Objective A flat foot is a complex postural deformity in which the medial longitudinal arch is decreased. It is associated with diverse symptoms and varying degrees of deformity and disability. This disorder can sometimes contribute to problems in the ankles and knee as it can alter the alignment. Conservative treatments are used to treat patients with a flat foot. One common treatment is the use of insoles with medial heel skive technique. The purpose of this study was to evaluate the effect of custom-molded insoles with new technique on pain and function in females with a flexible flat foot. Materials & Methods This research is a quasi-experimental study of before-and-after type that included 12 subjects with a flexible flat foot from the Social Welfare and Rehabilitation Sciences University of Tehran. To provide a negative cast, plaster cast impressions were taken for each participant's foot. According to the method of modification (medial heel skive) that was introduced by Kirby, the positive cast of the foot was corrected. Each person received an insole with medial heel skive technique. The pain and function of each foot were evaluated with a visual analogue scale and Foot and Ankle Outcome Score before applying the treatment and at six weeks follow-up. Paired t-test and non-parametric tests were used for statistical analysis. Results It was found that the pain and function significantly improved after 6 weeks of using insoles with medial heel skive technique in subjects with flat foot (P<0.001). Conclusion According to our findings, there was a significant difference in pain and function in patients with a flat foot through medial heel skive technique. Therefore, it seems that the insoles can be an effective prescription for subjects with a flat foot.
Abstract-The number of lower limb amputations is increasing significantly in developed countries. The knowledge of muscle synergy in subjects with loss of muscles could help to understand the general neural strategy underlying muscle coordination in walking. The aim of this study was to investigate the differences in healthy subject's dominant leg, amputee's intact leg (IL) and the amputee's prosthetic leg (PL) muscles using synergy analysis. Concatenated non-negative matrix factorization (CNMF) was performed to divide the surface electromyography (sEMG) data obtained from 6 upper knee and 4 shank muscles into muscle synergy (S) and activation coefficient profile (C) during walking. The difference in S showed low to high correlations inter-subjectively. The high correlation suggests that the central nervous system (CNS) activates the same groups of muscles synergistically. Amputee's muscle alterations due to inadequate proprioceptive feedback, weight bearing deficiency in PL and prosthesis type could lead to a low correlation in S between groups. The C showed to be statistically significantly different in some regions of the gait cycle (GC). These findings could provide valuable information for rehabilitation purposes and development of a synergy-based controller from sEMG for future generations of prostheses.
We simulated the knee arthrometry test to obtain a deeper understanding of the joint's stability behavior and interpret the arthrometric results more effectively. A 2D sagittal plane finite element model of the lower limb in the standard configuration of knee arthrometry was developed using ANSYS APDL. A detailed model of the knee joint was considered including the femoral articulating contour represented by an ellipse, the tibial plateau represented by a circular arc, and four major knee ligaments and their individual bundles represented by linear and nonlinear tensile springs. A deformable layer of articular cartilage was also considered over the tibial plateau to simulate the bones engagement more precisely. The model was analyzed while the tibia was subjected to an anterior drawer force of up to 150 N with 10 N increments and the tibial anterior translation was obtained. Simulation of the arthrometry test for different curvatures of the tibial plateau revealed that the bones engagement has a considerable effect on the knee joint's laxity. However, a considerable change from the intact knee's data curve was only observed when the ACL total ruptured was simulated. This emphasizes the difficult task involved when trying to distinguish the partial injuries of the ACL using arthrometric data.
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