Older people are subject to an increased risk of falling compared to the young, especially during obstacle negotiation. This study aimed to quantify the effects of long-term Tai-Chi Chuan (TCC) practice on the balance control during obstacle-crossing in older people in terms of the inclination angles (IA) of the body’s centre of mass (COM) relative to the centre of pressure (COP), and the rate of change of IA (RCIA). Fifteen healthy older adults who had practised TCC for at least 13 years and 15 healthy controls without any experience in TCC performed obstacle-crossing in a gait laboratory. The TCC group showed significantly greater leading and trailing toe-obstacle clearances but smaller trailing stride lengths when compared to controls. In the sagittal plane, the TCC group showed significantly smaller average anterior IA when the COM was anterior to the COP but greater average posterior IA when the COM was posterior to the COP, with significantly smaller average and peak RCIA over the crossing cycle. Long-term TCC practitioners showed an obstacle-crossing technique for less risk of tripping and better balance control, as indicated respectively by significantly increased toe-obstacle clearances and more posterior COM position relative to the COP with smaller anterior IA and RCIA during leading crossing and greater posterior IA and frontal RCIA at trailing-toe crossing. These benefits appeared to be related to the main features of TCC movements that emphasized maintaining balance during single-leg support and keeping the body weight on the trailing limb during the slow weight-shifting of double-limb support.

Older adults are at higher risk of falling following total knee arthroplasty (TKA). However, it remains unclear how long a full recovery of the balance control during gait post‐TKA will take. The current study aimed to bridge this knowledge gap via long‐term follow‐up gait analyses. Twelve older adults with severe bilateral medial knee osteoarthritis (OA) before, 3 and 12 months after TKA, and twelve healthy controls were evaluated for their balance control during level walking, in terms of the inclination angle (IA) of the center of pressure to center of mass vector, and the rate of change of IA (RCIA). The patients before TKA showed significantly increased sagittal IA but decreased RCIA throughout the gait cycle (p < 0.04) compared to controls, suggesting a compromised balance control. Three months post‐TKA, deviations in IA remained, although those in RCIA were improved to normal. One‐year post‐TKA, no significant differences were found in any of the IA‐ and RCIA‐related variables between patient and Control groups. The results show that TKA surgery was effective in reducing the deviations in the center of mass‐center of pressure control in patients with severe bilateral knee OA, and full recovery of balance control can be expected 1 year after surgery.

Avascular necrosis of the hip (AVN) is one of the most severe complications of surgical reduction when treating developmental dysplasia of the hip (DDH). The current study identified the differences in the balance control during walking in terms of the inclination angle (IA) of the center of pressure (COP) to the center of mass (COM), and the rate of change of IA (RCIA) between female juveniles with and without secondary AVN at the hip who were treated for unilateral DDH during toddlerhood as compared to their healthy peers. When compared to female healthy controls, the non-AVN group showed bilaterally similar compromised balance control with significantly decreased IA (p &lt; 0.05) but increased RCIA (p &lt; 0.04) in the sagittal plane during single-limb support (SLS) of the unaffected side, and in the frontal plane during terminal double-limb support (DLS) of the affected side. In contrast, the AVN increased between-side differences in the sagittal IA (p = 0.01), and sagittal and frontal RCIA during DLS (p &lt; 0.04), leading to bilaterally asymmetrical balance control. Secondary AVN significantly reduced IA and RCIA in the sagittal plane (p &lt; 0.05), and reduced range of RCIA in the frontal plane during initial DLS (p &lt; 0.05). The trend reversed during terminal DLS, indicating a conservative COM-COP control in the sagittal plane and a compromised control in the frontal plane during body weight acceptance, with a compromised COM-COP control in the frontal plane during weight release. The current results suggest that increased between-side differences in the sagittal IA, and sagittal and frontal RCIA during DLS are a sign of AVN secondary to treated unilateral DDH in female juveniles, and should be monitored regularly for early identification of the disease.

Background: Assessment of the sole morphology provides a clinically useful measure of the foot condition, but existing methods are mostly limited to two-dimensional or non-weight-bearing conditions. The current study aimed to assess the reliability of a novel method called Single-Image-Based Pin-Array Impression Reconstruction Method (SIBPAIR) implemented on a commercial foot assessment system, and the intra-rater, inter-rater and inter-session reliability of the SIBPAIR-based protocol for three-dimensional sole morphological measurements. Methods: The reliability of the SIBPAIR method, and the intra-rater, inter-rater, and inter-session reliability of the SIBPAIR-based protocol in measuring morphological parameters of the sole were assessed by repeated measurements of fifteen young healthy adults by two male physical therapists, in terms of intra-class correlation coefficients (ICC) and standard error of measurement (SEM). Results and Conclusions: The SIBPAIR method was found to have very high reliability with very small SEM values, and the SIBPAIR-based protocol also showed very high intra-rater, inter-rater, and inter-session reliability with small SEM. These results indicate that accurate and reliable measurements could be obtained by following the protocol regardless of the rater’s experience or time of measurement. This will be useful for foot assessment and subsequent applications, such as design and manufacture of customized orthoses or shoes.

BackgroundMid-shaft clavicle fractures account for 35 to 44% of injuries to the shoulder girdle. There is increasing evidence to support surgical repair, but poor functional outcomes have been reported, and associated factors remain unclear.MethodsThe three-dimensional poses of the shoulder bones during arm elevations were measured in 15 patients treated for mid-shaft clavicle fractures by open reduction and internal fixation, and in 15 healthy controls.Results and ConclusionNo significant between-side differences were found in the clavicle length after surgery (p &gt; 0.05). The patients showed increased scapular protraction at lower elevation angles and reduced scapular retraction at higher elevation angles during frontal-plane elevations, with significantly reduced clavicle retraction (p &lt; 0.05), with unaltered scapular rotation and tilt. The ranges of the observed changes were reduced to arm elevations at 60° and 90° in the scapular and sagittal planes. Similar changes were also found on the unaffected side, suggesting symmetrical bilateral compensation. The results suggest that shoulder kinematics in multi-plane arm elevations should be monitored for any signs of compromised bone motions following surgical treatment, and that rehabilitative training may be needed on both sides to improve the bilateral movement control of the shoulder complex.