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Biomechanical Consequences of Foot and Ankle Injury and Deformity: Kinematics and Muscle Function
KTH, School of Engineering Sciences (SCI), Mechanics.
2009 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to discuss kinematics and muscle function changes due to foot and ankle injury or deformity. The first study aims to characterize gait patterns of subjects with a common lower limb injury, ankle fractures. Using three-dimensional movement analysis with a modified multi-segment foot model, the inter-segment foot kinematics was determined during gait in 18 subjects one year after surgically treated ankle fractures. Gait data were compared to an age- and gender-matched control group and the correlations between functional ankle score and gait parameters were determined. It was observed that even with fairly good clinical results, restricted range of motion at and around the injured area, and less adducted forefoot were found in the injured limb. The second study aims to quantify the effect of subtalar inversion/eversion on the dynamic function of the main ankle dorsi/plantarflexors: gastrocnemius, soleus and tibialis anterior. Induced acceleration analysis was used to compute muscle-induced joint angular and body center of mass accelerations. A three-dimensional subject specific linkage model was configured by gait data and driven by 1 Newton of individual muscle force. The excessive subtalar inversion or eversion was modified by offsetting up to ±20˚ from the normal subtalar angle while other configurations remain unaltered. We confirmed that in the normal gait, muscles generally acted as their anatomical definitions and muscles can create motion in joints, even not spanned by the muscles. The plantarflexors play important roles in body support and forward progression. Excessive subtalar eversion had negative effect on ankle plantarflexion, which may induce a less plantarflexed ankle, less extended knee and more flexed hip after initial contact. This thesis focused on gait kinematics and muscle functions in the foot and ankle area employing both experimental gait and computational simulations. The findings can be regarded as references for evaluating of future patients and for dynamic muscle functions during gait.

Place, publisher, year, edition, pages
Sweden: US-AB , 2009. , x, 32 p.
Series
Trita-MEK, ISSN 0348-467X ; 2009:11
National Category
Mechanical Engineering
Identifiers
URN: urn:nbn:se:kth:diva-11217ISBN: 978-91-7415-410-8 (print)OAI: oai:DiVA.org:kth-11217DiVA: diva2:242161
Presentation
2009-09-24, V1, Teknikringen 76, Kungliga Tekniska Högskolan, Stockholm, 10:15 (English)
Opponent
Supervisors
Available from: 2009-10-08 Created: 2009-10-07 Last updated: 2010-11-04Bibliographically approved
List of papers
1. One year follow-up after operative ankle fractures: A prospective gait analysis study with a multi-segment foot model
Open this publication in new window or tab >>One year follow-up after operative ankle fractures: A prospective gait analysis study with a multi-segment foot model
Show others...
2010 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 31, no 2, 234-240 p.Article in journal (Refereed) Published
Abstract [en]

Ankle fractures are one of the most common lower limb traumas. Several studies reported short- and long-term post-operative results, mainly determined by radiographic and subjective functional evaluations. Three-dimensional gait analysis with a multi-segment foot model was used in the current study to quantify the inter-segment foot motions in 18 patients 1 year after surgically treated ankle fractures. Data were compared to that from gender- and age-matched healthy controls. The correlations between Olerud/Molander ankle score and kinematics were also evaluated. Patients with ankle fractures showed less plantarflexion and smaller range of motion in the injured talocrural joint, which were believed to be a sign of residual joint stiffness after surgery and immobilization. Moreover, the forefoot segment had smaller sagittal and transverse ranges of motion, less plantarflexion and the hallux segment had less dorsiflexion and smaller sagittal range of motion. The deviations found in the forefoot segment may contribute to the compensation mechanisms of the injured ankle joint. Findings of our study show that gait analysis with a multi-segment foot model provides a quantitative and objective way to perform the dynamic assessment of post-operative ankle fractures, and makes it possible to better understand not only how the injured joint is affected, but also the surrounding joints.

Keyword
Ankle fractures, Operative treatment, Gait analysis, Multi-segment foot, model, Olerud/Molander ankle score (OMAS), functional outcome analysis, rheumatoid-arthritis, coordinate system, kinematics, joint, kinetics, motion, knee
National Category
Mechanical Engineering
Identifiers
urn:nbn:se:kth:diva-19218 (URN)10.1016/j.gaitpost.2009.10.012 (DOI)000274584800017 ()2-s2.0-74449088350 (Scopus ID)
Note
QC 20110210Available from: 2010-08-05 Created: 2010-08-05 Last updated: 2017-12-12Bibliographically approved
2. The effect of excessive subtalar inversion/eversion on the dynamic function of the soleus and gastrocnemius during the stance phase
Open this publication in new window or tab >>The effect of excessive subtalar inversion/eversion on the dynamic function of the soleus and gastrocnemius during the stance phase
2009 (English)In: Proceedings of the ASME Summer Bioengineering Conference 2009, SBC2009, New York: AMER SOC MECHANICAL ENGINEERS , 2009, 1035-1036 p.Conference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
New York: AMER SOC MECHANICAL ENGINEERS, 2009
Keyword
BIOMECHANICS, GAIT
National Category
Mechanical Engineering
Identifiers
urn:nbn:se:kth:diva-25913 (URN)000280089000518 ()2-s2.0-77953778871 (Scopus ID)978-0-7918-4891-3 (ISBN)
Conference
ASME Summer Bioengineering Conference, Lake Tahoe, CA, JUN 17-21, 2009
Note
QC 20101104Available from: 2010-11-04 Created: 2010-11-04 Last updated: 2011-03-30Bibliographically approved

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