ResearchPad - feet https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Remote monitoring of clubfoot treatment with digital photographs in low resource settings: Is it accurate?]]> https://www.researchpad.co/article/elastic_article_14742 Clinical examination and functional assessment are often the first steps to assess outcome of clubfoot treatment. Clinical photographs may be an adjunct used to assess treatment outcomes in lower resourced settings where physical review by a specialist is limited. We aimed to evaluate the diagnostic performance of photographic images of patients with clubfoot in assessing outcome following treatment.MethodsIn this single-centre diagnostic accuracy study, we included all children with clubfoot from a cohort treated between 2011 and 2013, in 2017. Two physiotherapists trained in clubfoot management calculated the Assessing Clubfoot Treatment (ACT) score for each child to decide if treatment was successful or if further treatment was required. Photographic images were then taken of 79 feet. Two blinded orthopaedic surgeons assessed three sets of images of each foot (n = 237 in total) at two time points (two months apart). Treatment for each foot was rated as ‘success’, ‘borderline’ or ‘failure’. Intra- and inter-observer variation for the photographic image was assessed. Sensitivity, specificity, positive and negative predictive values were calculated for the photographic image compared to the ACT score.ResultsThere was perfect correlation between clinical assessment and photographic evaluation of both raters at both time-points in 38 (48%) feet. The raters demonstrated acceptable reliability with re-scoring photographs (rater 1, k = 0.55; rater 2, k = 0.88). Thirty percent (n = 71) of photographs were assessed as poor quality image or sub-optimal patient position. Sensitivity of outcome with photograph compared to ACT score was 83.3%–88.3% and specificity ranged from 57.9%–73.3%.ConclusionDigital photography may help to confirm, but not exclude, success of clubfoot treatment. Future work to establish photographic parameters as an adjunct to assessing treatment outcomes, and guidance on a standardised protocol for photographs, may be beneficial in the follow up of children who have treated clubfoot in isolated communities or lower resourced settings. ]]> <![CDATA[Special footwear designed for pregnant women and its effect on kinematic gait parameters during pregnancy and postpartum period]]> https://www.researchpad.co/article/elastic_article_13821 During pregnancy, an array of changes occurs in women body to enable the growth and development of the future baby and the consequent delivery. These changes are reflected in the range of motion of trunk, pelvis, lower limbs and other body segments, affect the locomotion and some of these changes may persist to the postpartum period. The aim of this study was to describe the changes affecting the gait during pregnancy and to determine the effect of tested footwear on kinematic gait characteristics during pregnancy as previous studies indicate that special orthopaedic insoles and footwear might be useful in prevention of the common musculoskeletal pain and discomfort related to pregnancy. Participants from the control group (n = 18), without any intervention, and the experimental group (n = 23), which was wearing the tested shoes, were measured at their 14, 28 and 37 gestational weeks and 28 weeks postpartum to capture the complete pregnancy-related changes in gait. The gait 3D kinematic data were obtained using Simi Motion System. The differences between the control and experimental group at the first data collection session in most of the analysed variables, as well as relatively high standard deviations of analysed variables indicate large individual differences in the gait pattern. The effect of tested footwear on kinematic gait pattern changes may be explained by its preventive effect against the foot arches falling. In the control group, changes associated previously with the foot arches falling and hindfoot hyperpronation were observed during advanced phases of pregnancy and postpartum, e.g. increase in knee flexion or increase in spinal curvature. For the comprehensive evaluation of the tested footwear on pregnancy gait pattern, future studies combining the kinematic and dynamic plantographic methods are needed.

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<![CDATA[The effect of contact sport expertise on postural control]]> https://www.researchpad.co/article/5c6f14f5d5eed0c48467abb2

It has been demonstrated that expertise in sport influences standing balance ability. However, little is known concerning how physical contact in sport affects balance ability. The aim of this study was to examine whether differences between contact and limited-contact sport experiences results in differences in postural control. Twenty male collegiate athletes (10 soccer/contact, 10 baseball/limited contact) and ten male untrained students stood quietly on a force plate under various bipedal and unipedal conditions, with and without vision. Significant differences for sway area and COP speed were found between the soccer players and the other two groups for unipedal stances without vision. Soccer players were found to have superior postural control compared with participants involved in limited contact sport or no sport at all. Contact sports may lead to increased postural control through enhanced use of proprioceptive and vestibular information.

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<![CDATA[Multifractality of posture modulates multisensory perception of stand-on-ability]]> https://www.researchpad.co/article/5c6c7582d5eed0c4843cfe31

By definition, perception is a multisensory process that unfolds in time as a complex sequence of exploratory activities of the organism. In such a system perception and action are integrated, and multiple energy arrays are available simultaneously. Perception of affordances interweaves sensory and motor activities into meaningful behavior given task constraints. The present contribution offers insight into the manner in which perception and action usher the organism through competent functional apprehension of its surroundings. We propose that the tensegrity structure of the body, manifested via multifractality of exploratory bodily movements informs perception of affordances. The affordance of stand-on-ability of ground surfaces served as the experimental paradigm. Observers viewed a surface set to a discrete angle and attempted to match it haptically with a continuously adjustable surface occluded by a curtain, or felt an occluded surface set to a discrete angle then matched it visually with a continuously adjustable visible surface. The complex intertwining of perception and action was demonstrated by the interactions of multifractality of postural sway with multiple energy arrays, responses, and changing geometric task demands.

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<![CDATA[Dynamic stability and stepping strategies of young healthy adults walking on an oscillating treadmill]]> https://www.researchpad.co/article/5c6dc9dad5eed0c48452a314

Understanding how people modify their stepping to maintain gait stability may provide information on fall risk and help to understand strategies used to reduce loss of balance. The purpose of this study was to identify the stepping strategies healthy young individuals select to maintain balance while walking on a destabilizing surface in various directions. A treadmill mounted on top of a 6 degree-of-freedom motion base was used to generate support surface oscillations in different degrees of freedom and amplitudes. Fifteen healthy young adults (21.3 ± 1.4 years) walked at self-selected speeds while continuous sinusoidal oscillations were imposed to the support surface in a one degree of freedom: rotation or translation in the mediolateral (ML) direction and rotation or translation in the anteroposterior (AP) direction, with each condition repeated at three different amplitudes. We compared step width, length, and frequency and the mean and variability of margin of stability (MoS) during each experimental walking condition with a control condition, in which the support surface was stationary. Subjects chose a common strategy of increasing step width (p < 0.001) and decreasing step length (p = 0.008) while increasing mediolateral MoS (p < 0.001), particularly during oscillations that challenged frontal plane control, with rotations of the walking surface producing the greatest changes to stepping.

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<![CDATA[Very severe tungiasis in Amerindians in the Amazon lowland of Colombia: A case series]]> https://www.researchpad.co/article/5c65dce5d5eed0c484dec4b0

Background

Tungiasis is a parasitic skin disease caused by penetrating female sand fleas. By nature, tungiasis is a self-limiting infection. However, in endemic settings re-infection is the rule and parasite load gradually accumulates over time. Intensity of infection and degree of morbidity are closely related.

Methodology/principal findings

This case series describes the medical history, the clinical pathology, the socio-economic and the environmental characteristics of very severe tungiasis in five patients living in traditional Amerindian communities in the Amazon lowland of Colombia. Patients had between 400 and 1,300 penetrated sand fleas. The feet were predominantly affected, but clusters of embedded sand fleas also occurred at the ankles, the knees, the elbows, the hands, the fingers and around the anus. The patients were partially or totally immobile. Patients 1 and 3 were cachectic, patient 2 presented severe malnutrition. Patient 3 needed a blood transfusion due to severe anemia. All patients showed a characteristic pattern of pre-existing medical conditions and culture-dependent behavior facilitating continuous re-infection. In all cases intradomiciliary transmission was very likely.

Conclusion/significance

Although completely ignored in the literature, very severe tungiasis occurs in settings where patients do not have access to health care and are stricken in a web of pre-existing illness, poverty and neglect. If not treated, very severe tungiasis may end in a fatal disease course.

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<![CDATA[Community based cross sectional study of podoconiosis and associated factors in Dano district, Central Ethiopia]]> https://www.researchpad.co/article/5c58d630d5eed0c484031865

Background

Podoconiosis, affects lower limb, is an entirely preventable non-communicable tropical disease common in low income countries. Globally it is estimated that there are 4 million peoples with podoconiosis and nationally it is estimated that there are 1.56 million cases of podoconiosis. Even though nationwide mapping has been conducted including the current district under investigation, there are no studies conducted to identify factors associated with podoconiosis in the district. Hence, this study was aimed to determine the prevalence of podoconiosis and associated factors in the west Shewa of Dano district community.

Method

A community based cross sectional study was conducted from March 1 to 26, 2018. Seven kebeles out of the total of twenty-three kebeles found in the district were selected randomly. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 652 study participants from the seven kebeles. Data was collected using interviewer administered structured questionnaire and observation. In addition, a blood sample was collected from the study subjects who had leg swelling for ruling out lymphedema due to lymphatic filarasis by using Immunochromatographic test card. Podoconiosis case was defined as bilateral but asymmetric swelling which develop first in the foot often confined to the lower leg and negative result for immune-chromatographic test (ICT card). The prevalence of podoconiosis was determined and multiple logistic regression model was fitted using SPSS version 23 to identify factors associated with podoconiosis.

Result

The prevalence of podoconiosis in Dano district was found to be 6.3% (95%CI: 5.8, 6.8). Age at first shoe wearing (AOR = 1.08,95% CI = 1.06–1.11), washing practice of feet by water only (AOR = 3.68, 95% CI = 1.47–9.24) and not wearing shoe daily (AOR = 9.32, 95% CI = 4.27–20.4) were found to be significantly associated with increased odds of podoconiosis.

Conclusion

This study revealed that there was significant burden of podoconiosis in the study area. Age at first shoe wearing, washing practice and frequency of shoe wearing were associated with the development of podoconiosis disease. Modalities to enhance the shoe wearing behaviour of the communities should be planned by high level decision makers working in the area of Health. Moreover, collaboration between local government and non-government stakeholders, and integration with existing programs addressing foot hygiene which involves washing feet with soap and water needs to be addressed.

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<![CDATA[Automatic real-time gait event detection in children using deep neural networks]]> https://www.researchpad.co/article/5c5ca2a9d5eed0c48441e836

Annotation of foot-contact and foot-off events is the initial step in post-processing for most quantitative gait analysis workflows. If clean force plate strikes are present, the events can be automatically detected. Otherwise, annotation of gait events is performed manually, since reliable automatic tools are not available. Automatic annotation methods have been proposed for normal gait, but are usually based on heuristics of the coordinates and velocities of motion capture markers placed on the feet. These heuristics do not generalize to pathological gait due to greater variability in kinematics and anatomy of patients, as well as the presence of assistive devices. In this paper, we use a data-driven approach to predict foot-contact and foot-off events from kinematic and marker time series in children with normal and pathological gait. Through analysis of 9092 gait cycle measurements we build a predictive model using Long Short-Term Memory (LSTM) artificial neural networks. The best-performing model identifies foot-contact and foot-off events with an average error of 10 and 13 milliseconds respectively, outperforming popular heuristic-based approaches. We conclude that the accuracy of our approach is sufficient for most clinical and research applications in the pediatric population. Moreover, the LSTM architecture enables real-time predictions, enabling applications for real-time control of active assistive devices, orthoses, or prostheses. We provide the model, usage examples, and the training code in an open-source package.

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<![CDATA[Objective measures of rollator user stability and device loading during different walking scenarios]]> https://www.researchpad.co/article/5c5b5283d5eed0c4842bca5f

Walking aids are widely used by older adults, however, alarmingly, their use has been linked to increased falls-risk, yet clinicians have no objective way of assessing user stability. This work aims to demonstrate the application of a novel methodology to investigate how the type of walking task, the amount of body weight supported by the device (i.e., device loading), and task performance strategy affect stability of rollator users. In this context, ten users performed six walking tasks with an instrumented rollator. The combined stability margin “SM” was calculated, which considers user and rollator as a combined system. A Friedman Test was used to investigate the effects of task on SM and a least-squares regression model was applied to investigate the relationship between device loading and SM. In addition, the effects of task performance strategy on SM were explored. As a result, it was found that: the minimum SM for straight line walking was higher than for more complex tasks (p<0.05); an increase in device loading was associated with an increase in SM (p<0.05); stepping up a kerb with at least 1 rollator wheel in ground contact at all times resulted in higher SM than lifting all four wheels simultaneously. Hence, we conclude that training should not be limited to straight line walking but should include various everyday tasks. Within person, SM informs on which tasks need practicing, and which strategy facilitates stability, thereby enabling person-specific guidance/training. The relevance of this work lies in an increase in walking aid users, and the costs arising from fall-related injuries.

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<![CDATA[Postural control in healthy adults: Determinants of trunk sway assessed with a chest-worn accelerometer in 12 quiet standing tasks]]> https://www.researchpad.co/article/5c521837d5eed0c4847977f3

Many diseases and conditions decrease the ability to control balance. In clinical settings, there is therefore a major interest in the assessment of postural control. Trunk accelerometry is an easy, low-cost method used for balance testing and constitutes an alternative method to the posturography using force platforms. The objective was to assess the responsiveness of accelerometry in a battery of 12 quiet standing tasks. We evaluated the balance of 100 healthy adults with an accelerometer fixed onto the sternum. We used the average amplitude of acceleration as an indirect measure of postural sways. The tasks of increased difficulty were realized with or without vision. The battery of tasks was repeated four times on two different days to assess reliability. We analyzed the extent to which the task difficulty and the absence of vision affected the trunk sway. The influence of individual characteristics (age, height, mass, sex, and physical activity level) was also assessed. The reliability analysis revealed that four repetitions of the battery of tasks are needed to reach a high accuracy level (mean ICC = 0.85). The results showed that task difficulty had a very large effect on trunk sways and that the removal of vision further increased sways. Concerning the effects of individual characteristics, we observed that women tended to oscillate more than men did in tasks of low difficulty. Age and physical activity level also had significant effects, whereas height and mass did not. In conclusion, age, sex, and physical fitness are confounders that should be considered when assessing patients’ balance. A battery of simple postural tasks measured by upper-trunk accelerometry can be a useful method for simple balance evaluation in clinical settings.

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<![CDATA[Selective effect of static stretching, concentric contractions, and a balance task on ankle force sense]]> https://www.researchpad.co/article/5c605a2ad5eed0c4847ccac1

Proper ankle motor control is critical for balance in the human body during functional activities such as standing, walking, and running. Different exercise modalities are often performed during the same training session where earlier activities may influence later ones. The purpose of the current study was to determine the acute effects of different exercise modalities on ankle force sense. Seventeen subjects performed four different intervention protocols (static stretching, balance task, concentric contractions, and control) in random order. Each session comprised measurements before and after the intervention protocol of the force sense of the ankle plantar flexors (PF) and dorsal flexors (DF) at 10% and 30% of maximal voluntary isometric contraction (MVC). Absolute errors (AE) were calculated separately for each force level and muscle group. An overall PF error (PF-SUM = PF at 10%MVC + PF at 30%MVC), DF error (DF-SUM = DF at 10%MVC + DF at 30%MVC) and ankle error (PF-DF-SUM = PF-SUM + DF-SUM) were also calculated. The main effect of time generally revealed that ankle force sense was significantly reduced after static stretching (PF-DF-SUM: Pre: 6.11±2.17 Nm, Post: 8.03±3.28 Nm; p < 0.05), but no significant differences were observed for the concentric contractions (PF-DF-SUM: Pre: 6.01±1.97 Nm, Post: 6.50±2.28 Nm) and the balance task (PF-DF-SUM: Pre: 5.25±1.97 Nm, Post: 5.50±1.26 Nm). The only significant interaction was observed for the PF-DF-SUM (F = 4.48, p = 0.008) due to greater error scores after stretching (+31.4%) compared to the concentric (+8.2%), balance (+4.8%), and control (-3.5%) conditions. Based on these results, static stretching should not be performed before activities that require a high ankle force sense such as balance, coordination, and precision tasks.

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<![CDATA[Exploration of a simplified clinical examination for scabies to support public health decision-making]]> https://www.researchpad.co/article/5c2e7fd7d5eed0c48451ba74

Introduction

In most settings, the diagnosis of scabies is reliant on time-consuming and potentially intrusive clinical examination of all accesible regions of skin. With the recent recognition of scabies as a neglected tropical disease by the World Health Organization there is a need for standardised approaches to disease mapping to define populations likely to benefit from intervention, and to measure the impact of interventions. Development and validation of simplified approaches to diagnose scabies would facilitate these efforts.

Methods

We utilised data from three population-based surveys of scabies. We classified each individual as having scabies absent or present overall, based on whole body assessment, and in each of 9 regions of the body. We calculated the sensitivity of diagnosing the presence of scabies based on each individual body region compared to the reference standard based on whole body examination and identified combinations of regions which provided greater than 90% sensitivity. We assessed the sensitivity according to gender, age group, severity of scabies and the presence or absence of impetigo.

Results

We included 1,373 individuals with scabies. The body regions with highest yield were the hands (sensitivity compared to whole body examination 51.2%), feet (49.7%), and lower legs (48.3%). Examination of the exposed components of both limbs provided a sensitivity of 93.2% (95% CI 91.2–94.4%). The sensitivity of this more limited examination was greater than 90% regardless of scabies severity or the presence or absence of secondary impetigo.

Discussion

We found that examination limited to hands, feet and lower legs was close to 90% for detecting scabies compared to a full body examination. A simplified and less intrusive diagnostic process for scabies will allow expansion of mapping and improved decision-making about public health interventions. Further studies in other settings are needed to prospectively validate this simplified approach.

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<![CDATA[Cranio-caudal and medio-lateral navicular translation are representative surrogate measures of foot function in asymptomatic adults during walking]]> https://www.researchpad.co/article/5c117b4fd5eed0c4846989f5

Introduction

The translation of the navicular bone is thought to be a representative surrogate measure to assess foot pronation and hence foot function; however, it is not known how it is related to multi-segment foot kinematics.

Methods

Cranio-caudal (NCC) and medio-lateral (NML) navicular translation and multi-segment foot kinematics from the Oxford Foot Model (OFM) were simultaneously assessed during the stance phase of walking in 20 healthy adults. Relationships to forefoot to hindfoot (FFtoHF), hindfoot to tibia (HFtoTBA) and global hindfoot (HFL) motion were explored by cross-correlations at zero phase shift.

Results

FFtoHF sagittal, transversal and frontal plane angles showed median cross correlations of -0.95, 0.82 and 0.53 with NCC and of 0.78, -0.81 and -0.90 with NML. HFtoTBA transversal and frontal plane angles had correlations of 0.15 and 0.74 with NCC and of -0.38 and -0.83 with NML. The HFL frontal plane angle showed correlations of 0.41 and -0.44 with NCC and NML, respectively.

Discussion

The strongest relationships were found between FFtoHF sagittal plane angles and NCC and between FFtoHF frontal plane angles and NML. However, cranio-caudal and medio-lateral navicular translation seem to be reasonable surrogates for the triplanar motion between the fore- and hindfoot. The medial longitudinal arch dropped and bulged medially, while the forefoot dorsiflexed, abducted and everted with respect to the hindfoot and vice-versa. The lower cross-correlation coefficients between the rear foot parameters and NCC/NML indicated no distinct relationships between rearfoot frontal plane and midfoot kinematics. The validity of rearfoot parameters, like Achilles tendon or Calcaneal angle, to assess midfoot function must be therefore questioned. The study could also not confirm a systematic relationship between midfoot kinematics and the internal/external rotation between the hindfoot and the tibia. The measurement of navicular translation is suggested as an alternative to more complex multi-segment foot models to assess foot function.

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<![CDATA[Novelty upon novelty visualized by rotational scanning electron micrographs (rSEM): Laboulbeniales on the millipede order Chordeumatida]]> https://www.researchpad.co/article/5c0841c9d5eed0c484fcabc2

Laboulbeniales are highly specific ectoparasitic fungi of arthropods (insects, millipedes, and arachnids). The first Laboulbeniales parasitizing the millipede order Chordeumatida (Diplopoda) were discovered and described as a new dioecious genus of Laboulbeniales, Thaxterimyces, to accommodate the new species T. baliensis. Also the millipede host is a new species and is described as Metopidiothrix sheari. This is the first time Laboulbeniales fungus and its millipede host are described as new together. Males of Metopidiothrix have the most extensive secondary sexual modifications in the entire class Diplopoda. Although nothing is known about the function of these modifications, the unique pattern of Laboulbeniales infection in the new millipede species is obviously related to host sexual behavior. Rotational Scanning Electron Micrographs (rSEM) are used to create a 3D comprehensive model to examine the fungal-host interaction, a more advanced visualization of the ectoparasitic fungus on its host. Laboulbeniales diversity on millipedes is still understudied, and a consistent effort is needed to unveil and understand the extent and diversity of this biological interaction. Due to their minute size and apparently non-detrimental effect on their hosts, Laboulbeniales in general have been largely ignored by mycologists and neglected by generations of entomologists. As a result a significant component of global biodiversity has been strongly underestimated, and a wealth of new discoveries is still to be made both in the field and in existing museum collections.

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<![CDATA[Understanding the impact loading characteristics of a badminton lunge among badminton players]]> https://www.researchpad.co/article/5bca48e640307c0516656417

Background

The rapid and repetitive badminton lunges would produce strenuous impact loading on the lower extremities of players and these loading are thought to be the contributing factors of chronic knee injuries. This study examined the impact loading characteristics in various groups of badminton athletes performing extreme lunges.

Methods

Fifty-two participants classified into male skilled, female skilled, male unskilled, and female unskilled groups performed badminton lunge with their maximum-effort. Shoe-ground kinematics, ground reaction forces, and knee moments were measured by using synchronised force platform and motion analysis system. A 2 (gender) x 2 (skill-level) factorial ANOVA was performed to determine the effects of different gender and different playing levels, as well as the interaction of two factors on all variables.

Results

Male athletes had faster approaching speed (male 3.87 and female 1.08 m/s), longer maximum lunge distance (male 1.47 and female 1.16 m), larger maximum (male 215.7 and female 121.65 BW/s) and mean loading rate (male 178.43 and female 81.77 BW/s) and larger peak knee flexion moment (male 0.75 and female 0.69) compared with female athletes (P < 0.001). Unskilled athletes exhibited smaller footstrike angle (skilled 45.78 and unskilled 32.35°), longer contact time (skilled 0.69 and unskilled 0.75 s), larger peak horizontal GRF (skilled 1.61 and unskilled 2.40 BW), smaller mean loading rate (skilled 150.15 and unskilled 110.05 BW/s) and larger peak knee flexion moment (P < .05; skilled 0.69 and unskilled 0.75 Nm/BW) than the skilled athletes. In addition, the interaction indicated greater peak GRF impact in female unskilled athletes compared with female skilled athletes (P < 0.001; female skilled 2.01 and female unskilled 2.95 BW), while there was no difference between male participants (P > 0.05; male skilled 2.19 and male unskilled 2.49 BW).

Conclusions

These data suggested that male athletes and/or unskilled athletes experience greater impact loading rates and peak knee flexion moment during lunge compared with female and skilled athletes, respectively. This may expose them to higher risk of overuse injuries. Furthermore, female unskilled athletes seemed to be more vulnerable to lower extremity injuries.

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<![CDATA[Bimodal ankle-foot prosthesis for enhanced standing stability]]> https://www.researchpad.co/article/5bb530cf40307c24312bb0af

Previous work suggests that to restore postural stability for individuals with lower-limb amputation, ankle-foot prostheses should be designed with a flat effective rocker shape for standing. However, most commercially available ankle-foot prostheses are designed with a curved effective rocker shape for walking. To address the demands of both standing and walking, we designed a novel bimodal ankle-foot prosthesis that can accommodate both functional modes using a rigid foot plate and an ankle that can lock and unlock. The primary objective of this study was to determine if the bimodal ankle-foot system could improve various aspects of standing balance (static, dynamic, and functional) and mobility in a group of Veterans with lower-limb amputation (n = 18). Standing balance was assessed while subjects completed a series of tests on a NeuroCom Clinical Research System (NeuroCom, a Division of Natus, Clackamas, OR), including a Sensory Organization Test, a Limits of Stability Test, and a modified Motor Control Test. Few statistically significant differences were observed between the locked and unlocked ankle conditions while subjects completed these tests. However, in the absence of visual feedback, the locked bimodal ankle appeared to improve static balance in a group of experienced lower-limb prosthesis users whose PLUS-M mobility rating was higher than approximately 73% of the sample population used to develop the PLUS-M survey. Given the statistically significant increase in mean equilibrium scores between the unlocked and locked conditions (p = 0.004), future testing of this system should focus on new amputees and lower mobility users (e.g., Medicare Functional Classification Level K1 and K2 prosthesis users). Furthermore, commercial implementation of the bimodal ankle-foot system should include a robust control system that can automatically switch between modes based on the user’s activity.

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<![CDATA[Modulation of plantar pressure and gastrocnemius activity during gait using electrical stimulation of the tibialis anterior in healthy adults]]> https://www.researchpad.co/article/5b03d272463d7e6e6b5b7907

High plantar flexor moment during the stance phase is known to cause high plantar pressure under the forefoot; however, the effects on plantar pressure due to a change of gastrocnemius medialis (GM) activity during gait, have not been investigated to date. Reciprocal inhibition is one of the effects of electrical stimulation (ES), and is the automatic antagonist alpha motor neuron inhibition which is evoked by excitation of the agonist muscle. The aim of this study was to investigate the influences of ES of the tibialis anterior (TA) on plantar pressure and the GM activity during gait in healthy adults. ES was applied to the TAs of twenty healthy male adults for 30 minutes at the level of intensity that causes a full range of dorsiflexion in the ankle (frequency; 50 Hz, on-time; 10 sec, off-time; 10 sec). Subjects walked 10 meters before and after ES, and we measured the peak plantar pressure (PP), pressure time integral (PTI), and gait parameters by using an F-scan system. The percentage of integrated electromyogram (%IEMG), active time, onset time, peak time, and cessation time of TA and GM were calculated. PP and PTI under the forefoot, rear foot, and total plantar surface significantly decreased after the application of ES. Meanwhile, changes of gait parameters were not observed. %IEMG and the active time of both muscles did not change; however, onset time and peak time of GM became significantly delayed. ES application to the TA delayed the timing of onset and peak in the GM, and caused the decrease of plantar pressure during gait. The present results suggest that ES to the TA could become a new method for the control of plantar pressure via modulation of GM activity during gait.

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<![CDATA[Cryptic, Sympatric Diversity in Tegu Lizards of the Tupinambis teguixin Group (Squamata, Sauria, Teiidae) and the Description of Three New Species]]> https://www.researchpad.co/article/5989dadbab0ee8fa60bb9ce7

Tegus of the genera Tupinambis and Salvator are the largest Neotropical lizards and the most exploited clade of Neotropical reptiles. For three decades more than 34 million tegu skins were in trade, about 1.02 million per year. The genus Tupinambis is distributed in South America east of the Andes, and currently contains four recognized species, three of which are found only in Brazil. However, the type species of the genus, T. teguixin, is known from Bolivia, Brazil, Colombia, Ecuador, French Guyana, Guyana, Peru, Suriname, Trinidad and Tobago, and Venezuela (including the Isla de Margarita). Here we present molecular and morphological evidence that this species is genetically divergent across its range and identify four distinct clades some of which are sympatric. The occurrence of cryptic sympatric species undoubtedly exacerbated the nomenclatural problems of the past. We discuss the species supported by molecular and morphological evidence and increase the number of species in the genus Tupinambis to seven. The four members of the T. teguixin group continue to be confused with Salvator merianae, despite having a distinctly different morphology and reproductive mode. All members of the genus Tupinambis are CITES Appendix II. Yet, they continue to be heavily exploited, under studied, and confused in the minds of the public, conservationists, and scientists.

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<![CDATA[Effects of different medial arch support heights on rearfoot kinematics]]> https://www.researchpad.co/article/5989db50ab0ee8fa60bdbd74

Background

Foot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait.

Methods

Nineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05).

Results

Eversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high.

Conclusion

Our results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait.

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<![CDATA[Molecular and Morphological Study of Leaping Frogs (Anura, Ranixalidae) with Description of Two New Species]]> https://www.researchpad.co/article/5989daf2ab0ee8fa60bc1718

The monotypic anuran family Ranixalidae is endemic to India, with a predominant distribution in the Western Ghats, a region that is home to several unique amphibian lineages. It is also one of the three ancient anuran families that diversified on the Indian landmass long before several larger radiations of extant frogs in this region. In recent years, ranixalids have been subjected to DNA barcoding and systematic studies. Nearly half of the presently recognized species in this family have been described over the last three years, along with recognition of a new genus to accommodate three previously known members. Our surveys in the Western Ghats further suggest the presence of undescribed diversity in this group, thereby increasing former diversity estimates. Based on rapid genetic identification using a mitochondrial gene, followed by phylogenetic analyses with an additional nuclear gene and detailed morphological studies including examination of museum specimens, new collections, and available literature, here we describe two new species belonging to the genus Indirana from the Western Ghats states of Karnataka and Kerala. We also provide new genetic and morphological data along with confirmed distribution records for all the species known prior to this study. This updated systematic revision of family Ranixalidae will facilitate future studies and provide vital information for conservation assessment of these relic frogs.

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