJA at an early follow-up point. Further study is warranted to determine any differences among previous, simultaneous, and subsequent STJA with ipsilateral TAR, and a matched longitudinal analysis is needed to determine longer term survivorship.

  15. Modular stem fixed-bearing total ankle replacement: prospective results of 23 consecutive cases with 3-year follow-up.

    PubMed

    Brigido, Stephen A; Galli, Melissa M; Bleazey, Scott T; Protzman, Nicole M

    2014-01-01

    In the present report, the 3-year outcomes of 23 consecutive patients treated with a modular stem fixed-bearing total ankle replacement are described. Pain, functional impairment, and disability were assessed annually using a visual analog scale. Complications and additional procedures also were recorded. Compared with preoperative pain (8.4 ± 1.4), functional impairment (8.7 ± 2.3), and disability (3.0 ± 2.5), there were statistically significant postoperative improvements at 1 year (pain, 2.6 ± 1.6; functional impairment, 3.1 ± 2.1; disability, 0.9 ± 1.2), 2 years (pain, 1.5 ± 1.3; functional impairment, 1.9 ± 1.4; disability, 0.6 ± 1.4), and 3 years (pain, 1.3 ± 1.3; functional impairment, 1.9 ± 1.9; disability, 0.4 ± 0.9; p ≤ .001). Pain, function, and disability significantly improved postoperatively from 1 to 2 years (p ≤ .008) and from 1 to 3 years (p ≤ .008). The reductions in pain, functional impairment, and disability were maintained from 2 to 3 years (p ≥ .08). Nine complications (39.1%) were encountered: 1 deep infection, 2 pulmonary embolisms, 3 wounds, 1 ectopic bone formation, 1 stiff joint, and 1 talar subsidence. In the 3-year follow-up period, 3 patients (13.0%) required additional procedures after the immediate postoperative phase. Our results have demonstrated that modular stem fixed-bearing prostheses can be implanted in a predictable and consistent fashion with resultant improvements in pain, function, and disability. Future studies evaluating the clinical outcomes after modular stem fixed-bearing total ankle replacement are warranted.

  16. Relationship of alignment and tibial cortical coverage to hypertrophic bone formation in Salto Talaris® total ankle arthroplasty.

    PubMed

    King, Christy M; Schuberth, John M; Christensen, Jeffrey C; Swanstrom, Katie M

    2013-01-01

    A retrospective analysis of 107 Salto Talaris(®) total ankle replacements was performed to determine the effect of alignment and tibial cortical coverage on the formation of heterotopic bone. The radiographic parameters were studied for at least 18 months to detect any changes over time. The angle of insertion of the implant was most often in varus and with a positive anterior slope. A slight increase was seen in the slope over time (p < .0001) but was not clinically relevant. The mean percentage of cortical coverage of the tibial component was 89%, and only 7 patients had complete coverage of both the anterior and the posterior cortices. The percentage of patients who had hypertrophic bone growth increased over time (p < .0001). As the slope of the implant increased, there was a negative correlation with the degree of tibial coverage (p = .007). There was also an increase in the extent of hypertrophic bone as the tibial coverage decreased. None of the patients had symptoms that required an additional surgical procedure. The results of the present study indicate a high incidence of hypertrophic bone proliferation when the dimensions of the tibial component do not match the anteroposterior depth of the tibia at the plane of resection. Despite the high occurrence rate, the clinical relevance of hypertrophic bone is obscure.

  17. 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

  18. Current thoughts on ankle arthritis.

    PubMed

    Ritterman, Scott A; Fellars, Todd A; Digiovanni, Christopher W

    2013-03-01

    The ankle is the most commonly injured joint in athletic and work activities. In contrast, osteoarthritis of the ankle joint is relatively rare and is typically post-traumatic or inflammatory in nature. Common symptoms that prompt an orthopaedic consultation include pain, disability and altered gait mechanics. Non-operative management has been the mainstay for previously undiagnosed patients. For those with advanced disease, ankle fusion or total ankle replacement may be the only surgical options. Though some recent studies have shown patients' preference for a well functioning ankle replacement, significant long- term follow-up data is lacking.

  19. 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.

  20. Agile Metrics: Progress Monitoring of Agile Contractors

    DTIC Science & Technology

    2014-01-01

    can be tailored to leverage the iterative nature of Agile meth- ods. Using optional contract funding lines or indefinite delivery indefinite quantity... naturally created during the execution of the Agile implementation. In the following paragraphs, we identify issues to consider in building an Agile...employing Agile methods [Hartman 2006]. Be prepared to mine and effectively use the metrics data that naturally occur in typical Ag- ile teams. In

  1. The outcome of the Mobility total ankle replacement at a mean of four years: Can poor outcomes be predicted from pre- and post-operative analysis?

    PubMed

    Muir, D; Aoina, J; Hong, T; Mason, R

    2013-10-01

    We performed a retrospective review of a consecutive series of 178 Mobility total ankle replacements (TARs) performed by three surgeons between January 2004 and June 2009, and analysed radiological parameters and clinical outcomes in a subgroup of 129 patients. The mean follow-up was 4 years (2 to 6.3). A total of ten revision procedures (5.6%) were undertaken. The mean Ankle Osteoarthritis Scale (AOS) pain score was 17 (0 to 88) and 86% of patients were clinically improved at follow-up. However, 18 patients (18 TARs, 14%) had a poor outcome with an AOS pain score of > 30. A worse outcome was associated with a pre-operative diagnosis of post-traumatic degenerative arthritis. However, no pre- or post-operative radiological parameters were significantly associated with a poor outcome. Of the patients with persistent pain, eight had predominantly medial-sided pain. Thirty TARs (29%) had a radiolucency in at least one zone. The outcome of the Mobility TAR at a mean of four years is satisfactory in > 85% of patients. However, there is a significant incidence of persistent pain, particularly on the medial side, for which we were unable to establish a cause.

  2. Ankle Sprains

    MedlinePlus

    ... the sole of the foot is facing inwards, stretching and possibly damaging the ligaments on the outer ... sprains: Always warm up and use the recommended stretching techniques for your ankles before playing sports, exercising, ...

  3. Ankle replacement

    MedlinePlus

    ... is surgery to replace the damaged bone and cartilage in the ankle joint. Artificial joint parts (prosthetics) ... Your surgeon will remove the damaged bone and cartilage. Your surgeon will replace the damaged part of: ...

  4. Sprained Ankles

    MedlinePlus

    ... are usually stronger than the growing bones and cartilage to which they are attached. Therefore, the growing part of the bone might separate or tear away before the ligament is injured. Types of Sprains In young children, the ankle is ...

  5. 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.

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

    PubMed

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

    2017-01-25

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

  7. Agility Quotient (AQ)

    DTIC Science & Technology

    2014-06-01

    system?s Agility IQ ?? and ?What is the requisite amount of Agility that is required?? This paper suggests a way forward and illustrates it, in the...answer two questions. “How can we measure a system’s Agility IQ ?” and “What is the requisite amount of Agility that is required?” This paper...agility is worth our attention. AQ can be patterned after the Intelligence Quotient ( IQ ). IQ is a score that is associated with educational potential

  8. Ankle replacement - discharge

    MedlinePlus

    You had an ankle replacement. Your surgeon removed and reshaped damaged bones, and put in an artificial ankle joint. You received pain medicine and were shown how to treat swelling around your new ankle joint.

  9. Chronic Ankle Instability

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  10. Robot-assisted gait training improves brachial–ankle pulse wave velocity and peak aerobic capacity in subacute stroke patients with totally dependent ambulation

    PubMed Central

    Han, Eun Young; Im, Sang Hee; Kim, Bo Ryun; Seo, Min Ji; Kim, Myeong Ok

    2016-01-01

    Abstract Objective: Brachial–ankle pulse wave velocity (baPWV) evaluates arterial stiffness and also predicts early outcome in stroke patients. The objectives of this study were to investigate arterial stiffness of subacute nonfunctional ambulatory stroke patients and to compare the effects of robot-assisted gait therapy (RAGT) combined with rehabilitation therapy (RT) on arterial stiffness and functional recovery with those of RT alone. Method: The RAGT group (N = 30) received 30 minutes of robot-assisted gait therapy and 30 minutes of conventional RT, and the control group (N = 26) received 60 minutes of RT, 5 times a week for 4 weeks. baPWV was measured and calculated using an automated device. The patients also performed a symptom-limited graded exercise stress test using a bicycle ergometer, and parameters of cardiopulmonary fitness were recorded. Clinical outcome measures were categorized into 4 categories: activities of daily living, balance, ambulatory function, and paretic leg motor function and were evaluated before and after the 4-week intervention. Results: Both groups exhibited significant functional recovery in all clinical outcome measures after the 4-week intervention. However, peak aerobic capacity, peak heart rate, exercise tolerance test duration, and baPWV improved only in the RAGT group, and the improvements in baPWV and peak aerobic capacity were more noticeable in the RAGT group than in the control group. Conclusion: Robot-assisted gait therapy combined with conventional rehabilitation therapy represents an effective method for reversing arterial stiffness and improving peak aerobic capacity in subacute stroke patients with totally dependent ambulation. However, further large-scale studies with longer term follow-up periods are warranted to measure the effects of RAGT on secondary prevention after stroke. PMID:27741123

  11. [Ankle joint arthritis--etiology, diagnosis and treatment].

    PubMed

    Uri, Ofir; Haim, Amir

    2008-11-01

    Ankle joint arthritis causes functional limitation and affects the quality of life many patients. It follows traumatic injuries, inflammatory joint arthritis, primary osteoarthritis, hemochromatosis and infections. Understanding the unique anatomy and biomechanics of the ankle is important for diagnosis and treatment of ankle joint pathology. The treatment of ankle joint arthritis has advanced considerably in recent years and it is still a surgical challenge. Total ankle replacement seems to be a promising form of treatment, even though current data does not demonstrate advantages over ankle joint arthrodesis.

  12. 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

  13. 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…

  14. Clean, Agile Processing Technology.

    DTIC Science & Technology

    1997-12-01

    Research ltr dtd 10 Jun 98 THIS PAGE IS UNCLASSIFIED FINAL REPORT CLEAN, AGILE PROCESSING TECHNOLOGY Contract # N00014-96-C-0139 PI: S. W . Sinton...Agile Processing Technology . T UNCLAS I N Sinton, S. W.IN S REQUIRED FOR (Explain needin detaiO E C This document is requested by the Canadian Department

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

    PubMed

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

    2015-01-01

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

  16. Focused Logistics: Putting Agility in Agile Logistics

    DTIC Science & Technology

    2011-05-19

    envisioned an agile and adaptable logstics system built around common situational understanding.5 The Focused Logistics concept specified the requirement to...the tracking of resources moving through the TD network. As a result, 112 Ibid, 20. 113 Ibid, 18-20. 39 distribution centers tagged inbound

  17. 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…

  18. 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?

  19. The ankle meter: an instrument for evaluation of anterior talar drawer in ankle sprain.

    PubMed

    Spahn, Gunter

    2004-07-01

    The aim of this study was to work out a clinical test which is possible to measure the anterior talar drawer (ATD) in patients after ankle sprain. The instrument for evaluation was called "ankle meter". The instrument consists of two plastic scales (heal scale and tibia scale). The instrument allows quantifying the results of the anterior drawing test. A total of 38 persons (16 men, 22 women) were available as control group. The persons were 28.8+/-10.1 years old. No proband had any ankle problems in his history. A total of 45 patients (25 males, 20 females) suffering from ankle sprain were included in the study. In these patients stress radiography (147.1 N) was performed to measure the ATD. In control group the clinical measured ATD was 1.7+/-1.3 mm. Measurement for detect the interobserver validity did not detect significant differences. The ATD of the joint after ankle sprain was significantly higher (8.9+/-4.3 mm). The difference between healthy and injured ankle in case of an ankle sprain was 7.4+/-4.2 mm. There was a significant correlation between clinical and radiological measured ATD (R=0.91). The results suggest that it is possible to measure the ATD exactly. The values of the clinical ATD measurement showed a good correlation with the results of stress radiography. Diligent clinical examination in combination with this special test are after this experiences sufficient to classify the severity of injury after ankle sprain.

  20. Test-Retest Reliability of Sudden Ankle Inversion Measurements in Subjects With Healthy Ankle Joints

    PubMed Central

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

    2007-01-01

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

  1. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  2. The effectiveness of the parachutist ankle brace in reducing ankle injuries in an airborne ranger battalion.

    PubMed

    Schumacher, J T; Creedon, J F; Pope, R W

    2000-12-01

    The purpose of this study was to determine if the parachutist ankle brace (PAB) decreases the number and severity of ankle injuries in an airborne Ranger battalion. A retrospective study was performed covering a 38-month period. A computer database was used to track all jump injuries with a diagnosis of ankle pain, sprain, or fracture. The frequency was calculated for ankle injuries per 1,000 jumps and the average length of medically restricted duty per ankle injury. A total of 13,782 static line parachute jumps were conducted during the study period. Without the PAB, 35 ankle injuries were seen (4.5/1,000 jumps), with 9 fractures and 316 days of medical restriction per 1,000 jumps. Using the PAB, 9 ankle injuries were seen (1.5/1,000 jumps), with 3 fractures and 71 days of medical restriction per 1,000 jumps. The correct use of the PAB appeared to significantly decrease the incidence of ankle injuries in this battalion.

  3. Ankle arthritis: review of diagnosis and operative management.

    PubMed

    Grunfeld, Robert; Aydogan, Umur; Juliano, Paul

    2014-03-01

    The diagnostic and therapeutic options for ankle arthritis are reviewed. The current standard of care for nonoperative options include the use of nonsteroidal antiinflammatory drugs, corticosteroid injections, orthotics, and ankle braces. Other modalities lack high-quality research studies to delineate their appropriateness and effectiveness. The gold standard for operative intervention in end-stage degenerative arthritis remains arthrodesis, but evidence for the superiority in functional outcomes of total ankle arthroplasty is increasing. The next few years will enable more informed decisions and, with more prospective high-quality studies, the most appropriate patient population for total ankle arthroplasty can be identified.

  4. [Revision arthroplasty of the ankle joint].

    PubMed

    Hintermann, B; Barg, A; Knupp, M

    2011-11-01

    In the last 20 years total ankle replacement has become a viable alternative to arthrodesis for end-stage osteoarthritis of the ankle. Numerous ankle prosthesis designs have appeared on the market in the past and attracted by the encouraging intermediate results reported in the literature, many surgeons have started to perform this procedure. With increased availability on the market the indications for total ankle replacement have also increased in recent years. In particular, total ankle replacement may now be considered even in younger patients. Therefore, despite progress in total ankle arthroplasty the number of failures may increase. Up to now, arthrodesis was considered to be the gold standard for salvage of failed ankle prostheses. Because of extensive bone loss on the talar side, in most instances tibiocalcaneal fusion is the only reliable solution. An alternative to such extended hindfoot fusions would be revision arthroplasty. To date, however, there are no reported results of revision arthroplasty for salvage of a failed ankle replacement.Based on our experience prosthetic components with a flat undersurface are most likely to be able to find solid support on remaining bone stock. The first 83 cases (79 patients, 46 males, 33 females, average age 58.9 years, range 30.6-80.7 years) with a average follow-up of 5.4 years (range 2-11 years) showed excellent to good results in 69 cases (83%), a satisfactory result in 12 cases (15%) and a fair result in 2 cases (2%) and 47 patients (56%) were pain free. Primary loosening was noted in three cases and of these two cases were successfully revised by another total ankle replacement and in one case with arthrodesis. Another case with hematogenous infection was also revised by arthrodesis. At the last follow-up control two components were considered to be loose and the overall loosening rate was thus 6%.This series has proven that revision arthroplasty can be a promising option for patients with failed total

  5. Chronic ankle instability: Current perspectives

    PubMed Central

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

    2016-01-01

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

  6. 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.

  7. 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!

  8. Operational Agility (La Maniabilite Operationnelle)

    DTIC Science & Technology

    1994-04-01

    describe how to go further and how to set up an analytical framework for the analysis of another fundamental property of modern combat aircraft, that is... analytical framework for the analysis of airframe agility and for the derivation of agility metrics. A general consensus has been found in relating agility...Gianchecchi, Aernmacchi Lt Col. G. Fristachi, Italian Air Force Prof. M. Innocenti, Auburn University/University of Pisa United Kingdom Mr P. Gordon

  9. Coaching for Better (Software) Buying Power in an Agile World

    DTIC Science & Technology

    2013-06-01

    professionals carefully to consider incorporation of agile methodologies into the set of acquisition tools at their disposal. This transformation is not...believes that DevOps , the process of warfighters and developers work- ing together throughout the project, is superior to volumes of detailed...Professionalism of the Total Acquisition Workforce The DoD needs to invest in training the acquisition workforce in agile methodologies to add tools that

  10. Ankle fracture - aftercare

    MedlinePlus

    Malleolar fracture; Tri-malleolar; Bi-malleolar; Distal tibia fracture; Distal fibula fracture; Malleolus fracture ... Some ankle fractures may require surgery when: The ends of the bone are out of line with each other (displaced). The ...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. [Arthrodesis and endoprostheses of the ankle joint: indications, techniques and pitfalls].

    PubMed

    Wirth, S H; Klammer, G; Espinosa, N

    2013-09-01

    If adequate conservative measures for the treatment of end-stage ankle osteoarthritis have failed, surgery may be taken into consideration. After exorbitant failure rates in the beginning of total ankle replacement, nowadays this kind of treatment has regained lot of interest and has become a viable alternative to ankle fusion. The correct indication and a precise explanation of the surgical procedure, outcomes and potential complications provide a solid base for future success.Currently, there is no doubt that total ankle replacement has become an important player in the treatment of symptomatic and debilitating end-stage ankle arthritis. With increasing number of patients who undergo total ankle replacement the experience with this kind of procedure increases too. As a consequence several surgeons have started to stretch indications favoring total ankle replacement. However, it must be mentioned here, despite progress in terms of improved anatomical and biomechanical understanding of the hindfoot and improved surgical techniques and instruments, total ankle replacement and ankle fusion remain challenging and difficult procedures. We provide a review article including an overview of the relevant techniques. This article should serve as rough guide for surgeons and help in decision-making regarding total ankle replacement and ankle fusion.

  16. 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.

  17. 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.

  18. 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.

  19. Towards Agile Ontology Maintenance

    NASA Astrophysics Data System (ADS)

    Luczak-Rösch, Markus

    Ontologies are an appropriate means to represent knowledge on the Web. Research on ontology engineering reached practices for an integrative lifecycle support. However, a broader success of ontologies in Web-based information systems remains unreached while the more lightweight semantic approaches are rather successful. We assume, paired with the emerging trend of services and microservices on the Web, new dynamic scenarios gain momentum in which a shared knowledge base is made available to several dynamically changing services with disparate requirements. Our work envisions a step towards such a dynamic scenario in which an ontology adapts to the requirements of the accessing services and applications as well as the user's needs in an agile way and reduces the experts' involvement in ontology maintenance processes.

  20. 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.

  1. Broken Ankle/Broken Foot

    MedlinePlus

    ... not warming up and stretching, also can cause foot and ankle injuries. Work in certain occupations. Certain work environments, such ... too little light may lead to falls and foot and ankle injuries. Have certain conditions. Having fragile bones (osteoporosis) or ...

  2. VISCOSUPPLEMENTATION IN ANKLE OSTEOARTHRITIS: A SYSTEMATIC REVIEW

    PubMed Central

    Faleiro, Thiago Batista; Schulz, Renata da Silva; Jambeiro, Jorge Eduardo de Schoucair; Tavares, Antero; Delmonte, Fernando Moreira; Daltro, Gildásio de Cerqueira

    2016-01-01

    ABSTRACT To evaluate the efficacy of viscosupplementation in patients with osteoarthritis of the ankle. A systematic review to evaluate the evidence in the literature on the use of viscosupplementation for osteoarthritis of the ankle. For this review, we considered blind randomized prospective studies involving the use of viscosupplementation for osteoarthritis of the ankle. A total of 1,961 articles were identified in various databases. After examining each of the articles, five articles were included in this review. Treatment with intraarticular hyaluronic acid is a safe treatment modality that significantly improves functional scores of patients, with no evidence of superiority in relation to other conservative treatments. Further clinical trials with larger numbers of patients are needed so that we can recommend its use and address unanswered questions. Systematic Review of Randomized Clinical Trials. PMID:26997916

  3. VISCOSUPPLEMENTATION IN ANKLE OSTEOARTHRITIS: A SYSTEMATIC REVIEW.

    PubMed

    Faleiro, Thiago Batista; Schulz, Renata da Silva; Jambeiro, Jorge Eduardo de Schoucair; Tavares, Antero; Delmonte, Fernando Moreira; Daltro, Gildásio de Cerqueira

    2016-01-01

    To evaluate the efficacy of viscosupplementation in patients with osteoarthritis of the ankle. A systematic review to evaluate the evidence in the literature on the use of viscosupplementation for osteoarthritis of the ankle. For this review, we considered blind randomized prospective studies involving the use of viscosupplementation for osteoarthritis of the ankle. A total of 1,961 articles were identified in various databases. After examining each of the articles, five articles were included in this review. Treatment with intraarticular hyaluronic acid is a safe treatment modality that significantly improves functional scores of patients, with no evidence of superiority in relation to other conservative treatments. Further clinical trials with larger numbers of patients are needed so that we can recommend its use and address unanswered questions . Systematic Review of Randomized Clinical Trials.

  4. 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.

  5. 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.

  6. X-Ray Exam: Ankle

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Ankle KidsHealth > For Parents > X-Ray Exam: Ankle A A A What's in this ... español Radiografía: tobillo What It Is An ankle X-ray is a safe and painless test that uses ...

  7. X-Ray Exam: Ankle

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Ankle KidsHealth > For Parents > X-Ray Exam: Ankle Print A A A What's in ... español Radiografía: tobillo What It Is An ankle X-ray is a safe and painless test that uses ...

  8. 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.

  9. Inserting Agility in System Development

    DTIC Science & Technology

    2012-07-01

    Agile IT Acquisition, IT Box, Scrum Inserting Agility in System Development Matthew R. Kennedy and Lt Col Dan Ward, USAF With the fast-paced nature...1,700 individuals and 71 countries, found Scrum and eXtreme Programming to be the most widely followed method- ologies (VersionOne, 2007). Other...University http://www.dau.mil 259 Defense ARJ, July 2012, Vol. 19 No. 3 : 249–264 Scrum Scrum is a framework used for project management, which is

  10. 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

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

    PubMed

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

    2015-10-01

    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.

  12. 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.

  13. Ankle sprain - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100209.htm Ankle sprain - Series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  14. Ankle Sprain Treatment

    MedlinePlus

    ... Treatment Page Content Article Body Acute ankle and foot injuries are common in athletes and other active young ... heels by pushing on the balls of your feet. Repeat steps 1 through 3. ... criteria Because injuries and recovery rates are different for every athlete, ...

  15. Are there any relationships among ankle proprioception acuity, pre-landing ankle muscle responses, and landing impact in man?

    PubMed

    Fu, Siu Ngor; Hui-Chan, Christina Wan Ying

    2007-05-01

    Proprioceptive input has been suggested to contribute to the pre-landing muscle responses associated with drop-landing, but its precise role has yet to be delineated. This study set out to examine the relationships among ankle proprioception, pre-landing muscle responses, and landing impact on drop-landing in healthy man. Fifteen healthy male basketball players aged 18 to 26 participated in this study. Passive ankle joint repositioning errors were used to examine ankle joint proprioception. Pre-landing EMG responses in the ankle muscles and the impact force on landing were recorded while the players performed self-initiated drops from a height of 30 cm. Results demonstrated that averaged ankle repositioning errors were significantly correlated with the co-contraction indexes between left tibialis anterior and medial gastrocnemius muscles (TA/MG CoI) (r=0.67, p=0.006), and showed a trend towards a relationship with the right TA/MG CoI (r=0.47, p=0.079). TA/MG CoI from both ankles were further related to the magnitude of the total impact force on landing (r=0.54 and 0.53, respectively; p<0.05). We concluded that male basketball players with less accurate ankle joint sense adopted greater co-contraction of ankle dorsiflexors and platarflexors, which was in turn associated with greater impact force at the moment of landing.

  16. 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.

  17. 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.

  18. Decompression of Posterior Ankle Impingement With Concomitant Anterior Ankle Pathology by Posterior Ankle Arthroscopy in the Supine Position.

    PubMed

    Lui, Tun Hing

    2016-10-01

    Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position. Concomitant anterior ankle arthroscopy can be performed with the usual orientation without the need of change of patient's position.

  19. 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

  20. Use of talectomy in modern foot and ankle surgery.

    PubMed

    Joseph, Thomas N; Myerson, Mark S

    2004-12-01

    Talectomy is a procedure that is undertaken rarely in modern orthopedic surgery; however, it has been performed for many years. Talectomy has been used most commonly in pediatric orthopedics with some degree of success in severe clubfoot deformity, arthrogryposis multiplex congenita, myelomeningocele, tuberculosis, and tumors. In adults, talectomy has been used in salvage procedures that involve nonunion of ankle fusions, failed total ankle arthroplasty, inflammatory arthropathy, neuroarthropathy, failed talar prostheses, failed pantalar fusions, adult neglected clubfoot, posttraumatic avascular necrosis talus, and deformities that are due to sciatic nerve palsy and compartment syndrome. This article consider what place talectomy has in modern adult foot and ankle surgery.

  1. [High complication rate after surgical treatment of ankle fractures].

    PubMed

    Bjørslev, Naja; Ebskov, Lars; Lind, Marianne; Mersø, Camilla

    2014-08-04

    The purpose of this study was to determine the quality and re-operation rate of the surgical treatment of ankle fractures at a large university hospital. X-rays and patient records of 137 patients surgically treated for ankle fractures were analyzed for: 1) correct classification according to Lauge-Hansen, 2) if congruity of the ankle joint was achieved, 3) selection and placement of the hardware, and 4) the surgeon's level of education. Totally 32 of 137 did not receive an optimal treatment, 11 were re-operated. There was no clear correlation between incorrect operation and the surgeon's level of education.

  2. Arthroscopic Capsular Release of the Ankle Joint.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Adhesive capsulitis of the ankle is also known as frozen ankle and results in marked fibrosis and contracture of the ankle capsule. Arthroscopic capsular release is indicated for symptomatic frozen ankle that is resistant to conservative treatment. It is contraindicated for ankle stiffness due to degenerative joint disease, intra-articular malunion, or adhesion of the extensors of the ankle. The procedure consists of endoscopic posterior ankle capsulectomy and arthroscopic anterior ankle capsulotomy. It has the advantages of being minimally invasive surgery and allowing early postoperative vigorous mobilization of the ankle joint.

  3. Supramalleolar osteotomy for realignment of the ankle joint.

    PubMed

    Siddiqui, Noman A; Herzenberg, John E; Lamm, Bradley M

    2012-10-01

    Ankle replacement systems have not been as reliable as hip replacements in providing long-term relief of pain, increased motion, and return to full activity. Supramalleolar Osteotomy is an extraarticular procedure that realigns the mechanical axis, thereby restoring ankle function. The literature discussing knee arthritis has shown that realignment osteotomies of the tibia improve function and prolong total knee replacement surgery. The success of the procedure is predicated on understanding the patient's clinical and radiographic presentation and proper preoperative assessment and planning.

  4. 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

  5. US in ankle impingement syndrome.

    PubMed

    Pesquer, Lionel; Guillo, Stephane; Meyer, Philippe; Hauger, Olivier

    2014-06-01

    Ankle impingement is a common condition occurring secondary to sprain or repeated microtrauma. Clinical symptoms are chronic pain located in the affected region and limited range of ankle motion. There are three types of ankle impingement syndrome: anterior impingement, which can be subdivided into anterolateral, anteromedial and purely anterior impingement; posterior impingement, which can be subdivided into posterior and posteromedial impingement; and calcaneal peroneal impingement which is secondary to planovalgus foot deformity. This paper evaluates physiological and clinical elements of these three types of ankle impingement syndrome as well as the role of ultrasound (US) imaging and US-guided treatment.

  6. What Is a Foot and Ankle Surgeon?

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  7. Osteoarthritis of the Foot and Ankle

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  8. Sports Injuries to the Foot and Ankle

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  9. Agile Development of Advanced Prototypes

    DTIC Science & Technology

    2014-11-01

    genetically modified babies. A case where researchers supplemented women’s defective mitochondria with healthy mitochondria from a donor was...and immersive experience showing genetic engineering’s implication for the future of medicine. 15. SUBJECT TERMS Agile Development, Games for...provoking perspective on genetic engineering’s implication for the future of medicine. Experiencing Living with Prostheses (Xense) During this period

  10. Making Agile Work for You

    DTIC Science & Technology

    2011-07-20

    Extreme Programming (XP) • SCRUM • Dynamic Systems Development Method (DSDM) • Adaptive Software Development • Crystal • Feature-Driven Development...Carnegie Mellon University Twitter #seiwebinar SCRUM Scrum is an iterative, incremental methodology for managing agile software projects. The Team

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

    PubMed

    Matlák, János; Tihanyi, József; Rácz, Levente

    2016-06-01

    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.

  12. [Ankle joint prosthesis for bone defects].

    PubMed

    Lampert, C

    2011-11-01

    Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus.

  13. Gender-specific influences of balance, speed, and power on agility performance.

    PubMed

    Sekulic, Damir; Spasic, Miodrag; Mirkov, Dragan; Cavar, Mile; Sattler, Tine

    2013-03-01

    The quick change of direction (i.e., agility) is an important athletic ability in numerous sports. Because of the diverse and therefore hardly predictable manifestations of agility in sports, studies noted that the improvement in speed, power, and balance should result in an improvement of agility. However, there is evident lack of data regarding the influence of potential predictors on different agility manifestations. The aim of this study was to determine the gender-specific influence of speed, power, and balance on different agility tests. A total of 32 college-aged male athletes and 31 college-aged female athletes (age 20.02 ± 1.89 years) participated in this study. The subjects were mostly involved in team sports (soccer, team handball, basketball, and volleyball; 80% of men, and 75% of women), martial arts, gymnastics, and dance. Anthropometric variables consisted of body height, body weight, and the body mass index. Five agility tests were used: a t-test (T-TEST), zig-zag test, 20-yard shuttle test, agility test with a 180-degree turn, and forward-backward running agility test (FWDBWD). Other tests included 1 jumping ability power test (squat jump, SQJ), 2 balance tests to determine the overall stability index and an overall limit of stability score (both measured by Biodex Balance System), and 2 running speed tests using a straight sprint for 10 and 20 m (S10 and S20, respectively). A reliability analysis showed that all the agility tests were reliable. Multiple regression and correlation analysis found speed and power (among women), and balance (among men), as most significant predictors of agility. The highest Pearson's correlation in both genders is found between the results of the FWDBWD and S10M tests (0.77 and 0.81 for men and women, respectively; p < 0.05). Power, measured using the SQJ, is significantly (p < 0.05) related to FWDBWD and T-TEST results but only for women (-0.44; -0.41). The balance measures were significantly related to the agility

  14. 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…

  15. 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.

  16. [Ankle brachial index measurement].

    PubMed

    Rucigaj, Tanja Planinsek

    2014-10-01

    Ultrasound examinations are noninvasive diagnostic methods which, along with appropriate history and clinical examination, provide basic information on the etiology and spread of the disease, as well as on treatment options required in patients with chronic venous insufficiency and arterial flow impairment. Doppler flow meter offers useful data on venous blood return, primarily in great veins, while both deep and superficial veins as well as arteries can be visualized and data on venous and arterial hemodynamics obtained by duplex ultrasonography. In addition, Doppler flow meter provides data on the peripheral arterial system action through ankle brachial index measurement, which will guide the choice of compression therapy when deciding on the treatment of peripheral arterial disease and mixed arteriovenous leg ulcers. However, diagnosis of arterial insufficiency requires additional examinations.

  17. Barriers to Achieving Mentally Agile Junior Leaders

    DTIC Science & Technology

    2009-01-21

    To help answer this question, this paper will describe the operational environment the agile leader must be prepared to operate within and the...senior leadership identified their need over eight years ago? To help answer this question, this paper will describe the operational environment the agile...to the reader. BARRIERS TO ACHIEVING MENTALLY AGILE JUNIOR LEADERS Persistent conflict and change characterize the strategic environment . We have

  18. Towards a Comparative Measure of Legged Agility

    DTIC Science & Technology

    2014-06-01

    so for this paper we explore the implications of a well-cited definition within the sports science community holding that agility is “a rapid whole...systems will have negligible agility according to our metric in accor- dance with biological observations that these motions require significantly less...W. Young, “Agility literature review: Classifications, training and testing,” Journal of sports sciences, vol. 24, no. 9, pp. 919–932, 2006. 19. D. L

  19. Osteoligamentous injuries of the medial ankle joint.

    PubMed

    Lötscher, P; Lang, T H; Zwicky, L; Hintermann, B; Knupp, M

    2015-12-01

    Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ankle joint osteoarthritis.

  20. 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.

  1. 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.

  2. Foot and Ankle Conditioning Program

    MedlinePlus

    ... and ankle pain and prevent further injury. Flexibility: Stretching the muscles that you strengthen is important for restoring range of motion and preventing injury. Gently stretching after strengthening exercises can help reduce muscle soreness ...

  3. 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( ...

  4. 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.

  5. 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

  6. 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.

  7. Chronic ankle instability.

    PubMed

    Gerstner Garces, Juan Bernardo

    2012-09-01

    Chronic instability of the ankle and anterolateral impingement syndrome are abnormalities that present as a result of inversion and forced plantar-flexion traumas of the foot, despite strict conservative management in the ER and in rehabilitation. A conservative approach is always the first choice of treatment, including anti-inflammatory medications, rehabilitation and proprioception, infiltration with steroids in impingement cases, and use of orthotics, whose true effectiveness is the subject of multiple studies and much debate. Good to excellent results can be obtained surgically with a minimally invasive approach, such as the arthroscopic technique presented herein. Such an approach is useful in managing a combination of conditions such as anterolateral impingement, synovitis, and osteochondral lesions of the talus. The method is easily reproducible, its learning curve is rapid, and it has the advantage of not preventing the use other arthroscopic methods, or open anatomic or nonanatomic methods (tendon transfers), in the case of failure. No nerve lesion was recorded, probably owing to the use of the security zone, and neither was there any arthrofibrosis, possibly related to the use of nonsteroidal anti-inflammatory medications in the immediate postsurgical period coupled with aggressive rehabilitation from the fourth week. The success of the technique is due to multidisciplinary team work leading to the ultimate achievement of patient satisfaction. This technique is not indicated for patients with a high sports demand or for sport professionals, until further biomechanical studies on its use and success are completed.

  8. 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…

  9. The RITE Approach to Agile Acquisition

    DTIC Science & Technology

    2013-04-01

    Review (SVR), and Production Readiness Review ( PRR ), which were evaluated against Agile development requirements. Further analysis was conducted...Audit (FCA), PRR , Operational Test Readiness Review (OTRR), Physical Configuration Audit (PCA), Integration Readiness Review (IRR), In Service...Technology (DSB Task Force, 2009, p. 48) In the context of the primary milestone reviews (PDR, CDR, and SVR/ PRR ), a nominal Agile development structure was

  10. 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…

  11. 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…

  12. Does ice immersion influence ankle joint position sense?

    PubMed

    Hopper, D; Whittington, D; Davies, J; Chartier, J D

    1997-01-01

    The purpose of this study was to determine whether a fifteen minute ice immersion treatment influenced the normal ankle joint position sense at 40% and 80% range of inversion and to establish the length of treatment effect through monitoring the rewarming process. Forty nine healthy volunteers between the ages of 17 and 28 were tested. Subjects were screened to exclude those with a history of ankle injuries. The subject's skin temperature over antero-lateral aspect of the ankle was measured using a thermocouple device during the fifteen minutes ice intervention and thirty minutes post-intervention. Testing of ankle joint position sense using the pedal goniometer was performed before and after a clinical application of ice immersion. The testing required the subject to actively reposition their ankle at 40% and 80% of their total range of inversion. The majority of subjects experienced numbness of the foot and ankle by the fifth or sixth minute during ice immersion. One minute after immersion skin temperatures averaged 15 degrees C + 1.7 degrees C. Skin temperature was seen to rise relatively rapidly for the first ten minutes and then slowed considerably. Subjects had not returned to the pre-test skin temperatures by thirty minutes. A significant difference in ankle joint position sense (p < 0.0499) following fifteen minutes of ice immersion was found. However, the magnitude of this difference (0.5 degree) would not be deemed significant in clinical practice. The research found no significant difference in joint position sense between 40% and 80% of the range of inversion both before and after cryotherapy. These findings suggest that the clinical application of cryotherapy is not deleterious to joint position sense and assuming normal joint integrity patients may resume exercise without increased risk of injury.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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 ...

  19. American College of Foot and Ankle Surgeons

    MedlinePlus

    ... Week @ ACFAS Poll Results Arthroscopy e-Book The Journal of Foot & Ankle Surgery Read some of the latest research from the official peer-reviewed scientific journal of ACFAS, The Journal of Foot & Ankle Surgery ( ...

  20. 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

  1. 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

  2. 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…

  3. 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.

  4. Supramalleolar osteotomies for degenerative joint disease of the ankle joint: indication, technique and results.

    PubMed

    Barg, Alexej; Pagenstert, Geert I; Horisberger, Monika; Paul, Jochen; Gloyer, Marcel; Henninger, Heath B; Valderrabano, Victor

    2013-09-01

    Patients with varus or valgus hindfoot deformities usually present with asymmetric ankle osteoarthritis. In-vitro biomechanical studies have shown that varus or valgus hindfoot deformity may lead to altered load distribution in the tibiotalar joint which may result in medial (varus) or lateral (valgus) tibiotalar joint degeneration in the short or medium term. The treatment of asymmetric ankle osteoarthritis remains challenging, because more than half of the tibiotalar joint surface is usually preserved. Therefore, joint-sacrificing procedures like total ankle replacement or ankle arthrodesis may not be the most appropriate treatment options. The shortand midterm results following realignment surgery, are very promising with substantial pain relief and functional improvement observed post-operatively. In this review article we describe the indications, surgical techniques, and results from of realignment surgery of the ankle joint in the current literature.

  5. Agile Leaders, Agile Institutions: Educating Adaptive and Innovative Leaders for Today and Tomorrow

    DTIC Science & Technology

    2005-03-18

    to organizational learning , specifically for militaries at war. With these lenses and informed by observations from the CCCs, the paper advances...rapid, effective organizational learning is the essence of organizational agility. In line with this paper’s concept of individual agility...organizational agility is a metaphor for organizational learning that is faster, more flexible, and more sensitive to the speed with which individual experiential

  6. Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

    PubMed

    Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

    2013-01-01

    Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in

  7. Incidence and variance of foot and ankle injuries in elite college football players.

    PubMed

    Kaplan, Lee D; Jost, Patrick W; Honkamp, Nicholas; Norwig, John; West, Robin; Bradley, James P

    2011-01-01

    We conducted a study on the risk for foot and ankle injuries in college football players on the basis of injury type and player position. In February 2006, we evaluated 320 intercollegiate football players at the National Football League Combine. All pathologic conditions and surgical procedures of the foot and ankle were recorded, and data were analyzed by player position to detect any trends. Seventy-two percent (n = 231) of the players had a history of foot and ankle injuries, with a total of 287 foot and ankle injuries (1.24 injuries/player injured). The most common injuries were lateral ankle sprain (n = 115), syndesmotic sprain (50), metatarsophalangeal dislocation/turf toe (36), and fibular fracture (25). Foot and ankle injuries were most common in kickers/punters (100% incidence), special teams (100%), running backs (83%), wide receivers (83%), and offensive linemen (80%). Lateral ankle sprains, the most common injuries, were treated surgically only 2.6% of the time. Offensive linemen were most likely to have had syndesmotic sprains (32%), and quarterbacks had the highest incidence of fibular fractures (16%). Foot and ankle injuries are common in collegiate football players, affecting 72% of players. Thirteen percent underwent surgical treatment. Trends are seen in the types of injuries for the different player positions.

  8. 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.

  9. Test Methods for Robot Agility in Manufacturing

    PubMed Central

    Downs, Anthony; Harrison, William; Schlenoff, Craig

    2017-01-01

    Purpose The paper aims to define and describe test methods and metrics to assess industrial robot system agility in both simulation and in reality. Design/methodology/approach The paper describes test methods and associated quantitative and qualitative metrics for assessing robot system efficiency and effectiveness which can then be used for the assessment of system agility. Findings The paper describes how the test methods were implemented in a simulation environment and real world environment. It also shows how the metrics are measured and assessed as they would be in a future competition. Practical Implications The test methods described in this paper will push forward the state of the art in software agility for manufacturing robots, allowing small and medium manufacturers to better utilize robotic systems. Originality / value The paper fulfills the identified need for standard test methods to measure and allow for improvement in software agility for manufacturing robots. PMID:28203034

  10. 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.

  11. Decision Science Challenges for C2 Agility

    DTIC Science & Technology

    2014-06-01

    Controlled and automatic human information processing: II. Perceptual learning , automatic attending and a general theory . Psychological Review, 84 (2...1 19 th ICCRTS “C2 Agility: Lessons Learned from Research and Operations” Decision Science Challenges for C2 Agility Topic 1 (First...systems. We have two vectors there. The first vector would be in things like man-machine interface. The second ... is in the whole area of cognition

  12. Agile Port and High Speed Ship Technologies

    DTIC Science & Technology

    2009-12-31

    Report PNW Agile Port System Demonstration Center for the Commercial Deployment of Transportation Technologies milestone agenda for accomplishing the... report summarizes the results of the remaining three projects in the FY05 program cycle, in particular the PNW Agile Port System Demonstration, a system...the accomplishment of each project and the program objectives. With the submission of this report the FY05 CCDoTT Program is complete. Bibliography

  13. Posterior tibial nerve lesions in ankle arthroscopy.

    PubMed

    Cugat, Ramon; Ares, Oscar; Cuscó, Xavier; Garcia, Montserrat; Samitier, Gonzalo; Seijas, Roberto

    2008-05-01

    Ankle arthroscopy provides a minimally invasive approach to the diagnosis and treatment of certain ankle disorders. Neurological complications resulting from ankle arthroscopy have been well documented in orthopaedic and podiatric literature. Owing to the superficial location of the ankle joint and the abundance of overlying periarticular neurovascular structures, complications reported in ankle arthroscopy are greater than those reported for other joints. In particular, all reported neurovascular injuries following ankle arthroscopy have been the direct result of distractor pin or portal placement. The standard posteromedial portal has recognized risks because of the proximity of the posterior neurovascular structures. There can be considerable variability in the course of these portals and their proximity to the neurovascular structures. We found one report of intra-articular damage to the posterior tibial nerve as a result of ankle arthroscopy in the English-language literature and we report this paper as a second case described in the literature.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. The Acute Effects of Static Stretching on Speed and Agility Performance Depend on Stretch Duration and Conditioning Level.

    PubMed

    Avloniti, Alexandra; Chatzinikolaou, Athanasios; Fatouros, Ioannis G; Avloniti, Christina; Protopapa, Maria; Draganidis, Dimitrios; Stampoulis, Theodoros; Leontsini, Diamanda; Mavropalias, George; Gounelas, George; Kambas, Antonios

    2016-10-01

    Avloniti, A, Chatzinikolaou, A, Fatouros, IG, Avloniti, C, Protopapa, M, Draganidis, D, Stampoulis, T, Leontsini, D, Mavropalias, G, Gounelas, G, and Kambas, A. The acute effects of static stretching on speed and agility performance depend on stretch duration and conditioning level. J Strength Cond Res 30(10): 2767-2773, 2016-Although static stretching (SS) is an integral part of physical preparation before training and competition, its usefulness in regards to power performance improvement has been questioned. The aim of this study was to investigate the effect of 6 SS durations on speed and agility performance. According to a cross-over design, 34 trained men (age, 20.5 ± 1.4 years; height, 1.81 ± 0.2 m; weight, 77.2 ± 2.6 kg; body fat, 8.2 ± 2.6%) participated in a control session (no stretch) and 6 experimental conditions (10, 15, 20, 30, 40, and 60 seconds) performed in a randomized order. Performance in speed (10 and 20 m) and agility (T-test) was measured after the control and experimental conditions. Static stretching, consisting of stretches for hip extensors, hip adductors, knee extensors, knee flexors, and ankle sole flexors, was performed after light cardiovascular exercise (8 minutes). A 1-way repeated-measures analysis of variance showed that speed was improved only by SS of short duration (15/20 seconds), whereas agility remained unaffected by all SS trials. When participants' speed and agility level was taken into account, it was revealed that only those of moderate performance demonstrated an improved speed (in 15- and 20-second trials) and agility (in 10- and 15-second trials) performance. These results suggest that short-duration SS protocols induce an acute improvement of speed and agility performance, whereas longer-duration SS protocols have neither positive nor negative effect. Furthermore, it seems that individuals of lower speed and agility performance level are more likely to benefit by a short-duration SS protocol.

  1. 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.

  2. 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.

  3. 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.

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

    PubMed

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

    2013-12-01

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

  6. Posterior ankle impingement in the dancer.

    PubMed

    Moser, Brad R

    2011-01-01

    Dancers spend a lot of time in the relevé position in demi-pointe and en pointe in their training and their careers. Pain from both osseous and soft tissue causes may start to occur in the posterior aspect of their ankle. This article reviews the potential causes of posterior ankle impingement in dancers. It will discuss the clinical evaluation of a dancer and the appropriate workup and radiographic studies needed to further evaluate a dancer with suspected posterior ankle impingement.

  7. Ankle instability and arthroscopic lateral ligament repair.

    PubMed

    Acevedo, Jorge I; Mangone, Peter

    2015-03-01

    Over the last 50 years, the surgical management of chronic lateral ankle ligament insufficiency has focused on 2 main categories: local soft-tissue reconstruction and tendon grafts/transfer procedures. There is an increasing interest in the arthroscopic solutions for chronic instability of the ankle. Recent biomechanical studies suggest the at least one of the arthroscopic techniques can provide equivalent results to current open local soft-tissue reconstruction (such as the modified Brostrom technique). Arthroscopic lateral ankle ligament reconstruction is becoming an increasingly acceptable method for the surgical management of chronic lateral ankle instability.

  8. Complications of Pediatric Foot and Ankle Fractures.

    PubMed

    Denning, Jaime R

    2017-01-01

    Ankle fractures account for 5% and foot fractures account for approximately 8% of fractures in children. Some complications are evident early in the treatment or natural history of foot and ankle fractures. Other complications do not become apparent until weeks, months, or years after the original fracture. The incidence of long-term sequelae like posttraumatic arthritis from childhood foot and ankle fractures is poorly studied because decades or lifelong follow-up has frequently not been accomplished. This article discusses a variety of complications associated with foot and ankle fractures in children or the treatment of these injuries.

  9. Effects of Neuromuscular Training on the Rear-foot Angle Kinematics in Elite Women Field Hockey Players with Chronic Ankle Instability

    PubMed Central

    Kim, Eunkuk; Choi, Hokyung; Cha, Jung-Hoon; Park, Jong-Chul; Kim, Taegyu

    2017-01-01

    The aims of this study were to investigate the ankle position, the changes and persistence of ankle kinematics after neuromuscular training in athletes with chronic ankle instability (CAI). A total of 21 national women’s field hockey players participated (CAI = 12, control = 9). Ankle position at heel strike (HS), midstance (MS), and toe touch (TT) in the frontal plane during walking, running and landing were measured using 3D motion analysis. A 6-week neuromuscular training program was undertaken by the CAI group. Measurements of kinematic data for both groups were measured at baseline and the changes in kinematic data for CAI group were measured at 6 and 24 weeks. The kinematic data at HS during walking and running demonstrated that the magnitude of the eversion in the CAI group (−5.00° and −4.21°) was less than in the control group (−13.45°and −9.62°). The kinematic data at MS also exhibited less ankle eversion in the CAI group (−9.36° and −8.18°) than in the control group (−18.52° and −15.88°). Ankle positions at TT during landing were comparable between groups. Following the 6-week training, the CAI participants demonstrated a less everted ankle at HS during walking and running (−1.77° and −1.76°) compared to the previous positions. They also showed less ankle eversion at MS (−5.14° and −4.19°). Ankle orientation at TT changed significantly to an inverted ankle position (from −0.26° to 4.11°). The ankle kinematics were restored back to the previous positions at 24 weeks except for landing. It appeared that athletes with unstable ankle had a relatively inverted ankle position, and that 6-week neuromuscular training had an immediate effect on changing ankle orientation toward a less everted direction. The changed ankle kinematics seemed to persist during landing but not during walking and running. Key points Athletes with unstable ankles had a relatively inverted ankle position during the initial contact and midstance

  10. 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.

  11. 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

  12. Search the Foot and Ankle: Interactive Foot Diagram

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  13. 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

  14. The Influence of Agility Training on Physiological and Cognitive Performance

    DTIC Science & Technology

    2010-11-01

    training, subjects completed a physical and cognitive battery of serum cortisol, VO2max, vertical jump , reaction time, Illinois Agility Test , body...strong trends toward the agility group improving more than the traditional group on VO2max (p=0.12), vertical jump (p=0.06), Illinois Agility Test ...levels, maximal oxygen uptake, Illinois Agility Test , Makoto reaction time, and vertical jump . The cognitive portion of the testing sessions

  15. Theoretical aspects of the agile mirror

    NASA Astrophysics Data System (ADS)

    Manheimer, Wallace M.; Fernsler, Richard

    1994-01-01

    A planar plasma mirror which can be oriented electronically could have the capability of providing electronic steering of a microwave beam in a radar or electronic warfare system. This system is denoted the agile mirror. A recent experiment has demonstrated such a planar plasma and the associated microwave reflection. This plasma was produced by a hollow cathode glow discharge, where the hollow cathode was a grooved metallic trench in a Lucite plate. Various theoretical aspects of this configuration of an agile mirror are examined here.

  16. Ankle arthrodesis fusion rates for mesenchymal stem cell bone allograft versus proximal tibia autograft.

    PubMed

    Anderson, John J; Boone, Joshua J; Hansen, Myron; Brady, Chad; Gough, Adam; Swayzee, Zflan

    2014-01-01

    Ankle arthrodesis is commonly used in the treatment of ankle arthritis. The present study compared mesenchymal stem cell (MSC) bone allografts and proximal tibia autografts as adjuncts in performing ankle arthrodesis. A total of 109 consecutive ankle fusions performed from 2002 to 2008 were evaluated retrospectively. Of the 109 fusions, 24 were excluded from the present study, leaving 85 patients who had undergone ankle arthrodesis. Of the 85 patients, 41 had received a proximal tibia autograft and 44, an MSC bone allograft. These 2 groups were reviewed and compared retrospectively at least 2 years postoperatively for the overall fusion rate, interval to radiographic fusion, and interval to clinical fusion. A modified and adjusted American College of Foot and Ankle Surgeons ankle scale was used to measure patient satisfaction. The overall fusion rate was 84.1% in the MSC bone allograft group and 95.1% in the proximal tibia autograft group (p = .158). The corresponding mean intervals to radiographic fusion were 13.0 ± 2.5 weeks and 11.3 ± 2.8 weeks (p ≤ .001). The interval to clinical fusion was 13.1 ± 2.1 weeks and 11.0 ± 1.5 weeks (p ≤ .001) in the MSC bone allograft and proximal tibia autograft group, respectively. No statistically significant difference was found in the fusion rates between the MSC bone allograft and proximal tibia autograft groups. Also, no statistically significant difference was found between the preoperative and postoperative scores using a modified and adjusted American College of Foot and Ankle Surgeons ankle scale between the 2 groups (p = .41 and p = .44, respectively). A statistically significant delay to radiographic and clinical fusion was present in the MSC bone allograft group compared with the proximal tibia autograft group; however, no difference was found in patient satisfaction.

  17. Planning, Estimating, and Monitoring Progress in Agile Systems Development Environments

    DTIC Science & Technology

    2010-04-01

    Jilemanifesto.orgf Nt:JRJ’HRDP GRUMMAN Agile Terminology Term Definition P d B kl R i /U S i b l dro uct ac og equ rements ser tor es to e comp ete Iteration...Marion, McKelvey, & Uhl- Bien . (2007). Leadership Quarterly, 18(4), 298-318. Agile Development Practices Agile Project Management with Scrum Ken Schwaber

  18. 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…

  19. 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

  20. How to Care for a Sprained Ankle

    MedlinePlus

    ... in shape with good muscle balance, flexibility and strength in your soft tissues. Additional Resources How to Stretch Your Ankle After a Sprain How to Strengthen Your Ankle After a Sprain This material was codeveloped by the American Academy of Orthopaedic ...

  1. 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…

  2. 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.

  3. The Holy Grail of Agile Acquisition

    DTIC Science & Technology

    2010-04-01

    Bestsellers …” [Erwin 2009] Motivation • Despite of Erwin’s recommendation… – Agility seems to be a simple concept and it is commonly perceived as a virtue...osd mil/dapaproject/>. . . Erwin 2009 Erwin, S.I., Washington Pulse, Pentagon Brass: Stay Away From Management Bestsellers , National Defense, August

  4. [Lateral instability of the upper ankle joint].

    PubMed

    Harrasser, N; Eichelberg, K; Pohlig, F; Waizy, H; Toepfer, A; von Eisenhart-Rothe, R

    2016-11-01

    Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments. Arthroscopic techniques offer the advantage of joint inspection and addressing intra-articular pathologies in combination with ligament repair. Accompanying pathologies must be adequately addressed during ligament repair to avoid persistent ankle discomfort. If syndesmotic insufficiency and tibiofibular instability are suspected, the objective should be early diagnosis with MRI and surgical repair.

  5. Tumours of the foot and ankle.

    PubMed

    Khan, Zeeshan; Hussain, Shakir; Carter, Simon R

    2015-09-01

    Sarcomas are rare tumours and particularly rarer in the foot and ankle region. The complex anatomy of the foot and ankle makes it unique and hence poses a challenge to the surgeon for limb salvage surgery. Other lesions found in the foot and ankle region are benign bone and soft tissue tumours, metastasis and infection. The purpose of this article is to discuss the relevance of the complex anatomy of the foot and ankle in relation to tumours, clinical features, their general management principles and further discussion about some of the more common bone and soft tissue lesions. Discussion of every single bone and soft tissue lesion in the foot and ankle region is beyond the scope of this article.

  6. [Three-dimensional analysis of the foot following implantation of a HINTEGRA ankle prosthesis: evaluation with the Heidelberg foot model].

    PubMed

    Müller, S; Wolf, S; Döderlein, L

    2006-05-01

    Detailed foot kinematics after total ankle replacement has not yet been investigated. In this study 11 patients with unilateral Hintegra ankle prosthesis were analysed with the Heidelberg Foot Model. This model measures the kinematics of the fore-, mid- and hindfoot in three clinical planes. Moreover, the kinetics of the hip, knee and ankle was captured. A diminished ROM was found in all foot segments investigated. The timing of the kinematics between sound and involved side appeared similar. A limitation in the hindfoot mobility, as experienced after ankle arthrodesis, was not observed. However, a careful hindfoot alignment is essential for optimal foot function, and previous malalignments should be corrected. Concerning the kinetics, the replaced ankle showed a decreased power generation compensated by an increase in power in the ipsilateral knee. For a more detailed evaluation, further studies are required which include pre- and postoperative data and also take into account different types of prostheses.

  7. AGILE and Gamma-Ray Bursts

    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.

    2006-05-19

    AGILE is a Scientific Mission dedicated to high-energy astrophysics supported by ASI with scientific participation of INAF and INFN. 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. The broadband detection of GRBs and the study of implications for particle acceleration and high energy emission are primary goals of th emission. AGILE can image GRBs with 2-3 arcminutes error boxes in the hard X-ray range, and provide broadband photon-by photon detection in the 15-45 keV, 03-50 MeV, and 30 MeV-30 GeV energy ranges. Microsecond on-board photon tagging and a {approx} 100 microsecond gamma-ray detection deadtime will be crucial for fast GRB timing. On-board calculated GRB coordinates and energy fluxes will be quickly transmitted to the ground by an ORBCOMM transceiver. AGILE have recently (December 2005) completed its gamma-ray calibration. It is now (January 2006) undergoing satellite integration and testing. The PLSV launch is planned in early 2006. AGILE is then foreseen to be fully operational during the summer of 2006. It will be the only mission entirely dedicated to high-energy astrophysics above 30 MeV during the period mid-2006/mid-2007.

  8. Investigating the strategic antecedents of agility in humanitarian logistics.

    PubMed

    L'Hermitte, Cécile; Brooks, Benjamin; Bowles, Marcus; Tatham, Peter H

    2016-12-16

    This study investigates the strategic antecedents of operational agility in humanitarian logistics. It began by identifying the particular actions to be taken at the strategic level of a humanitarian organisation to support field-level agility. Next, quantitative data (n=59) were collected on four strategic-level capabilities (being purposeful, action-focused, collaborative, and learning-oriented) and on operational agility (field responsiveness and flexibility). Using a quantitative analysis, the study tested the relationship between organisational capacity building and operational agility and found that the four strategic-level capabilities are fundamental building blocks of agility. Collectively they account for 52 per cent of the ability of humanitarian logisticians to deal with ongoing changes and disruptions in the field. This study emphasises the need for researchers and practitioners to embrace a broader perspective of agility in humanitarian logistics. In addition, it highlights the inherently strategic nature of agility, the development of which involves focusing simultaneously on multiple drivers.

  9. Short-Term High Intensity Plyometric Training Program Improves Strength, Power and Agility in Male Soccer Players

    PubMed Central

    Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

    2013-01-01

    The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 – 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer. PMID:23717351

  10. Reliability and smallest real difference of the ankle lunge test post ankle fracture.

    PubMed

    Simondson, David; Brock, Kim; Cotton, Susan

    2012-02-01

    This study aimed to determine the reliability and the smallest real difference of the Ankle Lunge test in an ankle fracture patient population. In the post immobilisation stage of ankle fracture, ankle dorsiflexion is an important measure of progress and outcome. The Ankle Lunge test measures weight bearing dorsiflexion, resulting in negative scores (knee to wall distance) and positive scores (toe to wall distance), for which the latter has proven reliability in normal subjects only. A consecutive sample of ankle fracture patients with permission to commence weight bearing, were recruited to the study. Three measurements of the Ankle Lunge Test were performed each by two raters, one senior and one junior physiotherapist. These occurred prior to therapy sessions in the second week after plaster removal. A standardised testing station was utilised and allowed for both knee to wall distance and toe to wall distance measurement. Data was collected from 10 individuals with ankle fracture, with an average age of 36 years (SD 14.8). Seventy seven percent of observations were negative. Intra and inter-rater reliability yielded intra class correlations at or above 0.97, p < .001. There was a significant systematic bias towards improved scores during repeated measurement for one rater (p = .01). The smallest real difference was calculated as 13.8mm. The Ankle Lunge test is a practical and reliable tool for measuring weightbearing dorsiflexion post ankle fracture.

  11. Caffeine supplementation and reactive agility in elite youth soccer players.

    PubMed

    Jordan, J Bradley; Korgaokar, Ajit; Farley, Richard S; Coons, John M; Caputo, Jennifer L

    2014-05-01

    This study examined the effects of caffeine supplementation (6 mg·kg-1) on performance of a reactive agility test (RAT) in 17 elite, male, youth (M = 14 y) soccer players. Using a double-blind, repeated-measures design, players completed 4 days of testing on the RAT after a standardized warm-up. On day 1, anthropometric measurements were taken and players were accommodated to the RAT. On day 2, baseline performance was established. Caffeine or placebo conditions were randomly assigned on day 3 and the condition was reversed on day 4. Players completed 3 randomized trials of the RAT on days 2, 3, and 4 with at least 1 trial to the players' dominant and nondominant sides. There were no significant differences among conditions in reaction time (RT) to the dominant side, heart rates at any point of measurement, or ratings of perceived exertion (RPE) after completion of the warm-up. Caffeine produced faster RT to the nondominant side (P = .041) and higher RPE at the conclusion of the RAT (P = .013). The effect on the total time (TT) to complete the agility test to the nondominant side approached significance (P = .051). Sprint time and TT to either side did not differ. Caffeine supplementation may provide ergogenic benefit to elite, male, youth soccer players.

  12. How to Stretch Your Ankle After a Sprain

    MedlinePlus

    ... ankle, which orthopaedic foot and ankle specialists call proprioception. Consider these home exercises when recuperating from an ankle sprain. Perform them twice per day. While seated, bring your ankle and foot all the way up as much as you can. Do this slowly, ...

  13. Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality.

    PubMed

    Hinds, Richard M; Danna, Natalie R; Capo, John T; Mroczek, Kenneth J

    2016-11-10

    Background The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. Methods The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Results Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. Conclusions There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Clinical Relevance Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online.

  14. Ankle fractures in elderly patients.

    PubMed

    Giannini, Sandro; Chiarello, Eugenio; Persiani, Valentina; Luciani, Deianira; Cadossi, Matteo; Tedesco, Giuseppe

    2013-10-01

    The incidence of ankle fractures (AFs) in the elderly is rising due to the increase in life expectancy. Rather than directly related to osteoporosis, AFs are a predictor of osteoporotic fractures in other sites. In women AFs are associated with weight and BMI. AFs are difficult to categorize; therapeutic options are non-operative treatment with plaster casts or surgical treatment with Kirschner's wires, plates and screws. The choice of treatment should be based not only on the fracture type but also on the local and general comorbidity of the patient. Considering the new evidence that postmenopausal women with AFs have disrupted microarchitecture and decreased stiffness of the bone compared with women with no fracture history, in our opinion low-trauma AFs should be considered in a similar way to the other classical osteoporotic fractures.

  15. Position versus force control: using the 2-DOF robotic ankle trainer to assess ankle's motor control.

    PubMed

    Farjadian, Amir B; Nabian, Mohsen; Hartman, Amber; Corsino, Johnathan; Mavroidis, Constantinos; Holden, Maureen K

    2014-01-01

    An estimated of 2,000,000 acute ankle sprains occur annually in the United States. Furthermore, ankle disabilities are caused by neurological impairments such as traumatic brain injury, cerebral palsy and stroke. The virtually interfaced robotic ankle and balance trainer (vi-RABT) was introduced as a cost-effective platform-based rehabilitation robot to improve overall ankle/balance strength, mobility and control. The system is equipped with 2 degrees of freedom (2-DOF) controlled actuation along with complete means of angle and torque measurement mechanisms. Vi-RABT was used to assess ankle strength, flexibility and motor control in healthy human subjects, while playing interactive virtual reality games on the screen. The results suggest that in the task with 2-DOF, subjects have better control over ankle's position vs. force.

  16. Foot and ankle injuries in theatrical dancers.

    PubMed

    Hardaker, W T; Margello, S; Goldner, J L

    1985-10-01

    The theatrical dancer is a unique combination of athlete and artist. The physical demands of dance class, rehearsal, and performance can lead to injury, particularly to the foot and ankle. Ankle sprains are the most common acute injury. Chronic injuries predominate and relate primarily to the repeated impact loading of the foot and ankle on the dance floor. Contributing factors include anatomic variation, improper technique, and fatigue. Early and aggressive conservative management is usually successful and surgery is rarely indicated. Orthotics play a limited but potentially useful role in treatment. Following treatment, a structured rehabilitation program is fundamental to the successful return to dance.

  17. The Salto Talaris XT Revision Ankle Prosthesis.

    PubMed

    Roukis, Thomas S

    2015-10-01

    The Salto Talaris XT Revision Ankle Prosthesis is an anatomically designed fixed-bearing prosthesis available in the United States based on the design of previous Salto systems. The Salto Talaris XT Revision Ankle Prosthesis design optimizes surface area, cortical contact, and ultrahigh-molecular-weight polyethylene conformity. Two tibial component designs, both with the same base plate dimensions, are available, the standard conical fixation plug affixed to a short keel and a long-stemmed version. The author presents an overview of the Salto Talaris XT Revision Ankle Prosthesis surgical technique and pearls for successful application.

  18. Effect of ankle proprioceptive training on static body balance

    PubMed Central

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

    2015-01-01

    [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

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

    PubMed

    Prissel, Mark A; Roukis, Thomas S

    2014-12-01

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

  20. 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.

  1. Fall 2014 SEI Research Review Applying Agile Methods to DoD

    DTIC Science & Technology

    2014-10-28

    2014 © 2014 Carnegie Mellon University Agile Defense Adoption Proponents Team (ADAPT) member E-Learning Agile Course Multiple Presentations ... presentations , program committees: GSAW 2014, Agile 2014, Contracts in Agile International Meeting, AFEI/SEI DoD Agile Summit, GAO Working Groups 8

  2. XP Workshop on Agile Product Line Engineering

    NASA Astrophysics Data System (ADS)

    Ghanam, Yaser; Cooper, Kendra; Abrahamsson, Pekka; Maurer, Frank

    Software Product Line Engineering (SPLE) promises to lower the costs of developing individual applications as they heavily reuse existing artifacts. Besides decreasing costs, software reuse achieves faster development and higher quality. Traditionally, SPLE favors big design upfront and employs traditional, heavy weight processes. On the other hand, agile methods have been proposed to rapidly develop high quality software by focusing on producing working code while reducing upfront analysis and design. Combining both paradigms, although is challenging, can yield significant improvements.

  3. 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.

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

    PubMed

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

    2014-01-01

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

  5. Transfibular ankle arthrodesis: A novel method for ankle fusion – A short term retrospective study

    PubMed Central

    Balaji, S Muthukumar; Selvaraj, V; Devadoss, Sathish; Devadoss, Annamalai

    2017-01-01

    Background: Ankle arthrodesis has long been the traditional operative treatment for posttraumatic arthritis, rheumatoid arthritis, infection, neuromuscular conditions, and salvage of failed ankle arthroplasty. It remains the treatment of choice for patients in whom heavy and prolonged activity is anticipated. We present our short term followup study of functional outcome of patients who underwent transfibular ankle arthrodesis for arthritis of ankle due to various indications. Materials and Methods: 29 transfibular ankle arthrodesis in 29 patients performed between April 2009 and April 2014 were included in this study. The mean age was 50 years (range 22-75 years). The outcome analysis with a minimum of 1-year postoperative followup were included. All the patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot scale. Results: All cases of ankle fusions (100%) progressed to solid union in a mean postoperative duration of 3.8 months (range 3–6 months). All patients had sound arthrodesis. The mean followup period was 32.52 months (standard deviation ± 10.34). The mean AOFAS score was 74 (pain score = 32, functional score = 42). We found that twenty patients (68.96%) out of 29, had excellent results, 7 (24.13%) had good, and 2 (6.89%) showed fair results. Conclusion: Transfibular ankle arthrodesis is a simple and effective procedure for ankle arthritis. It achieves a high rate of union and good functional outcome on midterm followup. PMID:28216754

  6. Angular deformity of the ankle with sparing of the distal fibula following meningococcal septicaemia: a case series involving 14 ankles in ten children.

    PubMed

    Monsell, F P; McBride, A R T; Barnes, J R; Kirubanandan, R

    2011-08-01

    Progressive angular deformity of an extremity due to differential physeal arrest is the most common late orthopaedic sequela following meningococcal septicaemia in childhood. A total of ten patients (14 ankles) with distal tibial physeal arrest as a consequence of meningococcal septicaemia have been reviewed. Radiological analysis of their ankles has demonstrated a distinct pattern of deformity. In 13 of 14 cases the distal fibular physis was unaffected and continued distal fibular growth contributed to a varus deformity. We recommend that surgical management should take account of this consistent finding during the correction of these deformities.

  7. 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.

  8. 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 ...

  9. Foot and ankle injuries in dance.

    PubMed

    Kadel, Nancy J

    2006-11-01

    Although dancers develop overuse injuries common in other athletes, they are also susceptible to unique injuries. This article reviews common foot and ankle problems seen in dancers and provides some basic diagnosis and treatment strategies.

  10. Autologous split peroneus longus lateral ankle stabilization.

    PubMed

    Budny, Adam M; Schuberth, John M

    2012-01-01

    Lateral ankle instability is a common clinical entity, and a variety of surgical procedures are available for stabilization after conservative management fails. Herein the authors reviewed outcomes after performing autologous split peroneus longus lateral ankle stabilization, using a previously described surgical technique to anatomically recreate the anterior talofibular and calcaneofibular ligaments. Twenty-five consecutive patients from 2 surgeons' practices underwent reconstruction between March 2007 and January 2011 with a minimum follow-up of 12 (range 12 to 51) months (mean 29.5 months). Follow-up interviews demonstrated 92.0% good or excellent outcomes with only 8.0% rating the outcome as fair and none as poor; 92.0% had no recurrent sprains or difficulty going up or down hills; 88.0% related no difficulty with uneven ground. The authors conclude that the autologous split peroneus longus lateral ankle stabilization results in a stable ankle with a low rate of complications and high patient satisfaction.

  11. Arthroscopic Taloplasty for an Anterolateral Snapping Ankle.

    PubMed

    Lui, Tun Hing

    2016-12-01

    Anterior ankle snapping syndrome is rare. Snapping of the extensor digitorum longus due to attenuated inferior extensor retinaculum and snapping due to hypertrophied or low-lying peroneal tertius muscle have been reported. We reported a new mechanism of anterolateral snapping due to a hypertrophied talar head. Anterolateral snapping ankle can be revealed by active dorsiflexion and plantarflexion of the ankle with the foot inverted. Foot inversion will tension the inferior extensor retinaculum and uncover the dorsolateral prominence of the talar head. The dorsolateral prominence of the talar head will snap over the proximal edge of the inferior extensor retinaculum. This technical note reports the technique of arthroscopic contouring of the talar head via extra-articular ankle arthroscopy. We named this technique arthroscopic taloplasty.

  12. 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.

  13. Effects of different agility training programs among first-grade elementary school students.

    PubMed

    Yanci, Javier; Arcos, Asier Los; Salinero, Juan Jose; Mendiguchia, Jurdan; Gil, Eneko; Santesteban, David; Grande, Ignacio

    2015-03-01

    The aim of the study was to determine which agility training program (low, moderate or high contextual interference) was more effective in first-grade primary school students to provide reliable information to physical education teachers for designing more effective agility programs. A total of 57 first-grade elementary school students participated in the present study. They were randomized into three groups to compare the effects of three different agility training programs based on contextual interference: low contextual interference (N = 19), moderate contextual interference (N = 19), and high contextual interference (N = 19). Contextual interference refers to the relative amount of interference created when integrating two or more tasks into a particular aspect of a training session. Significant improvements in agility were found in the low (p < 0.01, ES = 1.79) and moderate (p < 0.05, ES = 0.61) contextual interference groups after a 4-week training period. These improvements were higher in the low contextual interference group. The high contextual interference group showed no improvements (p > 0.05, ES = 0.28) after the intervention program. Our results suggested that the low contextual interference program is still more effective than the moderate contextual interference program in this group of primary school students.

  14. 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

  15. 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

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

    PubMed

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

    2017-02-08

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

  17. Rolling and tumbling: status of the SuperAGILE experiment

    NASA Astrophysics Data System (ADS)

    Del Monte, E.; Costa, E.; di Persio, G.; Donnarumma, I.; Evangelista, Y.; Feroci, M.; Lapshov, I.; Lazzarotto, F.; Mastropietro, M.; Morelli, E.; Pacciani, L.; Rapisarda, M.; Rubini, A.; Soffitta, P.; Tavani, M.; Argan, A.; Trois, A.

    2010-07-01

    The SuperAGILE experiment is the hard X-ray monitor of the AGILE mission. It is a 2 x one-dimensional imager, with 6-arcmin angular resolution in the energy range 18 - 60 keV and a field of view in excess of 1 steradian. SuperAGILE is successfully operating in orbit since Summer 2007, providing long-term monitoring of bright sources and prompt detection and localization of gamma-ray bursts. Starting on October 2009 the AGILE mission lost its reaction wheel and the satellite attitude is no longer stabilized. The current mode of operation of the AGILE satellite is a Spinning Mode, around the Sun-pointing direction, with an angular velocity of about 0.8 degree/s (corresponding to 8 times the SuperAGILE point spread function every second). In these new conditions, SuperAGILE continuously scans a much larger fraction of the sky, with much smaller exposure to each region. In this paper we review some of the results of the first 2.5 years of "standard" operation of SuperAGILE, and show how new implementations in the data analysis software allows to continue the hard X-ray sky monitoring by SuperAGILE also in the new attitude conditions.

  18. 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.

  19. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain

    PubMed Central

    Ju, Sung-Bum; Park, Gi Duck

    2017-01-01

    [Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function. PMID:28265157

  20. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain.

    PubMed

    Ju, Sung-Bum; Park, Gi Duck

    2017-02-01

    [Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function.

  1. Effect of treadmill walking with ankle stretching orthosis on ankle flexibility and gait

    PubMed Central

    Cho, Young-ki; Kim, Si-hyun; Jeon, In-cheol; Ahn, Sun-hee; Kwon, Oh-yun

    2015-01-01

    [Purpose] The purpose of this study was to evaluate the kinematics of the ankle in the lunge to estabilish effectiveness of an ankle stretching orthosis (ASO) on the ankle dorsiflexion range of motion (ROM) of individuals with limited dorsiflexion ROM. [Subjects and Methods] Forty ankles with decreased dorsiflexion ROM of 20 participants were evaluated in this study. After wearing the ASO, participants walked on a treadmill for 15 minutes. Participants walked on the treadmill at a self-selected comfortable speed. Ankle dorsiflexion ROM, maximum dorsiflexion ROM before heel-off, and time to heel-off during the stance phase of gait were measured before and after 15 minutes of treadmill walking with the ASO. The differences in all variables between before and after treadmill walking with ASO were analyzed using the paired t-test. [Results] Ankle active and passive ROM, and dorsiflexion ROM during lunge increased significantly after treadmill walking with ASO. Treadmill walking with the ASO significantly increased the angle of maximal dorsiflexion before heel-off and time to heel-off during the stance phase. [Conclusion] The results of this study show that treadmill walking with the ASO effectively improved ankle flexibility and restored the normal gait pattern of the ankle joint by increasing dorsiflexion ROM, maximal angle of dorsiflexion, and time to heel-off in the stance phase. PMID:25995601

  2. The results of ankle arthrodesis with screws for end stage ankle arthrosis.

    PubMed

    Torudom, Yingyong

    2010-02-01

    Aim of this study was to evaluate the results of ankle arthrodesis with screws in patients with ankle arthrosis. The author studied 19 patients (20 feet) who had been treated by ankle arthrodesis with screws from 2003 to 2008. Ten patients were men (11 feet) and nine (9 feet) were women. Their mean age was 56 years (30 to 65), and the average duration of follow-up was four years (2 to 6). Two compression screws were used in all feet. Union was achieved in 19 of the 20 feet (95%). Average scores for pain and clinical condition are increase after operation. One re-operation was performed for nonunion. Author conclude that ankle arthrodesis with screws was effective treatment for ankle arthrosis.

  3. Is ankle involvement underestimated in rheumatoid arthritis? Results of a multicenter ultrasound study.

    PubMed

    Gutierrez, Marwin; Pineda, Carlos; Salaffi, Fausto; Raffeiner, Bernd; Cazenave, Tomas; Martinez-Nava, Gabriela A; Bertolazzi, Chiara; Vreju, Florentin; Inanc, Nevsun; Villaman, Eduardo; Delle Sedie, Andrea; Dal Pra, Fernando; Rosemffet, Marcos

    2016-11-01

    The aim of this study is to investigate the prevalence of subclinical ankle involvement by ultrasound in patients with rheumatoid arthritis (RA). The study was conducted on 216 patients with RA and 200 healthy sex- and age-matched controls. Patients with no history or clinical evidence of ankle involvement underwent US examination. For each ankle, tibio-talar (TT) joint, tibialis anterior (TA) tendon, extensor halux (EH) and extensor common (EC) tendons, tibialis posterior (TP) tendon, flexor common (FC) tendon and flexor hallux (FH) tendon, peroneous brevis (PB) and longus (PL) tendons, Achilles tendon (AT) and plantar fascia (PF) were assessed. The following abnormalities were recorded: synovitis, tenosynovitis, bursitis, enthesopathy and rupture. BMI, DAS28, RF ESR and CRP were also obtained. A total of 432 ankles of patients with RA and 400 ankles of healthy controls were assessed. In 188 (87%) patients with RA, US showed ankle abnormalities whereas, in control group, US found abnormalities in 57 (28.5 %) subjects (p = 0.01). The most frequent US abnormality in RA patients was TP tenosynovits (69/216) (31.9 %), followed by PL tenosynovitis (58/216) (26.9 %), TT synovitis (54/216) (25 %), PB tenosynovitis (51/216) (23.6 %), AT enthesopathy (41/216) (19 %) and AT bursitis (22/216) (10.2 %). In 118 RA patients out of 216 (54.6%), a positive PD was found. No statistically significant correlation was found between the US findings and age, disease duration, BMI, DAS28, RF, ESR and CRP. The present study provides evidence of the higher prevalence of subclinical ankle involvement in RA patients than in age- and gender-matched healthy controls identified by US.

  4. Compression stockings in the management of fractures of the ankle: a randomised controlled trial.

    PubMed

    Sultan, M J; Zhing, T; Morris, J; Kurdy, N; McCollum, C N

    2014-08-01

    In this randomised controlled trial, we evaluated the role of elastic compression using ankle injury stockings (AIS) in the management of fractures of the ankle. A total of 90 patients with a mean age of 47 years (16 to 79) were treated within 72 hours of presentation with a fracture of the ankle, 31 of whom were treated operatively and 59 conservatively, were randomised to be treated either with compression by AIS plus an Aircast boot or Tubigrip plus an Aircast boot. Male to female ratio was 36:54. The primary outcome measure was the functional Olerud-Molander ankle score (OMAS). The secondary outcome measures were; the American Orthopaedic Foot and Ankle Society score (AOFAS); the Short Form (SF)-12v2 Quality of Life score; and the frequency of deep vein thrombosis (DVT). Compression using AIS reduced swelling of the ankle at all time points and improved the mean OMAS score at six months to 98 (95% confidence interval (CI) 96 to 99) compared with a mean of 67 (95% CI 62 to 73) for the Tubigrip group (p < 0.001). The mean AOFAS and SF-12v2 scores at six months were also significantly improved by compression. Of 86 patients with duplex imaging at four weeks, five (12%) of 43 in the AIS group and ten (23%) of 43 in the Tubigrip group developed a DVT (p = 0.26). Compression improved functional outcome and quality of life following fracture of the ankle. DVTs were frequent, but a larger study would be needed to confirm that compression with AISs reduces the incidence of DVT.

  5. [Chronic diseases of the ankle joint].

    PubMed

    Rand, T; Trattnig, S; Breitenseher, M; Kreuzer, S; Wagesreither, S; Imhof, H

    1999-01-01

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemophilic patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use of MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging

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

    PubMed

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

    2007-10-11

    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.

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

    PubMed Central

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

    2015-01-01

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

  8. 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).

  9. 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

  10. [Kirschner wire transfixation of unstable ankle fractures: indication, surgical technique and outcomes].

    PubMed

    Marvan, J; Džupa, V; Bartoška, R; Kachlík, D; Krbec, M; Báča, V

    2015-01-01

    PURPOSE OF THE STUDY The aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis. MATERIAL AND METHODS Between 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1-year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. The fractures were categorised according to the Weber classification. A patient group treated by one-stage osteosynthesis, a group with definitive transfixation and a group of patients in whom temporary transfixation was converted to definitive osteosynthesis were assessed and compared. RESULTS The group treated by one-stage osteosynthesis included 278 patients with an average age of 47 years; the group of 20 patients with definitive transfixation had an average age of 67 years, and the group of 60 patients who had temporary transfixation with subsequent conversion to internal osteosynthesis were 55 years on average. In the group with one-stage osteosynthesis, 223 (80%) ankle fractures on post-injury radiographs were associated with minor joint dislocations and 55 (20%) with major dislocations. On the other hand, the radiographs of the patients treated by temporary transfixation and delayed open reduction with internal fixation showed major dislocations in 38 (63%) and minor dislocations in the rest of the patients (37%); the difference between the two groups was statistically significant (p<0.001). Posterior malleolar fractures were most frequent in the group with temporary transfixation (60%) and least frequent in the group with primary osteosynthesis (44%); also this difference was statistically significant (p=0.032). At one-year follow-up, in the group with one-stage osteosynthesis, 220 patients (79%) had no radiographic signs of posttraumatic ankle osteoarthritis while

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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°

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. [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.

  6. Measurement of passive ankle stiffness in subjects with chronic hemiparesis using a novel ankle robot.

    PubMed

    Roy, Anindo; Krebs, Hermano I; Bever, Christopher T; Forrester, Larry W; Macko, Richard F; Hogan, Neville

    2011-05-01

    Our objective in this study was to assess passive mechanical stiffness in the ankle of chronic hemiparetic stroke survivors and to compare it with those of healthy young and older (age-matched) individuals. Given the importance of the ankle during locomotion, an accurate estimate of passive ankle stiffness would be valuable for locomotor rehabilitation, potentially providing a measure of recovery and a quantitative basis to design treatment protocols. Using a novel ankle robot, we characterized passive ankle stiffness both in sagittal and in frontal planes by applying perturbations to the ankle joint over the entire range of motion with subjects in a relaxed state. We found that passive stiffness of the affected ankle joint was significantly higher in chronic stroke survivors than in healthy adults of a similar cohort, both in the sagittal as well as frontal plane of movement, in three out of four directions tested with indistinguishable stiffness values in plantarflexion direction. Our findings are comparable to the literature, thus indicating its plausibility, and, to our knowledge, report for the first time passive stiffness in the frontal plane for persons with chronic stroke and older healthy adults.

  7. Corrective supramalleolar osteotomy for malunited pronation-external rotation fractures of the ankle.

    PubMed

    Hintermann, B; Barg, A; Knupp, M

    2011-10-01

    We undertook a prospective study to analyse the outcome of 48 malunited pronation-external rotation fractures of the ankle in 48 patients (25 females and 23 males) with a mean age of 45 years (21 to 69), treated by realignment osteotomies. The interval between the injury and reconstruction was a mean of 20.2 months (3 to 98). In all patients, valgus malalignment of the distal tibia and malunion of the fibula were corrected. In some patients, additional osteotomies were performed. Patients were reviewed regularly, and the mean follow-up was 7.1 years (2 to 15). Good or excellent results were obtained in 42 patients (87.5%) with the benefit being maintained over time. Congruent ankles without a tilted talus (Takakura stage 0 and 1) were obtained in all but five cases. One patient required total ankle replacement.

  8. Osteochondral defects in the ankle: why painful?

    PubMed

    van Dijk, C Niek; Reilingh, Mikel L; Zengerink, Maartje; van Bergen, Christiaan J A

    2010-05-01

    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.

  9. Lateral ligament reconstruction procedures for the ankle.

    PubMed

    Tourné, Y; Mabit, C

    2017-02-01

    Capsule/ligament lesions of the lateral compartment of the ankle lead to lateral laxity, which is a prime contributor to chronic ankle instability. Lateral ligament reconstruction stabilizes the joint. Exhaustive preoperative clinical and paraclinical work-up is essential. The present article classifies, presents and criticizes the main techniques in terms of long-term stabilization and reduction of osteoarthritis risk. Anatomic ligament repair with reinforcement (mainly extensor retinaculum) or anatomic ligament reconstruction are the two recommended options. Non-anatomic reconstructions using the peroneus brevis should be abandoned. Arthroscopy is increasingly being developed, but results need assessment on longer follow-up than presently available. Postoperative neuromuscular reprogramming is fundamental to optimal recovery. Finally, the concept of complex ankle instability is discussed from the diagnostic and therapeutic points of view. The various forms of ligament reconstruction failure and corresponding treatments are reported.

  10. Bilateral ankle edema with bilateral iritis.

    PubMed

    Kumar, Sunil

    2007-07-01

    I report two patient presented to me with bilateral symmetrical ankle edema and bilateral acute iritis. A 42-year-old female of Indian origin and 30-year-old female from Somalia both presented with bilateral acute iritis. In the first patient, bilateral ankle edema preceded the onset of bilateral acute iritis. Bilateral ankle edema developed during the course of disease after onset of ocular symptoms in the second patient. Both patients did not suffer any significant ocular problem in the past, and on systemic examination, all clinical parameters were within normal limit. Lacrimal gland and conjunctival nodule biopsy established the final diagnosis of sarcoidosis in both cases, although the chest x-rays were normal.

  11. Effects of small-sided game and change-of-direction training on reactive agility and change-of-direction speed.

    PubMed

    Young, Warren; Rogers, Nathan

    2014-01-01

    The purpose of this study was to determine the effects of training change-of-direction speed and small-sided games on performance in the Planned-AFL agility test and reactive agility. Twenty-five elite-standard U-18 Australian Rules football players were randomly allocated either to a change-of-direction group or a small-sided games group. Players participated in one or two 15-min sessions per week with 11 sessions conducted over a 7-week period during the season. Tests conducted immediately before and after the training period included the Planned-AFL agility test and a video-based reactive agility test specific to Australian Rules football. The reactive agility test variables were total time, decision time and movement response time. The small-sided games group improved total time (P = 0.008, effect size = 0.93), which was entirely attributable to a very large reduction in decision time (P < 0.001, effect size = 2.32). Small-sided games produced a trivial change in movement response time as well as in the Planned-AFL agility test (P > 0.05). The change-of-direction training produced small to trivial changes in all of the test variables (P > 0.05, effect size = 0-0.2). The results suggest that small-sided games improve agility performance by enhancing the speed of decision-making rather than movement speed. The change-of-direction training was not effective for developing either change-of-direction speed as measured by the Planned-AFL test or reactive agility.

  12. Foot and Ankle Injuries in American Football.

    PubMed

    Hsu, Andrew R; Anderson, Robert B

    Physicians need to be aware of a variety of foot and ankle injuries that commonly occur in American football, including turf toe, Jones fractures, Lisfranc injuries, syndesmotic and deltoid disruption, and Achilles ruptures. These injuries are often complex and require early individual tailoring of treatment and rehabilitation protocols. Successful management and return to play requires early diagnosis, a thorough work-up, and prompt surgical intervention when warranted with meticulous attention to restoration of normal foot and ankle anatomy. Physicians should have a high suspicion for subtle injuries and variants that can occur via both contact and noncontact mechanisms.

  13. Dietary and viscosupplementation in ankle arthritis.

    PubMed

    Khosla, Shaun K; Baumhauer, Judith F

    2008-09-01

    Glucosamine and chondroitin sulfate are the most well-marketed dietary supplements directed toward managing symptoms associated with osteoarthritis. The presumption of their benefit in the ankle is based largely on promising results from their use in knee osteoarthritis. Likewise, viscosupplementation has proved to be efficacious in the management of osteoarthritis of the knee. Preliminary studies demonstrate a realization of this benefit in the ankle joint, but further research is required. So far, the literature has shown the dietary and viscosupplementation discussed in this article to be relatively safe for use.

  14. Ankle injuries. Tips from sports medicine physicians.

    PubMed

    Swain, R A; Holt, W S

    1993-02-15

    In dealing with an ankle sprain, worrisome features are few but important to recognize. A "pop" heard or felt at the time of injury, a prolonged course, or a history of several previous injuries are all of concern. Medial tenderness on palpation, positive results on a squeeze test, or markedly positive results on stress testing are also indicators of severe injuries, which may require referral for treatment. Stress testing by an experienced clinician is appropriate for chronic or severe cases. Otherwise, treatment of the acute, uncomplicated ankle injury is straightforward, focusing on early mobilization, rehabilitation, and protection.

  15. [Back to the emergency department with a painful ankle].

    PubMed

    van Egmond, Pim W; van de Rest, Hendrik J M; Nolte, Peter A

    2014-01-01

    A 31-year-old woman came to the Emergency Department with a painful ankle 2 days after a fall off a horse. On the day of the accident, she was misdiagnosed with a lateral ankle sprain. A lateral X-ray of the ankle showed a positive 'V-sign', which is pathognomonic for a fracture of the lateral process of the talus.

  16. Proprioception in classical ballet dancers. A prospective study of the influence of an ankle sprain on proprioception in the ankle joint.

    PubMed

    Leanderson, J; Eriksson, E; Nilsson, C; Wykman, A

    1996-01-01

    We studied prospectively the influence of ankle sprains on proprioception as measured by recording the postural sway of classical ballet dancers. Excellent balance and coordination are important for classical ballet dancers, and postural stability requires adequate proprioception from the ankle joint. Fifty-three professional dancers from the Royal Swedish Ballet, Stockholm, and 23 nonathletes, the control group, participated in the investigation. Postural sway was recorded and analyzed with a stabilimeter using a specially designed, portable, computer-assisted force plate. Six dancers sustained ankle sprains during followup. The recordings were obtained of these dancers before and after the injuries. The stabilometry results differed among the male and female dancers and the control group as follows: 1) the male dancers demonstrated a smaller total area of sway, and 2) both the male and female dancers had a smaller mean sway on the left foot than on the right (no mean difference in sway was found between the left and right foot in the control group). In comparison with the condition before injury and with the uninjured foot, the postural stability of the dancer was impaired for several weeks after the ankle sprain. Postural stability gradually improved during rehabilitation and improvement still occurred several weeks after professional dancing had resumed.

  17. Reflections on Software Agility and Agile Methods: Challenges, Dilemmas, & the Way Ahead

    DTIC Science & Technology

    2005-05-11

    Mellon University 10 Research Team Richard Baskerville and Balasubramanian Ramesh Department of Computer Information Systems, Georgia State University...University 38 References Agile Manifesto. http://agilemanifesto.org/ Baskerville , R., Pries-Heje, J., Levine, L., & Ramesh, B. (2005). The high speed...balancing game: How software companies cope with Internet speed. Scandinavian Journal of Information Systems 16, 11-54. Baskerville , R., Levine, L

  18. 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

  19. 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.

  20. 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.

  1. Malignant melanoma of the foot and ankle.

    PubMed

    John, K J; Hayes, D W; Green, D R; Dickerson, J

    2000-04-01

    Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

  2. 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

  3. Moving target detection for frequency agility radar by sparse reconstruction.

    PubMed

    Quan, Yinghui; Li, YaChao; Wu, Yaojun; Ran, Lei; Xing, Mengdao; Liu, Mengqi

    2016-09-01

    Frequency agility radar, with randomly varied carrier frequency from pulse to pulse, exhibits superior performance compared to the conventional fixed carrier frequency pulse-Doppler radar against the electromagnetic interference. A novel moving target detection (MTD) method is proposed for the estimation of the target's velocity of frequency agility radar based on pulses within a coherent processing interval by using sparse reconstruction. Hardware implementation of orthogonal matching pursuit algorithm is executed on Xilinx Virtex-7 Field Programmable Gata Array (FPGA) to perform sparse optimization. Finally, a series of experiments are performed to evaluate the performance of proposed MTD method for frequency agility radar systems.

  4. Moving target detection for frequency agility radar by sparse reconstruction

    NASA Astrophysics Data System (ADS)

    Quan, Yinghui; Li, YaChao; Wu, Yaojun; Ran, Lei; Xing, Mengdao; Liu, Mengqi

    2016-09-01

    Frequency agility radar, with randomly varied carrier frequency from pulse to pulse, exhibits superior performance compared to the conventional fixed carrier frequency pulse-Doppler radar against the electromagnetic interference. A novel moving target detection (MTD) method is proposed for the estimation of the target's velocity of frequency agility radar based on pulses within a coherent processing interval by using sparse reconstruction. Hardware implementation of orthogonal matching pursuit algorithm is executed on Xilinx Virtex-7 Field Programmable Gata Array (FPGA) to perform sparse optimization. Finally, a series of experiments are performed to evaluate the performance of proposed MTD method for frequency agility radar systems.

  5. 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.

  6. 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

  7. Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS)

    PubMed Central

    2012-01-01

    Background and purpose A questionnaire was introduced by the New Zealand Arthroplasty Registry for use when evaluating the outcome of total ankle replacement surgery. We evaluated the reliability, validity, and responsiveness of the modified Swedish version of the questionnaire (SEFAS) in patients with osteoarthritis or inflammatory arthritis before and/or after their ankle was replaced or fused. Patients and methods The questionnaire was translated into Swedish and cross-culturally adapted according to a standardized procedure. It was sent to 135 patients with ankle arthritis who were scheduled for or had undergone surgery, together with the foot and ankle outcome score (FAOS), the short form 36 (SF-36) score, and the EuroQol (EQ-5D) score. Construct validity was evaluated with Spearman’s correlation coefficient when comparing SEFAS with FAOS, SF-36, and EQ-5D, content validity by calculating floor and ceiling effects, test-retest reliability with intraclass correlation coefficient (ICC), internal consistency with Cronbach’s alpha (n = 62), agreement by Bland-Altman plot, and responsiveness by effect size and standardized response mean (n = 37). Results For construct validity, we correlated SEFAS with the other scores and 70% or more of our predefined hypotheses concerning correlations could be confirmed. There were no floor or ceiling effects. ICC was 0.92 (CI 95%: 0.88–0.95), Cronbach’s alpha 0.96, effect size was 1.44, and the standardized response mean was 1.00. Interpretation SEFAS is a self-reported foot and ankle score with good validity, reliability and responsiveness, indicating that the score can be used to evaluate patients with osteoarthritis or inflammatory arthritis of the ankle and outcome of surgery. PMID:22313352

  8. Ankle impingement syndromes: a review of etiology and related implications.

    PubMed

    Hess, Gregory William

    2011-10-01

    Ankle injuries are common occurrences in athletics involving and requiring extreme ranges of motion. Ankle sprains specifically occur with a 1 in 10,000 person rate in active individuals each day. If trauma is repetitive, the ankle structures have potential to experience secondary injury and dysfunction. Included in this category of dysfunction are both anterior and posterior ankle impingement syndromes where disruption of the bony structures, joint capsule, ligaments, and tendons typically occurs. Ankle impingement is described as ankle pain that occurs during athletic activity, with recurrent, extreme dorsiflexion or plantar flexion with the joint under a load. Ankle impingements can be classified according to what structures become involved both anteriorly and posteriorly. Osseous impingement, soft tissue impingement, impingement of the distal fascicle of anterior inferior tibiofibular ligament, and meniscoid lesions are all documented causes of ankle impingement. These changes tend to be brought about and exacerbated by extreme ranges of motion. Understanding various impingement types will better enable the clinician to prevent, identify, treat, and rehabilitate affected ankles. Acknowledging activities that predispose to ankle impingement syndrome will enhance prevention and recovery processes. Description of ankle impingement etiology and pathology is the objective of the current review.

  9. 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

  10. [Arthroscopically assisted treatment of ankle fractures].

    PubMed

    Braunstein, M; Baumbach, S F; Böcker, W; Mutschler, W; Polzer, H

    2016-02-01

    Acute ankle fractures are one of the most common fractures in adults with an incidence of 0.1-0.2 % per year. Operative treatment by open reduction and internal fixation (ORIF) is the standard method of treatment for unstable or dislocated fractures. The main goal of the operation is the anatomical realignment of the joint and restoration of ankle stability; nevertheless, anatomical reduction does not automatically lead to favorable clinical results. According to several studies the mid-term and in particular the long-term outcome following operative treatment is often poor with residual symptoms including chronic pain, stiffness, recurrent swelling and ankle instability. There is growing evidence that this poor outcome might be related to occult intra-articular injuries involving cartilage and soft tissues. In recent studies the frequency of fracture-related osteochondral lesions was reported to be approximately 64 %. By physical examination, standard radiography or even computed tomography (CT), these intra-articular pathologies cannot be reliably diagnosed; therefore, many authors emphasize the value of ankle arthroscopy in acute fracture treatment as it has become a safe and effective diagnostic and therapeutic procedure. Arthroscopically assisted open reduction and internal fixation (AORIF) allows control of the reduction as well examination of all intra-articular structures. If necessary, intra-articular pathologies can be addressed by removing ruptured ligaments and loose bodies, performing chondroplasty or microfracturing. So far there is no evidence that supplementary ankle arthroscopy increases the complication rate. On the other hand, the positive effect of AORIF has also not been clearly documented; nevertheless, there are clear indications that arthroscopically assisted fracture treatment is beneficial, especially in complex fractures.

  11. A new ankle foot orthosis for running.

    PubMed

    Bishop, David; Moore, Allan; Chandrashekar, Naveen

    2009-09-01

    Traumatic knee injuries in automobile accidents and sports often lead to damage of the peroneal nerve. A lack of control of muscles innervated by the peroneal nerve due to this damage, results in the inability to dorsiflex and evert the foot and to extend the toes. This condition is commonly known as foot drop. Foot drop reduces the stability in the body while walking and running and may also cause injury due to lack of foot clearance during the swing phase of the gait. Traditionally, an ankle foot orthosis (AFO), comprised of a moulded sheet of plastic that conforms around the posterior calf and distally contains all or part of the calcaneous as well as the plantar foot, is used to treat foot drop. The intent of this orthosis is to dorsiflex the foot to provide clearance during the swing phase of walking and running. Traditional AFO results in increased pressures due to a decrease in dorsiflexion range of motion at the ankle and make the orthosis increasingly uncomfortable to wear. Several other existing designs of foot drop AFO suffer from similar inadequacies. To address these issues, a new AFO was developed. The device was successfully used by one person with foot drop without issues for more than one year. This new design conforms to the lower anterior shin and dorsum of the foot using dorsiassist Tamarack ankle joints to allow for greater plantar and dorsiflexion range of motion. While still limiting ankle inversion it does allow for more ankle eversion. This orthosis can be discretely worn inside shoes due to its smaller size, and can be worn for a longer period of time without discomfort.

  12. 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.

  13. 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

  14. Value Creation by Agile Projects: Methodology or Mystery?

    NASA Astrophysics Data System (ADS)

    Racheva, Zornitza; Daneva, Maya; Sikkel, Klaas

    Business value is a key concept in agile software development approaches. This paper presents results of a systematic review of literature on how business value is created by agile projects. We found that with very few exceptions, most published studies take the concept of business value for granted and do not state what it means in general as well as in the specific study context. We could find no study which clearly indicates how exactly individual agile practices or groups of those create value and keep accumulating it over time. The key implication for research is that we have an incentive to pursue the study of value creation in agile project by deploying empirical research methods.

  15. Laterality and performance of agility-trained dogs.

    PubMed

    Siniscalchi, Marcello; Bertino, Daniele; Quaranta, Angelo

    2014-01-01

    Correlations between lateralised behaviour and performance were investigated in 19 agility-trained dogs (Canis familiaris) by scoring paw preference to hold a food object and relating it to performance during typical agility obstacles (jump/A-frame and weave poles). In addition, because recent behavioural studies reported that visual stimuli of emotional valence presented to one visual hemifield at a time affect visually guided motor responses in dogs, the possibility that the position of the owner respectively in the left and in the right canine visual hemifield might be associated with quality of performance during agility was considered. Dogs' temperament was also measured by an owner-rated questionnaire. The most relevant finding was that agility-trained dogs displayed longer latencies to complete the obstacles with the owner located in their left visual hemifield compared to the right. Interestingly, the results showed that this phenomenon was significantly linked to both dogs' trainability and the strength of paw preference.

  16. 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 DIAL measurements in the field.

  17. 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.

  18. Pilot users in agile development processes: motivational factors.

    PubMed

    Johannessen, Liv Karen; Gammon, Deede

    2010-01-01

    Despite a wealth of research on user participation, few studies offer insights into how to involve multi-organizational users in agile development methods. This paper is a case study of user involvement in developing a system for electronic laboratory requisitions using agile methodologies in a multi-organizational context. Building on an interpretive approach, we illuminate questions such as: How does collaboration between users and developers evolve and how might it be improved? What key motivational aspects are at play when users volunteer and continue contributing in the face of considerable added burdens? The study highlights how agile methods in themselves appear to facilitate mutually motivating collaboration between user groups and developers. Lessons learned for leveraging the advantages of agile development processes include acknowledging the substantial and ongoing contributions of users and their roles as co-designers of the system.

  19. 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.

  20. 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.

  1. Contribution of strength characteristics to change of direction and agility performance in female basketball athletes.

    PubMed

    Spiteri, Tania; Nimphius, Sophia; Hart, Nicolas H; Specos, Christina; Sheppard, Jeremy M; Newton, Robert U

    2014-09-01

    Research has often examined the relationship between 1 or 2 measures of strength and change of direction (COD) ability reporting inconsistent relationships to performance. These inconsistencies may be the result of the strength assessment used and the assumption that 1 measure of strength can represent all "types" of strength required during a COD task. Therefore the purpose of this study was to determine the relationship between several lower-body strength and power measures, COD, and agility performance. Twelve (n = 12) elite female basketball athletes completed a maximal dynamic back squat, isometric midthigh pull, eccentric and concentric only back squat, and a countermovement jump, followed by 2 COD tests (505 and T-test) and a reactive agility test. Pearson product-moment correlation and stepwise regression analysis were performed on all variables. The percentage contribution of each strength measure to an athletes total strength score was also determined. Our results demonstrated that both COD tests were significantly correlated to maximal dynamic, isometric, concentric, and eccentric strength (r = -0.79 to -0.89), with eccentric strength identified as the sole predictor of COD performance. Agility performance did not correlate with any measure of strength (r = -0.08 to -0.36), whereas lower-body power demonstrated no correlation to either agility or COD performance (r = -0.19 to -0.46). These findings demonstrate the importance of multiple strength components for COD ability, highlighting eccentric strength as a deterministic factor of COD performance. Coaches should aim to develop a well-rounded strength base in athletes; ensuring eccentric strength is developed as effectively as the often-emphasized concentric or overall dynamic strength capacity.

  2. Agile Software Development in Defense Acquisition: A Mission Assurance Perspective

    DTIC Science & Technology

    2012-03-23

    AEROSPACE REPORT NO ATR -2012(9010)-2 Agile Software Development in Defense Acquisition - A Mission Assurance Perspective March 23, 2012 Peter...release; distribution unlimited. aoUc£23>o;r7 AEROSPACE REPORT NO ATR -2012(9010)-2 Agile Software Development in Defense Acquisition - A Mission...Engineering and Technology Group Approved for public release; distribution unlimited. (A\\ AEROSPACE ^•^ Aautoff $m MK*I? taH AEROSPACE REPORT NO ATR

  3. Spectroscopic Investigation of Materials for Frequency Agile Laser Systems.

    DTIC Science & Technology

    1985-01-01

    fluorescence spectra and lifetimes of divalent Rh, Ru, Pt, and Ir ions in alkali halide crystals are measured using pulsed nitrogen laser excitation...AD-Ai5t 73t SPECTROSCOPIC INVESTIGRTION OF MATERIALS FOR FREQUENCY t/ AGILE LASER SYSTEMS(U) OKLAHOMA STATE UNIV STILLWATER DEPT OF PHYSICS R C...INVESTIGATION OF MATERIALS FOR FREQUENCY AGILE LASER SYSTEMS Richard C. Powell, Ph.D. Principal Investigator Department of Physics OKLAHOMA STATE UNIVERSITY

  4. Addressing the Barriers to Agile Development in DoD

    DTIC Science & Technology

    2015-05-01

    acquisition development  IT programs are subject to extensive documentation, reviews, and oversight that inhibits speed and agility needed for IT  Major...Based on Program, Ops, and Technical Risk Structuring an Agile Program  Notional: 6 Month Release with 4-Week Sprints – Continual development...integration, and testing – Monthly demonstration of capabilities to users  Gov’t testers, certifiers, and users involved early and often – Minimizes

  5. Architectural Tactics to Support Rapid and Agile Stability

    DTIC Science & Technology

    2012-05-01

    20 CrossTalk—May/June 2012 RAPID AND AGILE STABILITY • Scrum teams, product development teams, component teams, or feature teams spend almost...and individuals in the roles of Scrum master, developer, project manager, and architect on projects from organizations that develop embedded real...agile stability. Using Scrum , 25 teams participated in the develop- ment effort. Some of the teams were colocated; teams (waste), while not evolving

  6. Identification, Characterization, and Evaluation Criteria for Systems Engineering Agile Enablers

    DTIC Science & Technology

    2015-01-16

    monitoring communications in social media groups and websites (such as LinkedIn or Facebook groups associated with the Scaled Agile Framework, Lean... Identification , Characterization, and Evaluation Criteria for Systems Engineering Agile Enablers Technical Report SERC-2015-TR-049-1...currently valid OMB control number 1. REPORT DATE 16 JAN 2015 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Identification

  7. Need for Agility in Security Constraints for Distributed Simulation

    DTIC Science & Technology

    2014-06-01

    Submission to: 19th ICCRTS Title: Need for Agility in Security Constraints for Distributed Simulation (024) Topics: Primary Topic: 5...Modelling and Simulation , Alternates: 4. Experimentation, Metrics and Analysis, and 1. Concepts, Theory, and Policy S. K. Numrich, Ph.D...REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Need for Agility in Security Constraints for Distributed Simulation

  8. Light-Driven Chiral Molecular Motors for Passive Agile Filters

    DTIC Science & Technology

    2014-05-20

    AFRL-OSR-VA-TR-2014-0121 LIGHT-DRIVEN CHIRAL MOLECULAR MOTORS FOR PASSIVE AGILE FILTERS Quan Li KENT STATE UNIV OH Final Report 05/20/2014...Prescribed by ANSI Std. Z39.18 1 FINAL REPORT Title: Light-driven Chiral Molecular Motors for Passive Agile Filters AFOSR...As we proposed originally, the major objective of this project was to synthesize novel light- driven chiral molecular motors or switches targeted

  9. 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.

  10. 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.

  11. Treatment of anterolateral impingements of the ankle joint by arthroscopy.

    PubMed

    Hassan, Al-Husseiny Moustafa

    2007-09-01

    Impingement syndromes of the ankle joint are among the most common intraarticular ankle lesions. Soft tissue impingement lesions of the ankle usually occur as a result of synovial, or capsular irritation secondary to traumatic injuries, usually ankle sprains, leading to chronic ankle pain. The aim of this prospective study was to evaluate arthroscopic debridement of an anterolateral soft tissue impingement of the ankle. During the period between October 2000 and February 2004, 23 patients with residual complaints after an ankle sprain were diagnosed as anterolateral impingement of the ankle, and were treated by arthroscopic debridement. At a minimum of 6 months follow up, patients were asked to complete an American orthopaedic foot and ankle society (AOFAS) ankle and hind foot score. The average follow-up was 25 months (range 12-38). The average pre-operative patient assessed AOFAS score was 34 (range 4-57). At the end of follow-up the mean AOFAS score was 89 (range 60-100). In terms of patient satisfaction 22 patients said they would accept the same arthroscopic procedure again for the same complaints. At the end of follow-up, 7 patients had excellent results, and 14 patients had good results while two patients had fair results. We believe that arthroscopic debridement of the anterolateral impingement soft tissues are a good, and effective method of treatment.

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

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The NASA/McDonnell Douglas Corporation (MDC) X-36 Tailless Fighter Agility Research Aircraft is steered to it's hangar at NASA Dryden Flight Research Center, Edwards, California, following arrival 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 1,250 pounds. It was 19 feet long and three feet high with a

  13. 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 wait to attach a hoist to the X-36 Tailless Fighter Agility Research Aircraft, which 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 1,250 pounds. It was 19 feet long and three feet high

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

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The NASA/McDonnell Douglas Corporation (MDC) X-36 Tailless Fighter Agility Research Aircraft in it's hangar at NASA Dryden Flight Research Center, Edwards, California, following its arrival 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 1,250 pounds. It was 19 feet long and three feet high with a wingspan of

  15. 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

  16. The effects of ankle Kinesio taping on ankle stiffness and dynamic balance.

    PubMed

    Fayson, Shirleeah D; Needle, Alan R; Kaminski, Thomas W

    2013-01-01

    The purpose of this study was to determine the effects of Kinesio® taping on static restraint and dynamic postural control of the ankle joint. Thirty female subjects with no history of ankle injury participated in this study. Subjects were tested for passive ankle laxity and stiffness, and time to stabilization following forward, backward, medial, and lateral hops. Subjects were tested prior to tape application, immediately following application, and following 24 hours of use. Differences between taping conditions were investigated using analyses of variance and pairwise comparisons. Stiffness increased following initial application and 24 hours of Kinesio® tape use (F = 6.99, p = .003), despite no observed changes in ankle laxity (F = 0.77, p = .49); however, no changes were observed in time-to-stabilization (F = 0.03, p = .97). Our results suggest that Kinesio® tape may improve static restraint in the ankle joint without altering peak motion or dynamic postural control. A future investigation into Kinesio® tape efficacy in injury prevention or rehabilitation is warranted.

  17. Foot and ankle injuries in dance.

    PubMed

    Brown, Treg D; Micheli, Lyle J

    2004-06-01

    This review focuses on many of the foot and ankle injuries commonly seen among dancers. These unique athletes place extreme demands on their musculoskeletal system and thereby face a variety of acute and overuse injuries. Conservative treatment is successful in the majority of cases, but these patients often continue to dance while healing--commonly prolonging and at times complicating treatment. When surgery is being contemplated, the dancer's performance level and expectations about returning to dance after surgery should be thoroughly explored. Foot and ankle surgeries that routinely yield good to excellent results in the general population can prematurely end a dancer's otherwise promising career. The physician must consider all these factors when designing an appropriate treatment plan for a dancer.

  18. Movements causing ankle fractures in parachuting.

    PubMed Central

    Ellitsgaard, N; Warburg, F

    1989-01-01

    The parachutist injured in a dramatic accident often describes the injury in an incomplete and biased way and evaluation of materials based solely upon subjective information of this kind can be misleading and of no value for recommendations. As the relation between the mechanical factors of the injury and the lesion in ankle fractures is well documented, an investigation of clinical, radiological and operative findings in 46 parachutists with ankle fractures was conducted. Classification was possible in 44 of 46 fractures. The description of the cause of the trauma in 21 supination-eversion fractures and in 13 pronation-eversion fractures was most frequently faulty landing position or obstacles. The cause of seven supination fractures was oscillation of the parachutist whilst descending with sudden impact against the lateral aspect of the foot. For prophylaxis we recommend improvement of landing and steering techniques and the support of semi-calf boots. PMID:2730996

  19. Pediatric Ankle Fractures: Concepts and Treatment Principles

    PubMed Central

    Su, Alvin W.; Larson, A. Noelle

    2016-01-01

    Synopsis Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate exam, imaging, and knowledge of fracture patterns specific to children. Treatment is guided by patient history, physical examination, plain film radiographs and, in some instances, CT. Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity. PMID:26589088

  20. Symptomatic anterior subtalar arthrosis after ankle arthrodesis.

    PubMed

    Lui, Tun Hing

    2014-05-13

    A 76-year-old man reported right lateral heel pain 11 years after ankle arthrodesis. Clinically, there was tenderness in the right sinus tarsi and over the junction point between the talonavicular and calcaneocuboid joints. Radiographs showed that the joint spaces of the posterior subtalar joint and the talonavicular joint were preserved although there were osteophytes at both joints. Arthroscopic findings showed degeneration of the anterior subtalar and talonavicular joints. The symptoms subsided after arthroscopic debridement.

  1. Effects of using an unstable inclined board on active and passive ankle range of motion in patients with ankle stiffness.

    PubMed

    Yoo, Won-Gyu

    2015-07-01

    [Purpose] The present study assessed the effects of using an unstable inclined board on the active and passive ankle range of motion in patients with ankle stiffness. [Subjects] The study included 10 young female patients with ankle stiffness. [Methods] The patients were divided into the following two groups: a group that performed ankle dorsiflexion stretching exercises using a wooden inclined board and a group that performed stretching exercises using an air-cushioned inclined board (unstable inclined board). Active and passive ankle dorsiflexion angles were measured bilaterally using a goniometer. [Results] Both inclined boards significantly increased active and passive ankle dorsiflexion. After performing ankle stretching exercises, active dorsiflexion significantly increased the unstable inclined board compared to that using the wooden inclined board. However, the passive dorsiflexion angles did not differ significantly between the two groups after ankle stretching exercises. [Conclusion] The use of an unstable inclined board might stimulate activation of the ankle dorsiflexors in addition to stretching muscle or tissue. Active ankle dorsiflexion was more effectively improved with stretching exercises using an unstable inclined board than with exercises using a wooden inclined board.

  2. Epidemiology of ankle and foot overuse injuries in sports: A systematic review.

    PubMed

    Sobhani, S; Dekker, R; Postema, K; Dijkstra, P U

    2013-12-01

    Studies regarding ankle and foot overuse injuries are quite diverse in research methodology, data reporting, and outcomes. The aims of this systematic review were to analyze the methodology of published studies regarding ankle and foot overuse injuries in different sports disciplines and to summarize epidemiological data of ankle and foot overuse injuries. Four electronic databases, PubMed (MEDLINE), EMBASE, CINAHL, and SPORTDiscus(®) were systematically searched up to June 2011. A total of 89 articles on 23 sports disciplines were included in this review. Soccer, running, and gymnastics were the most frequently studied sports. Achilles tendinopathy, plantar fasciitis, and stress fracture were the most frequently studied injuries. Study design and reporting methods were heterogeneous. Most studies suffered from a weak methodology and poor reporting. The most common weaknesses were lack of a clear case definition, describing assessment procedures and reporting sample characteristics. Due to methodological heterogeneity of studies, inter-sports and intra-sports comparisons and meta-analysis were not possible. Methodology of most studies on incidence and prevalence of ankle and foot overuse injuries is insufficient. Based on the results, we recommend authors to clearly define cases, describe assessment procedures and report sample characteristics adequately.

  3. 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.

  4. 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.

  5. 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.

  6. "Agile" Battery Technology Transfer-Lessons Learnt

    NASA Astrophysics Data System (ADS)

    Sabatini, P.; Annoni, G.; Grossi, R.; Alia, Sergio; Reulier, David

    2008-09-01

    AGILE, the high energy astrophysics mission of the Italian Space Agency launched on April 23rd 2007, is the first LEO satellite to be powered by Saft's commercially available space qualified MPS176065 rechargeable lithium ion batteries.Saft and Carlo Gavazzi Space (CGS) have achieved a successful technology transfer replacing Ni-H2 batteries with high energy lithium ion batteries in a full speed program (4 months) and with a cost effective approach. The battery system comprises 2 x 24 Saft MPS176065 space qualified Li-ion cells in an 8s3p configuration (3 parallel arrays each composed by 8 series cell) with a nominal capacity of 2 x 480 Wh and an integral autonomous cell balancing system that ensures the maximum possible battery life.The MPS176065 space qualified cell is based on Saft's well proven MP series of prismatic rechargeable Li-ion batteries. It offers an extremely high capacity made possible by the stainless steel prismatic container that makes use of the volume which is otherwise lost when conventional cylindrical cells are packed together. A single prismatic cell has about 20% more volumetric energy density than an equivalent pack of cylindrical cells.

  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. 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.

  9. Orthopedic rehabilitation using the "Rutgers ankle" interface.

    PubMed

    Girone, M; Burdea, G; Bouzit, M; Popescu, V; Deutsch, J E

    2000-01-01

    A novel ankle rehabilitation device is being developed for home use, allowing remote monitoring by therapists. The system will allow patients to perform a variety of exercises while interacting with a virtual environment (VE). These game-like VEs created with WorldToolKit run on a host PC that controls the movement and output forces of the device via an RS232 connection. Patients will develop strength, flexibility, coordination, and balance as they interact with the VEs. The device will also perform diagnostic functions, measuring the ankle's range of motion, force exertion capabilities and coordination. The host PC transparently records patient progress for remote evaluation by therapists via our existing telerehabilitation system. The "Rutgers Ankle" Orthopedic Rehabilitation Interface uses double-acting pneumatic cylinders, linear potentiometers, and a 6 degree-of-freedom (DOF) force sensor. The controller contains a Pentium single-board computer and pneumatic control valves. Based on the Stewart platform, the device can move and supply forces and torques in 6 DOFs. A proof-of-concept trial conducted at the University of Medicine and Dentistry of New Jersey (UMDNJ) provided therapist and patient feedback. The system measured the range of motion and maximum force output of a group of four patients (male and female). Future medical trials are required to establish clinical efficacy in rehabilitation.

  10. Posterior malleolar fractures of the ankle.

    PubMed

    Bartoníček, J; Rammelt, S; Tuček, M; Naňka, O

    2015-12-01

    Despite an increasing awareness of injuries to PM in ankle fracture-dislocations, there are still many open questions. The mere presence of a posterior fragment leads to significantly poorer outcomes. Adequate diagnosis, classification and treatment require preoperative CT examination, preferably with 3D reconstructions. The indication for surgical treatment is made individually on the basis of comprehensive assessment of the three-dimensional outline of the PM fracture and all associated injuries to the ankle including syndesmotic instability. Anatomic fixation of the avulsed posterior tibiofibular ligament will contribute to syndesmotic stability and restore the integrity of the incisura tibiae thus facilitating anatomic reduction of the distal fibula. A necessary prerequisite is mastering of posterolateral and posteromedial approaches and the technique of direct reduction and internal fixation. Further clinical studies with higher numbers of patients treated by similar methods and evaluation of pre- and postoperative CT scans will be necessary to determine reliable prognostic factors associated with certain types of PM fractures and associated injuries to the ankle.

  11. 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

  12. Talar Osteochondroma Fracture Presenting as Posterior Ankle Impingement.

    PubMed

    Ercin, Ersin; Bilgili, Mustafa Gokhan; Gamsizkan, Mehmet; Avsar, Serdar

    2016-05-01

    Osteochondromas are the most common benign bone tumors. They are usually asymptomatic and found incidentally. When symptomatic, the symptoms are usually due to its location and size. Fracture of an osteochondroma presenting as posterior ankle impingement is a rare condition. We describe a 22-year-old man with solitary exostosis who presented with a posterior ankle mass and posterior ankle impingement with 2 years of follow-up. Surgical intervention was the treatment of choice in this patient, and histologic examination revealed a benign osteochondroma. Osteochondromas found in the posterior aspect of the talus can be complicated by fracture due to persistent motion of the ankle. Talar osteochondroma should be included in the differential diagnosis of posterior ankle impingement causes. Posterior talar osteochondromas, especially when a stalk is present, should be treated surgically before it is more complicated by a fracture and posterior ankle impingement.

  13. [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.

  14. Finite element stress analysis of some ankle joint prostheses.

    PubMed

    Falsig, J; Hvid, I; Jensen, N C

    1986-05-01

    A three-dimensional finite element stress analysis was employed to calculate stresses in a distal tibia modelled with three simple total ankle joint replacement tibial components. The bone was modelled as a composite structure consisting of cortical and trabecular bone in which the trabecular bone was either homogeneous with a constant modulus of elasticity or heterogenous with experimentally determined heterogeneity. The results were sensitive to variations in trabecular bone material property distributions, with lower stresses being calculated in the heterogeneous model. An anterolateral application of load, which proved the least favourable, was used in comparing the prosthetic variants. Normal and shear stresses at the trabecular bone-cement interface and supporting trabecular bone were slightly reduced by addition of metal backing to the polyethylene articular surface, and a further reduction to very low values was obtained by addition of a long intramedullary peg bypassing stresses to the cortical bone.

  15. 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

  16. 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.

  17. 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.

  18. Design, modelling and simulation aspects of an ankle rehabilitation device

    NASA Astrophysics Data System (ADS)

    Racu, C. M.; Doroftei, I.

    2016-08-01

    Ankle injuries are amongst the most common injuries of the lower limb. Besides initial treatment, rehabilitation of the patients plays a crucial role for future activities and proper functionality of the foot. Traditionally, ankle injuries are rehabilitated via physiotherapy, using simple equipment like elastic bands and rollers, requiring intensive efforts of therapists and patients. Thus, the need of robotic devices emerges. In this paper, the design concept and some modelling and simulation aspects of a novel ankle rehabilitation device are presented.

  19. Assessment and management of patients with ankle injuries.

    PubMed

    Walker, Jennie

    2014-08-19

    Foot and ankle injuries are common and can have a significant effect on an individual's daily activities. Nurses have an important role in the assessment, management, ongoing care and support of patients with ankle injuries. An understanding of the anatomy and physiology of the ankle enables nurses to identify significant injuries, which may result in serious complications, and communicate effectively with the multidisciplinary team to improve patient care and outcomes.

  20. Multivariable static ankle mechanical impedance with relaxed muscles.

    PubMed

    Lee, Hyunglae; Ho, Patrick; Rastgaar, Mohammad A; Krebs, Hermano I; Hogan, Neville

    2011-07-07

    Quantitative characterization of ankle mechanical impedance is important to understand how the ankle supports lower-extremity functions during interaction with the environment. This paper reports a novel procedure to characterize static multivariable ankle mechanical impedance. An experimental protocol using a wearable therapeutic robot, Anklebot, enabled reliable measurement of torque and angle data in multiple degrees of freedom simultaneously, a combination of inversion-eversion and dorsiflexion-plantarflexion. The measured multivariable torque-angle relation was represented as a vector field, and approximated using a method based on thin-plate spline smoothing with generalized cross validation. The vector field enabled assessment of several important characteristics of static ankle mechanical impedance, which are not available from prior single degree of freedom studies: the directional variation of ankle mechanical impedance, the extent to which the ankle behaves as a spring, and evidence of uniquely neural contributions. The method was validated by testing a simple physical "mock-up" consisting of passive elements. Experiments with young unimpaired subjects quantified the behavior of the maximally relaxed human ankle, showing that ankle mechanical impedance is spring-like but strongly direction-dependent, being weakest in inversion. Remarkably, the analysis was sufficiently sensitive to detect a subtle but statistically significant deviation from spring-like behavior if subjects were not fully relaxed. This method may provide new insight about the function of the ankle, both unimpaired and after biomechanical or neurological injury.

  1. Clinical outcome after anatomical reconstruction of the lateral ankle ligaments using the Duquennoy technique in chronic lateral instability of the ankle: a long-term follow-up study.

    PubMed

    Muijs, S P J; Dijkstra, P D S; Bos, C F A

    2008-01-01

    We performed a retrospective study to assess the long-term outcome of non-augmented anatomical direct repair of the lateral ankle ligaments, as originally described by Duquennoy et al, for the treatment of chronic lateral instability of the ankle. This procedure aims to restore stability by the re-insertion and tightening of the original talofibular and calcaneofibular ligaments without division of the ligament. We examined the outcome in terms of the post-operative quality of life, the function of the joint and the development of osteoarthritis. Between 1985 and 2002, 23 patients (11 males, 12 females) with a mean age of 32 years (15 to 58) who had undergone this procedure completed the Short-Form 36 assessment of quality of life and the Olerud and Molander Ankle score for the subjective evaluation of symptoms. Clinical re-evaluation, including examination of the ankle and the completion of the American Orthopaedic Foot and Ankle Society questionnaire was performed on 21 patients after a mean follow-up of 13 years (3 to 22.2). At the final follow-up radiographs of both ankles were taken to assess the development of osteoarthritis. The mean total Short-Form 36 and Olerud and Molander Ankle scores in 23 patients at final follow-up were 79.6 points (37 to 100) and 81.6 points (40 to 100), respectively. The mean total post-operative American Orthopaedic Foot and Ankle Society score in 21 patients was 89.7 points (72 to 100). We found a significant post-operative reduction in talar tilt and anterior drawer sign (chi-squared test, p <0.001). The functional outcome of the procedure was excellent in ten patients (48%), good in seven (33%) and fair in four (19%). The results in terms of ankle function and stability did not deteriorate with time and there was little restriction in movement. This procedure is simple and effective with a very low rate of complications.

  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. 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

  4. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Methods Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclusion if they assessed the effect of a non-surgical intervention on ankle joint dorsiflexion in healthy populations. Studies were quality rated using a standard quality assessment scale. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and results were pooled where study methods were homogenous. Results Twenty-three studies met eligibility criteria, with a total of 734 study participants. Results suggest that there is some evidence to support the efficacy of static stretching alone (SMDs: range 0.70 to 1.69) and static stretching in combination with ultrasound (SMDs: range 0.91 to 0.95), diathermy (SMD 1.12), diathermy and ice (SMD 1.16), heel raise exercises (SMDs: range 0.70 to 0.77), superficial moist heat (SMDs: range 0.65 to 0.84) and warm up (SMD 0.87) in improving ankle joint dorsiflexion ROM. Conclusions Some evidence exists to support the efficacy of stretching alone and stretching in combination with other therapies in increasing ankle joint ROM in healthy individuals. There is a paucity of quality evidence to support the efficacy of other non-surgical interventions, thus further research in this area is warranted. PMID:24225348

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

    PubMed Central

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

    2015-01-01

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

  6. The effect of ankle taping on the ground reaction force in vertical jump performance.

    PubMed

    Koyama, Keiji; Kato, Tomoo; Yamauchi, Junichiro

    2014-05-01

    The purpose of this study was to investigate the effects of closed basket weave (CBW) ankle taping on the vertical ground reaction force during the contact phase before the take-off in vertical jump performance. We hypothesized that ankle taping would limit the capability for explosive force generation during the contact phase before the take-off in jump performance. Twelve healthy young men (age, 20.2 ± 1.3 years; height, 1.76 ± 0.05 m; body mass, 66.1 ± 6.1 kg; mean ± SD) performed a vertical jump performance on a force plate without (CON) or with ankle taping (CBW technique) of the right ankle joint. Vertical jump ability was assessed using 2 styles of vertical jump with no arm swing: a countermovement jump (CMJ) and squat jump (SJ). From the vertical ground reaction force (GRF), maximum jump height, vertical impulse (VI), rate of force development, maximum GRF (GRFmax), and time-series GRF (GRFts) during the contact phase before the take-off in jump performance were determined. Jump height was significantly lower for CBW (36.6 ± 6.6 cm) than CON (38.1 ± 6.7 cm) in CMJ, but not in SJ. Rate of force development and GRFts at 35, 40, 45, 50, 55, 60, and 65% of total time of the contact phase in jumping performance were also significantly smaller for CBW than CON in CMJ, but not in SJ. Conversely, VI and GRFmax were not significantly different between the groups in either jump condition. These results suggest that ankle taping impairs CMJ performance, because of a decreased ability to develop large force rapidly on the ground before the take-off.

  7. Quality of Surgical Case Notes at Dow University Hospital according to modified ANKLe score

    PubMed Central

    Jawaid, Masood; Bakhtiar, Nighat; Khalique, Abdul; Masood, Zubia

    2013-01-01

    Objective: To find out quality of surgical case notes according to modified Adjusted Note keeping and Legibility (ANKLe) score in Dow University Hospital. Methods: For this audit, medical records of all the patients admitted in Dow University Hospital surgery department were reviewed from February 2012 to April 2012. The modified ANKLe score (total 24) is formed by the combination of, the content (out of 20) and legibility (out of 4) to give an overall score out of 24. A score of at least 20 (content score 17/20; legibility score 3/4) is considered as acceptable. It means that a surgical record is legible and the majority of the essential content is recorded. Results: A total of 236 records were evaluated. Overall mean ± standard deviation (SD) of ANKLe score was 18.4± 2.1 out of maximum score of 24. Content and legibility has overall mean scores of 14.4 out of 20 and 3.9 out of 4 respectively. Only two variables, patient’s name and consultant on call were documented in 100% of records while the least documented variable were social history 2 (0.2%). Legibility scoring system provides that 218notes out of total set of 236 notes (that is 92.4% of overall notes) have achieved a score of 4. The benchmark of 80% was achieved in 26.1% for total ANKLe score, 6.8% for contents and 99.1% for legibility. Conclusion: Overall, quality of records is not good but legibility part scores exceptionally high. PMID:24353683

  8. Evaluating the Effects of Ankle-Foot Orthosis Mechanical Property Assumptions on Gait Simulation Muscle Force Results.

    PubMed

    Hegarty, Amy K; Petrella, Anthony J; Kurz, Max J; Silverman, Anne K

    2017-03-01

    Musculoskeletal modeling and simulation techniques have been used to gain insights into movement disabilities for many populations, such as ambulatory children with cerebral palsy (CP). The individuals who can benefit from these techniques are often limited to those who can walk without assistive devices, due to challenges in accurately modeling these devices. Specifically, many children with CP require the use of ankle-foot orthoses (AFOs) to improve their walking ability, and modeling these devices is important to understand their role in walking mechanics. The purpose of this study was to quantify the effects of AFO mechanical property assumptions, including rotational stiffness, damping, and equilibrium angle of the ankle and subtalar joints, on the estimation of lower-limb muscle forces during stance for children with CP. We analyzed two walking gait cycles for two children with CP while they were wearing their own prescribed AFOs. We generated 1000-trial Monte Carlo simulations for each of the walking gait cycles, resulting in a total of 4000 walking simulations. We found that AFO mechanical property assumptions influenced the force estimates for all the muscles in the model, with the ankle muscles having the largest resulting variability. Muscle forces were most sensitive to assumptions of AFO ankle and subtalar stiffness, which should therefore be measured when possible. Muscle force estimates were less sensitive to estimates of damping and equilibrium angle. When stiffness measurements are not available, limitations on the accuracy of muscle force estimates for all the muscles in the model, especially the ankle muscles, should be acknowledged.

  9. 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.

  10. 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.

  11. The measurement and improvement of the lateral agility of the F-18

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

    The effect of vehicle configuration and flight control system performance on the roll agility of a modern fighter aircraft has been investigated. A batch simulation of a generic F-18 Hornet was used to study the roll agility as measured by the time to roll through 90 deg metric. Problems discussed include definition of agility, factors affecting the agility of a vehicle, the development of the time to roll through 90 deg agility metric, and a simulation experiment. It is concluded that the integral of stability or wind axis roll rate should be used as a measure of the roll measure traversed. The time through roll angle 90 deg metric is considered to be a good metric for measuring the transient performance aspect of agility. Roll agility of the F-18, as measured by 90 deg metric, can be improved by 10 to 30 percent. Compatible roll and rudder actuator rates can significantly affect 90 deg agility metric.

  12. The effects of ankle-foot orthoses on the ankle and knee in persons with myelomeningocele: an evaluation using three-dimensional gait analysis.

    PubMed

    Thomson, J D; Ounpuu, S; Davis, R B; DeLuca, P A

    1999-01-01

    The purpose of this study was to determine the effects of the ankle-foot orthosis (AFO) on gait patterns in patients with low-level myelomeningocele and to identify any abnormal gait patterns that may lead to future knee instability and pain. A total of 28 children (26 L4-level sides, 18 L5-level sides, and 10 S1-2-level sides) underwent a three-dimensional gait analysis when ambulating barefoot and with AFOs. Results show significant improvements in sagittal plane function with reductions in excessive ankle dorsiflexion, increases in peak plantar flexor moment, and reductions in crouch and knee extensor moment in the L4 and L5 groups. The only improvement in the S1-2 group was a reduction in excessive dorsiflexion, but there was a reduction in power generation at the ankle. The S1-2 group had normal transverse plane knee motion in stance during barefoot walking that increased significantly (p < 0.01) with the AFO. Both the L5 and L4 groups showed greater-than-normal transverse plane knee motion in stance during barefoot walking that also increased significantly (p < 0.01) with the AFO. The results suggest that excessive knee transverse plane rotation may contribute to knee instability more than coronal plane abnormalities. The AFO in S1-2-level patients may be more detrimental for the knee than barefoot walking.

  13. 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.

  14. 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.

  15. Decision Support for Iteration Scheduling in Agile Environments

    NASA Astrophysics Data System (ADS)

    Szőke, Ákos

    Today’s software business development projects often lay claim to low-risk value to the customers in order to be financed. Emerging agile processes offer shorter investment periods, faster time-to-market and better customer satisfaction. To date, however, in agile environments there is no sound methodological schedule support contrary to the traditional plan-based approaches. To address this situation, we present an agile iteration scheduling method whose usefulness is evaluated with post-mortem simulation. It demonstrates that the method can significantly improve load balancing of resources (cca. 5×), produce higher quality and lower-risk feasible schedule, and provide more informed and established decisions by optimized schedule production. Finally, the paper analyzes benefits and issues from the use of this method.

  16. Examining the relation of osteochondral lesions of the talus to ligamentous and lateral ankle tendinous pathologic features: a comprehensive MRI review in an asymptomatic lateral ankle population.

    PubMed

    Galli, Melissa M; Protzman, Nicole M; Mandelker, Eiran M; Malhotra, Amit D; Schwartz, Edward; Brigido, Stephen A

    2014-01-01

    Given the frequency and burden of ankle sprains, the pathologic features identified on magnetic resonance imaging (MRI) scans are widely known in the symptomatic population. Ankle MRI pathologic features in the asymptomatic population, however, are poorly understood. Such examinations are rarely undertaken unless an ankle has been injured or is painful. We report the systematic MRI findings from the reports of 108 consecutive asymptomatic lateral ankles (104 patients). Our purpose was to (1) report the prevalence of osteochondral lesions of the talus (OLTs) and pathologic features of the medial and lateral ligaments, peroneal tendons, and superior peroneal retinaculum (SPR); (2) correlate the presence of OLTs with the pathologic features of the medial and lateral ligaments, peroneal tendons, and SPR; and (3) correlate ligamentous discontinuity with the peroneal pathologic features, OLTs, and SPR pathologic features. A total of 16 OLTs (14.81%) were present (13 medial and 3 lateral). Of the 16 patients with OLTs, 8 (50.00%) had concomitant peroneal pathologic findings. Healthy medial and lateral ligaments were noted in 41 patients (37.96%), and ligamentous discontinuity was grade I in 25 (23.15%), II in 32 (29.63%), III in 5 (4.63%), and grade IV in 5 patients (4.63%). A weak positive correlation was found between attenuation or tears of the superficial deltoid and medial OLTs (phi coefficient = 0.23, p = .0191) and a moderate positive correlation between tears of the posterior talofibular ligament and lateral OLTs (phi coefficient = 0.30, p = .0017). Additionally, a moderate positive correlation between ligamentous discontinuity and tendinopathy of the peroneus brevis was noted [Spearman's coefficient(106) = 0.29, p = .0024]. These findings add to the evidence of concomitant pathologic features in the asymptomatic population. To definitively assess causation and evaluate the clinical evolution of radiologic findings, future, prospective, longitudinal

  17. The AGILE Mission and Gamma-Ray Bursts

    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.

    2007-05-01

    The AGILE Mission 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 at the beginning of 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. The broadband detection of GRBs and the study of implications for particle acceleration and high energy emission are primary goals of the mission. AGILE can image GRBs with 2-3 arcminute error boxes in the hard X-ray range, and provide broadband photon-by photon detection in the 15-45 keV, 03-50 MeV, and 30 MeV-30 GeV energy ranges. Microsecond on-board photon tagging and a {approx} 100 microsecond gamma-ray detection deadtime will be crucial for fast GRB timing. On-board calculated GRB coordinates and energy fluxes will be quickly transmitted to the ground by an ORBCOMM transceiver. AGILE is now (January 2007) undergoing final satellite integration and testing. The PLS V launch is planned in spring 2007. AGILE is then foreseen to be fully operational during the summer of 2007.

  18. The Perfect Process Storm: Integration of CMMI, Agile, and Lean Six Sigma

    DTIC Science & Technology

    2012-12-01

    projects using similar iterative methodologies includ- ing Scrum , Crystal, and Feature-driven Development leading to the meeting of the Agile...1986 Lean Six Sigma (LSS) Late 1990’s Lean Production 1990 CMM 1987 - 2002 CMMI 2002V1.3 2010 Agile XP 1996 Agile Manifesto 2001 Scrum 2001...Business Process Improvement. Most recently his efforts have targeted BPI for 22 Agile SCRUM projects, deploy- ing Project and Process Management

  19. A Survey of Parachute Ankle Brace Breakages

    DTIC Science & Technology

    2008-01-10

    reduced since it was subject to abrasion from the concrete in the harness shed, asphalt on the loading ramp, and dirt on the drop zone. b. DJ...strap was also directly under the heel and subject to abrasion from concrete in the harness shed, asphalt on the loading ramp, and dirt on the drop...airborne injuries), airborne students who did not wear the brace were 1.90 times more likely to experience an ankle sprain, 1.47 times more likely to

  20. Normal Variants: Accessory Muscles About the Ankle.

    PubMed

    Cheung, Yvonne

    2017-02-01

    Accessory muscles around the ankle are commonly encountered as incidental findings on cross-sectional imaging. Mostly asymptomatic, accessory muscles sometimes mimic mass lesions. They have been implicated as the cause of tarsal tunnel syndrome, impingement of surrounding structures, and chronic pain. Distinguishing these muscles can be challenging, because some travel along a similar path. This article describes these accessory muscles in detail, including their relationships to the aponeurosis of the lower leg. An imaging algorithm is proposed to aid in identification of these muscles, providing a valuable tool in diagnostic accuracy and subsequent patient management.

  1. 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

  2. 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.

  3. 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.

  4. Adaptive sports ankle prosthetics. Interview by Sarah A. Curran.

    PubMed

    Lyle, David K

    2012-09-01

    Participating in sport at all levels is gaining a dedicated following and this is also apparent in individuals with an amputation. Currently, there is a wide variety of ankle prostheses available which attempt to provide function, control, and comfort, as well as good aesthetic appeal. Participation in sport, however, increases the demands placed upon ankle prostheses. This can compromise function and performance, and constrain the opportunities of participation in various outdoor and water sports. In acknowledging this limitation and the need to develop more versatile ankle prostheses, this article introduces the evolution of a prototype ankle prosthesis referred to as "Adaptive Sports Ankle." The ankle prosthesis, which is compatible with any foot pyramid adapter, offers the same range of motion as the normal human ankle joint and is made up of components that are chemical and corrosion resistant. These design features that are specifically created to accommodate below-the-knee amputees provide an ideal prosthesis for those wishing to lead an active lifestyle and participate in aquatic (i.e. swimming, surfing, and scuba diving), snowboarding, and equestrian activities. Although it is acknowledged that there is a need to establish research on the Adaptive Sports Ankle, its introduction to the market will enhance and expand opportunities of those individuals with a lower limb amputation to lead an active and healthy lifestyle.

  5. How to Strengthen Your Ankle After a Sprain

    MedlinePlus

    ... of the band with your hand and gently push your ankle down as far as you can and then back to the starting ... with your foot pointing down and pull your ankle up as far as you can. Return to the ...

  6. 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.

  7. Find an Orthopaedic Foot and Ankle MD/DO

    MedlinePlus

    ... of the Smaller Toes How To... Foot Health Foot Injury Footwear News Videos Find a Surgeon Información en ... all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle. Orthopaedic foot and ankle surgeons work ...

  8. 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…

  9. Understanding acute ankle ligamentous sprain injury in sports.

    PubMed

    Fong, Daniel Tp; Chan, Yue-Yan; Mok, Kam-Ming; Yung, Patrick Sh; Chan, Kai-Ming

    2009-07-30

    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 be

  10. 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

  11. 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

  12. 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.

  13. Prospective Epidemiological Study of Basketball Injuries During One Competitive Season: Ankle Sprains and Overuse Knee Injuries

    PubMed Central

    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

  14. Preoperative gait characterization of patients with ankle arthrosis.

    PubMed

    Khazzam, Michael; Long, Jason T; Marks, Richard M; Harris, Gerald F

    2006-08-01

    The purpose of this study was to evaluate the kinematic changes that occur about the foot and ankle during gait in patients with degenerative joint disease (DJD). By comparing a normal adult population with what was found in the DJD population we determined how the motion of theses groups differed, thereby characterizing how this pathology affects foot and ankle motion. A 15-camera Vicon Motion Analysis System was used in conjunction with weight bearing radiographs to obtain three-dimensional motion of the foot and ankle during ambulation. The study was comprised of 34 patients and 35 ankles diagnosed with DJD (19 men and 15 women) of the ankle and 25 patients with normal ankles (13 men and 12 women). Dynamic foot and ankle motion was analyzed using the four-segment Milwaukee Foot Model (MFM). The data from this model resulted in three-dimensional (3D) kinematic parameters in the sagittal, coronal, and transverse planes as well as spatial-temporal parameters. Patient health status was evaluated using the SF-36 Health Survey and American Orthopaedics Foot and Ankle Society (AOFAS) hindfoot scores. The DJD group showed significant differences (p<0.001) as compared to normals with prolonged stance time, shortened stride length, reduced cadence and a walking speed which was only 66.96% of normal. Overall, kinematic data in the DJD cohort showed significant differences (p<0.001) in all planes of motion for tibial, hindfoot and forefoot motion as compared to normals. The average preoperative AOFAS hindfoot score was 26. DJD of the ankle results in decreased range of motion during gait. This decreased range of motion may be related to several factors including bony deformity, muscle weakness, and attempts to decrease the pain associated with weight bearing. To date there has not been a study which describes the effect of this disease process on motion of the foot and ankle. These findings may prove to be useful in the pre-operative assessment of these patients.

  15. Imaging appearances of lateral ankle ligament reconstruction.

    PubMed

    Chien, Alexander J; Jacobson, Jon A; Jamadar, David A; Brigido, Monica Kalume; Femino, John E; Hayes, Curtis W

    2004-01-01

    Six patients were retrospectively identified as having undergone lateral ligament reconstruction surgery. The surgical procedures were categorized into four groups: direct lateral ligament repair, peroneus brevis tendon rerouting, peroneus brevis tendon loop, and peroneus brevis tendon split and rerouting. At radiography and magnetic resonance (MR) imaging, the presence of one or more suture anchors in the region of the anterior talofibular ligament indicates direct ligament repair, whereas a fibular tunnel indicates peroneus brevis tendon rerouting or loop. Both ultrasonography (US) and MR imaging demonstrate rerouted tendons as part of lateral ankle reconstruction; however, MR imaging can also depict the rerouted tendon within an osseous tunnel if present, especially if T1-weighted sequences are used. Artifact from suture material may obscure the tendon at MR imaging but not at US. With both modalities, the integrity of the rerouted peroneus brevis tendon is best evaluated by following the tendon proximally from its distal attachment site, which typically remains unchanged. The rerouted tendon or portion of the tendon can then be traced proximally to its reattachment site. Familiarity with the surgical procedures most commonly used for lateral ankle ligament reconstruction, and with the imaging features of these procedures, is essential for avoiding diagnostic pitfalls and ensuring accurate assessment of the ligament reconstruction.

  16. [Chronic instability in the ankle area].

    PubMed

    Dubrana, F; Poichotte, A; Toullec, E; Colin, D; Guillodo, Y; Moati, J-C; Brilhauht, J; Musset, T; Feron, F; Richou, J; Henri, M; Guillemot, E

    2006-06-01

    For ankle sprains, the initial radiological work-up must include weight-bearing AP and lateral stress views of the sprained and healthy ankle. Films are taken in auto-varus. Other explorations included arthroMRI, arthroscanner or MRI which can be indicated preoperatively to confirm suspected cartilage injury or an associated ligament tear. These techniques should be employed when pertinent information can be expected according to the clinical situation and the operator's experience. In the emergency setting, ultrasonography can provide a simple low-cost confirmation of joint hematoma which is more precise than x-rays with a positive predictive value of nearly 100%. The objective and subjective clinical outcome after surgical anatomic repair or ligamentoplasty are quite similar. The two principal differences relate to persistent subjective instability and post-operative surgical complications. Thus there are advantages and disadvantages for each option advantage for anatomical repair because of the low rate of surgical complications and advantage for ligament repairs which stabilize the subtalar joint with a low rate of residual instability.

  17. 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

    2011-09-09

    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.

  18. Biomechanics of the Ankle-Foot System during Stair Ambulation: Implications for Design of Advanced Ankle-Foot Prostheses

    DTIC Science & Technology

    2011-12-15

    A.H., 2007. Effect of ankle–foot orthosis on roll-over shape in adults with hemiplegia. Journal of Rehabilitation Research and Development 44 (1), 11...20. Gates, D.H., 2004. Characterizing Ankle Function During Stair Ascent, Descent, And Level Walking For Ankle Prosthesis And Orthosis Design. M.S

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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.

  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. 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

  6. 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.

  7. Considerations for Using Agile in DoD Acquisition

    DTIC Science & Technology

    2010-04-01

    Buettner, Aerospace Joe Tatem, Raytheon Stephany Bellomo, SEI Nanette Brown, SEI John Foreman, SEI Dr. John Goodenough, SEI Harry Levinson, SEI...event_details.php?id=452 [2] H. Glazer, J. Dalton, D. Anderson, M. Konrad , and S. Shrum, "CMMI or Agile: Why Not Embrace Both," Carnegie Mellon

  8. 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…

  9. 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.

  10. Correlation between agility and sprinting according to student age.

    PubMed

    Yanci, Javier; Los Arcos, Asier; Grande, Ignacio; Gil, Eneko; Cámara, Jesús

    2014-06-01

    The purposes of the study were to assess sprinting and agility performance characteristics and to determine the relationship between these two motor skills in elementary education students. Sprinting and agility performance were assessed in 176 children (88 boys and 88 girls) divided into three groups: Group 1 (G1, N = 98; 48 boys and 50 girls), from the first year of elementary education; Group 2 (G2, N = 38; 15 boys and 23 girls), from the second year of elementary education; Group 3 (G3, N = 40; 25 boys and 15 girls), from the third year of elementary education. Significant differences (p < 0.001) were found in agility ability among the groups and between G1-G3 and G2-G3 in the 5 and 15 m sprint. Regarding gender of the students of the same age, significant differences (p < 0.001) between boys and girls in group G1 and G2 were obtained in the 5 and 15 m sprint. The correlation between agility and acceleration was significant but moderate (0.3 < r < 0.7) in all groups (G1, G2, and G3), in most cases. When the gender factor was included, the results were heterogeneous. Assessing this correlation according to age and gender produced heterogeneous results. For this reason, we think that both are independent qualities and that age and gender are two factors that influence the correlation results.

  11. 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.

  12. 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…

  13. 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.

  14. On the biomimetic design of agile-robot legs.

    PubMed

    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.

  15. 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…

  16. 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

  17. Foot and ankle injuries in dance.

    PubMed

    Macintyre, J; Joy, E

    2000-04-01

    Acute traumatic injuries are common in ballet dancers. A careful history, thorough examination, and appropriate imaging should allow for the diagnosis of most problems. The clinician must have a high index of suspicion for occult bony injuries, especially if the patient fails to recover as expected. Aggressive treatment of the sprained ankle is essential to maintain foot and ankle mobility and prevent prolonged disability and subsequent overuse injuries. Kinetic chain dysfunctions are common in ballet dancers with overuse injuries and commonly follow ankle sprains. They may represent a secondary phenomenon that developed in response to the compensatory movement changes caused by the initial injury. It is important to remember, however, that these dysfunctions may have been long standing and a causative factor in the injury. Regardless of the time of onset of the dysfunction, residual kinetic chain dysfunction associated with incomplete rehabilitation of an injury may predispose the dancer to further injuries. Untreated dysfunctions at one site in the kinetic chain may predispose to compensatory dysfunction at other sites in the chain. Accordingly, it is essential to thoroughly examine the entire chain for functional movements when dealing with an injury, because identification and treatment of the kinetic chain dysfunction is important in the rehabilitation of the dancing athlete. Kinetic chain dysfunctions are common in injured ballet dancers and may be a cause of repeated injury. Why then are these dysfunctions left untreated? Medical personnel caring for dancers are sometimes guilty of tunnel vision, and focus solely on the injured site without considering what is happening at other sites in the kinetic chain. This oversight is compounded when the physicians or therapists are satisfied with discovering simply what injury has occurred rather than asking why the injury has occurred. The significance of kinetic chain dysfunctions is only just beginning to be

  18. 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.

  19. Effect of salt intake and potassium supplementation on brachial-ankle pulse wave velocity in Chinese subjects: an interventional study

    PubMed Central

    Wang, Y.; Mu, J.J.; Geng, L.K.; Wang, D.; Ren, K.Y.; Guo, T.S.; Chu, C.; Xie, B.Q.; Liu, F.Q.; Yuan, Z.Y.

    2014-01-01

    Accumulating evidence has suggested that high salt and potassium might be associated with vascular function. The aim of this study was to investigate the effect of salt intake and potassium supplementation on brachial-ankle pulse wave velocity (PWV) in Chinese subjects. Forty-nine subjects (28-65 years of age) were selected from a rural community of northern China. All subjects were sequentially maintained on a low-salt diet for 7 days (3.0 g/day NaCl), a high-salt diet for an additional 7 days (18.0 g/day NaCl), and a high-salt diet with potassium supplementation for a final 7 days (18.0 g/day NaCl+4.5 g/day KCl). Brachial-ankle PWV was measured at baseline and on the last day of each intervention. Blood pressure levels were significantly increased from the low-salt to high-salt diet, and decreased from the high-salt diet to high-salt plus potassium supplementation. Baseline brachial-ankle PWV in salt-sensitive subjects was significantly higher than in salt-resistant subjects. There was no significant change in brachial-ankle PWV among the 3 intervention periods in salt-sensitive, salt-resistant, or total subjects. No significant correlations were found between brachial-ankle PWV and 24-h sodium and potassium excretions. Our study indicates that dietary salt intake and potassium supplementation, at least in the short term, had no significant effect on brachial-ankle PWV in Chinese subjects. PMID:25493387

  20. 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

  1. Summary of Human Ankle Mechanical Impedance During Walking.

    PubMed

    Lee, Hyunglae; Rouse, Elliott J; Krebs, Hermano Igo

    2016-01-01

    The human ankle joint plays a critical role during walking and understanding the biomechanical factors that govern ankle behavior and provides fundamental insight into normal and pathologically altered gait. Previous researchers have comprehensively studied ankle joint kinetics and kinematics during many biomechanical tasks, including locomotion; however, only recently have researchers been able to quantify how the mechanical impedance of the ankle varies during walking. The mechanical impedance describes the dynamic relationship between the joint position and the joint torque during perturbation, and is often represented in terms of stiffness, damping, and inertia. The purpose of this short communication is to unify the results of the first two studies measuring ankle mechanical impedance in the sagittal plane during walking, where each study investigated differing regions of the gait cycle. Rouse et al. measured ankle impedance from late loading response to terminal stance, where Lee et al. quantified ankle impedance from pre-swing to early loading response. While stiffness component of impedance increases significantly as the stance phase of walking progressed, the change in damping during the gait cycle is much less than the changes observed in stiffness. In addition, both stiffness and damping remained low during the swing phase of walking. Future work will focus on quantifying impedance during the "push off" region of stance phase, as well as measurement of these properties in the coronal plane.

  2. Summary of Human Ankle Mechanical Impedance During Walking

    PubMed Central

    Rouse, Elliott J.; Krebs, Hermano Igo

    2016-01-01

    The human ankle joint plays a critical role during walking and understanding the biomechanical factors that govern ankle behavior and provides fundamental insight into normal and pathologically altered gait. Previous researchers have comprehensively studied ankle joint kinetics and kinematics during many biomechanical tasks, including locomotion; however, only recently have researchers been able to quantify how the mechanical impedance of the ankle varies during walking. The mechanical impedance describes the dynamic relationship between the joint position and the joint torque during perturbation, and is often represented in terms of stiffness, damping, and inertia. The purpose of this short communication is to unify the results of the first two studies measuring ankle mechanical impedance in the sagittal plane during walking, where each study investigated differing regions of the gait cycle. Rouse et al. measured ankle impedance from late loading response to terminal stance, where Lee et al. quantified ankle impedance from pre-swing to early loading response. While stiffness component of impedance increases significantly as the stance phase of walking progressed, the change in damping during the gait cycle is much less than the changes observed in stiffness. In addition, both stiffness and damping remained low during the swing phase of walking. Future work will focus on quantifying impedance during the “push off” region of stance phase, as well as measurement of these properties in the coronal plane. PMID:27766187

  3. 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

  4. 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

  5. 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…

  6. Static ankle impedance in stroke and multiple sclerosis: a feasibility study.

    PubMed

    Lee, Hyunglae; Patterson, Tara; Ahn, Jooeun; Klenk, Daniel; Lo, Albert; Krebs, Hermano Igo; Hogan, Neville

    2011-01-01

    Quantitative characterization of ankle mechanical impedance is critical for understanding lower extremity function in persons with neurological disorders. In this paper, we examine the feasibility of employing an ankle robot and multivariable analysis to determine static ankle impedance in 4 patients: 1 with multiple sclerosis and 3 with stroke. We employed a scalar based vector field approximation method which was successful in identifying young healthy subjects' ankle impedance. It enabled clear interpretation of spatial ankle impedance structure and intermuscular feedback at the ankle for both affected and unaffected legs. Measured impedance of two patients was comparable to healthy young subjects, while the other two patients had significantly different static ankle impedance properties.

  7. Supramalleolar osteotomy for ankle valgus in myelomeningocele.

    PubMed

    Abraham, E; Lubicky, J P; Songer, M N; Millar, E A

    1996-01-01

    Fifty-five supramalleolar osteotomies were performed in 35 patients for progressive hindfoot valgus in myelomeningocele. All patients were ambulatory. The most common motor level of innervation was L3 in 42 limbs. The average age at surgery was 12 years. The average follow-up was 8 years. Preoperatively, all patients experienced progressive difficulty with brace use, and anteroposterior weight-bearing ankle radiographs showed a valgus tilt of the talotibial angle (TTA) of > or = 10 degrees with an average of 18 degrees. The average postoperative correction of TTA was 17 degrees. The results were graded as follows: excellent, 42 limbs; good, eight limbs; fair, three limbs; and poor, two limbs. The fair and poor limb results were the result of loss of correction or nonunion. The best results were seen when the TTA was corrected to 5 degrees of varus.

  8. [Lateral ligament injuries of the ankle joint].

    PubMed

    Walther, M; Kriegelstein, S; Altenberger, S; Volkering, C; Röser, A; Wölfel, R

    2013-09-01

    Lateral ligament injuries are the most common sports injury and have a high incidence even in non-sportive activities. Although lateral ligament injuries are very common there is still a controversial debate on the best management. The diagnosis is based on clinical examination and X-ray images help to rule out fractures. Further imaging, especially magnetic resonance imaging (MRI) is used to diagnose associated injuries. According to the recommendations of the various scientific societies the primary therapy of lateral ligament injuries is conservative. Chronic ankle instability develops in 10-20 % of patients and the instability can be a result of sensomotoric deficits or insufficient healing of the lateral ligament complex. If the patient does not respond to an intensive rehabilitation program an operative reconstruction of the lateral ligaments has to be considered. Most of the procedures currently performed are anatomical reconstructions due to better long-term results compared to tenodesis procedures.

  9. Arthroscopic Management of Posteromedial Ankle Impingement

    PubMed Central

    Lui, Tun Hing

    2015-01-01

    Posteromedial ankle impingement is a rare clinical entity. It usually follows an inversion injury, with compression of the posterior tibiotalar ligament between the medial malleolus and talus. This can be treated by posterior ankle endoscopy through the posteromedial and posterolateral portals. The flexor hallucis longus tendon can be examined for any tenosynovitis or tendinopathy. The posteromedial corner of the ankle joint is reached with the instruments staying on the lateral side of the flexor hallucis longus tendon. The inflamed synovium, scar tissue, and fibrillated cartilage are debrided. PMID:26697299

  10. 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.

  11. 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.

  12. 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.

  13. Arthroscopic Management of Posteromedial Ankle Impingement.

    PubMed

    Lui, Tun Hing

    2015-10-01

    Posteromedial ankle impingement is a rare clinical entity. It usually follows an inversion injury, with compression of the posterior tibiotalar ligament between the medial malleolus and talus. This can be treated by posterior ankle endoscopy through the posteromedial and posterolateral portals. The flexor hallucis longus tendon can be examined for any tenosynovitis or tendinopathy. The posteromedial corner of the ankle joint is reached with the instruments staying on the lateral side of the flexor hallucis longus tendon. The inflamed synovium, scar tissue, and fibrillated cartilage are debrided.

  14. 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

  15. 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.

  16. Ankle control and strength training for children with cerebral palsy using the Rutgers Ankle CP: a case study.

    PubMed

    Cioi, Daniel; Kale, Angad; Burdea, Grigore; Engsberg, Jack; Janes, William; Ross, Sandy

    2011-01-01

    The purpose of the study described here was to develop and feasibility test the Rutgers Ankle CP, aimed at ankle strengthening and improved control for children with cerebral palsy (CP). The system was an upgrade in hardware (new foot attachment, new robot controller) and software (new games and programming language) of the earlier Rutgers Ankle in order to permit training of children with CP. The new Rutgers Ankle CP was used to train ankle strength and motor control in a 7 year old boy with CP during 36 rehabilitation sessions (12 weeks, 3 times/week). Assessments for impairment, function and quality of life were taken before and after training. Results indicated improvements in both strength and motor control. Gait function improved substantially in ankle kinematics, speed and endurance. Overall function (GMFM) indicated improvements that were typical of other ankle strength training programs. Quality of life increased beyond what would be considered a minimal clinical important difference. While these results are only for a single participant, they are very encouraging toward improving the function and quality of life of children with cerebral palsy. Further research with a larger number of participants is planned.

  17. MIDFOOT AND FOREFOOT INVOLVEMENT IN LATERAL ANKLE SPRAINS AND CHRONIC ANKLE INSTABILITY. PART 1: ANATOMY AND BIOMECHANICS

    PubMed Central

    Feger, Mark A.; Hertel, Jay

    2016-01-01

    The modern human foot is the culmination of more than five million years of evolution. The ankle-foot complex absorbs forces during loading, accommodates uneven surfaces, and acts as a lever for efficient propulsion. The ankle-foot complex has six independent functional segments that should be understood for proper assessment and treatment of foot and ankle injuries: the shank, rearfoot, midfoot, lateral forefoot, and the medial forefoot. The compliance of the individual segments of the foot is dependent on velocity, task, and active and passive coupling mechanisms within each of the foot segments. It is also important to understand the passive, active, and neural subsystems that are functionally intertwined to provide structure and control to the multisegmented foot. The purpose of the first part of this clinical commentary and current concepts review was to examine foot and ankle anatomy, detail the roles of the intrinsic and extrinsic foot and ankle musculature from a multisegmented foot perspective, and discuss the biomechanics of the ankle-foot complex during function. The interplay of segmental joint mobility, afferent and efferent sensorimotor function, and movement and stabilization provided by the extrinsic and intrinsic musculature is required to coordinate and execute the complex kinematic movements in the ankle-foot complex during propulsion. Level of Evidence 5 PMID:27904801

  18. MIDFOOT AND FOREFOOT INVOLVEMENT IN LATERAL ANKLE SPRAINS AND CHRONIC ANKLE INSTABILITY. PART 1: ANATOMY AND BIOMECHANICS.

    PubMed

    Fraser, John J; Feger, Mark A; Hertel, Jay

    2016-12-01

    The modern human foot is the culmination of more than five million years of evolution. The ankle-foot complex absorbs forces during loading, accommodates uneven surfaces, and acts as a lever for efficient propulsion. The ankle-foot complex has six independent functional segments that should be understood for proper assessment and treatment of foot and ankle injuries: the shank, rearfoot, midfoot, lateral forefoot, and the medial forefoot. The compliance of the individual segments of the foot is dependent on velocity, task, and active and passive coupling mechanisms within each of the foot segments. It is also important to understand the passive, active, and neural subsystems that are functionally intertwined to provide structure and control to the multisegmented foot. The purpose of the first part of this clinical commentary and current concepts review was to examine foot and ankle anatomy, detail the roles of the intrinsic and extrinsic foot and ankle musculature from a multisegmented foot perspective, and discuss the biomechanics of the ankle-foot complex during function. The interplay of segmental joint mobility, afferent and efferent sensorimotor function, and movement and stabilization provided by the extrinsic and intrinsic musculature is required to coordinate and execute the complex kinematic movements in the ankle-foot complex during propulsion.

  19. 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

  20. Diagnostic Value of CT Arthrography for Evaluation of Osteochondral Lesions at the Ankle

    PubMed Central

    Kirschke, Jan S.; Braun, Sepp; Baum, Thomas; Holwein, Christian; Schaeffeler, Christoph; Imhoff, Andreas B.; Rummeny, Ernst J.; Woertler, Klaus

    2016-01-01

    Background. To retrospectively determine the diagnostic value of computed tomography arthrography (CTA) of the ankle in the evaluation of (osteo)chondral lesions in comparison to conventional magnetic resonance imaging (MRI) and intraoperative findings. Methods. A total of N = 79 patients had CTAs and MRI of the ankle; in 17/79 cases surgical reports with statements on cartilage integrity were available. Cartilage lesions and bony defects at talus and tibia were scored according to defect depth and size by two radiologists. Statistical analysis included sensitivity analyses and Cohen's kappa calculations. Results. On CTA, 41/79 and 31/79 patients had full thickness cartilage defects at the talus and at the tibia, respectively. MRI was able to detect 54% of these defects. For the detection of full thickness cartilage lesions, interobserver agreement was substantial (0.72 ± 0.05) for CTA and moderate (0.55 ± 0.07) for MRI. In surgical reports, 88–92% and 46–62% of full thickness defects detected by CTA and MRI were described. CTA findings changed the further clinical management in 15.4% of cases. Conclusions. As compared to conventional MRI, CTA improves detection and visualization of cartilage defects at the ankle and is a relevant tool for treatment decisions in unclear cases. PMID:27891511

  1. Three-dimensional finite element stress analysis of the polypropylene, ankle-foot orthosis: static analysis.

    PubMed

    Chu, T M; Reddy, N P; Padovan, J

    1995-07-01

    An asymmetric 3-dimensional finite element model (FEM) of the ankle-foot orthosis (AFO) together with the ankle-foot complex was developed using the computer aided design (CAD) program PATRAN. Static analysis of normal and pathological motions of the ankle-foot complex such as the "drop-foot" problem were conducted using the FEM program ADINA. A total of 313 three dimensional solid elements and 10 truss elements were used. Heel strike and toe-off condition were simulated. Results revealed that the peak compressive stress (1.6 MPa) in the AFO model occurred in the heel regions of the AFO and the maximum tensile stress (0.8 MPa) occurred in the neck region of the AFO during toe-off. Parametric analyses revealed that the model was sensitive to the elastic moduli of the AFO and of the soft tissue, but was relatively insensitive to the ligament stiffness. The results confirmed the hypothesis that peak stresses in the orthosis occur in the heal and neck regions of the orthosis.

  2. 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.

  3. Ankle injury manipulation before or after X-ray--does it influence success?

    PubMed

    Hastie, G R; Divecha, H; Javed, S; Zubairy, A

    2014-03-01

    Many acute, deformed ankle injuries are manipulated in the Emergency Department (ED) before X-rays are taken to confirm the nature of the injury. This often occurs in the absence of neurovascular or skin compromise without consideration of other possible injuries such as talar, subtalar or calcaneal injuries. We believe that an inappropriate manipulation of an unknown injury pattern may place the patient at increased risk. A balance needs to be struck between making the correct diagnosis and preventing any further neurovascular or skin compromise. We prospectively reviewed 197 patients admitted to the Royal Blackburn Hospital with acute ankle injuries. Their ED notes were reviewed, specifically assessing whether a manipulation was performed; if so, was it performed before X-rays and the documented reasons. A total of 90 ankle fractures were manipulated and 31 of these were performed before X-ray. One manipulation was performed for vascular compromise, one for nerve symptoms, three for critical skin and 25 for undocumented reasons. Outcomes (re-manipulation, delay to surgery and need for open reduction and internal fixation (ORIF)) were compared between injuries manipulated before or after X-ray. Re-manipulation was found to be significant (44% before X-ray vs. 18% after X-ray; chi-squared test: p=0.03; relative risk (RR)=2.72; 95% confidence interval (CI): 1.15-6.44). Delay to surgery and need for ORIF were not statistically different. We conclude that performing ankle injury X-rays before an attempt at manipulation, in the absence of neurovascular deficit or critical skin, may constitute best practice as it provides a better assessment of fracture configuration, guides initial reduction and significantly lowers the risk of re-manipulation and the potential risks associated with sedation without delaying surgery.

  4. Difference in Agility, Strength, and Flexibility in Competitive Figure Skaters Based on Level of Expertise and Skating Discipline.

    PubMed

    Slater, Lindsay V; Vriner, Melissa; Zapalo, Peter; Arbour, Kat; Hart, Joseph M

    2016-12-01

    Slater, LV, Vriner, M, Zapalo, P, Arbour, K, and Hart, JM. Difference in agility, strength, and flexibility in competitive figure skaters based on level of expertise and skating discipline. J Strength Cond Res 30(12): 3321-3328, 2016-Figure skating is an extremely difficult sport that requires a combination of grace, artistry, flexibility, speed, and power. Although many skaters are involved with strength and conditioning programs, there is no current information about differences in off-ice performance measures based on skating discipline and level. The purpose of this study was to compare agility, strength, and flexibility performance based on skating discipline and level. A total of 343 figure skaters from 4 different disciplines (singles, dance, pair, and synchronized skating) and 3 different levels (novice, junior, and senior) completed combine testing with the United States Figure Skating Association. All subjects completed the hexagon agility test, t-test, triple bound jumps, vertical jump, timed tuck jumps, push-ups, v-ups, hand press, front split, seated reach, and stork pose. A multivariate analysis of variance with Scheffe's post hoc was used to identify differences in performance based on skating discipline and level. Mean differences, Cohen's d effect sizes, and 95% confidence intervals were reported for all significant differences. Senior and junior skaters tended to be faster and stronger than novice skaters. Singles, dance, and pair skaters tended to be more agile, stronger, and flexible than synchronized skaters, however, senior synchronized skaters tended to perform better than senior skaters in other disciplines. These results indicate that strength and conditioning professionals should consider skating discipline and level when designing strengthening programs for figure skaters.

  5. Ankle Arthrodesis Using an Anterior Titanium Dual Locked Plating Construct.

    PubMed

    Flint, Wesley W; Hirose, Christopher B; Coughlin, Michael J

    Ankle arthrodesis is currently the reference standard treatment for end-stage tibiotalar arthrosis. The fusion rates have varied in the published data from 59% to 100%. We reviewed 60 cases of consecutive anterior ankle arthrodesis using an anterior dual locked plating construct with respect to the fusion rate, time to fusion, pain relief, and complications. The patients were followed up for a mean of 1.1 years (range 16 weeks to 4 years). We found that our fusion rate was 97% for ankles not requiring structural allograft. The mean interval to fusion was 11.7 weeks, excluding those with a structural allograft. The mean visual analog scale pain scores decreased from 7 preoperatively to 2 at the final follow-up visit. Anterior ankle arthrodesis with dual locked plating provides excellent results with respect to the fusion rate with a low complication rate.

  6. Limiting the use of routine radiography for acute ankle injuries.

    PubMed Central

    Cockshott, W. P.; Jenkin, J. K.; Pui, M.

    1983-01-01

    In the diagnosis of ankle injuries routine radiography is often productive. An international survey of the average number of radiographs made of injured ankles suggested that two projections are adequate to detect fractures. This was confirmed in a prospective study of 242 patients coming to a hospital emergency department with recent ankle injuries. All the fractures could be identified on an anteroposterior or a lateral projection, although some were more obvious on an oblique view. As well, all the fractures were associated with malleolar soft-tissue swelling. Thus, radiography for acute ankle injuries could safely be restricted to patients with soft-tissue swelling, and fractures could be diagnosed using only two routine projections, though for management purposes additional projections might be needed. With a policy of limiting the use of radiography substantial cost reductions are possible. Images FIG. 1 PMID:6407744

  7. Magnetic resonance imaging of sports injuries of the ankle.

    PubMed

    Morrison, William B

    2003-04-01

    Basic sports-related injuries of the ankle include ligament tear, tendon degeneration and tear, bone bruise, fracture, impingement, osteochondral defect, and plantar fasciitis. This article discusses the magnetic resonance imaging appearance of these injuries.

  8. Posteromedial dislocation of the ankle without fracture or diastasis.

    PubMed

    Wang, L C; Love, M B

    1993-02-01

    This case report describes a patient with posteromedial dislocation of the ankle without fracture and without disruption of the tibiofibular syndesmosis. The pathogenesis of this uncommon lesion is discussed.

  9. 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.

  10. Ultrasound of ankle and foot: overuse and sports injuries.

    PubMed

    Khoury, Viviane; Guillin, Raphaël; Dhanju, Jag; Cardinal, Etienne

    2007-06-01

    Sports and overuse injuries of the ankle and foot are commonly encountered in clinical practice. Ultrasound (US) has been established as an excellent diagnostic modality for foot and ankle injuries, providing a rapid noninvasive, economical, and readily available tool that is well tolerated by the patient with acute or chronic pain. The opportunity for dynamic examination is another advantage of US in evaluating ankle and foot pathology, where maneuvers such as muscle contraction and stressing of the joint may be particularly helpful. In many cases, US can be used as a first-line and only imaging modality for diagnosis. This article focuses on ankle disorders related to sports or overuse that affect tendons, including tendinosis, tenosynovitis, paratendinitis, rupture, dislocation, and ligaments that are commonly torn. The sonographic features of certain common foot disorders related to physical activity and overuse are also discussed, including plantar fasciitis, Morton's neuroma, stress fractures, and plantar plate injury.

  11. Ultrasound-guided intervention in the ankle and foot

    PubMed Central

    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

  12. 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

  13. Antibiotic-loaded cement beads for Charcot ankle osteomyelitis.

    PubMed

    Ramanujam, Crystal L; Zgonis, Thomas

    2010-10-01

    The concomitant presence of osteomyelitis and diabetic Charcot neuroarthropathy of the foot and ankle places those patients affected at increased risk for limb loss. Antibiotic-loaded cement has been reported to be useful in the treatment of deep soft tissue and joint infections. The authors present an overview of this adjunctive treatment modality and present a case report using antibiotic-loaded cement beads in staged reconstruction for Charcot ankle osteomyelitis.

  14. 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

  15. Lower Extremity Kinematics and Ground Reaction Forces After Prophylactic Lace-Up Ankle Bracing

    PubMed Central

    DiStefano, Lindsay J; Padua, Darin A; Brown, Cathleen N; Guskiewicz, Kevin M

    2008-01-01

    Context: Long-term effects of ankle bracing on lower extremity kinematics and kinetics are unknown. Ankle motion restriction may negatively affect the body's ability to attenuate ground reaction forces (GRFs). Objective: To evaluate the immediate and long-term effects of ankle bracing on lower extremity kinematics and GRFs during a jump landing. Design: Experimental mixed model (2 [group] × 2 [brace] × 2 [time]) with repeated measures. Setting: Sports medicine research laboratory. Patients or Other Participants: A total of 37 healthy subjects were assigned randomly to either the intervention (n  =  11 men, 8 women; age  =  19.63 ± 0.72 years, height  =  176.05 ± 10.58 cm, mass  =  71.50 ± 13.15 kg) or control group (n  =  11 men, 7 women; age  =  19.94 ± 1.44 years, height  =  179.15 ± 8.81 cm, mass  =  74.10 ± 10.33 kg). Intervention(s): The intervention group wore braces on both ankles and the control group did not wear braces during all recreational activities for an 8-week period. Main Outcome Measure(s): Initial ground contact angles, maximum joint angles, time to reach maximum joint angles, and joint range of motion for sagittal-plane knee and ankle motion were measured during a jump-landing task. Peak vertical GRF and the time to reach peak vertical GRF were assessed also. Results: While participants were wearing the brace, ankle plantar flexion at initial ground contact (brace  =  35° ± 13°, no brace  =  38° ± 15°, P  =  .024), maximum dorsiflexion (brace  =  21° ± 7°, no brace  =  22° ± 6°, P  =  .04), dorsiflexion range of motion (brace  =  56° ± 14°, no brace  =  59° ± 16°, P  =  .001), and knee flexion range of motion (brace  =  79° ± 16°, no brace  =  82° ± 16°, P  =  .036) decreased, whereas knee flexion at initial ground contact increased (brace  =  12° ± 9°, no brace  =  9° ± 9°, P  =  .0001). Wearing the brace for 8

  16. Gait generation for powered Hip-Ankle-Linkage-Orthosis.

    PubMed

    Jaeryoung Lee; Mizumoto, Ryota; Obinata, Goro; Genda, Eiichi; Stefanov, Dimitar; Aoki, Hirofumi; Yanling Pei

    2015-08-01

    A hip-knee-ankle-foot orthotic system called `HALO'(Hip and Ankle Linked Orthosis) for paraplegic walking has been developed in our previous study. Each ankle joint of the HALO system is linked with a medial single joint via a wire which allows both feet of the orthosis to stay always parallel to the floor during walking and assists swinging the leg. The tests of the HALO system demonstrated that it allows smoother walking and easy don/doff. In order to improve further the characteristics of the previous design, we started a new project called pHALO aiming at further reducing of the energy expenditure during walking. As a difference from the previous solution where ankle joints were restrained, the new solution will incorporate two actuators to control the ankle joints angles. As an intermediate step from the development of the pHALO system, in this study we added to the existing system a feedback PI controller to control the ankle joint angle of the right foot in the push-off phase and conducted an experiment to evaluate the effect of the new design on the walking patterns and energy efficiency. The results showed longer stride length, faster gait speed, smaller variation of the CoG, and less energy consumption.

  17. In vitro measurement of intraarticular pressure in the ankle joint.

    PubMed

    Suckel, Andreas; Muller, Otto; Wachter, Nikolaus; Kluba, Torsten

    2010-05-01

    Ankle joint affections and injuries are common problems in sports traumatology and in the daily routine of arthroscopic surgeons. However, there is little knowledge regarding intraarticular loads. Pressures on the ankle were determined in a dynamic model on 8 cadaver specimens, applying forces to tendons of the foot over the stance phase under vertical loading. A characteristic course of loading in the tibiotalar joint with a rapid increase upon heel contact was observed. It increased gradually to reach a maximum after 70% of the stance phase, during the push-off phase. The major torque in the ankle joint is located anterolaterally. A dynamic loading curve of the ankle joint can be demonstrated. These observations explain phenomena such as the appearance of osteophytes on the anterior tibia in the case of ankle osteoarthritis and the relatively low incidence of posterior tibial edge fragments in the case of trimalleolar ankle fracture. Furthermore, the medial side of the talus is less loaded compared to the lateral side, which appears relevant to the treatment of osteochondrosis dissecans.

  18. 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

  19. Valdecoxib provides effective pain relief following acute ankle sprain.

    PubMed

    Diaz, J A; Cuervo, C; Valderrama, A M; Kohles, J

    2006-01-01

    We sought to determine whether valdecoxib is as effective as diclofenac in treating acute ankle sprain. Patients (n=202) with acute first- and second-degree ankle sprain were randomized to valdecoxib (40 mg twice daily on day 1 followed by 40 mg once daily on days 2-7) or diclofenac (75 mg twice daily). The primary efficacy end-point was the Patient's Assessment of Ankle Pain visual analogue scale (VAS, 0-100 mm) value on day 4. Valdecoxib was as efficacious as diclofenac in treating the signs and symptoms of acute ankle sprain. The mean VAS reduction in ankle pain on day 4 was not different between groups; the two-sided 95% confidence interval for the between-group difference was within the prespecified limit for non-inferiority (10 mm). There were no significant differences between groups for all secondary efficacy end-points. The two treatments were similarly effective and well tolerated for treatment of acute ankle sprain.

  20. 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.

  1. 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.

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

    PubMed Central

    Feger, Mark A.; Hertel, Jay

    2016-01-01

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

  3. DoD Acquisitions Reform: Embracing and Implementing Agile

    DTIC Science & Technology

    2015-12-01

    austerity, the DoD must focus on Agile implementation in three main areas: training, business process re-engineering and contracting guidance.   It ...specific recommendations and bound the topic of research, the focus of this paper is on information technology ( IT ) acquisitions specifically, which...The B-52 lived and died by the quality of its sheet metal. Today, our aircraft will live or die by the quality of our software” (Hagan, Hurt

  4. 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

  5. Achieving Agility and Stability in Large-Scale Software Development

    DTIC Science & Technology

    2013-01-16

    question Which software development process are you currently using? 1. Agile software development (e.g., using Scrum , XP practices, test-driven... Scrum teams, product development teams, component teams, feature teams) spend almost all of their time fixing defects, and new capability...architectural runway provides the degree of architectural stability to support the next n iterations of development. In a Scrum project environment

  6. Achieving Agility and Stability in Large-Scale Software Development

    DTIC Science & Technology

    2013-01-16

    question Which software development process are you currently using? 1. Agile software development (e.g., using Scrum , XP practices, test-driven... Scrum teams, product development teams, component teams, feature teams) spend almost all of their time fixing defects, and new capability...architectural runway provides the degree of architectural stability to support the next n iterations of development. In a Scrum project environment, the

  7. Integrating Agile Combat Support within Title 10 Wargames

    DTIC Science & Technology

    2015-03-26

    incorporate logistics into Air Force Title 10 wargames. More specifically, we capture Air Force Materiel Command’s (AFMC) Agile Combat Support (ACS...within an unclassified general wargame scenario. Logistics has been omitted from wargames for a multitude of reasons throughout the years. We...develop a logistics simulation model of a simplified wargame scenario designed to be run within the Logistics Composite Model (LCOM) Analysis Toolkit

  8. In Pursuit of Agile Acquisition: Are We There Yet?

    DTIC Science & Technology

    2013-03-01

    bureaucracy in the methodology, and avoid promoting activities that would further expand regulatory guidance and oversight to improve agility. Once an...through an integrated digital system called Blue Force Tracker . Instead of the lack of situational awareness, units now use streaming video to help...to trace forensics collected at other crime scenes or events and trace the data back to specific individuals thus identifying dangerous insurgents

  9. 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.

  10. Laser agile illumination for object tracking and classification - Feasibility study

    NASA Technical Reports Server (NTRS)

    Scholl, Marija S.; Vanzyl, Jakob J.; Meinel, Aden B.; Meinel, Marjorie P.; Scholl, James W.

    1988-01-01

    The 'agile illumination' concept for discrimination between ICBM warheads and decoys involves a two-aperture illumination with coherent light, diffraction of light by propagation, and a resulting interference pattern on the object surface. A scanning two-beam interference pattern illuminates one object at a time; depending on the shape, momentum, spinning, and tumbling characteristics of the interrogated object, different temporal signals will be obtained for different classes of objects.

  11. Force Projection, Strategic Agility and the Big Meltdown

    DTIC Science & Technology

    2001-05-18

    UNLIMITED Number of Pages 29 ii Abstract of FORCE PROJECTION, STRATEGIC AGILITY AND THE BIG MELTDOWN Due to global warming , the polar icepack which...INTRODUCTION The polar icecap which covers the Arctic Ocean is melting. It is a well-known, scientific fact. Global warming is the generally...operational factors and functions, as applicable. 3 CHAPTER II BACKGROUND Global Warming and the Arctic During this and the last century, researchers have

  12. Effect of multilayer high-compression bandaging on ankle range of motion and oxygen cost of walking

    PubMed Central

    Roaldsen, K S; Elfving, B; Stanghelle, J K; Mattsson, E

    2012-01-01

    Objective To evaluate the effects of multilayer high-compression bandaging on ankle range of motion, oxygen consumption and subjective walking ability in healthy subjects. Method A volunteer sample of 22 healthy subjects (10 women and 12 men; aged 67 [63–83] years) were studied. The intervention included treadmill-walking at self-selected speed with and without multilayer high-compression bandaging (Proforeº), randomly selected. The primary outcome variables were ankle range of motion, oxygen consumption and subjective walking ability. Results Total ankle range of motion decreased 4% with compression. No change in oxygen cost of walking was observed. Less than half the subjects reported that walking-shoe comfort or walking distance was negatively affected. Conclusion Ankle range of motion decreased with compression but could probably be counteracted with a regular exercise programme. There were no indications that walking with compression was more exhausting than walking without. Appropriate walking shoes could seem important to secure gait efficiency when using compression garments. PMID:21810941

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. The reliability of a functional agility test for water polo.

    PubMed

    Tucher, Guilherme; de Souza Castro, Flávio Antônio; Garrido, Nuno Domingos; Martins da Silva, António José Rocha

    2014-06-28

    Few functional agility tests for water polo take into consideration its specific characteristics. The preliminary objective of this study was to evaluate the reliability of an agility test for water polo players. Fifteen players (16.3 ± 1.8 years old) with a minimum of two years of competitive experience were evaluated. A Functional Test for Agility Performance (FTAP) was designed to represent the context of this sport. Several trials were performed to familiarize the athlete with the movement. Two experienced coaches measured three repetitions of the FTAP. Descriptive statistics, repeated measures analysis of variance (ANOVA), 95% limit of agreement (LOA), intraclass correlation coefficient (ICC) and standard error of measurements (SEM) were used for data analysis. It was considered that certain criteria of reliability measures were met. There was no significant difference between the repetitions, which may be explained by an effect of the evaluator, the ability of the players or fatigue (p > 0.05). The ICC average from evaluators was high (0.88). The SEM varied between 0.13 s and 0.49 s. The CV average considering each individual was near 6-7%. These values depended on the condition of measurement. As the FTAP contains some characteristics that create a degree of unpredictability, the same athlete may reach different performance results, increasing variability. An adjustment in the sample, familiarization and careful selection of subjects help to improve this situation and enhance the reliability of the indicators.

  18. 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

  19. SAR imagery using chaotic carrier frequency agility pulses

    NASA Astrophysics Data System (ADS)

    Xu, Xiaojian; Feng, Xiangzhi

    2011-06-01

    Synthetic aperture radar (SAR) systems are getting more and more applications in both civilian and military remote sensing missions. With the increasing deployment of electronic countermeasures (ECM) on modern battlefields, SAR encounters more and more interference jamming signals. The ECM jamming signals cause the SAR system to receive and process erroneous information which results in severe degradations in the output SAR images and/or formation of phony images of nonexistent targets. As a consequence, development of the electronic counter-countermeasures (ECCM) capability becomes one of the key problems in SAR system design. This paper develops radar signaling strategies and algorithms that enhance the ability of synthetic aperture radar to image targets under conditions of electronic jamming. The concept of SAR using chaotic carrier frequency agility pulses (CCFAP-SAR) is first proposed. Then the imaging procedure for CCFAP-SAR is discussed in detail. The ECCM performance of CCFAP-SAR for both depressive noise jamming and deceptive repeat jamming is analyzed. The impact of the carrier frequency agility range on the image quality of CCFAP-SAR is also studied. Simulation results demonstrate that, with adequate agility range of the carrier frequency, the proposed CCFAP-SAR performs as well as conventional radar with linear frequency modulation (LFM) waveform in image quality and slightly better in anti-noise depressive jamming; while performs very well in anti-deception jamming which cannot be rejected by LFM-SAR.

  20. Biomechanics of the ankle-foot system during stair ambulation: implications for design of advanced ankle-foot prostheses.

    PubMed

    Sinitski, Emily H; Hansen, Andrew H; Wilken, Jason M

    2012-02-02

    Unilateral lower limb prosthesis users display temporal, kinematic, and kinetic asymmetries between limbs while ascending and descending stairs. These asymmetries are due, in part, to the inability of current prosthetic devices to effectively mimic normal ankle function. The purpose of this study was to provide a comprehensive set of biomechanical data for able-bodied and unilateral transtibial amputee (TTA) ankle-foot systems for level-ground (LG), stair ascent (SA), and stair descent (SD), and to characterize deviations from normal performance associated with prosthesis use. Ankle joint kinematics, kinetics, torque-angle curves, and effective shapes were calculated for twelve able-bodied individuals and twelve individuals with TTA. The data from this study demonstrated the prosthetic limb can more effectively mimic the range of motion and power output of a normal ankle-foot during LG compared to SA and SD. There were larger differences between the prosthetic and able-bodied limbs during SA and SD, most evident in the torque-angle curves and effective shapes. These data can be used by persons designing ankle-foot prostheses and provide comparative data for assessment of future ankle-foot prosthesis designs.

  1. 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

  2. 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.

  3. 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.

  4. 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 . 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 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 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.

  5. 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

  6. Extraarticular Supramalleolar Osteotomy for Managing Varus Ankle Osteoarthritis, Alternatives for Osteotomy: How and Why?

    PubMed

    Lee, Woo-Chun

    2016-03-01

    The supramalleolar osteotomy has been reported to be a joint preserving surgery with good clinical outcome for asymmetric ankle osteoarthritis, especially varus ankle osteoarthritis. Conventional supramalleolar osteotomy of the tibia and fibula creates angulation and translation of the ankle joint without changing the width of the ankle mortise. Distal tibial oblique osteotomy improved the preoperative clinical and radiological parameters; however, mean talar tilt angle did not decrease. Assessment of the ankle arthritis in sagittal, axial, and coronal planes may be helpful to achieve a decrease of the talar tilt in ankle osteoarthritis.

  7. The medial malleolus osteoligamentous complex and its role in ankle fractures.

    PubMed

    Davidovitch, Roy I; Egol, Kenneth A

    2009-01-01

    Ankle stability in ankle fractures is dependent on multiple factors. The medial malleolus and the associated deltoid ligament provide for ankle stability on the medial side. Over the years, the relative importance of this medial malleolar osteoligamentous complex (MMOLC) has been debated. This review will describe the evolution of ankle fracture surgery from the perspective of the contribution of the MMOLC to re-establishing ankle stability. Also discussed are the surgical and nonsurgical treatment options, various presentations of medial sided injuries in ankle fractures, and, finally, current recommendations for fixation.

  8. Functional instability in non-contact ankle ligament injuries

    PubMed Central

    Rose, A.; Lee, R.; Williams, R.; Thomson, L.; Forsyth, A.

    2000-01-01

    Objectives—To measure objectively functional standing balance in the acute stages of non-contact ankle sprain, and to compare patients with controls. Methods—A Chattanooga balance machine was used to measure postural stability in patients with acute ankle sprain and uninjured controls over a two week period, in one and two legged stance, with eyes open and closed. Participants also completed the Olerud and Molander questionnaire to provide a subjective measure of ankle function. Results—There was a highly significant improvement in questionnaire scores for the patients during the study period (p<0.0001). Patients appeared to be less stable than controls in all balance tests, although the difference did not reach significance. There was evidence of improvement over time in the number of tests successfully completed on the injured leg in single legged stance with eyes closed (p = 0.043) between visits 1 and 3. Conclusions—The patient group showed a subjective improvement, which supports clinical experience of treating acute ankle injuries. There is some evidence that on average the patient group appeared to be less stable than controls in all balance tests, although the difference did not reach statistical significance, even on the uninjured leg. There is a need to carry out further studies to confirm the results found in this pilot study and to investigate the hypotheses generated. It would be useful to evaluate a simple test that could be used clinically to monitor progress after ankle injury, and also to identify athletes with decreased functional stability, who may be more at risk of sustaining ankle injury. Key Words: balance; ankle; sprain; postural stability; injury prevention PMID:11049145

  9. 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.

  10. The influence of physical and cognitive factors on reactive agility performance in men basketball players.

    PubMed

    Scanlan, Aaron; Humphries, Brendan; Tucker, Patrick S; Dalbo, Vincent

    2014-01-01

    This study explored the influence of physical and cognitive measures on reactive agility performance in basketball players. Twelve men basketball players performed multiple sprint, Change of Direction Speed Test, and Reactive Agility Test trials. Pearson's correlation analyses were used to determine relationships between the predictor variables (stature, mass, body composition, 5-m, 10-m and 20-m sprint times, peak speed, closed-skill agility time, response time and decision-making time) and reactive agility time (response variable). Simple and stepwise regression analyses determined the individual influence of each predictor variable and the best predictor model for reactive agility time. Morphological (r = -0.45 to 0.19), sprint (r = -0.40 to 0.41) and change-of-direction speed measures (r = 0.43) had small to moderate correlations with reactive agility time. Response time (r = 0.76, P = 0.004) and decision-making time (r = 0.58, P = 0.049) had large to very large relationships with reactive agility time. Response time was identified as the sole predictor variable for reactive agility time in the stepwise model (R(2) = 0.58, P = 0.004). In conclusion, cognitive measures had the greatest influence on reactive agility performance in men basketball players. These findings suggest reaction and decision-making drills should be incorporated in basketball training programmes.

  11. 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

  12. 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

  13. Ankle arthrodesis: A systematic approach and review of the literature

    PubMed Central

    Yasui, Youichi; Hannon, Charles P; Seow, Dexter; Kennedy, John G

    2016-01-01

    Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis (ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus (0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches (open or arthroscopic) and differing fixation methods (internal or external fixation). Each technique has its advantage and disadvantages. Success of ankle arthrodesis can be dependent on several factors, including patient selection, surgeons’ skills, patient comorbidities, operative care, etc. However, from our experience, the majority of ESAA patients obtain successful clinical outcomes. This review aims to outline the indications and goals of arthrodesis for treatment of ESAA and discuss both open and arthroscopic ankle arthrodesis. A systematic step by step operative technique guide is presented for both the arthroscopic and open approaches including a postoperative protocol. We review the current evidence supporting each approach. The review finishes with a report of the most recent evidence of outcomes after both approaches and concerns regarding the development of hindfoot arthritis. PMID:27900266

  14. Ankle arthrodesis: A systematic approach and review of the literature.

    PubMed

    Yasui, Youichi; Hannon, Charles P; Seow, Dexter; Kennedy, John G

    2016-11-18

    Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis (ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus (0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches (open or arthroscopic) and differing fixation methods (internal or external fixation). Each technique has its advantage and disadvantages. Success of ankle arthrodesis can be dependent on several factors, including patient selection, surgeons' skills, patient comorbidities, operative care, etc. However, from our experience, the majority of ESAA patients obtain successful clinical outcomes. This review aims to outline the indications and goals of arthrodesis for treatment of ESAA and discuss both open and arthroscopic ankle arthrodesis. A systematic step by step operative technique guide is presented for both the arthroscopic and open approaches including a postoperative protocol. We review the current evidence supporting each approach. The review finishes with a report of the most recent evidence of outcomes after both approaches and concerns regarding the development of hindfoot arthritis.

  15. 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.

  16. 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

  17. Ankle injury mechanisms: lessons learned from cadaveric studies.

    PubMed

    Funk, James R

    2011-04-01

    The biomechanics of ankle injury have been studied extensively, primarily through mechanical testing of human cadavers. Cadaveric testing is an invaluable methodology in biomechanics, because the magnitude and direction of the loading can be measured precisely and correlated with the resulting injury pattern. Clinical and epidemiological studies provide useful descriptions of injury patterns that occur in the real world, but their retrospective nature precludes a definitive analysis of the forces that caused the injury. Understanding the mechanism of ankle injuries is essential for developing countermeasures to prevent injury and for reconstructing injurious events. Knowledge of an injury's mechanism can also suggest potential associated injuries, which is helpful in diagnosis and treatment. The purpose of this review is to summarize the published research on ankle injury mechanisms with an emphasis on biomechanical experiments on human cadavers. Injury patterns are described based on the principal axis of force or torque producing the injury in conjunction with off-axis forces and out-of-plane foot positions. A mechanistic description of ankle injuries is complicated by the fact that the same mechanism can sometimes produce different injuries and the same injury can sometimes be caused by multiple mechanisms. Nonetheless, a framework for relating injury mechanisms and injury patterns is a valuable tool in the understanding, prevention, and treatment of ankle injuries.

  18. Diagnosing deltoid injury in ankle fractures: the gravity stress view.

    PubMed

    Michelson, J D; Varner, K E; Checcone, M

    2001-06-01

    In the lateral malleolar ankle fracture without talar shift there is much uncertainty regarding the diagnosis of deltoid ligament injury severe enough to require surgical treatment. The current study evaluated the mechanical integrity of the ankle using a novel gravity-stress mortise radiographic view, which is practical for clinical use. Eight cadaveric lower extremities were tested under the following conditions: (1) intact ankle, (2) distal fibular oblique osteotomy, (3) plated fibula after osteotomy, (4) transection of the superficial deltoid with fibula osteotomized or plated, and (5) all possible combinations of deep deltoid transection with superficial deltoid transected or repaired and fibula osteotomized or plated. For each condition, a mortise radiograph was taken of the specimen while it was mounted horizontally, lateral side down. Fibular osteotomy with or without transection of the superficial deltoid did not alter the mortise radiograph appearance of the ankles. With combined deep and superficial deltoid transection and fibular osteotomy, the talus always (eight of eight specimens) showed a lateral shift of 2 mm or greater and a valgus tilt of 15 degrees or more. The gravity stress view of the ankle was found to reproducibly document destabilizing deltoid ligament damage.

  19. Is Hardware Removal Recommended after Ankle Fracture Repair?

    PubMed Central

    Jung, Hong-Geun; Kim, Jin-Il; Park, Jae-Yong; Park, Jong-Tae; Eom, Joon-Sang

    2016-01-01

    The indications and clinical necessity for routine hardware removal after treating ankle or distal tibia fracture with open reduction and internal fixation are disputed even when hardware-related pain is insignificant. Thus, we determined the clinical effects of routine hardware removal irrespective of the degree of hardware-related pain, especially in the perspective of patients' daily activities. This study was conducted on 80 consecutive cases (78 patients) treated by surgery and hardware removal after bony union. There were 56 ankle and 24 distal tibia fractures. The hardware-related pain, ankle joint stiffness, discomfort on ambulation, and patient satisfaction were evaluated before and at least 6 months after hardware removal. Pain score before hardware removal was 3.4 (range 0 to 6) and decreased to 1.3 (range 0 to 6) after removal. 58 (72.5%) patients experienced improved ankle stiffness and 65 (81.3%) less discomfort while walking on uneven ground and 63 (80.8%) patients were satisfied with hardware removal. These results suggest that routine hardware removal after ankle or distal tibia fracture could ameliorate hardware-related pain and improves daily activities and patient satisfaction even when the hardware-related pain is minimal. PMID:27819005

  20. Development of an internally braced prosthesis for total talus replacement.

    PubMed

    Regauer, Markus; Lange, Mirjam; Soldan, Kevin; Peyerl, Steffen; Baumbach, Sebastian; Böcker, Wolfgang; Polzer, Hans

    2017-03-18

    Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability. A custom made hemiprosthesis was developed using computed tomography and magnetic resonance imaging data of the affected and contralateral talus considering the principles and technology for the development of the S.T.A.R. prosthesis (Stryker). Additionally, four eyelets for fixation of artificial ligaments were added at the correspondent footprints of the most important ligaments. Two modifications can be provided according to the clinical requirements: A tri-articular hemiprosthesis or a bi-articular hemiprosthesis combined with the tibial component of the S.T.A.R. total ankle replacement system. A feasibility study was performed using a fresh frozen human cadaver. Maximum range of motion of the ankle was measured and ligamentous stability was evaluated by use of standard X-rays after application of varus, valgus or sagittal stress with 150 N. Correct implantation of the prosthesis was technically possible via an anterior approach to the ankle and using standard instruments. Malleolar osteotomies were not required. Maximum ankle dorsiflexion and plantarflexion were measured as 22-0-28 degrees. Maximum anterior displacement of the talus was 6 mm, maximum varus tilt 3 degrees and maximum valgus tilt 2 degrees. Application of an internally braced prosthesis for total talus replacement in humans is technically feasible and might be a reasonable procedure in carefully selected cases with no better alternatives left.