Preliminary kinematic evaluation of a new stance-control knee–ankle–foot orthosis
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As everyone knows, foot and ankle play a decisive role in human activities. In the recent ten years, management of lesions of foot and ankle has drawn increasing attention and interest of orthopedic scholars so that great progress has been made in this field, but there have still been many controversial issues. This review gives a brief introduction of the most up to date development and problems in the research of foot and ankle fractures, and also suggests some basic principles in treating such fractures.
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This chapter contains sections titled: The Importance of Foot and Nail Care Learning Outcomes The Influence of Lifespan on Foot Health and Hygiene Physical Influences on Foot Health and Foot Hygiene Psychological Influences on Foot Health and Foot Hygiene Sociocultural Influences on Foot Health and Foot Hygiene Environmental Influences on Foot Health and Foot Hygiene Politico-Economic Influences on Foot Health and Foot Hygiene Foot Care Common Foot Conditions Common Foot Abnormalities Nursing Assessment of the Feet Anatomy of the Nail Common Nail Disorders Nursing Management Cutting Finger- and Toenails Conclusion References
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There is no standardized method reported in the literature to measure ROM of the ankle after a total ankle arthroplasty, which limits the possibility to compare results from the various ankle designs. It seems that most of the measurements are a combination of ankle and midfoot motion, not the tibiotalar joint. A protocol was developed to accurately measure the true tibiotalar and midfoot motion before and after an ankle replacement. Lateral radiographs were taken of the ankle with the patient in a weightbearing position, and measurements were done along fixed landmarks. In this study, the tibiotalar, midfoot, and combined ROM were measured preoperative and 1 year postoperative in a standardized, reproducible fashion. The preoperative tibiotalar ROM was 18.5 degrees and combined ankle and midfoot motion 25.1 degrees. The true tibiotalar motion after an Agility total ankle arthroplasty was 23.4 degrees, and the combined ankle and midfoot motion was 31.3 degrees. The average improvement in ROM in the tibiotalar joint was approximately 5 degrees, and combined ROM was 6.1 degrees. Preoperative ROM proved to be the main factor determining the eventual postoperative ROM. It is possible to accurately measure the true ankle and the midfoot motion and those measurements should be used when reporting on the results of ankle replacements. Total ankle arthroplasty resulted in a statistically significant, but clinically less than expected, increase in ROM.
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Currently, patients who have suffered foot and ankle fractures are being evaluated by means of questionnaires, physical examination and X-rays. This dissertation examines foot and ankle mobility during gait in patients with different types of foot and ankle trauma based on an objective and reliable foot model (i.e. the Oxford Foot Model). Compared to healthy volunteers, all groups showed a lower walking speed and a reduced foot and ankle mobility. The reduced foot and ankle mobility was associated with the level of patient satisfaction reported in the questionnaires and the extent of fracture healing. This dissertation shows that this foot model is a promising diagnostic tool.
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The responsiveness of the Manchester–Oxford Foot Questionnaire (MOXFQ) was compared with foot/ankle-specific and generic outcome measures used to assess all surgery of the foot and ankle. We recruited 671 consecutive adult patients awaiting foot or ankle surgery, of whom 427 (63.6%) were female, with a mean age of 52.8 years (18 to 89). They independently completed the MOXFQ, Short-Form 36 (SF-36) and EuroQol (EQ-5D) questionnaires pre-operatively and at a mean of nine months (3.8 to 14.4) post-operatively. Foot/ankle surgeons assessed American Orthopaedic Foot and Ankle Society (AOFAS) scores corresponding to four foot/ankle regions. A transition item measured perceived changes in foot/ankle problems post-surgery. Of 628 eligible patients proceeding to surgery, 491 (78%) completed questionnaires and 262 (42%) received clinical assessments both pre- and post-operatively. The regions receiving surgery were: multiple/whole foot in eight (1.3%), ankle/hindfoot in 292 (46.5%), mid-foot in 21 (3.3%), hallux in 196 (31.2%), and lesser toes in 111 (17.7%). Foot/ankle-specific MOXFQ, AOFAS and EQ-5D domains produced larger effect sizes (> 0.8) than any SF-36 domains, suggesting superior responsiveness. In analyses that anchored change in scores and effect sizes to patients’ responses to a transition item about their foot/ankle problems, the MOXFQ performed well. The SF-36 and EQ-5D performed poorly. Similar analyses, conducted within foot-region based sub-groups of patients, found that the responsiveness of the MOXFQ was good compared with the AOFAS. This evidence supports the MOXFQ’s suitability for assessing all foot and ankle surgery.
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Objective: To investigate the effect of continuous passive motion(CPM) training on the knee joint range of motion after operation of knee fractures. Methods: Forty seven cases of knee joint fractures were divided into 4 groups randomly. After all patients were subjected to conventional physical therapy, the patients in Gl, G2 and G3 groups received continuous passive motion training on the first,second and third week postoperatively for 4 weeks respectively. Results: On the sixth week after treatment, the postoperative knee joint range of motion in G0, G1, G2 and G3 groups was (64±5)°, (89 ±7)°, (73 ±4)° and (68 ±3)° respectively. There was significant difference among the 4 groups. Conclusion: Early applied CPM training can quickly promote the rehabilitation of knee function.
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Rehabilitation is very important to the therapeutic effect of total knee arthroplasty,and it's also the key measure for the knee function to reach the expected effect after the surgery.The cinesiateics including the training of muscle strength,range of joint motion,joint position sense and gait is the most important content which can improve the knee joint function.The training of muscle strength is used to improve the knee muscle strength of flex and ext end;early training of passive and continued positive motion of knee joint to improve the knee range of motion;the gait training to improve the quaility of life.
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To investigate the difference of range of motion (ROM) of ankle according to pushing force, gender and knee position.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.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.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.
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