Using surface markers to describe the kinematics of the medial longitudinal arch.

Background: Static and dynamic assessment of the medial longitudinal arch (MLA) is an essential aspect for measuring foot function in both clinical and research fields. Despite this, most multi-segment foot models lack the ability to directly track the MLA. This study aimed to assess various methods of MLA assessment, through motion capture of surface markers on the foot during various activities.

Efficacy of quantifying marker-cluster rigidity in a multi-segment foot model: a Monte-Carlo based global sensitivity analysis and regression model.

Marker-based clinical gait analysis and multi-segment foot models (MSFM) have been successfully used for the diagnosis and clinical management of various lower limb disorders. The accuracy and validity of the kinematics measured depend on the design of the model, as well as on the adherence to its inherent rigid body assumption. This study applies a Monte-Carlo based global sensitivity analysis to evaluate the efficacy of using 'rigid body error ()' in quantifying the rigidity of a MSFM marker-cluster.

Comparison of the hindfoot axes of a multi-segment foot model to the underlying bony anatomy.

Musculoskeletal models used in gait analysis require coordinate systems to be identified for the body segments of interest. It is not obvious how hindfoot (or rearfoot) axes defined by skin-mounted markers relate to the anatomy of the underlying bones. The aim of this study was to compare the marker-based axes of the hindfoot in a multi-segment foot model to the orientations of the talus and calcaneus as characterized by their principal axes of inertia.

Marker cluster rigidity in a multi-segment foot model.

Multi-segment foot models (MSFM) are used in gait analysis for the diagnosis and planning of treatment for patients with foot deformities. Like other biomechanical models, MSFMs represent the leg and foot as a series of linked rigid segments, but such a simplification may not be appropriate, particularly for the flexible forefoot. This study investigated the appropriateness of the rigid body assumption on marker clusters used to define the individual segments (tibia, hindfoot, forefoot) of a widely-used MSFM.

Viscoelasticity of Tendons Under Transverse Compression.

Tendons are highly anisotropic and also viscoelastic. For understanding and modeling their 3D deformation, information is needed on their viscoelastic response under off-axis loading. A study was made, therefore, of creep and recovery of bovine digital extensor tendons when subjected to transverse compressive stress of up to ca.

Transverse Compression of Tendons.

A study was made of the deformation of tendons when compressed transverse to the fiber-aligned axis. Bovine digital extensor tendons were compression tested between flat rigid plates. The methods included: in situ image-based measurement of tendon cross-sectional shapes, after preconditioning but immediately prior to testing; multiple constant-load creep/recovery tests applied to each tendon at increasing loads; and measurements of the resulting tendon displacements in both transverse directions.

Muscle contributions to centre of mass acceleration during turning gait in typically developing children: A simulation study.

Turning while walking requires substantial joint kinematic and kinetic adaptations compared to straight walking in order to redirect the body centre of mass (COM) towards the new walking direction. The role of muscles and external forces in controlling and redirecting the COM during turning remains unclear. The aim of this study was to compare the contributors to COM medio-lateral acceleration during 90° pre-planned turns about the inside limb (spin) and straight walking in typically developing children.

The use of turning tasks in clinical gait analysis for children with cerebral palsy.

Background: Turning while walking is a crucial component of locomotion that is performed using an outside (step) or inside (spin) limb strategy. The aims of this paper were to determine how children with cerebral palsy perform turning maneuvers and if specific kinematic and kinetic adaptations occur compared to their typically developing peers.

Methods: Motion capture data from twenty-two children with cerebral palsy and fifty-four typically developing children were collected during straight and 90° turning gait trials.

Does increasing applied load lead to contact changes indicative of knee osteoarthritis? A subject-specific FEA study.

This study investigated whether increased loading (representing obesity) in the extended knee and flexed knee led to increased stresses in areas of typical medial and lateral osteoarthritis cartilage lesions, respectively. We created two paired sets of subject-specific finite element models; both sets included models of extended knees and of flexed knees. The first set represented normal loading; the second set represented increased loading.

Health-related quality of life in children with flexible flatfeet: a cross-sectional study.

Purpose: The effect of paediatric flexible flatfeet (PFF) on health-related quality of life (HRQOL) has not been investigated. In this prospective cross-sectional study, the HRQOL of children with PFF was compared to those with typically developing feet (TDF) using two validated measures. We hypothesised that reduced HRQOL would be observed in children with PFF.

Ground reaction forces and lower-limb joint kinetics of turning gait in typically developing children.

Turning is a common locomotor task essential to daily activity; however, very little is known about the forces and moments responsible for the kinematic adaptations occurring relative to straight-line gait in typically developing children. Thus, the aims of this study were to analyse ground reaction forces (GRFs), ground reaction free vertical torque (TZ), and the lower-limb joint kinetics of 90° outside (step) and inside (spin) limb turns. Step, spin, and straight walking trials from fifty-four typically developing children were analysed.

Motion analysis to track navicular displacements in the pediatric foot: relationship with foot posture, body mass index, and flexibility.

Background: Increased navicular drop (NDro) and navicular drift (NDri) are associated with musculoskeletal pathology in adults. The aim of this study was to investigate navicular motion in children, with respect to foot posture, and identify altered patterns of motion that demonstrate midfoot dysfunction. Navicular motion in different activities was evaluated as well as the role of flexibility and body mass index (BMI).

Spatio-temporal parameters and lower-limb kinematics of turning gait in typically developing children.

Turning is a requirement for most locomotor tasks; however, knowledge of the biomechanical requirements of successful turning is limited. Therefore, the aims of this study were to investigate the spatio-temporal and lower-limb kinematics of 90° turning. Seventeen typically developing children, fitted with full body and multi-segment foot marker sets, having performed both step (outside leg) and spin (inside leg) turning strategies at self-selected velocity, were included in the study.

Influence of altered gait patterns on the hip joint contact forces.

Children who exhibit gait deviations often present a range of bone deformities, particularly at the proximal femur. Altered gait may affect bone growth and lead to deformities by exerting abnormal stresses on the developing bones. The objective of this study was to calculate variations in the hip joint contact forces with different gait patterns.

Identifying gait events without a force plate during running: a comparison of methods.

This paper presents a comparison of four different methods of identifying the times of foot-strike and toe-off during running based on gait marker trajectories. The event times predicted by the methods were compared to those identified using a force plate for both over-ground and treadmill running. The effect of using different threshold values for the detection of gait events using force plate data was also investigated, and as a result, all assessments of event detection accuracy were based on a cut-off value of 10N.

Subject-specific axes of the ankle joint complex.

The aim of this study was to use a two-axis ankle joint model and an optimisation process (van den Bogert et al., 1994) to calculate and compare the talocrural and subtalar hinge axes for non-weight-bearing ankle motion, weight-bearing ankle motion, and walking in normal, healthy adult subjects and to see which of the first two sets of axes better fit the walking data. Motion data for the foot and shank were collected on eight subjects whilst they performed the activities mentioned.

Gait compensations caused by foot deformity in cerebral palsy.

Cerebral palsy (CP) is a complex syndrome, with multiple interactions between joints and muscles. Abnormalities in movement patterns can be measured using motion capture techniques, however determining which abnormalities are primary, and which are secondary, is a difficult task. Deformity of the foot has anecdotally been reported to produce compensatory abnormalities in more proximal lower limb joints, as well as in the contralateral limb.

The sclerotic line: why it appears under knee replacements (a study based on the Oxford knee).

Background: Radiolucent lines and sclerotic margins are often seen on knee radiographs taken a year or longer after knee replacement surgery. Histology has shown that the radiolucent zone is predominantly fibrocartilage and the sclerotic margin is lamellar bone. The reasons for their existence are not clearly understood.

Correlation between lower limb bone morphology and gait characteristics in children with spastic diplegic cerebral palsy.

Background: Children with spastic diplegic cerebral palsy (CP) exhibit abnormal walking patterns and frequently develop lower limb, long bone deformities. It is important to determine if any relationship exists between bone morphology and movement of the lower limbs in children with CP. This is necessary to explain and possibly prevent the development of these deformities.

Determination of gait patterns in children with spastic diplegic cerebral palsy using principal components.

This study developed an objective graphical classification method of spastic diplegic cerebral palsy (CP) gait patterns based on principal component analysis (PCA). Gait analyses of 20 healthy and 20 spastic diplegic CP children were examined to define gait characteristics. PCA was used to reduce the dimensionality of 27 parameters (26 selected kinematics variables and age of the children) for the 40 subjects in order to identify the dominant variability in the data.

Experimental validation of a finite element model of a human cadaveric tibia.

Finite element (FE) models of long bones are widely used to analyze implant designs. Experimental validation has been used to examine the accuracy of FE models of cadaveric femurs; however, although convergence tests have been carried out, no FE models of an intact and implanted human cadaveric tibia have been validated using a range of experimental loading conditions. The aim of the current study was to create FE models of a human cadaveric tibia, both intact and implanted with a unicompartmental knee replacement, and to validate the models against results obtained from a comprehensive set of experiments.

Simultaneous in vitro measurement of patellofemoral kinematics and forces.

This study involved the development and testing of a system for the simultaneous in vitro measurement of tibiofemoral kinematics and patellofemoral kinematics and forces. Knee motion was tracked using a Vicon 370, and patellofemoral force was measured using a six degree-of-freedom transducer based on the design of Singerman et al. Using this system, twelve knee specimens were tested in supine leg extension under a simulated quadriceps force.

Can functional electric stimulation-assisted rowing reproduce a race-winning rowing stroke?

Objective: To compare the ergometer rowing technique of a person with spinal cord injury (SCI), using functional electric stimulation (FES) of his leg muscles, with that of a well-defined group of able-bodied rowers.

Design: Whole-body kinematics and kinetics and electric activity of selected muscles were measured during ergometer rowing.

Setting: A hospital-based motion analysis laboratory.

Femoral muscle attachment locations in children and adults, and their prediction from clinical measurement.

Accurate representation of children's musculo-skeletal anatomy is becoming increasingly important to biomechanical techniques such as gait analysis. This study used magnetic resonance imaging to examine the locations of the femoral insertions of the psoas, vastus medialis and gastrocnemius muscles in five adults and 17 children (including 7 children with cerebral palsy). The relationship of muscle attachment locations with age and bone geometry was then determined.