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Institute
Background
Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet.
Methods
Thirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected.
Results
Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group.
Conclusions
The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.
Introduction:
In children, the impact of hearing loss on biomechanical gait parameters is not well understood. Thus, the objectives of this study were to examine three-dimensional lower limb joint torques in deaf compared to age-matched healthy (hearing) children while walking at preferred gait speed.
Methods:
Thirty prepubertal boys aged 8-14 were enrolled in this study and divided into a group with hearing loss (deaf group) and an age-matched healthy control. Three-dimensional joint torques were analyzed during barefoot walking at preferred speed using Kistler force plates and a Vicon motion capture system.
Results:
Findings revealed that boys with hearing loss showed lower joint torques in ankle evertors, knee flexors, abductors and internal rotators as well as in hip internal rotators in both, the dominant and non-dominant lower limbs (all p < 0.05; d = 1.23-7.00; 14-79%). Further, in the dominant limb, larger peak ankle dorsiflexor (p < 0.001; d = 1.83; 129%), knee adductor (p < 0.001; d = 3.20; 800%), and hip adductor torques (p < 0.001; d = 2.62; 350%) were found in deaf participants compared with controls.
Conclusion:
The observed altered lower limb torques during walking are indicative of unstable gait in children with hearing loss. More research is needed to elucidate whether physical training (e.g., balance and/or gait training) has the potential to improve walking performance in this patient group. (C) 2019 Elsevier Ltd. All rights reserved.
Background:
There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.
Methods:
Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6-20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.
Results:
COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.
Conclusion:
Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
Background: There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners.
Methods: Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6–20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force.
Results: COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR.
Conclusion: Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
Background. Dynamic balance is often assessed in athletes using either the Star Excursion Balance Test (SEBT) or the Y Balance Test (YBT). There is evidence that the results for the three common directions are not comparable. Thus, the question is open to debate as to which instrument is better suited to measure training-induced changes over time. Objectives. The aim of this study is to compare the changes in the SEBT and the YBT, measured before and after six weeks of balance and strength exercise programmes in young and healthy athletes. Methods. A total of 30 young male athletes aged 15-17 years participated in this study and were involved in a six-week combined training, including balance and strength exercise. During pre-and post-training periods, the SEBT and YBT were conducted in random order. Results. The comparison between the changes in the SEBT and YBT with a paired sample T-test showed a significant increase in PM (p=0.001) and PL reach directions (p=0.000). No differences were observed in the A reach direction (p=0.38). Conclusion. the responsiveness levels of the SEBT and YBT are similar is valid. Also, because of higher effect size value in the anterior direction in YBT compared with SEBT, this balance test could possibly be preferred in this direction for postural control evaluation.
Background:
Social isolation through quarantine represents an effective means to prevent COVID-19 infection. A negative side-effect of quarantine is low physical activity.
Research question:
What are the differences of running kinetics and muscle activities of recreational runners with a history of COVID-19 versus healthy controls?
Methods:
Forty men and women aged 20-30 years participated in this study and were divided into two experimental groups. Group 1 (age: 24.1 +/- 2.9) consisted of participants with a history of COVID-19 (COVID group) and group 2 (age: 24.2 +/- 2.7) of healthy age and sex-matched controls (controls). Both groups were tested for their running kinetics using a force plate and electromyographic activities (i.e., tibialis anterior [TA], gastrocnemius medialis [Gas-M], biceps femoris [BF], semitendinosus [ST], vastus lateralis [VL], vastus medialis [VM], rectus femoris [RF], gluteus medius [Glut-M]).
Results:
Results demonstrated higher peak vertical (p = 0.029; d=0.788) and medial (p = 0.004; d=1.119) ground reaction forces (GRFs) during push-off in COVID individuals compared with controls. Moreover, higher peak lateral GRFs were found during heel contact (p = 0.001; d=1.536) in the COVID group. COVID-19 individuals showed a shorter time-to-reach the peak vertical (p = 0.001; d=3.779) and posterior GRFs (p = 0.005; d=1.099) during heel contact. Moreover, the COVID group showed higher Gas-M (p = 0.007; d=1.109) and lower VM activity (p = 0.026; d=0.811) at heel contact.
Significance:
Different running kinetics and muscle activities were found in COVID-19 individuals versus healthy controls. Therefore, practitioners and therapists are advised to implement balance and/or strength training to improve lower limbs alignment and mediolateral control during dynamic movements in runners who recovered from COVID-19.
Background:
Shoe mileage is an important factor that may influence the risk of sustaining injuries during walking. The aims of this study were to examine the effects of shoe mileage on ground reaction forces and activity of lower limb muscles during walking in genu varus individuals compared with controls.
Methods:
Fifteen healthy and 15 genu varus females received a new pair of running shoes. They were asked to wear these shoes over 6 months. Pre and post intervention, mechanical shoe testing was conducted and ground reaction forces and muscle activities of the right leg were recorded during walking at preferred gait speed.
Findings:
Significant group-by-time interactions were found for shoe stiffness, antero-posterior and vertical impact peak. We observed higher shoe stiffness and lower impact peaks after intervention in both groups with larger effect sizes in genu varus. Significant group-by-time interactions were identified for vastus medialis (loading phase) and rectus femoris (loading and push-off). For vastus medialis, significant decreases were found from pre-to-post during the loading phase in the control group. Rectus femoris activity was higher post intervention during the loading and push-off phases in both groups with larger effect sizes in genu varus.
Interpretation:
Our findings indicate that the observed changes in ground reaction forces are more prominent in genu varus individuals. Together with our findings on shoe stiffness, it seems appropriate to change running shoes after an intense wearing time of 6 months, particularly in genu varus individuals.
Background
Sand is an easy-to-access, cost-free resource that can be used to treat pronated feet (PF). Therefore, the aims of this study were to contrast the effects of walking on stable ground versus walking on sand on ground reaction forces (GRFs) and electromyographic (EMG) activity of selected lower limb muscles in PF individuals compared with healthy controls.
Methods
Twenty-nine controls aged 22.2±2.5 years and 30 PF individuals aged 22.2±1.9 years were enrolled in this study. Participants walked at preferred speed and in randomized order over level ground and sand. A force plate was included in the walkway to collect GRFs. Muscle activities were recorded using EMG system.
Results
No statistically significant between-group differences were found in preferred walking speed when walking on stable ground (PF: 1.33±0.12 m/s; controls: 1.35±0.14 m/s; p = 0.575; d = 0.15) and sand (PF: 1.19±0.11 m/s; controls: 1.23±0.18 m/s; p = 0.416; d = 0.27). Irrespective of the group, walking on sand (1.21±0.15 m/s) resulted in significantly lower gait speed compared with stable ground walking (1.34±0.13 m/s) (p<0.001; d = 0.93). Significant main effects of “surface” were found for peak posterior GRFs at heel contact, time to peak for peak lateral GRFs at heel contact, and peak anterior GRFs during push-off (p<0.044; d = 0.27–0.94). Pair-wise comparisons revealed significantly smaller peak posterior GRFs at heel contact (p = 0.005; d = 1.17), smaller peak anterior GRFs during push-off (p = 0.001; d = 1.14), and time to peak for peak lateral GRFs (p = 0.044; d = 0.28) when walking on sand. No significant main effects of “group” were observed for peak GRFs and their time to peak (p>0.05; d = 0.06–1.60). We could not find any significant group by surface interactions for peak GRFs and their time to peak. Significant main effects of “surface” were detected for anterior-posterior impulse and peak positive free moment amplitude (p<0.048; d = 0.54–0.71). Pair-wise comparisons revealed a significantly larger peak positive free moment amplitude (p = 0.010; d = 0.71) and a lower anterior-posterior impulse (p = 0.048; d = 0.38) when walking on sand. We observed significant main effects of “group” for the variable loading rate (p<0.030; d = 0.59). Pair-wise comparisons revealed significantly lower loading rates in PF compared with controls (p = 0.030; d = 0.61). Significant group by surface interactions were observed for the parameter peak positive free moment amplitude (p<0.030; d = 0.59). PF individuals exhibited a significantly lower peak positive free moment amplitude (p = 0.030, d = 0.41) when walking on sand. With regards to EMG, no significant main effects of “surface”, main effects of “group”, and group by surface interactions were observed for the recorded muscles during the loading and push-off phases (p>0.05; d = 0.00–0.53).
Conclusions
The observed lower velocities during walking on sand compared with stable ground were accompanied by lower peak positive free moments during the push-off phase and loading rates during the loading phase. Our findings of similar lower limb muscle activities during walking on sand compared with stable ground in PF together with lower free moment amplitudes, vertical loading rates, and lower walking velocities on sand may indicate more relative muscle activity on sand compared with stable ground. This needs to be verified in future studies.
This study aimed to investigate the effects of eight weeks of barefoot running exercise on sand versus control on measures of walking kinetics and muscle activities in individuals with diagnosed pronated feet. Sixty physically active male adults with pronated feet were randomly allocated into an intervention or a waiting control group. The intervention group conducted an 8-weeks progressive barefoot running exercise program on sand (e.g., short sprints) with three weekly sessions. Pre and post intervention, participants walked at a constant speed of 1.3 m/s +/- 5% on a 18 m walkway with a force plate embedded in the middle of the walkway. Results showed significant group-by-time interactions for peak impact vertical and lateral ground reaction forces. Training but not control resulted in significantly lower peak impact vertical and lateral ground reaction forces. Significant group-by-time interactions were observed for vastus lateralis activity during the loading phase. Training-induced increases were found for the vastus lateralis in the intervention but not in the control group. This study revealed that the applied exercise program is a suitable means to absorb ground reaction forces (e.g., lower impact vertical and lateral peaks) and increase activities of selected lower limb muscles (e.g., vastus lateralis) when walking on stable ground.
Background: There is evidence that frontal plane lower limb malalignment (e.g., genu varus) is a risk factor for knee osteoarthritis development. However, only scarce information is available on gait biomechanics and muscle activity in boys with genu varus. Research question: To examine the effects of knee varus alignment on lower limb kinematics, kinetics and muscular activity during walking at self-selected speed in boys with genu varus versus healthy age-matched controls. Methods: Thirty-six boys were enrolled in this study and divided into a group of boys with genu varus (n = 18; age: 11.66 +/- 1.64 years) and healthy controls (n = 18; age: 11.44 +/- 1.78 years). Three-dimensional kinematics, ground reaction forces, loading rates, impulses and free moments of both limbs were recorded during five walking trials at self-selected speed. Surface electromyography was recorded for rectus femoris and vastus lateralis/medialis muscles. Results: No significant between-group differences were found for gait speed. Participants in the genu varus group versus controls showed larger peak knee flexion (p = 0.030; d = 0.77), peak knee adduction (p < 0.001; d = 1.63), and peak ankle eversion angles (p < 0.001; d = 2.06). Significantly higher peak ground reaction forces were found at heel contact (vertical [p = 0.002; d = 1.16] and posterior [p < 0.001; d = 1.63] components) and at push off (vertical [p = 0.010; d = 0.93] and anterior [p < 0.001; d = 1.34] components) for genu varus versus controls. Peak medial ground reaction force (p = 0.032; d = 0.76), vertical loading rate (p < 0.001; d = 1.52), anterior-posterior impulse (p = 0.011; d = 0.92), and peak negative free moment (p = 0.030; d = 0.77) were significantly higher in genu varus. Finally, time to reach peak forces was significantly shorter in genu varus boys compared with healthy controls (p < 0.01; d = 0.73-1.60). The genu varus group showed higher activities in vastus lateralis (p < 0.001; d = 1.82) and vastus medialis (p = 0.013; d = 0.90) during the loading phase of walking. Significance: Our study revealed genu varus specific gait characteristics and muscle activities. Greater knee adduction angle in genu varus boys may increase the load on the medial compartment of the knee joint. The observed characteristics in lower limb biomechanics and muscle activity could play a role in the early development of knee osteoarthritis in genu varus boys.