Technique for <i>in vivo</i> measurement of the three‐dimensional kinematics and laxity characteristics of the ankle joint complex

Siegler, Sorin; Wang, Dinghua; Plasha, Elizabeth; Berman, Arnold T.

doi:10.1002/jor.1100120315

Cited by 43 publications

(19 citation statements)

References 27 publications

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“…Serious skin breakdown in the spinal cord injury population has been reported most frequently over the ischial tuberosities [24] due to concentrated high pressure over bony prominences, which has been considered the most important etiologic factor in pressure ulcer formation in wheelchair users [7]. These facts favorably correspond to the results predicted from our FE analysis.…”

Section: Discussionsupporting

confidence: 83%

Finite Element Analysis for Evaluation of Pressure Ulcer on the Buttock: Development and Validation

Makhsous

Lim

Hendrix

et al. 2007

IEEE Trans. Neural Syst. Rehabil. Eng.

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The interface pressure is currently the only clinical tool to estimate the risk of sitting-related pressure ulcers. However, it provides little information on the loading condition in deep tissues. We present a comprehensive 3-D finite element (FE) model for human buttocks with the consideration of the joint configuration and realistic boundary conditions in a sitting posture. Sitting induced soft tissue deformation, internal pressure, and von-Mises stress were computed. The FE model was well validated qualitatively using actual displacement obtained from magnetic resonance imaging (MRI) images. FE analysis demonstrated that the deformation induced by sitting pressure was substantially different among muscle, fat, and skin. The deformation of the muscle varied with location and the maximum was seen in the regions underneath the bony prominence of ischial tuberosity. In these regions, the range of compressive pressure was 65-80 kPa, 50-60 kPa, and 55-65 kPa, for skin, fat, and muscle, respectively. The von-Mises stress distribution had a similar pattern. In conclusion, this study suggests a new methodology for the development and validation of FE models for investigating the risk of sitting-related soft tissue

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Section: Discussionsupporting

confidence: 83%

Finite Element Analysis for Evaluation of Pressure Ulcer on the Buttock: Development and Validation

Makhsous

Lim

Hendrix

et al. 2007

IEEE Trans. Neural Syst. Rehabil. Eng.

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“…Thus, knowing if ankle-complex motion between ankles in the same individual differs is imperative for accurate diagnosis. To date, few investigators have quantified differences in the uninjured ankle complex for right and left or dominant and nondominant motion, 4,20,21 primarily because a reliable and repeatable method for quantifying anklecomplex motion has been unavailable. [22][23][24] Our data are far more comprehensive than the data that normally are used to evaluate ankle-complex motion, except when researchers use a device similar to the Hollis Ankle Arthrometer as an evaluation tool.…”

Section: Limb Dominancementioning

confidence: 99%

“…18,25,26 These findings of symmetry were consistent with previous reports of the mechanical laxity characteristics of the ankle complex between legs. 4,20,21 Based on data obtained using 3-dimensional kinematics, Stefanyshyn and Engsberg 20 determined that ranges of motion for inversion, eversion, and total I-E were not different between the right and left legs in participants with no history of ankle injury. Siegler et al 21 noted no differences for inversion, eversion, or total I-E rotation comparisons of left and right ankles.…”

Section: Limb Dominancementioning

confidence: 99%

Arthrometric Measurement of Ankle-Complex Motion: Normative Values

Schwarz

Kovaleski

Heitman

et al. 2011

Journal of Athletic Training

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Intervention(s): Each ankle underwent anteroposterior (AP) and inversion-eversion (I-E) loading using an ankle arthrometer.Main Outcome Measure(s): Recorded anterior, posterior, and total AP displacement (millimeters) at 125 N and inversion, eversion, and total I-E rotation (degrees) at 4 Nm.Results: Women had greater ankle-complex motion for all variables except for posterior displacement. Total AP displacement of the ankle complex was 18.79 6 4.1 mm for women and 16.70 6 4.8 mm for men (U 5 3742.5, P , .01). Total I-E rotation of the ankle complex was 42.106 6 9.06 for women and 34.136 6 10.16 for men (U 5 2807, P , .001). All variables were normally distributed except for anterior displacement, inversion rotation, eversion rotation, and total I-E rotation in the women's ankles and eversion rotation in the men's ankles; these variables were skewed positively.Conclusions: Our study increases the available database on ankle-complex motion, and it forms the basis of norm-referenced clinical comparisons and the basis on which quantitative definitions of ankle pathologic conditions can be developed.Key Words: normal distribution, flexibility Key PointsN This study increases the available database on ankle-complex motion and forms the basis of norm-referenced clinical comparisons.N Women had greater ankle range of motion than men, and all of the range-of-motion variables measured were normally distributed except for anterior displacement, inversion rotation, eversion rotation, and total inversion-eversion rotation, which showed a higher incidence toward hypermobility.N Our findings are clinically important because they will assist in the clinical decision-making process, enabling comparisons to be made with individual patient data and enabling quantitative definitions of ankle conditions to be developed.

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“…2,3,13,14 With inversion loading, no authors of biomechanical studies have reported end-range stiffness characteristics for the intact ankle or for the ankle with combined lesions of the ATFL and CFL despite reporting increased instability. [14][15][16][17][18][19] Therefore, the mechanical property of stiffness may be important to understanding how injury affects joint stability. Given the lack of information on the behavior of the viscoelastic properties of the ankle complex after ankle ligament injury, our understanding of the characteristics of the passive connective tissues before and after injury could be enhanced by examining these effects.…”

mentioning

confidence: 99%

Joint Stability Characteristics of the Ankle Complex After Lateral Ligamentous Injury, Part I: A Laboratory Comparison Using Arthrometric Measurement

Kovaleski

Heitman

Gurchiek

et al. 2014

Journal of Athletic Training

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. Dr Liu is currently at the School of Kinesiology, Auburn University, AL. Context:The mechanical property of stiffness may be important to investigating how lateral ankle ligament injury affects the behavior of the viscoelastic properties of the ankle complex. A better understanding of injury effects on tissue elastic characteristics in relation to joint laxity could be obtained from cadaveric study.Objective: To biomechanically determine the laxity and stiffness characteristics of the cadaver ankle complex before and after simulated injury to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) during anterior drawer and inversion loading.Design: Cross-sectional study. Setting: University research laboratory.Patients or Other Participants: Seven fresh-frozen cadaver ankle specimens.Intervention(s): All ankles underwent loading before and after simulated lateral ankle injury using an ankle arthrometer. Main Outcome Measure(s):The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness.Results: Isolated ATFL and combined ATFL and CFL sectioning resulted in increased anterior displacement but not end-range stiffness when compared with the intact ankle. With inversion loading, combined ATFL and CFL sectioning resulted in increased range of motion and decreased end-range stiffness when compared with the intact and ATFL-sectioned ankles.Conclusions: The absence of change in anterior end-range stiffness between the intact and ligament-deficient ankles indicated bony and other soft tissues functioned to maintain stiffness after pathologic joint displacement, whereas inversion loading of the CFL-deficient ankle after pathologic joint displacement indicated the ankle complex was less stiff when supported only by the secondary joint structures.Key Words: ankle instability, joint laxity measurement, ankle sprains Key PointsThe injury mechanism consisted of serial sectioning of the major anatomic support structures of the lateral ankle complex. Anterior displacement was greater in the ankles with isolated anterior talofibular ligament (ATFL) sectioning and combined ATFL and calcaneofibular ligament (CFL) sectioning than in the intact ankles, but end-range stiffness did not increase after lateral ligament sectioning, indicating that bony and other soft tissues functioned to maintain anterior stiffness after pathologic joint displacement. With inversion loading, ankle-complex rotation increased and end-range stiffness decreased after CFL sectioning, indicating that the ankle complex was less stiff when supported only by the secondary joint structures.

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Technique for in vivo measurement of the three‐dimensional kinematics and laxity characteristics of the ankle joint complex

Cited by 43 publications

References 27 publications

Finite Element Analysis for Evaluation of Pressure Ulcer on the Buttock: Development and Validation

Finite Element Analysis for Evaluation of Pressure Ulcer on the Buttock: Development and Validation

Arthrometric Measurement of Ankle-Complex Motion: Normative Values

Joint Stability Characteristics of the Ankle Complex After Lateral Ligamentous Injury, Part I: A Laboratory Comparison Using Arthrometric Measurement

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