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<p> The present study develops a foot model to improve segment power estimates in the vertical jump. Modifications to the traditional foot model included the addition of a forefoot segment to allow for power flow across the metatarsal-phalangeal joint, and a re-definition of the ankle joint position to decrease foot segment length variability. The foot model was evaluated by comparison of the total segment power (TSP) with the rate of change of energy (RCE) of the foot segment. Pearson's correlation coefficients and percent root mean square (% RMS) error were used to compare curves. </p> <p> Power flow analysis was performed on a counter-movement jump (CMJ) and a squat jump (SQJ) for each of 8 male and 8 female subjects. Both a 4-Link and a 5-Link, sagittal plane, link-segment model were used to calculate the joint and muscle powers. </p> <p> The combination of both modifications to the traditional foot model (i.e. 5-Link(ankle) model), resulted in dramatic improvements for the match between the TSP and RCE. When comparing the traditional model with the 5-Link(ankle) model for the CMJ, correlation coefficients improved from -0.46 to 0.92 for the male group and from -0.50 to 0.77 for the female group. The %RMS error decreased from 380.5% to 35.4% for the male group and from 466.9% to 71.6% for the female group. SQJ improvements were similar. </p> <p> Ankle joint position re-definition succeeded in compensating for foot segment length changes in most cases, and indicates that a single point can be located to act as a hinge joint between the foot and leg segments throughout the vertical jump motion. Improvements associated with the addition of a forefoot segment to the traditional linksegment model indicate that substantial power flow occurs through the metatarsal-phalangeal joint during vertical jump motions. </p> / Thesis / Master of Science (MSc)

Tetracycline molecules including doxycycline (DOX), consist of a group of broad-spectrum antibiotics. In addition, tetracyclines inhibit matrix metalloproteinase (MMPs) that contribute to tissue remodeling, inflammation, angiogenesis and are over-expressed in certain pathologies - such as Alzheimer’s disease, metastasis and diabetic foot ulcers (DFUs). Tetracyclines are hypothesized to inhibit MMPs through the chelation and sequestration of catalytic divalent ions such zinc and calcium. This inhibitory duality may be beneficial in pathologies that are characterized by MMP over-expression and prone to infection, such as DFUs. Compared to oral administration, topical DOX is an attractive route of administration for chronic wound healing as it may minimize the risks: associated antibiotic resistance; is being targeted directly to the wound bed. However, DOX is notoriously unstable in aqueous solution and common topical formulations. Liquid chromatography and mass spectrometry (LCMS) were employed to monitor stability using an in vitro MMP assay and an applicable E. coli anti-bacterial assay was assessed to quantify drug activity. 2 % (w/w) topical DOX demonstrated an acceptable stability 30 day when stored at 4 ºC. DOX inhibited MMP9 activity with an IC50 value of 48.27 μM. With respect to anti-bacterial activity, using cultured BL21 E.Coli and quantification of drug activity as an expression of colony forming units (CFUs) successfully reproduced the antimicrobial IC50 of doxycycline as 4.3 µM. Transdermal DOX has the potential to improve standard of care for DFUs, quality of life for the patient and reduce costs to the healthcare system. / Thesis / Master of Science (MSc) / Tetracyclines comprise of a group of broad-spectrum antibiotics; whose primary mechanism of action is inhibition of protein synthesis through binding of the bacterial ribosome. In addition, tetracyclines inhibit matrix metalloprotease (MMPs), zinc-dependent proteases that contribute to tissue remodeling, angiogenesis and are over-expressed in certain pathophysiologies such as diabetic foot ulcers (DFUs). The antibacterial mechanism of DOX on MMPs is reported and understood, however the inhibition is hypothesized to involve cation chelation. Thus, investigating this interaction is warranted to assist in developing a therapeutic for DFUs. A more logical product would involve direct topical application, such as a stable transdermal formulation of DOX.

Athletic performance is an important factor to consider when designing athletic footwear. Improvements in agility drill performance can lead to improved sports performance. Changing footwear characteristics can be one way to help improve performance. The design and materialization of the upper of a shoe can impact biomechanical metrics and needs to be further explored during agility movements. Therefore, the first purpose of this study was to investigate the impact that stiffening the upper panel of an athletic shoe could have on agility performance using biomechanical outcome measures that correlate with athletic performance. Stiffening the upper panel significantly altered contact time during the lateral skater jump with the stiffest shoe having the shortest contact time compared to the other two shoe stiffness conditions (p=0.020-0.046). Shoe upper panel stiffness significantly changed peak concentric power in the anterior-posterior drill where the least stiff shoe produced the highest power compared to the stiffest shoe (p=0.006). The same dataset was used to address the second goal of this study which was to model the foot and ankle complex as a system of gears to understand force attenuation and propulsion during agility tasks. Although no differences were found between footwear conditions in gearing, it was shown that modeling the foot and ankle system through gearing can advance our understanding of the impact that footwear changes can have on performance and may be an important outcome measure in future footwear studies. / Master of Science / Athletic performance is an important factor to consider when designing athletic footwear. Through changes in shoe design, it is possible to improve agility drill performance. The design and materials used to construct the upper (top portion of the shoe) of the shoe can change the way an athlete completes a task and therefore, these measures need to be explored during several agility movements. The first goal of this study was to determine the impact of stiffening the upper portion of an athletic shoe on agility performance using outcome measures that are associated with improved athletic performance. Stiffening the upper portion of the shoe altered the contact time during the lateral skater jump with the stiffest shoe having the shortest contact time compared to the other two shoe conditions. Shoe upper panel stiffness also impacted peak concentric power in the anterior-posterior drill where the least stiff shoe produced the highest power compared to the stiffest shoe. The same dataset was used to model the foot and ankle as a system of gears in order to understand how an individual absorbs force and then utilizes force to move the body forward or to the side when completing agility tasks. Although no differences were found between footwear conditions when assessing gearing, it was shown that modeling the foot and ankle system in this way could aid in the understanding of how footwear changes can alter performance.

No / Bullosis diabeticorum is considered a rare skin manifestation of diabetes mellitus. Tense blisters appear rapidly, mostly on the feet, the cause of which is unclear, with multiple pathophysiologies hypothesised. This is a retrospective review of 4 diabetic patients who presented over six months with diabetic bullae; the condition may therefore not be as rare as commonly believed. All the patients had early surgical debridement followed by topical negative pressure wound dressings. A multidisciplinary team that included vascular surgeons, diabetologists, diabetic foot care team, wound care team, physiotherapists and occupational therapists managed the patients and none of them required amputations. We propose an alternative way of managing these patients with early surgical debridement followed by topical negative pressure wound dressing.

No / The establishment of a correct diagnosis links care to established guidelines and underpins all subsequent therapeutic activity. Problems can arise when definitions of disease overlap, as is the case with diabetic foot ulceration and pressure ulcers on the foot occurring in people with diabetes. In such cases, clinicians must ensure that patients receive a care bundle that recognises both the wound causation (pressure and shear) and the underlying pathology (diabetic neuropathy, potential foot architecture disruption and ischaemia). All patients with diabetes that have foot ulceration, irrespective of wound aetiology should, therefore, be seen by the multidisciplinary diabetic foot team. Care can then be optimised to include appropriate assessments, including assessment of peripheral perfusion, correct offloading, appropriate diabetic management, and general foot and skin care.

Individuals with stroke often demonstrate impaired ankle-foot function, commonly termed dropped foot that affects their ability to walk safely at home and within their community. While interventions are available to improve gait function, they have inconsistency demonstrated positive effects due to the lack of evidence-based practice guidelines and a limited understanding of the mechanisms leading to dropped foot. The aim of this dissertation was to 1) determine the relationship between dropped foot gait deviations and impaired sensorimotor control, 2) compare gait biomechanics between stroke survivors with and without dropped foot impairment, and 3) evaluate the immediate effects of an ankle-foot orthotic (AFO) and functional electrical stimulation (FES) device among stroke survivors with dropped foot impairment. Our evaluation combined standardized clinical measures of ankle-foot function (i.e. sensorimotor control, strength, spasticity and range of motion) and gait analysis using advanced laboratory techniques (i.e. electromyography and electrical goniometers) to quantify mechanisms of dropped foot impairment. Fifty-five stroke survivors completed the assessment prior to discharge from inpatient rehabilitation. Individuals with poor generation of isometric dorsiflexor force and reduced passive ankle range of motion were likely to demonstrate greater plantarflexion in swing and limited stance phase ankle joint excursion, respectively. Results from the gait analysis revealed a delayed onset and reduced activation time of the ankle dorsiflexors, and decreased co-activation time in the stance phase as possible mechanisms leading to dropped foot. A detailed case series was performed with four stroke survivors with dropped foot currently using an AFO. Application of an AFO immediately improved peak dorsiflexion in the swing phase and limited ankle range of motion during stance. When walking with the FES device, individuals with moderate dorsiflexor muscle weakness improved their ankle position at initial contact and increased peak dorsiflexion during stance, while no significant changes were observed among individuals with greater impairment. Overall, the results highlighted individual differences in response to interventions aimed at improving dropped foot gait deviations. These findings contribute to a greater understanding of gait dysfunction post stroke, and may lead to the development of a more effective clinical assessment and intervention strategies to improve dropped foot impairment.

Title: Problems of the functional flatfoot Objective: The aim of this diploma thesis is problems of the functional flatfoot. Main goal is to describe relation between change of structure, disorder of foot function and development of flatfoot. The thesis tries to describe the behavior of foot and arch in standing and walking. Another goal is to summarize the diagnostic possibilities of flatfoot. Methods: The diploma thesis has descriptive-analytical character. It's written in form of literature review. Results: This thesis demonstrates the problem of disunity nomenclature concerning the problem of flatfoot. Specifically, it concerns the interpretation of the words of functional flatfoot, movement components in foot and laboratory diagnostic methods. There is offered an explanation of the concept of functional flatfoot. Further work indicated that the acquired flatfoot is a question of a functional disorder that may progress to structural changes. The static and dynamic loadings were confirmed by the role of small muscles of the foot in the role of dynamic stabilization and influence of femoral rotation on the foot arch. There were summarized methods used for the diagnosis of flatfoot including dynamic plantography. Keywords: flat foot, foot arch, kinesiology, diagnostics