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Context: Decreased flexibility in muscles and joints of lower extremities is commonly observed in runners. Understanding the effect of decreased flexibility on knee walking kinematics in runners is important because, over time, altered gait patterns can make runners vulnerable to overuse injuries or degenerative pathologies. Objectives: To compare hamstring and iliotibial-band (ITB) flexibility and knee kinematics in runners and nonrunners. Design: A descriptive, comparative laboratory study. Setting: Hamstring and ITB flexibility were measured with the active knee-extension test and the modified Ober test, respectively, in both groups of participants. Three-dimensional (3D) walking kinematic data were then recorded at the knee using a motion-tracking system. Participants: 18 runners and 16 nonrunners. Main Outcome Measures: Knee-extension angle (hamstring flexibility) and hip-adduction angle (ITB flexibility). Knee kinematic parameters of interest included knee angle at initial contact, peak knee angles, and knee-angle range in all planes of movement. Results: The runners had a significantly less flexible ITB than the nonrunners (hip adduction [-] and adduction [+] angles, 3.1° ± 5.6° vs -6.4° ± 4.5°; P < .001). The runners demonstrated a greater mean tibial external-rotation angle at initial contact (7.3° ± 5.8° vs 2.0° ± 4.0°; P = .01) and a smaller mean peak tibial internal-rotation angle (-1.6° ± 3.0° vs -4.2° ± 3.2°; P = .04) than the nonrunners. Conclusion: This study provides new insight into the relationship between muscle flexibility and 3D knee kinematics in runners. This supports the premise that there is an association between muscle flexibility and transverse-plane knee kinematics in this population. [ABSTRACT FROM AUTHOR]

Background: The International Committee of the Red Cross supports a worldwide program of prosthetic fitting and rehabilitation. In this context, a prosthetic foot was developed and widely distributed in least developed countries.Study Design: Prospective, randomized, double-blind, controlled study.Objective: To compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (CR-Equipements™ solid ankle cushion heel, International Committee of the Red Cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot, Otto Bock).Methods: A total of 15 participants with unilateral transtibial amputation were evaluated using the two prosthetic feet in a randomized prospective double-blind crossover study. Main outcomes were patient satisfaction questionnaires (Satisfaction with Prosthesis Questionnaire and prosthetic foot satisfaction) and energy expenditure (oxygen consumption-mL/kg/min, oxygen cost-mL/kg/m, and heart rate-bpm).Results: There were no significant differences between the two prosthetic feet for satisfaction and energy expenditure.Conclusion: The low-cost solid ankle cushion heel foot with polypropylene keel provides comparable satisfaction and similar energy expenditure as the solid ankle cushion heel foot with wooden keel. Clinical relevance The results of this study support the application and widespread use of the CR-Equipements™ solid ankle cushion heel foot. From a cost-effectiveness standpoint, patients are well satisfied and exhibit similar outcomes at a substantially lower cost. [ABSTRACT FROM AUTHOR]

The purpose of this study is twofold: (1) to develop a classification method to distinguish between asymptomatic (AS) and knee osteoarthritis (OA) gait patterns using ground reaction force (GRF) measurements, and (2) to investigate OA severity within OA gait patterns. Features were first extracted from the GRF vectors to be used for classification. We investigated a two-level hierarchical classification and analysis method using the nearest neighbor rule. At the first level, the GRF data were classified into two classes: AS and OA. At the second level, the GRF data of OA patients were classified according to the pathology severity. The OA patients were grouped into two OA severity categories according to the Kellgren and Lawrence (KL) scale: KL 1 and KL 2 for one category, and KL 3 and KL 4 for the other. Experiments were conducted using data of 42 cases, 16 AS and 26 pathological. The method discriminated between AS and OA subjects with an accuracy of 38 of 42 cases, and assessed the severity correctly with an accuracy of 20 of 26 cases. These results demonstrated the validity of both, the feature and the classifier, for automatic classification of AS and knee OA gait patterns and for analysis of OA severity. [ABSTRACT FROM AUTHOR]

Anatomical knee joint features and osteoarthritis (OA) severity are associated, however confirming causals link to altered knee loading is challenging. This study leverages statistical shape models (SSM) to investigate the relationship between joint shape/alignment and knee loading during gait in knee OA (KOA) patients to understand their contribution to elevated medial knee loading in OA. Musculoskeletal (MSK) models were created for the mean as well as the first eight SSM principal modes of variation (−3,−2,−1, +1, +2, +3 standard deviations for each mode) and used as input to a MSK modeling framework. Using an identical KOA gait pattern (i.e., joint kinematics and ground reaction forces), we ran simulations for each MSK model and evaluated medial compartment loading magnitude and contact distribution at the instant of first and second peak of knee joint loading. An increase in external rotation, posterior tibia translation and a decrease in medial joint space and medial femoral condylar size predisposed the medial compartment knee joint to overloading during gait. This was coupled with an anterior and medial shift in contact location with increasing external rotated tibial position and increasing posterior tibial translation with respect to the femur. Next, results also highlighted a posterior shift of the medial compartment loading location with decreasing medial joint space. This study provides important population‐based insights on how knee shape and alignment predispose individuals with KOA to elevated medial compartmental knee loading. This information can be crucial in assessing the risk for medial KOA development and progression. [ABSTRACT FROM AUTHOR]

Background: The International Committee of the Red Cross supports a worldwide program of prosthetic fitting and rehabilitation. In this context, a prosthetic foot was developed and widely distributed in least developed countries., Study Design: Prospective, randomized, double-blind, controlled study., Objective: To compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (CR-Equipements ™ solid ankle cushion heel, International Committee of the Red Cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot, Otto Bock)., Methods: A total of 15 participants with unilateral transtibial amputation were evaluated using the two prosthetic feet in a randomized prospective double-blind crossover study. Main outcomes were patient satisfaction questionnaires (Satisfaction with Prosthesis Questionnaire and prosthetic foot satisfaction) and energy expenditure (oxygen consumption-mL/kg/min, oxygen cost-mL/kg/m, and heart rate-bpm)., Results: There were no significant differences between the two prosthetic feet for satisfaction and energy expenditure., Conclusion: The low-cost solid ankle cushion heel foot with polypropylene keel provides comparable satisfaction and similar energy expenditure as the solid ankle cushion heel foot with wooden keel. Clinical relevance The results of this study support the application and widespread use of the CR-Equipements ™ solid ankle cushion heel foot. From a cost-effectiveness standpoint, patients are well satisfied and exhibit similar outcomes at a substantially lower cost.

This study provides a basic understanding of the kinematic characteristics of the knee during different daily activities based on a functional knee analyzer, which allows a three-dimensional evaluation of the knee in motion. The results showed that there was significant difference in knee motion between the patients with knee osteoarthritis (OA) and normal subjects during lunging, squatting and no weight-bearing knee flexion-extension. The data obtained by the knee analyzer was sensitive enough to distinguish young and middle-aged subjects from OA subjects during different daily activities; squatting gave the best results. On the other hand, the OA and elderly subjects had similar knee flexion and adduction angle profiles. This founding may partially explain the increased prevalence of OA in elderly people. The results support the use of functional knee analyzer for biomechanical analysis of daily activities, especially squatting, as a clinical evaluation tool for patients with knee osteoarthritis.