Title: Effect of mechanical correction of hallux valgus deformity Objectives: The aim of this diploma thesis is to investigate the influence of axial correction of hallux valgus deformity on static and dynamic postural stability. Methods: This pilot study involved 8 people ranging in age from 22 to 30 years with mild or moderate degree of hallux valgus deformity. Five probands had hallux valgus deformity bilaterally, three probands had deformity unilaterally on the right leg. Axial correction of position of first MTP joint was made by tape. Postural stability was measured using computerized dynamic posturography EquiTest Smart System from Neurocom before and after intervention. Measured data were processed using Neurocom Balance Manager Software. For the analysis of the data were used statistical methods - paired t-test, Wilcoxon rank test and the rate of clinical significance (Cohen's d). Results: The results indicates that the axial correction of hallux valgus deformity has positive effect on the dynamic postural stability. This impact wasn't demonstrated in static situations. Keywords: hallux valgus, great toe, postural stability, corrective taping, computerized dynamic posturography

Background: The incidence of anterior cruciate ligament (ACL) –injury is 3-5 times greater in female athletes compared to male athletes. This may be partially attributed to lower levels of hamstring-quadriceps co-contraction in females with subsequent knee kinematics that increases risk of ACL-injury. Finding training methods that improves co-contraction and increases knee stability is important. Objectives: To evaluate the effects of a new device on hamstring-quadriceps co-contraction and to investigate if training with the device can alter knee kinematics in female athletes. Study design: Controlled experimental study design with repeated measures. Method: Twenty soccer and floor ball athletes were measured with electromyography (EMG) for hamstring-quadriceps co-contraction while performing squats with and without the device. Thirteen athletes also underwent three-dimensional kinematic analyses, measuring knee abduction angles (at initial ground contact and peak angle) during a drop jump, before and after a six week intervention period with the device. Friedman’s test and Wilcoxon signed rank test was used to assess differences and effect sizes (ES) were calculated. Results: Co-contraction was consistently larger on the device (medial side: p<0.001, ES=0.88; lateral side: p<0.001, ES=0.80) and the ratio of medial-to-lateral co-contraction increased (p=0.001, ES=0.79). In the kinematic analysis low adherence rates amongst our subjects meant that the effects of the device on kinematics could not be measured. Conclusion: Performing squats with the new training device stimulates increased hamstring-quadriceps co-contraction and increases the ratio of medial-to-lateral co-contraction. The effects of the device on knee kinematics have yet to be determined.

Title: Ranges of joint mobility in the hip and ankle joints and evaluation of flat feet on a podoscope when finding hallux valgus in classical ballet dancers Objectives: The aim of this thesis is to evaluate if selected parameters: passive range of motion (ROM) of rotations in hip joints, Q angle, passive range of motion of plantar flexion in ankle joints and the foot index are connected with the finding of hallux valgus (HV) diagnose. These factors will be compared between two groups of ballet dancers, one with HV and one without the HV diagnose. Methods: This observational case control study involved 30 probands between the age of 20-40 years. The experimental group consisted of classical ballet dances with the HV angle (HVA) >15ř at least on one foot (n1 = 19), in the control group were classical ballet dancers with the HVA <15ř bilaterally (n2 = 11). The HVA, ROM of the rotations in the hip joints, ROM of the plantar flexion in the ankle joints and Q angle were measured by a goniometer. The plantogram was captured by a photograph of the foot while standing on a podoscope and then it was evaluated by the Sztriter-Godunov method. Analysis of the data was done in R software by means of a Welch's Two-Sample t-Test and the correlation was given by Pearson's Correlation Coefficient. Results: Contrary...

Title: The immediate effect of Russian electrical stimulation on m. abductor hallucis on postural stability in women with dysfunction of hallux valgus Objectives: The aim of this diploma theses is to investigate the immediate effect of Russian eletrical stimulation on m. abductor hallucis on postural stability in women with mild or moderate dysfunction of hallux valgus. Methods: This is an experimental pilot study in which 16 women aged 23-28 years participated. The entry criteria for participation in the research were: mild or moderate dysfunction of hallux valgus according to the Manchester scale, angle of hallux valgus ≥ 15ř at least on one lower limb. Probands could not participate in the research if: they completed a rehabilitation program to affect hallux valgus deformity, underwent surgery for hallux valgus deformity, suffered an injury of the lower limbs in the last six months before the start of the research or if they were pregnant. The examination of postural stability took place in the Kinesiology Laboratory of FTVS UK on the NeuroCom SMART EquiTest System posturograph. The following tests were selected: Sensory Organization Test, Motor Control Test, Weight Bearing Squat and Limits of Stability test. Russian stimulation was applied on the abductor hallucis muscle of both lower limbs...

Knee osteoarthritis (KOA) is the primary cause of chronic immobility in populations over the age of 65. It is a joint degenerative disease in which the articular cartilage in the knee joint wears down over time, leading to symptoms of pain, instability, joint stiffness, and misalignment of the lower extremities. Without intervention, these symptoms gradually worsen over time, decreasing the overall knee range of motion (ROM) and ability to walk. Current clinical interventions include offloading braces, which mechanically realign the lower extremities to alleviate the pain experienced in the medial compartment of the knee joint. Though these braces have proven effective in pain management, studies have shown a significant decrease in knee ROM while using the brace. Concurrently, development of active exoskeletons for rehabilitative gait has increased within recent years in efforts to provide patients with a more effective intervention for dealing with KOA. Though some developed exoskeletons are promising in their efficacy of fostering gait therapy, these devices are heavy, tethered, difficult to control, unavailable to patients, or costly due to the number of complicated components used to manufacture the device. However, the idea that an active component can improve gait therapy for patients motivates this study. This study proposes the design of an adjustable lower extremity exoskeleton which features a single linear actuator adapted onto a commercially available offloading brace. This design hopes to provide patients with pain alleviation from the brace, while also actively driving the knee through flexion and extension. The design and execution of this exoskeleton was accomplished by 3D computer simulation, 3D CAD modeling, and rapid prototyping techniques. The exoskeleton features 3D printed, ABS plastic struts and supports to achieve successful adaptation of the linear actuator to the brace and an electromechanical system with a rechargeable operating capacity of 7 hours. Design validation was completed by running preliminary gait trials of neutral gait (without brace or exoskeleton), offloading brace, and exoskeleton to observe changes between the different gait scenarios. Results from this testing on a single subject show that there was an observed, significant decrease in average knee ROM in the offloading brace trials from the neutral trials and an observed, significant increase in average knee ROM in the exoskeleton trials when compared to the brace trials as hypothesized. Further evaluation must be completed on the clinical efficacy of this device with a larger, and clinically relevant sample size to assess knee ROM, pain while using the device, and overall comfort level. Further development of this design could focus on material assessment, cost analysis, and risk mitigation through failure mode analysis.

No description available.

Anterior cruciate ligament (ACL) injuries are a major problem among female athletes. Screening for the risk of ACL injuries tends to focus on landing tasks, which may be limited in sports where changing direction is the main action involved in noncontact ACL injuries such as soccer. To investigate whether there is a relationship between single-legged landing (SLL), cutting (90° cuts), and pivoting (180° turns) in terms of the characteristics of dynamic valgus. Study Design: Controlled laboratory study. Methods: Twenty female soccer players (mean ± SD: age, 21.0 ± 3.9 years; height, 1.65 ± 0.08 m; mass, 58.4 ± 6.4 kg) performed a minimum of 6 trials of SLL from a 0.3-m drop height and cutting and pivoting all on the right leg. Kinematics and kinetics were calculated from 3-dimensional motion analysis. Results: Strong correlations were found for peak knee abduction angles between tasks (R = 0.63-0.86, P < .01), whereas only moderate correlations between SLL and cutting (R = 0.46, P < .05), cutting and pivoting (R = 0.56, P < .05), and SLL and pivoting (R = 0.43, P > .05) were found between tasks for peak knee abduction moments. Conclusion: The results suggest that female athletes who exhibit poor SLL mechanics perform the same during various changing direction tasks. Clinical Relevance: The results support the use of existing screening tests that involve landing tasks to identify at-risk athletes for noncontact ACL injuries.

Context: Two-dimensional (2D) video analysis of frontal-plane dynamic knee valgus during common athletic screening tasks has been purported to identify individuals who may be at high risk of suffering knee injuries such as anterior cruciate ligament tear or patellofemoral pain syndrome. Although the validity of 2D video analysis has been studied, the associated reliability and measurement error have not. To assess the reliability and associated measurement error of a 2D video analysis of lower limb dynamic valgus. Design: Reliability study. Participants: 20 recreationally active university students (10 women age 21.5 ± 2.3 y, height 170.1 ± 6.1 cm, weight 66.2 ± 10.2 kg, and 10 men age 22.6 ± 3.1 y, height 177.9 ± 6.0 cm, weight 75.8 ± 7.9 kg). Main Outcome Measurement: Within-day and between-days reliability and measurement-error values of 2D frontal-plane projection angle (FPPA) during common screening tasks. Interventions: Participants performed single-leg squat and drop jump and single-leg landings from a standard 28-cm step with standard 2D digital video camera assessment. Results: Women demonstrated significantly higher FPPA in all tests except the left single-leg squat. Within-day ICCs showed good reliability and ranged from .59 to .88, and between-days ICCs were good to excellent, ranging from .72 to .91. Standard error of measurement and smallest detectable difference values ranged from 2.72° to 3.01° and 7.54° to 8.93°, respectively. Conclusions: 2D FPPA has previously been shown to be valid and has now also been shown to be a reliable measure of lower extremity dynamic knee valgus. Using the measurement error values presented along with previously published normative data, clinicians can now make informed judgments about individual performance and changes in performance resulting from interventions.

Le pied plat valgus dynamique idiopathique est une déformation touchant un grand nombre d’enfants. Il fait l’objet de la plupart des consultations d’orthopédie pédiatrique et donne communément lieu au port d’orthèses plantaires correctives. Le pied étant un segment dont l’architecture lui confère des propriétés de souplesse et de robustesse, une altération de sa structure, en particulier touchant à la forme de la voute plantaire, peut engendrer des modifications de la marche. Les atteintes de cette déformation sont au cœur de beaucoup d’études mais la littérature reste toujours parcellaire et centrée sur quelques variables mesurées sur le membre inférieur. En revanche, s’il est important d’évaluer la déformation localement, la marche reste une coordination de l’ensemble des segments corporels hautement hiérarchisée, dont l’évaluation de la performance nécessite des analyses plus globales. Le travail de cette thèse s’attachera à effectuer une caractérisation de l’effet de la présence d’un pied plat valgus dynamique sur la marche de l’enfant, mêlant des méthodes issues de la biomécanique classique, aux analyses de données et aus théories des systèmes dynamiques non linéaires.Les principaux résultats de ce travail concernent la multiplicité des atteintes biomécanique et les nombreuses modifications que le pied plat valgus dynamique engendre au niveau musculaire et cinématique sur le membre inférieur. Les mouvements intrinsèques du pied s’avèrent refléter particulièrement le défaut de maitrise de la marche à l’échelle du patient. Enfin, le pied s’avèrera jouer un rôle protecteur du centre de masse vis-à-vis du maintien de la stabilité dynamique lors de la marche. / The pediatric flexible flat foot is a common deformation. It is the reason of most pediatric orthopedic consultations and commonly leads corrective foot orthotics prescription. The specific architecture of the normal foot gives it properties of adaptation, strength and flexibility. Any alteration of its structure, particularly related to the shape of the plantar arch can cause modifications in gait. A lot of studies investigated the effects of this deformation, but are generally centered on a small number of variables, only at the level of the lower limb. However, if the local deformation is important to assess, it is unlikely to represent the complex non-linear coordination of the whole body segments related to gait performance. This thesis aims at characterizing the effect of flexible flat foot on gait in children, from a biomechanical point of view at the lower limb level as well as at the global coordination level, using methods from classicla biomechanics, data analysis and non linear dynamical systems theories.The major outcomes of this work are the multiplicity of biomechanical effects and the numerous changes on muscles activities and kinematics of the lower limb caused by flexible flat foot. The intrinsic foot movements particularly reflect the lack of control of gait at the patient's level. The particular role of the trunk and contralateral leg regarding the specific locomotor pattern of patients will be detailed. Finally, the foot will appear to have a protective role of the center of mass concerning resistance to perturbations and maintaining gait dynamic stability.

The diploma thesis "Vliv palce nohy na stabilitu stoje a chůze" is focused on the function of hallux at stance and through the gait cycle and particularly to halluxes influence on stability of the stated motor stereotypes. The theoretical part summarizes the knowledge gained through literature research on anatomy and kinesiology of hallux. It also contains analysis of gait cycle and muscle coordination through it with emphasis upon activity of foot and function of hallux muscles. The practical part attempts to objectivize changes in stability and changes of loading of foot with instrumental examination. Force plate Balance Master® and GaitPlatform FDM were used for the measurements. On the force plate the parametres of movement of the centre of mass (COM, COG) and maintenance of stability while standing were compared. GaitPlatform® was used for measurement of ground reaction forces while standing and walking. Powered by TCPDF (www.tcpdf.org)