Foot kinematics

Top PDF Foot kinematics:

Are clinical measures of foot posture and mobility associated with foot kinematics when walking?

Are clinical measures of foot posture and mobility associated with foot kinematics when walking?

Compared to other static foot posture measures and the FMM measure, the FPI was retained as a significant predictor across a greater number of kinematic variables than all other measures. This suggests that the FPI, a measure consisting of multiple observations in all three planes of motion, may allow for a more comprehensive association with foot kinematics than measures that consist of a single, uniplanar observation (which is the case for NNHt and or DAH). However, the amount of variability that was explained by the FPI was ultimately similar to other foot posture measures as demonstrated by the small range of R 2 change values between foot posture measures. For example, the kinematic variable that displayed the largest range of adjusted R 2 change values was peak midfoot adduction. In this instance, the R 2 change values ranged from 0.076 (for AI) to 0.188 (for NNHt), a range of only 0.112. This indicates that the foot posture measures identified as significant pre- dictors in regression analyses display a similar ability to predict individual kinematic variables.
Show more

12 Read more

The role of tibialis posterior fatigue on foot kinematics during walking

The role of tibialis posterior fatigue on foot kinematics during walking

during walking. These preliminary results suggest that the anatomical structure of the foot is not associated with the dependence of muscular activity that an individual requires to maintain normal foot kinematics during gait. However, it has been discussed earlier that reduced force output of tibialis posterior may have been compensated for by other muscles. Therefore, it is possible that com- pensation strategies may have masked the true relation- ship between anatomical structure and tibialis posterior contribution. The present investigation was also limited by the fact that the standing rearfoot angle was the only structural measurement of the foot. For instance, the range of motion (ROM) of the rearfoot might influence the degree to which an individual's rearfoot eversion can change following fatigue. If the peak rearfoot eversion angle was close to their end ROM during the pre-fatigue gait, then structural restraints would prevent any further increases in eversion following fatigue. In addition, struc- tural measures of the arch and forefoot have not been reported here. It is possible that a rigid cavus foot would rely less on muscular contribution to maintain the integ- rity of the arch and forefoot during walking. Indeed a recent study demonstrated that during gait, flat-arched individuals exhibit greater activity of tibialis posterior compared to those with normal arches [14]. Future stud- ies with more comprehensive foot structure evaluations are required to understand the contributions of bony anatomy and muscular activation to foot biomechanics.
Show more

8 Read more

Quantitative assessment of early biomechanical modifications in diabetic foot patients: the role of foot kinematics and step width

Quantitative assessment of early biomechanical modifications in diabetic foot patients: the role of foot kinematics and step width

At the same time, we studied intrinsic dynamic ROM of the foot (focusing on metatarsophalangeal joint). Until now, an unbiased understanding of foot kinematics has been difficult to achieve due to the complexity of foot structure and motion [23]. For these reasons, data about segmental kinematics of the foot are less standardized and less reported in literature than other joints. Specific studies reported results useful for clinical interpretation, with different marker sets to study dynamic foot kine- matics [24–27], i.e. with particular clinical focus on stance phase, providing information about coronal plane alignment of the rear-foot, transverse and sagittal plane alignment of the metatarsal bones, and changes at the medial longitudinal arch [26]. It was also established the importance of a multisegment foot model for kinematics not to consider the entire foot as a rigid body connected to the shank [28]. Anyway, reproducibility of marker lo- cation and skin motion artifact made most of these methods weak [29].
Show more

8 Read more

Are clinical measures of foot posture and mobility associated with foot kinematics when walking?

Are clinical measures of foot posture and mobility associated with foot kinematics when walking?

Compared to other static foot posture measures and the FMM measure, the FPI was retained as a significant predictor across a greater number of kinematic variables than all other measures. This suggests that the FPI, a measure consisting of multiple observations in all three planes of motion, may allow for a more comprehensive association with foot kinematics than measures that consist of a single, uniplanar observation (which is the case for NNHt and or DAH). However, the amount of variability that was explained by the FPI was ultimately similar to other foot posture measures as demonstrated by the small range of R 2 change values between foot posture measures. For example, the kinematic variable that displayed the largest range of adjusted R 2 change values was peak midfoot adduction. In this instance, the R 2 change values ranged from 0.076 (for AI) to 0.188 (for NNHt), a range of only 0.112. This indicates that the foot posture measures identified as significant pre- dictors in regression analyses display a similar ability to predict individual kinematic variables.
Show more

13 Read more

Characterizing multisegment foot kinematics during gait in diabetic foot patients

Characterizing multisegment foot kinematics during gait in diabetic foot patients

Protocols which consider the foot as a single rigid segment or does not consider the motion of the midfoot relatives to the adjacent subsegments cannot fully describe the dia- betic foot disease consequences [13-20,20-22]. Therefore direct skin marker placement on selected anatomical landmarks (ALs), was chosen, together with a 3D four seg- ments foot kinematics protocol. A static acquisition was used to define the anatomical Bone Embedded Frames (anatomical BEFs). Diabetic patients frequently have rigidity of toes or presence of ulcers which make protocols requiring marker placement on hallux impossible [13,18,19,21,22]. Moreover, the most recent studies [19,21,22] do not report all three rotational degrees of freedom of the three relevant foot sub-segments. Foot bio- mechanics alteration in the neuropathic patients [4] affects also their posture [6,23], this entails that a foot motion analysis protocol must be incorporated in a full body gait analysis protocol [15-17,20,24-26]. Finally, no study has reported on the clinical impact of foot kine- matic analysis in diabetic patients [13,14,18,19,21,22]. The objective of this study was to devise a reproducible and clinically meaningful protocol [25] specific for the treatment of diabetic patients, which starting from the kinematics could help in preventing diabetic foot from ulcer or callus formation.
Show more

11 Read more

Effect of Surface Hardness on Three-Segment Foot Kinematics during Barefoot Running

Effect of Surface Hardness on Three-Segment Foot Kinematics during Barefoot Running

The foot kinematics response of running on different surfaces has been previously examined by several researchers [11]– [13]. Fu et al. [14] studied the effects of running on different surfaces on the characteristics of in-shoe plantar pressure and tibial acceleration. No significant differences were found in the plantar pressures, pressure–time integral and peak pressure distribution for the concrete, synthetic, grass, and normal treadmill surfaces. Similarly, Tessutti et al. [15] investigated the influence of running on asphalt, concrete, natural grass, and rubber on in-shoe pressure patterns in adult recreational runners. The results showed that among the more rigid surfaces (asphalt and concrete), there were no differences in the pressure patterns and similar behavior was observed on the rubber surface. Moreover, investigation on how mid sole hardness, surface stiffness, and running duration influence running kinematics has been conducted by Hardin et al. [9]. They found that an increase of midsole hardness resulted in greater peak ankle dorsiflexion velocity meanwhile increase of surface stiffness resulted in decreased hip and knee flexion on contact, reduced maximal hip flexion, and increased peak angular velocities of the hip, knee, and ankle. This study indicates that lower-extremity kinematics was adapted to increase midsole hardness, surface stiffness, and running duration.
Show more

9 Read more

Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

recorded (walking speed was not measured). Local co- ordinate frames (LCF) were defined for each segment. For the tibia anatomical markers on both malleoli, fibula head and tibial tuberosity were used to align the LCF relative to the technical markers on the mid shin [9-11]. For the heel and midfoot the LCF was set parallel to the global system when in relaxed standing. For the first metatarsal and hallux, reflective markers were positioned on the plates to enable the anterior/posterior (x) axis to follow the approximate long axis of the metatarsal and hallux respectively. The medial/lateral axes were 90° to the x-axis and parallel to the supporting surface. Rota- tions between distal and proximal adjacent segments were calculated using Euler rotation sequence z x y. Data were normalised to 0-100% of stance and averaged across ten trials. The reference position (0 degrees) was the foot position when the subject stood upright (figure 2). Other studies have used a subtalar “neutral” position [16-18], which lacks validity (has no proven functional meaning) and has been shown to be more subjective [19-23].
Show more

12 Read more

Foot kinematics in walking on a level surface and on stairs in patients with hallux rigidus before and after cheilectomy

Foot kinematics in walking on a level surface and on stairs in patients with hallux rigidus before and after cheilectomy

The patients were recruited from the outpatient depart- ment (foot and ankle) at our institution. All consecutive patients with an indication for cheilectomy but who did not present criteria for exclusion were included in the study. Exclusion criteria were previous operations on the foot and ankle, rheumatic diseases, and relevant foot de- formities other than hallux rigidus. Fourteen consecutive patients with the indication for cheilectomy were initially included. Eight patients participated in both test ses- sions. In all cases the reason for refusal/drop out, unfor- tunately, was the long duration of the measurement. Eight patients (59.1 ± 6.4 years, mean ± standard devi- ation (SD), BMI 26.2 ± 2.5 kg/m 2 , six women, two men) could be tested on the day prior to the operation and at 1.1 ± 0.3 years after the operation between 10/2006 and 10/2008.
Show more

10 Read more

Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome

Relationships between the Foot Posture Index and foot kinematics during gait in individuals with and without patellofemoral pain syndrome

A number of studies attempting to correlate clinical measures of foot posture with dynamic foot function dur- ing gait in healthy individuals have been published [10-13] since Razeghi and Batt’s [7] review. Although all of these studies reported static clinical measurements to be associated with dynamic function, a number of metho- dological issues need to be considered, particularly when attempting to apply these findings to a PFPS population. Three of these studies [10,11,13] used two dimensional video analysis, which may not provide adequate represen- tation of the multiplanar three-dimensional motion occurring at the foot during gait. Additionally, one study evaluated arch height [13] which has subsequently been found to poorly discriminate between individuals with PFPS and controls [9]; and two [10,11] evaluated longitu- dinal arch angle, which exhibits poor reliability in indivi- duals with PFPS [9]. Finally, all four studies [10-13] evaluated an asymptomatic population, limiting their applicability to a PFPS population.
Show more

8 Read more

Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis

Following ethical approval (University of Salford Ethics committee) 27 subjects (table 1) who attended the Uni- versity Podiatry clinic every 4-8 weeks for debridement of plantar callus were recruited and gave informed con- sent. The inclusion criterion was one of two types of forefoot PPH pattern. Group 1 displayed PPH only under metatarsal heads 2, 3 and 4. Group 2 displayed PPH only under the 1 st and 5 th metatarsal heads (n = 13). PPH (callus) was a distinct area of thickened and hardened upper layer of the skin having distinct boundaries with normal skin, and a regular oval outline (Figure 1). Whilst no measure of foot posture or type was used, anecdotally, subjects in Group 1 had a physi- cal appearance of pes planus (low medial arch profile) and those in Group 2 displayed pes cavus (high medial arch profile). These were consistent with the Root para- digm. None of the subjects displayed heloma durum. All subjects showed the same PPH pattern on both feet, except for three subjects who displayed the pattern under the left forefoot only. Thus, total sample was 24 limbs from group 1 (11 right, 13 left), 27 limbs from group 2 (13 right, 14 left). All subjects had negative his- tory of lower limb injury or systemic disease (e.g. dia- betes, rheumatoid arthritis).
Show more

13 Read more

Analyzing the effect of Slipper cast and Circumferential wrap molding in the manufacture of insoles on ankle kinematics in patients with flexible flat foot

Analyzing the effect of Slipper cast and Circumferential wrap molding in the manufacture of insoles on ankle kinematics in patients with flexible flat foot

42 about molding method of slp, Zifchock et al (2008) and Davis et al (2008) as well as custom and non- custom insoles in separate studies on the rate of change of the maximum angle and speed of aversion compared with no insole in healthy people had reported very little, but this little change in the potential long- term effect on reported foot kinematics (Leung et al., 1998). Also this result was similar to Chen et al (2009) that reported custom insoles had no significant effect on the maximum aversion angle of foot ankle (Chen et al., 2009), and all of those studies had same results with the current study, although these studies specially were not indicated the type of molding, methods and tools used, but maximum angle and speed of aversion affected by none of used insoles in these studies. In other words, it can be stated that the maximum aversion deviation in the ankle not immediate affected of molding methods and no significant change was observed. On the other hand, some studies reported the effect of custom and semi-custom orthotics on reducing the maximum aversion speed (Zifchock et al. 2008, McLean et al. 2006, Steele et al., 1998), that was inconsistent with the results of the current study.Also Simon Fuk-Tan and et al reported the effect of TCIFMP custom insole (having central arch, made of semi-rigid Plastvlyz and PPT) in a significant reduction of the valgus rare foot of people with flexible flat foot (Simon Fuk-Tan et al., 2015) And stated that pronation angle of patients when using sports shoes with insole significantly reach to normal state that is different with the results of current study. Perhaps the reason for this contradiction with the present study was the kind of sport shoes used in each of the studies. All those studies evaluated the immediate effect of different auxiliary and preventive insoles that is formed in a variety of forms and materials in different groups of subjects on the ankle joint kinematics especially in pronation control and maximum angle of ankle aversion, while Anders and et al in addition to the immediate effect, examined the long-term impact (4 months) of custom insoles (for certain construction methods were noted) in patients with chronic pain in the ankle pronation excessive pronation on the angle of an amount Navicular bone breakdown (Andreasen et al., 2013), that results showed no significant effect in reducing the immediate and long-term head pronation angle that was similar to result of current study.
Show more

6 Read more

Modifying the Rizzoli foot model to improve the diagnosis of pes-planus: application to kinematics of feet in teenagers

Modifying the Rizzoli foot model to improve the diagnosis of pes-planus: application to kinematics of feet in teenagers

The present results are in good agreement with established biomechanical knowledge and common clinical observa- tions. In general, the kinematic patterns reported here are consistent with those reported in other studies that used the marker-set and the definitions from Leardini et al. [10], i.e. [2,11-16,18,28]. With the exception of one add- itional marker on the calcaneus, these adjustments en- hanced the original protocol with no significant alterations to the marker-set, to the biomechanical model, and to the overall time required by the data collection and analysis. In conclusion, the present study reports improvements of a previous protocol for multi-segment foot kinematics, and provides a useful reference kinematic dataset for the whole gait cycle, which may be employed in clinically- oriented analyses of younger participants.
Show more

7 Read more

Effect of plano-valgus foot posture on midfoot kinematics during barefoot walking in an adolescent population

Effect of plano-valgus foot posture on midfoot kinematics during barefoot walking in an adolescent population

In accordance with what observed by Lin et al. [4] on a slightly younger PV population, but in contrast with other reports [13, 15], the PV group walked with re- duced stride length and walking speed. This is normally associated with some functional deficit, and may be due to the significant foot postural alterations displayed by those children included in the PV subgroup. However, kinetic and pressure analyses could not be performed due to limitations of the present setup, thus functional impairments and compensations in the lower limb joints associated with PV kinematic alterations shall be ad- dressed in future investigations. Although PV kinematics could not be compared to a speed-matched gait data set, this appeared to have only marginally affected the differ- ences in joint kinematics between PV and ND, as most of the kinematic alterations were strongly consistent with those measured in static posture. Moreover, the ef- fect of cadence on foot joints range of motion was found to be significant mainly between slow- and fast-walking cadence, in the frontal and transverse planes only [30]. It should also be highlighted that only 20 PV adolescents were analysed, and that the age was limited to 13 years - the age at which children’s feet reach full skeletal matur- ity [2, 5, 31] and clinical assessment of pes-planus condi- tion is recommended at the authors ’ Institution. These limitations somehow restrict the generalizability of these results to a larger plano-valgus paediatric population. Nevertheless this study provides objective information on foot kinematics for a critical paediatric population presenting significant alterations of foot skeletal morph- ology, and for which the choice of the most appropriate treatment is still highly debated. In terms of limitations of the methodology, while the Rizzoli Foot Model is a widely used and extensively validated kinematic protocol [19, 20, 32] presenting a balance of moderate repeatabil- ity and reasonable test-retest error [33], it should be reminded that kinematic analysis of foot joints via skin- markers is intrinsically affected by skin-motion artifacts.
Show more

9 Read more

Foot propelled swimming kinematics and turning strategies in common loons

Foot propelled swimming kinematics and turning strategies in common loons

The motion of the foot in swimming loons resembles that of grebes, suggesting that loons may also generate lift forces for propulsion. Loons (Figs 2 and 3) and grebes (Johansson and Norberg, 2001) paddle their feet lateral to the body, whereas cormorants paddle their feet ventrally underneath the body (Ribak et al., 2004). Nevertheless, all three underwater swimming species demonstrate almost no motion of the feet opposite to the travel direction relative to the surrounding water (Fig. 3). Because the feet do not substantially push water backward, propulsion cannot depend on drag forces. Instead, loons direct their feet dorsally and medially relative to still water throughout the power stroke. Consequently, this perpendicular motion relative to their travel direction likely produces drag to resist buoyancy and lift for forward propulsion. Although the foot kinematics of loons resembles that of grebes, grebes possess lobate toes that likely act as individual hydrofoils to increase lift production (Johansson and Norberg, 2000). Instead, the webbed feet of loons may enhance lift by functioning like a propeller. As the foot arcs dorsally, the surface of the foot is pitched, leading with digit IV. Lift generated by the angle of attack of the foot would contribute to forward propulsion without moving backward relative to still water. This potential ‘ propeller ’ mechanism differs from the proposed ‘ delta wing ’ function for cormorant feet (Johansson and Norberg, 2003). By relying on lift instead of drag forces for propulsion, loons can produce propulsive forces at any swim speed, whereas drag-based propulsion is limited to slower speed swimming (Vogel, 2008). Thus, despite variation in whether the feet are moved ventral (cormorants) or lateral (grebes and loons) to the body, three independent lineages of foot-propelled swimming birds indicate the probable use of lift-based propulsion. Contrary to previous findings (Jimenéz Ortega, 2005), we observed that swimming loons
Show more

11 Read more

Movement coordination patterns between the foot joints during walking

Movement coordination patterns between the foot joints during walking

Methods: Three-dimensional multi-segment foot kinematics were recorded in 13 adults during walking. A modified vector coding technique was used to identify coordination patterns between foot joints involving calcaneus, midfoot, metatarsus and hallux segments. According to the type and direction of joints rotations, these were classified as in-phase (same direction), anti-phase (opposite directions), proximal or distal joint dominant. Results: In early stance, 51 to 75% of walking trials showed proximal-phase coordination between foot joints comprising the calcaneus, midfoot and metatarsus. In-phase coordination was more prominent in late stance, reflecting synergy in the simultaneous inversion occurring at multiple foot joints. Conversely, a distal-phase coordination pattern was identified for sagittal plane motion of the ankle relative to the midtarsal joint, highlighting the critical role of arch shortening to locomotor function in push-off.
Show more

7 Read more

Foot orthoses alter lower limb biomechanics but not jump performance in basketball players with and without flat feet

Foot orthoses alter lower limb biomechanics but not jump performance in basketball players with and without flat feet

findings showed that the use of foot orthoses resulted in a reduction between 1 and 3° of ankle eversion for all partic- ipants during CMJ and SBJ. These small magnitudes of change in ankle frontal plane angles found in our study are consistent with other studies measuring the effects of foot orthoses on foot kinematics [38, 39]. Our results show that an increase in ankle stability would not relate to jumping performance and is consistent with another study that increased ankle stability using collar height and heel counter stiffness of footwear [30]. One possible explan- ation is that when jumping from a stationary position, the foot pushes off using mainly the forefoot [3]. This is unlike other forms of locomotion such as walking and running where there is considerable rearfoot and midfoot involve- ment during ground contacts. The foot orthoses used in our study provide support primarily in the rearfoot and midfoot areas [22], which may have caused changes in the shape and biomechanics on these regions of the foot. The forefoot, which is used more during jumps, may not be af- fected by the prefabricated foot orthoses used in our study and therefore may not be effective in enhancing jumping performances. Other jumping studies on basketball foot- wear have shown that changing the forefoot structures (e.g., bending stiffness) of a shoe can play an important role in jumping performance [25, 28]. Future studies may consider if a forefoot varus wedge and segmented stiffness insoles may improve jumping performances in basketball players. Foot orthosis accounted for large effect sizes in ankle eversion (21.8% variance) in CMJ and accounted for large effect in ankle eversion (18.5% variance) and peak ankle frontal moment (17% variance) at SBJ. Although the magnitude of change was small, the large effect sizes found in this study would encourage future longitudinal studies to ascertain the impact of these biomechanical dif- ferences to potentially improve movement analyses to tailor training strategies to improve jump performances.
Show more

14 Read more

Swimming kinematics and hydrodynamic imaging in the blind Mexican cave
fish (Astyanax fasciatus)

Swimming kinematics and hydrodynamic imaging in the blind Mexican cave fish (Astyanax fasciatus)

Blind Mexican cave fish (Astyanax fasciatus) lack a functioning visual system, and are known to use self-generated water motion to sense their surroundings; an ability termed hydrodynamic imaging. Nearby objects distort the flow field created by the motion of the fish. These flow distortions are sensed by the mechanosensory lateral line. Here we used image processing to measure detailed kinematics, along with a new behavioural technique, to investigate the effectiveness of hydrodynamic imaging. In a head- on approach to a wall, fish reacted to avoid collision with the wall at an average distance of only 4.0±0.2 mm. Contrary to previous expectation, there was no significant correlation between the swimming velocity of the fish and the distance at which they reacted to the wall. Hydrodynamic imaging appeared to be most effective when the fish were gliding with their bodies held straight, with the proportion of approaches to the wall that resulted in collision increasing from 11% to 73% if the fish were beating their tails rather than gliding as they neared the wall. The swimming kinematics of the fish were significantly different when swimming beside a wall compared with when swimming away from any walls. Blind cave fish frequently touched walls when swimming alongside them, indicating that they use both tactile and hydrodynamic information in this situation. We conclude that although hydrodynamic imaging can provide effective collision avoidance, it is a short-range sense that may often be used synergistically with direct touch.
Show more

10 Read more

Abstract To solve the problem of angle coupling of the welding robot kinematics equations, we build the 3D

Abstract To solve the problem of angle coupling of the welding robot kinematics equations, we build the 3D

Researching the inverse kinematics of the welding robot is a very important topic in the kinematics and the trajectory planning. It is very difficult to build the general algorithm because the inverse kinematics of robot is becoming more and more difficult along the increasing of the robot sports joints. In resent years, to solve the inverse kinematics equation, we put forward the analytic method, forward analytic method [1] , iterative method [2] , geometric method [3] , neural network theory and so on. Under these methods, Paul [4] and Wang Qizhi put forward the analytic method, but the problem is that some reverse answers they put forward are not the correct answers. Besides this, Liu song guo, Wang hongbin, and Chen Ning put forward the methods of iterative method and new analytic method, but these cannot correctly calculate the angle via extracting enough elements. So, to solve the angle coupling problem, and to conveniently solve the sine and cosine of each angle, this paper analysis the inverse kinematics answer aimed at the PUMA560 welding robot, using the single or serial matrix 1
Show more

5 Read more

The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking in individuals with incomplete spinal cord injury

The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking in individuals with incomplete spinal cord injury

joint angles using electrogoniometers (1200 Hz, Biomet- rics, Ltd., Ladysmith, VA). Goniometers were re-zeroed in the neutral position before each condition. We recorded stride cycle data from each foot using a pair of complete footswitches (B & L Engineering, Tustin CA). We recorded bilateral lower limb surface electromyography (EMG) (1200 Hz, Konigsberg Instruments, Inc., Pasadena, CA) of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG), lateral gastrocnemius (LG), vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) and medial ham- strings (MH) using bipolar surface electrodes (2.5 cm inter-electrode distance). The EMG amplifier bandwidth was 1000 Hz. We visually inspected EMG during manual muscle tests prior to walking to minimize cross talk, mov- ing electrode placements as necessary. We recorded artifi- cial pneumatic muscle and elastic band tension using tension/compression force transducers (1200 Hz, Omega Engineering, Stamford, CT) placed in series with the orthoses attachment brackets. All signals were collected simultaneously via the same data acquisition board to ensure synchronization.
Show more

17 Read more

The effect of a knee ankle foot orthosis on lower limb kinematics and kinetics in an individual with varus knee alignment

The effect of a knee ankle foot orthosis on lower limb kinematics and kinetics in an individual with varus knee alignment

The participant was seated on a casting table and cotton stockinet was applied over the left limb. An indelible pencil was used to mark the positions of the following anatomical landmarks: the medial and lateral malleoli, the head of the fibula, and the outline of the patella. A plastic tube was placed over the left anterior aspect to facilitate cast removal (Figure 4.1). An elastic plaster bandage was applied from just below the greater trochanter to the toes. The plaster was strengthened over the knee and ankle joint areas to avoid cast breakage during cast removal. The participant was positioned in ten degrees of knee flexion, which is the best position for knee joint to start movement (the functional position), and a valgus force directed was applied over the knee joint, while the ankle joint was fixed in a neutral position. Manual varus correction was then applied up to a maximal position where the participant felt he could tolerate. The limb was held in this position until the plaster had set. Then, the negative cast was removed by a cast cutter along the plastic tube, and the stockinet was cut off and removed. After that, measurements were taken for the left side (circumstances above and below the knee joint, the foot length, and the knee joint diameter).
Show more

189 Read more

Show all 3905 documents...