ORCID Profile
0000-0002-1158-8917
Current Organisation
University of South Australia
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Publisher: Elsevier BV
Date: 05-2020
Publisher: Informa UK Limited
Date: 19-08-2019
DOI: 10.1080/02640414.2019.1651582
Abstract: Foot orthoses and insoles are prescribed to runners, however their impact on running economy and performance is uncertain. The aim of this systematic review and meta-analysis was to determine the effect of foot orthoses and insoles on running economy and performance in distance runners. Seven electronic databases were searched from inception until June 2018. Eligible studies investigated the effect of foot orthoses or insoles on running economy (using indirect calorimetry) or running performance. Standardised mean differences (SMDs) were computed and meta-analyses were conducted using random effects models. Methodological quality was assessed using the Quality Index. Nine studies met the criteria and were included: five studies investigated the effect of foot orthoses on running economy and four investigated insoles. Foot orthoses were associated with small negative effects on running economy compared to no orthoses (SMD 0.42 [95% CI 0.17,0.72] p = 0.007). Shock absorbing insoles were also associated with negative effects on running economy, but an imprecise estimate (SMD 0.26 [95% CI -0.33,0.84] p = 0.83). Quality Index scores ranged from 4 to 15 out of 17. Foot orthoses and shock absorbing insoles may adversely affect running economy in distance runners. Future research should consider their potential effects on running performance.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
Publisher: Springer Science and Business Media LLC
Date: 30-10-2017
Publisher: Informa UK Limited
Date: 03-2013
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.INJURY.2017.10.040
Abstract: To identify and describe the characteristics of existing practices for postoperative weight bearing and management of tibial plateau fractures (TPFs), identify gaps in the literature, and inform the design of future research. Seven electronic databases and clinical trial registers were searched from inception until November 17th 2016. Studies were included if they reported on the surgical management of TPFs, had a mean follow-up time of ≥1year and provided data on postoperative management protocols. Data were extracted and synthesized according to study demographics, patient characteristics and postoperative management (weight bearing regimes, immobilisation devices, exercises and complications). 124 studies were included involving 5156 patients with TPFs. The mean age across studies was 45.1 years (range 20.8-72 60% male), with a mean follow-up of 34.9 months (range 12-264). The most frequent fracture types were AO/OTA classification 41-B3 (29.5%) and C3 (25%). The most commonly reported non-weight bearing time after surgery was 4-6 weeks (39% of studies), with a further 4-6 weeks of partial weight bearing (51% of studies), resulting in 9-12 weeks before full weight bearing status was recommended (55% of studies). Loading recommendations for initial weight bearing were most commonly toe-touch/<10kg (28%), 10kg-20kg (33%) and progressive (39%). Time to full weight bearing was positively correlated with the proportion of fractures of AO/OTA type C (r=0.465, p=0.029) and Schatzker type IV-VI (r=0.614, p<0.001). Similar rates of rigid (47%) and hinged braces were reported (58%), most frequently for 3-6 weeks (43% of studies). Complication rates averaged 2% of patients (range 0-26%) for abnormal varus/valgus and 1% (range 0-22%) for non-union or delayed union. Postoperative rehabilitation for TPFs most commonly involves significant non-weight bearing time before full weight bearing is recommended at 9-12 weeks. Partial weight bearing protocols and brace use were varied. Type of rehabilitation may be an important factor influencing recovery, with future high quality prospective studies required to determine the impact of different protocols on clinical and radiological outcomes.
Publisher: Elsevier BV
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 08-10-2021
DOI: 10.1186/S12913-021-07096-7
Abstract: Wearable activity monitors (WAMs, e.g. Fitbits and research accelerometers) show promise for helping health care professionals (HCPs) measure and intervene on patients’ activity patterns. This study aimed to describe the clinical use of WAMs within South Australia, barriers and enablers, and future opportunities for large-scale clinical use. A descriptive qualitative study was undertaken using semi-structured interviews. Participants were HCPs with experience using WAMs in South Australian clinical settings. Commencing with participants identified through the research team’s professional networks, snowball recruitment continued until all identified eligible HCPs had been invited. Semi-structured interviews were used to explore the research aims, with quantitative data analysed descriptively, and qualitative data analysed thematically. 18 participants (physiotherapists n = 8, exercise physiologists n = 6, medical consultants n = 2, and research personnel recommended by medical consultants n = 2), represented 12 discrete “hubs” of WAM use in clinical practice, spanning rehabilitation, orthopaedics, geriatrics, intensive care, and various inpatient-, outpatient-, community-based hospital and private-practice settings. Across the 12 hubs, five primarily used Fitbits® (various models), four used research-grade accelerometers (e.g. GENEActiv, ActivPAL and StepWatch accelerometers), one used Whoop Bands® and another used smartphone-based step counters. In three hubs, WAMs were used to observe natural activity levels without intervention, while in nine they were used to increase (i.e. intervene on) activity. Device selection was typically based on ease of availability (e.g. devices borrowed from another department) and cost-economy (e.g. Fitbits® are relatively affordable compared with research-grade devices). Enablers included device characteristics (e.g. accuracy, long battery life, simple metrics such as step count) and patient characteristics (e.g. motivation, rehabilitation population, tech-savvy), whilst barriers included the HCPs’ time to download and interpret the data, multidisciplinary team attitudes and lack of protocols for managing the devices. At present, the use of WAMs in clinical practice appears to be fragmented and ad hoc, though holds promise for understanding patient outcomes and enhancing therapy. Future work may focus on developing protocols for optimal use, system-level approaches, and generating cost-benefit data to underpin continued health service funding for ongoing/wide-spread WAM use.
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.JSAMS.2018.09.002
Abstract: To investigate whether functional overreaching affects locomotor system behaviour when running at fixed relative intensities and if any effects were associated with changes in running performance. Prospective intervention study. Ten trained male runners completed three training blocks in a fixed order. Training consisted of one week of light training (baseline), two weeks of heavy training designed to induce functional overreaching, and ten days of light taper training designed to allow athletes to recover from, and adapt to, the heavy training. Locomotor behaviour, 5-km time trial performance, and subjective reports of training status (Daily Analysis of Life Demands for Athletes (DALDA) questionnaire) were assessed at the completion of each training block. Locomotor behaviour was assessed using detrended fluctuation analysis of stride intervals during running at speeds corresponding to 65% and 85% of maximum heart rate (HR Time trial performance (effect size ±95% confidence interval (ES): 0.16±0.06 p<0.001), locomotor behaviour at 65% HR Locomotor behaviour during running at 65% HR
Publisher: Wiley
Date: 17-10-2023
DOI: 10.1002/JOR.25455
Abstract: The aim of this study was to determine the effect of surgical change to the acetabular offset and femoral offset on the abductor muscle and hip contact forces after primary total hip arthroplasty (THA) using computational methods. Thirty‐five patients undergoing primary THA were recruited. Patients underwent a computed tomography scan of their pelvis and hip, and underwent gait analysis pre‐ and 6‐months postoperatively. Surgically induced changes in acetabular and femoral offset were used to inform a musculoskeletal model to estimated abductor muscle and hip joint contact forces. Two experiments were performed: (1) influence of changes in hip geometry on hip biomechanics with preoperative kinematics and (2) influence of changes in hip geometry on hip biomechanics with postoperative kinematics. Superior and medial placement of the hip centre of rotation during THA was most influential in reducing hip contact forces, predicting 63% of the variance ( p 0.001). When comparing the preoperative geometry and kinematics model, with postoperative geometry and kinematics, hip contact forces increased after surgery (0.68 BW, p = 0.001). Increasing the abductor lever arm reduced abductor muscle force by 28% ( p 0.001) and resultant hip contact force by 17% (0.6 BW, p = 0.003), with both preoperative and postoperative kinematics. Failure to increase abductor lever arm increased resultant hip contact force 11% (0.33 BW, p 0.001). In conclusion, increasing the abductor lever arm provides a substantial biomechanical benefit to reduce hip abductor and resultant hip joint contact forces. The magnitude of this effect is equivalent to the average increase in hip contact force seen with improved gait from pre‐to post‐surgery.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Human Kinetics
Date: 05-2022
Abstract: Purpose: Determine the impact of preseason and between-seasons changes in in idual physical performance on injury risk in elite junior Australian football players and if injuries sustained during a season impact subsequent-season performance improvement. Methods: This prospective cohort study assessed in idual performance measures (sprint speed, jump, agility, and aerobic endurance) during preseason over 4 consecutive seasons. Injury status (injured/not injured) was tracked weekly to determine the relationship between in idual performance and in-season injury occurrence. Mixed models were used to determine the relationship between physical performance and injury, and the effect of injury on physical performance improvement. Results: A total of 206 players played 2 consecutive seasons and were included (17.6 y, 181.9 cm, 75.7 kg). Faster players during preseason experienced higher injury incidence (injuries/season) during that playing season (incidence rate ratio = 0.127 P = .034). Injury incidence was not influenced by between-seasons change in any performance measure. Players injured during their first season maintained their aerobic fitness, which declined in noninjured players ( d = 0.39 P = .013). Players who sustained a lower-limb injury during their first season saw smaller improvements in sprint speed than players who did not get injured ( d = 0.39 P = .035). Conclusion: Faster players experience higher injury incidence than slower players and may require specific prevention interventions. Players who experience a lower-limb injury during the playing season do not improve sprint speed between seasons to the same extent as players who do not get injured, highlighting the need for targeted high-speed running ability development as part of rehabilitation.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 02-2016
Publisher: Elsevier BV
Date: 08-2023
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JOCA.2022.02.603
Abstract: To summarise the available evidence relating to the diagnosis, epidemiology, burden, outcome assessment and treatment of foot and ankle osteoarthritis (OA) and to develop an agenda to guide future research. Members of the International Foot and Ankle Osteoarthritis Consortium compiled a narrative summary of the literature which formed the basis of an interactive discussion at the Osteoarthritis Research Society International World Congress in 2021, during which a list of 24 research agenda items were generated. Following the meeting, delegates were asked to rank the research agenda items on a 0 to 100 visual analogue rating scale (0 = not at all important to 100 = extremely important). Items scoring a mean of 70 or above were selected for inclusion. Of the 45 delegates who attended the meeting, 31 contributed to the agenda item scoring. Nineteen research agenda items met the required threshold: three related to diagnosis, four to epidemiology, four to burden, three to outcome assessment and five to treatment. Key knowledge gaps related to foot and ankle OA were identified, and a comprehensive agenda to guide future research planning was developed. Implementation of this agenda will assist in improving the understanding and clinical management of this common and disabling, yet relatively overlooked condition.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2016
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JOCA.2018.12.022
Abstract: To investigate the demographic, symptomatic, clinical and structural foot characteristics associated with potential phenotypes of midfoot osteoarthritis (OA). Cross-sectional study of 533 community-dwelling adults aged ≥50 years with foot pain in the past year. Health questionnaires and clinical assessments of symptoms, foot structure and function were undertaken. Potential midfoot OA phenotypes were defined by the pattern of radiographic joint involvement affecting either the medial midfoot (talonavicular, navicular-1 Of 879 eligible feet, 168 had medial midfoot OA, 103 central midfoot OA, 76 both medial and central midfoot OA and 532 no/minimal OA. Having both medial and central midfoot OA was associated with higher pain scores, dorsally-located midfoot pain (OR 2.54, 95%CI 1.45, 4.45), hallux valgus (OR 1.76, 95%CI 1.02, 3.05), flatter foot posture (β 0.44, 95%CI 0.12, 0.77), lower medial arch height (β 0.02, 95%CI 0.01, 0.03) and less subtalar inversion and 1 Distinct phenotypes of midfoot OA appear challenging to identify, with substantial overlap in symptoms and clinical characteristics. Phenotypic differences in symptoms, foot posture and function were apparent in this study only when both the medial and central midfoot were involved.
Publisher: Human Kinetics
Date: 03-2017
Abstract: Stride-to-stride fluctuations in running-stride interval display long-range correlations that break down in the presence of fatigue accumulated during an exhaustive run. The purpose of the study was to investigate whether long-range correlations in running-stride interval were reduced by fatigue accumulated during prolonged exposure to a high training load (functional overreaching) and were associated with decrements in performance caused by functional overreaching. Ten trained male runners completed 7 d of light training (LT 7 ), 14 d of heavy training (HT 14 ) designed to induce a state of functional overreaching, and 10 d of light training (LT 10 ) in a fixed order. Running-stride intervals and 5-km time-trial (5TT) performance were assessed after each training phase. The strength of long-range correlations in running-stride interval was assessed at 3 speeds (8, 10.5, and 13 km/h) using detrended fluctuation analysis. Relative to performance post-LT 7 , time to complete the 5TT was increased after HT 14 (+18 s P .05) and decreased after LT 10 (–20 s P = .03), but stride-interval long-range correlations remained unchanged at HT 14 and LT 10 ( P .50). Changes in stride-interval long-range correlations measured at a 10.5-km/h running speed were negatively associated with changes in 5TT performance ( r –.46 P = .03). Runners who were most affected by the prolonged exposure to high training load (as evidenced by greater reductions in 5TT performance) experienced the greatest reductions in stride-interval long-range correlations. Measurement of stride-interval long-range correlations may be useful for monitoring the effect of high training loads on athlete performance.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
DOI: 10.11124/JBISRIR-2016-002949
Abstract: Based on the observation that rehabilitation practices for tibial plateau fractures are inconsistent and lack uniformity in the published literature, this scoping review will seek to identify all relevant studies that have reported on rehabilitation for tibial plateau fractures in order to comprehensively map the characteristics of the practices. This scoping review will then be used to identify commonalities across the included studies in order to identify potential focus questions for subsequent systematic reviews.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JOCA.2018.02.897
Abstract: To determine the change in walking gait biomechanics after total hip arthroplasty (THA) for osteoarthritis (OA) compared to the pre-operative gait status, and to compare the recovery of gait following THA with healthy in iduals. Systematic review with meta-analysis of studies investigating changes in gait biomechanics after THA compared to (1) preoperative levels and (2) healthy in iduals. Data were pooled at commonly reported time points and standardised mean differences (SMDs) were calculated in meta-analyses for spatiotemporal, kinematic and kinetic parameters. Seventy-four studies with a total of 2,477 patients were included. At 6 weeks postoperative, increases were evident for walking speed (SMD: 0.32, 95% confidence intervals (CI) 0.14, 0.50), stride length (SMD: 0.40, 95% CI 0.19, 0.61), step length (SMD: 0.41, 95% CI 0.23, 0.59), and transverse plane hip range of motion (ROM) (SMD: 0.36, 95% CI 0.05, 0.67) compared to pre-operative gait. Sagittal, coronal and transverse hip ROM was significantly increased at 3 months (SMDs: 0.50 to 1.07). At 12 months postoperative, patients demonstrated deficits compared with healthy in iduals for walking speed (SMD: -0.59, 95% CI -1.08 to -0.11), stride length (SMD: -1.27, 95% CI -1.63, -0.91), single limb support time (SMD: -0.82, 95% CI -1.23, -0.41) and sagittal plane hip ROM (SMD: -1.16, 95% CI -1.83, -0.49). Risk of bias scores ranged from seven to 24 out of 26. Following THA for OA, early improvements were demonstrated for spatiotemporal and kinematic gait patterns compared to the pre-operative levels. Deficits were still observed in THA patients compared to healthy in iduals at 12 months.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.JBIOMECH.2019.01.031
Abstract: Marker-based dynamic functional or regression methods are used to compute joint centre locations that can be used to improve linear scaling of the pelvis in musculoskeletal models, although large errors have been reported using these methods. This study aimed to investigate if statistical shape models could improve prediction of the hip joint centre (HJC) location. The inclusion of complete pelvis imaging data from computed tomography (CT) was also explored to determine if free-form deformation techniques could further improve HJC estimates. Mean Euclidean distance errors were calculated between HJC from CT and estimates from shape modelling methods, and functional- and regression-based linear scaling approaches. The HJC of a generic musculoskeletal model was also perturbed to compute the root-mean squared error (RMSE) of the hip muscle moment arms between the reference HJC obtained from CT and the different scaling methods. Shape modelling without medical imaging data significantly reduced HJC location error estimates (11.4 ± 3.3 mm) compared to functional (36.9 ± 17.5 mm, p = <0.001) and regression (31.2 ± 15 mm, p = <0.001) methods. The addition of complete pelvis imaging data to the shape modelling workflow further reduced HJC error estimates compared to no imaging (6.6 ± 3.1 mm, p = 0.002). Average RMSE were greatest for the hip flexor and extensor muscle groups using the functional (16.71 mm and 8.87 mm respectively) and regression methods (16.15 mm and 9.97 mm respectively). The effects on moment-arms were less substantial for the shape modelling methods, ranging from 0.05 to 3.2 mm. Shape modelling methods improved HJC location and muscle moment-arm estimates compared to linear scaling of musculoskeletal models in patients with hip osteoarthritis.
Publisher: Informa UK Limited
Date: 18-08-2021
Publisher: Springer Science and Business Media LLC
Date: 28-06-2018
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.KNEE.2014.08.004
Abstract: Footwear and insoles are used to reduce knee load in people with medial knee osteoarthritis (OA), despite a limited understanding of foot function in this group. The aim of this study was to investigate the differences in foot kinematics between adults with and without medial knee OA during barefoot walking. Foot kinematics were measured during walking in 30 adults 15 with medial knee OA (mean age was 67.0 with a standard deviation (SD) of 8.9 years height was 1.66 with SD of 0.13 m body mass was 84.2 with SD of 15.8 kg BMI was 30.7 with SD of 6.2 kg/m(2) K-L grade 3: 5, grade 4: 10) and 15 aged and gender matched control participants with 12 motion analysis cameras using the IOR multi-segment foot model. Motion of the knee joint, hindfoot, midfoot, forefoot and hallux were compared between groups using clustered linear regression. The knee OA group displayed reduced coronal plane range of motion of the midfoot (mean 3.8° vs. 5.4°, effect size=1.1, p=0.023), indicating reduced midfoot mobility. There was also a reduced sagittal plane range of motion at the hallux in the knee OA group compared to the control group (mean 29.6° vs. 36.3°, effect size=1.2, p=0.008). No statistically significant differences in hindfoot or forefoot motion were observed. People with medial knee OA display altered foot function compared to healthy controls. As foot and knee function are related, it is possible that altered foot function in people with knee OA may influence the effects of footwear and insoles.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.FORSCIINT.2018.05.008
Abstract: Barefoot impressions collected from crime scenes can be used in forensic analysis. The reliability of the measurement method employed during comparison of these foot impressions is paramount to prevent incorrect conclusions being made. A number of methods of obtaining measurements from barefoot impressions have been described in the research literature however there has been no comprehensive review of their reliability. Therefore, the aim of this systematic review was to determine the reliability of measurements used to describe footprint morphology obtained from static and dynamic barefoot impressions. Four electronic databases were searched from inception to 23 November 2017. Eligible studies were required to report either the test-retest, intra or inter-rater reliability of measurements taken from barefoot impressions for the purposes of identification or classification of foot morphology. Methodological quality was assessed using the COSMIN checklist. Eleven studies were identified that reported the reliability of 10 measurements (Reel method, arch index, Chippaux-Smirak index, footprint angle, Staheli index, contact area, Martirosov's K index, toe score and metatarsal ridge-to-toe measurement). High intra-rater reliability has been established for the Reel method (ICC=0.98-0.99), arch index (ICC=0.96-0.99), Chippaux-Smirak index (ICC=0.98-0.99), footprint angle (ICC=0.97-0.98), Staheli index (ICC=0.98-0.99) and footprint index (ICC=0.96-0.97). High inter-rater reliability has been established for the Reel method (ICC=0.99) and footprint angle (ICC=0.99). Overall methodological quality was rated as 'Poor' to 'Fair'. The measurement developed by Reel et al. has both its intra- and inter-rater reliability established to be high. However, the findings of this review were unable to inform a recommendation of one specific technique based on reliability data due to a small body of research at this time. Furthermore, there is a lack of data on the reliability of footprint measurement and comparison techniques in real-world scenarios. Overall, the findings regarding reliability of the techniques covered in this systematic review are to be interpreted with caution due to the methodological quality of reliability testing conducted within the included studies.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2018
Publisher: Springer Science and Business Media LLC
Date: 28-01-2023
DOI: 10.1186/S13063-023-07104-7
Abstract: Foot and ankle involvement is common in rheumatic and musculoskeletal diseases (RMDs). High-quality evidence is lacking to determine the effectiveness of treatments for these disorders. Heterogeneity in the outcomes used across clinical trials and observational studies hinders the ability to compare findings, and some outcomes are not always meaningful to patients and end-users. The Core set of Outcome Measures for FOot and ankle disorders in RheumaTic and musculoskeletal diseases (COMFORT) study aims to develop a core outcome set (COS) for use in all trials of interventions for foot and ankle disorders in RMDs. This protocol addresses core outcome domains ( what to measure) only. Future work will focus on core outcome measurement instruments ( how to measure). COMFORT: Core Domain Set is a mixed-methods study involving the following: (i) identification of important outcome domains through literature reviews, qualitative interviews and focus groups with patients and (ii) prioritisation of domains through an online, modified Delphi consensus study and subsequent consensus meeting with representation from all stakeholder groups. Findings will be disseminated widely to enhance uptake. This protocol details the development process and methodology to identify and prioritise domains for a COS in the novel area of foot and ankle disorders in RMDs. Future use of this standardised set of outcome domains, developed with all key stakeholders, will help address issues with outcome variability. This will facilitate comparing and combining study findings, thus improving the evidence base for treatments of these conditions. Future work will identify suitable outcome measurement instruments for each of the core domains. This study is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database, as of June 2022: www.comet-initiative.org/Studies/Details/2081
Publisher: Wiley
Date: 02-12-2023
DOI: 10.1002/ACR.24955
Abstract: To compare magnetic resonance imaging (MRI)–detected structural abnormalities in patients with symptomatic midfoot osteoarthritis (OA), patients with persistent midfoot pain, and asymptomatic controls, and to explore the association between MRI features, pain, and foot‐related disability. One hundred seven adults consisting of 50 patients with symptomatic and radiographically confirmed midfoot OA, 22 adults with persistent midfoot pain but absence of radiographic OA, and 35 asymptomatic adults underwent 3T MRI of the midfoot and clinical assessment. MRIs were read for the presence and severity of abnormalities (bone marrow lesions [BMLs], subchondral cysts, osteophytes, joint space narrowing [JSN], effusion‐synovitis, tenosynovitis, and enthesopathy) using the Foot Osteoarthritis MRI Score. Pain and foot‐related disability were assessed with the Manchester Foot Pain and Disability Index. The severity sum score of BMLs in the midfoot was greater in patients with midfoot pain and no signs of OA on radiography compared to controls ( P = 0.007), with a pattern of involvement in the cuneiform–metatarsal joints similar to that in patients with midfoot OA. In univariable models, BMLs (ρ = 0.307), JSN (ρ = 0.423), and subchondral cysts (ρ = 0.302) were positively associated with pain ( P 0.01). In multivariable models, MRI abnormalities were not associated with pain and disability when adjusted for covariates. In in iduals with persistent midfoot pain but no signs of OA on radiography, MRI findings suggested an underrecognized prevalence of OA, particularly in the second and third cuneiform–metatarsal joints, where BML patterns were consistent with previously recognized sites of elevated mechanical loading. Joint abnormalities were not strongly associated with pain or foot‐related disability.
Publisher: Wiley
Date: 09-03-2022
DOI: 10.1002/ACR.24514
Abstract: Musculoskeletal conditions of the foot and ankle are common, yet the cost‐effectiveness of the variety of treatments available is not well defined. The aim of this systematic review was therefore to identify, appraise, and synthesize the literature pertaining to the cost‐effectiveness of interventions for musculoskeletal foot and ankle conditions. Electronic databases were searched for studies presenting economic evaluations of nonsurgical and surgical treatments for acute or chronic musculoskeletal conditions of the foot and ankle. Data on cost, incremental cost‐effectiveness, and quality‐adjusted life years for each intervention and comparison were extracted. Risk of bias was assessed using the Drummond checklist for economic studies (range 0–35). Thirty‐six studies were identified reporting nonsurgical interventions (n = 10), nonsurgical versus surgical interventions (n = 14), and surgical interventions (n = 12). The most common conditions were osteoarthritis, ankle fracture, and Achilles tendon rupture. The strongest economic evaluations were for interventions managing end‐stage ankle osteoarthritis, ankle sprain, ankle fracture, calcaneal fracture, and Achilles tendon rupture. Total ankle replacement and ankle arthrodesis for end‐stage ankle osteoarthritis, in particular, have been demonstrated through high‐quality studies to be cost‐effective compared to the nonsurgical alternative. Selected interventions for musculoskeletal foot and ankle conditions dominate comparators, whereas others require thoughtful consideration as they provide better clinical improvements, but at an increased cost. Researchers should consider measuring and reporting costs alongside clinical outcome to provide context when determining the appropriateness of interventions for other foot and ankle symptoms to best inform future clinical practice guidelines.
Publisher: Wiley
Date: 29-05-2020
DOI: 10.1002/JOR.24716
Publisher: Wiley
Date: 26-07-2021
DOI: 10.1002/ACR.24594
Publisher: Informa UK Limited
Date: 2010
Publisher: Informa UK Limited
Date: 2021
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 06-2016
Abstract: Study Design Systematic review. Background Despite improvements in self-reported symptoms and perceived functional ability after total hip arthroplasty (THA) and total knee arthroplasty (TKA), it is unclear whether changes in objectively measured physical activity (PA) occur after surgery. Objective To determine if objectively measured PA increases after THA and TKA in adults with osteoarthritis. Methods Five electronic databases were searched from inception to March 3, 2015. All study designs objectively measuring PA before and after THA or TKA were eligible, including randomized controlled trials, cohort studies, and case-control studies. Two reviewers independently screened abstracts and full texts and extracted study demographic, PA, and clinical outcome data. Standardized mean differences (SMDs) and 95% confidence intervals were calculated for accelerometer- and pedometer-derived estimates of PA. Risk of methodological bias was assessed with Critical Appraisal Skills Programme checklists. Results Eight studies with a total of 373 participants (238 TKA, 135 THA) were included. Findings were mixed regarding improvement in objectively measured PA at 6 months after THA (SMDs, -0.20 to 1.80) and TKA (SMDs, -0.36 to 0.63). Larger improvements from 2 studies at 1 year postsurgery were generally observed after THA (SMDs, 0.39 to 0.79) and TKA (SMDs, 0.10 to 0.85). However, at 1 year, PA levels were still considerably lower than those of healthy controls (THA SMDs, -0.25 to -0.77 TKA SMDs, -1.46 to -1.80). Risk-of-bias scores ranged from 3 to 9 out of 11 (27%-82%) for cohort studies, and from 3 to 8 out of 10 (30%-80%) for case-control studies. Conclusion The best available evidence indicates negligible changes in PA at 6 months after THA or TKA, with limited evidence for larger changes at 1 year after surgery. In the 4 studies that reported control-group data, postoperative PA levels were still considerably less than those of healthy controls. Improved perioperative strategies to instill behavioral change are required to narrow the gap between patient-perceived functional improvement and the actual amount of PA undertaken after THA and TKA. Registered with PROSPERO (registration number CRD42014010155). Level of Evidence Therapy, level 2a. J Orthop Sports Phys Ther 2016 (6):431-442. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6449.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 17-10-2023
DOI: 10.1249/MSS.0000000000003062
Abstract: High-impact loads have been linked with running injuries. Fatigue has been proposed to increase impact loads, but this relationship has not been rigorously examined, including the associated role of muscle strength, power, and endurance. This study aimed to investigate the effect of fatigue on impact loading in runners and the role of muscle function in mediating changes in impact loading with fatigue. Twenty-eight trained endurance runners performed a fixed-intensity time to exhaustion test at 85% of V̇O 2max . Tibial accelerations were measured using leg-mounted inertial measurement units and s led every minute until volitional exhaustion. Tests of lower limb muscle strength, power, and endurance included maximal isometric strength (soleus, knee extensors, and knee flexors), single leg hop for distance, and the one leg rise test. Changes in peak tibial acceleration (PTA, g ) were compared between time points throughout the run (0%, 25%, 50%, 75%, and 100%). Associations between the change in PTA and lower limb muscle function tests were assessed (Spearman’s rho [ r s ]). PTA increased over the duration of the fatiguing run. Compared with baseline (0%) (mean ± SD, 9.1 g ± 1.6 g ), there was a significant increase at 75% (9.9 g ± 1.7 g , P = 0.001) and 100% (10.1 g ± 1.8 g , P 0.001), with no change at 25% (9.6 g ± 1.6 g , P = 0.142) or 50% (9.7 g ± 1.7 g , P = 0.053). Relationships between change in PTA and muscle function tests were weak and not statistically significant ( r s = −0.153 to 0.142, all P 0.05). Peak axial tibial acceleration increased throughout a fixed-intensity run to exhaustion. The change in PTA was not related to performance in lower limb muscle function tests.
Publisher: Wiley
Date: 06-2021
DOI: 10.1002/ACR.24182
Abstract: To compare foot and leg muscle strength in people with symptomatic midfoot osteoarthritis (OA) with asymptomatic controls, and to determine the association between muscle strength, foot pain, and disability. Participants with symptomatic midfoot OA and asymptomatic controls were recruited for this cross‐sectional study from general practices and community health clinics. The maximum isometric muscle strength of the ankle plantarflexors, dorsiflexors, invertors and evertors, and the hallux and lesser toe plantarflexors was measured using hand‐held dynamometry. Self‐reported foot pain and foot‐related disability were assessed with the Manchester Foot Pain and Disability Index. Differences in muscle strength were compared between groups. Multivariable regression was used to determine the association between muscle strength, foot pain, and disability after adjusting for covariates. People with midfoot OA (n = 52) exhibited strength deficits in all muscle groups, ranging from 19% (dorsiflexors) to 30% (invertors) relative to the control group (n = 36), with effect sizes of 0.6–1.1 ( P 0.001). In those with midfoot OA, ankle invertor muscle strength was negatively and independently associated with foot pain (β = –0.026 [95% confidence interval (95% CI) –0.051, –0.001] P = 0.045). Invertor muscle strength was negatively associated with foot‐related disability, although not after adjustment for depressive symptoms (β = –0.023 [95% CI –0.063, 0.017] P = 0.250). People with symptomatic midfoot OA demonstrate weakness in the foot and leg muscles compared to asymptomatic controls. Preliminary indications from this study suggest that strengthening of the foot and leg muscles may offer potential to reduce pain and improve function in people with midfoot OA.
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 04-2019
DOI: 10.1302/0301-620X.101B4.BJJ-2018-1240.R1
Abstract: The purpose of this exploratory study was to investigate if the 24-hour activity profile (i.e. waking activities and sleep) objectively measured using wrist-worn accelerometry of patients scheduled for total hip arthroplasty (THA) improves postoperatively. A total of 51 THA patients with a mean age of 64 years (24 to 87) were recruited from a single public hospital. All patients underwent THA using the same surgical approach with the same prosthesis type. The 24-hour activity profiles were captured using wrist-worn accelerometers preoperatively and at 2, 6, 12, and 26 weeks postoperatively. Patient-reported outcomes (Hip Disability and Osteoarthritis Outcome Score (HOOS)) were collected at all timepoints except two weeks postoperatively. Accelerometry data were used to quantify the intensity (sedentary, light, moderate, and vigorous activities) and frequency (bouts) of activity during the day and sleep efficiency. The analysis investigated changes with time and differences between Charnley class. Patients slept or were sedentary for a mean of 19.5 hours/day preoperatively and the 24-hour activity pattern did not improve significantly postoperatively. Outside of sleep, the patients spent their time in sedentary activities for a mean of 620 minutes/day (sd 143) preoperatively and 641 minutes/day (sd 133) six months postoperatively. No significant improvements were observed for light, moderate, and vigorous intensity activities (p = 0.140, p = 0.531, and p = 0.407, respectively). Sleep efficiency was poor ( 85%) at all timepoints. There was no postoperative improvement in sleep efficiency when adjusted for medications (p 0.05). Patient-reported outcome measures showed a significant improvement with time in all domains when compared with preoperative levels. There were no differences with Charnley class at six months postoperatively. However, Charnley class C patients were more sedentary at two weeks postoperatively when compared with Charnley class A patients (p 0.05). There were no further differences between Charnley classifications. This study describes the 24-hour activity profile of THA patients for the first time. Prior to THA, patients in this cohort were inactive and slept poorly. This cohort shows no improvement in 24-hour activity profiles at six months postoperative. Cite this article: Bone Joint J 2019 -B:415–425.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2021
DOI: 10.1249/FIT.0000000000000669
Abstract: • Exercise interventions targeting improvements in movement quality can increase training safety and effectiveness. • Movement quality–specific training can cause improvements in functionally relevant performance outcomes in a way that may be perceived as easier than traditional training interventions. • Assessing movement quality before prescribing exercise can highlight areas of training focus while identifying key exercises that your clients can perform safely.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.INJURY.2018.01.025
Abstract: Classification systems such as the Schatzker and AO/OTA have been proposed for standardised assessment of tibial plateau fractures and to guide clinical decision making. However, there has been no comprehensive literature review of all classification systems for tibial plateau fractures, including assessment of their reliability. The aim of this systematic review was to identify and appraise previously established classification systems for tibial plateau fractures and determine their reliability for fracture classification. Six databases were searched from inception until October 2016. Classification systems for tibial plateau fractures were identified. No restriction was placed on imaging modality (plain film X-ray, CT, MRI). Data synthesis was performed to identify common features of the systems, their prevalence within the literature and studies of intra and inter-rater reliability of fracture classification using Kappa coefficient (κ). Thirty-eight classification systems were identified, five of which were a sub-classification of a single fracture type from a previous tool. The Schatzker and AO/OTA classification systems were the most commonly reported. Of the tools identified only five have been tested for inter and intra-observer reliability (Schatzker, AO/OTA, Duparc, Hohl and Luo). Reliability of more simplistic classification systems, such as that by Luo et al. (three-column) was typically high (intra-κ = 0.67-0.81, inter-κ = 0.71-0.87), but with the disadvantage of providing less information on fracture patterns and morphology. Intra and inter-observer reliability using plain film X-ray was frequently moderate (κ = 0.40-0.60), with 2D and 3D CT typically improving reliability of classification. Only 11 of the 32 complete classification systems identified association of fracture classification with clinical outcome. Frequently used systems for classification of tibial plateau fractures display moderate intra and inter-observer reliability. More sophisticated imaging modalities such as 2D and 3D CT typically improve reliability estimates. Using fracture classification based on imaging findings to predict clinical outcome was not a commonly reported goal of newly developed systems. More detailed assessment of fracture patterns and morphology, in conjunction with information on surgical fixation, may be desirable for predicting outcomes and to guide clinical decision making.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JBIOMECH.2016.08.005
Abstract: Estimation of joint reaction forces (JRF) is critical for the understanding of load-related pathologies, such as osteoarthritis (OA). Typically, singular components at discrete time-points are presented without knowledge of their orientation over time. The aim of this study was to develop and demonstrate the utility of a method for the concise and intuitive representation of JRF orientation. A scaled musculoskeletal model of the lower limbs was informed by walking gait data from adults with knee OA (n=10) and healthy controls (C) (n=10). Muscle forces and subsequently JRF were computed. The intersections of the JRF vector and a transverse plane proximal to the joint were computed. The 95% confidence ellipse was computed for these points. This allowed the following metrics to be calculated: the normalised area of the ellipse (A) the ratio of the long and short axes (R) the angle between the long axis of the ellipse and the anterior-posterior axis of the distal segment (α) and the position of the centre of the ellipse relative to the origin of the segment (X
Publisher: Informa UK Limited
Date: 06-06-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
DOI: 10.1519/JSC.0000000000002058
Abstract: Bennett, H, Davison, K, Arnold, J, Slattery, F, Martin, M, and Norton, K. Multicomponent musculoskeletal movement assessment tools: a systematic review and critical appraisal of their development and applicability to professional practice. J Strength Cond Res 31(10): 2903–2919, 2017—Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.
Publisher: International Journal of Sports Physical Therapy
Date: 06-2019
Publisher: Wiley
Date: 14-07-2015
DOI: 10.1002/JOR.22969
Abstract: Total knee arthroplasty (TKA) in people with knee osteoarthritis increases knee-specific and general physical function, but it has not been established if there is a relationship between changes in these elements of functional ability. This study investigated changes and relationships between knee biomechanics during walking, physical activity, and use of time after TKA. Fifteen people awaiting TKA underwent 3D gait analysis before and six months after surgery. Physical activity and use of time were determined in free-living conditions from a high resolution 24-h activity recall. After surgery, participants displayed significant improvements in sagittal plane knee biomechanics and improved their physical activity profiles, standing for 105 more minutes (p=0.001) and performing 64 min more inside chores on average per day (p=0.008). Changes in sagittal plane knee range of motion (ROM) and peak knee flexion positively correlated with changes in total daily energy expenditure, time spent undertaking moderate to vigorous physical activity, inside chores and passive transport (r=0.52-0.66, p=0.005-0.047). Restoration of knee function occurs in parallel and is associated with improvements in physical activity and use of time after TKA. Increased functional knee ROM is required to support improvements in total and context specific physical activity.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.GAITPOST.2013.09.021
Abstract: Our understanding of age-related changes to foot function during walking has mainly been based on plantar pressure measurements, with little information on differences in foot kinematics between young and older adults. The purpose of this study was to investigate the differences in foot kinematics between young and older adults during walking using a multi-segment foot model. Joint kinematics of the foot and ankle for 20 young (mean age 23.2 years, standard deviation (SD) 3.0) and 20 older adults (mean age 73.2 years, SD 5.1) were quantified during walking with a 12 camera Vicon motion analysis system using a five segment kinematic model. Differences in kinematics were compared between older adults and young adults (preferred and slow walking speeds) using Student's t-tests or if indicated, Mann-Whitney U tests. Effect sizes (Cohen's d) for the differences were also computed. The older adults had a less plantarflexed calcaneus at toe-off (-9.6° vs. -16.1°, d = 1.0, p = <0.001), a smaller sagittal plane range of motion (ROM) of the midfoot (11.9° vs. 14.8°, d = 1.3, p = <0.001) and smaller coronal plane ROM of the metatarsus (3.2° vs. 4.3°, d = 1.1, p = 0.006) compared to the young adults. Walking speed did not influence these differences, as they remained present when groups walked at comparable speeds. The findings of this study indicate that independent of walking speed, older adults exhibit significant differences in foot kinematics compared to younger adults, characterised by less propulsion and reduced mobility of multiple foot segments.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 27-05-2021
Abstract: This article was updated on July 19, 2021, because of a previous error. On page 1172, in the Results section entitled “Sedentary Activity,” the sentence that had read “Postoperatively, 32% at 1 year and 14% at 2 years were sedentary for hours per day.” now reads “Postoperatively, 32% at 1 year and 41% at 2 years were sedentary for hours per day.” Despite marked improvements in self-reported pain, perceived functional ability, and gait function following primary total hip arthroplasty (THA), it remains unclear whether these improvements translate into improved physical activity and sleep behaviors. The aim of this study was to determine the change in 24-hour activity profile (waking activities and sleep) and laboratory-based gait function from preoperatively to 2 years following the THA. Fifty-one patients undergoing primary THA at a single public hospital were recruited. All THAs were performed using a posterior surgical approach with the same prosthesis type. A wrist-worn accelerometer was used to capture 24-hour activity profiles preoperatively and at 1 and 2 years postoperatively. Three-dimensional gait analysis was performed to determine changes in temporospatial and kinematic parameters of the hip and pelvis. Patients showed improvements in all temporospatial and kinematic parameters with time. Preoperatively, patients were sedentary or asleep for a mean time (and standard deviation) of 19.5 ± 2.2 hours per day. This remained unchanged up to 2 years postoperatively (19.6 ± 1.3 hours per day). Sleep efficiency remained suboptimal ( %) at all time points and was worse at 2 years (77% ± 10%) compared with preoperatively (84% ± 5%). More than one-quarter of the s le were sedentary for hours per day at 1 year (32%) and 2 years (41%), which was greater than the preoperative percentage (21%). Patients accumulated their activity performing light activities however, patients performed less light activity at 2 years compared with preoperative levels. No significant differences (p = 0.935) were observed for moderate or vigorous activity across time. Together with improvements in self-reported pain and perceived physical function, patients had significantly improved gait function postoperatively. However, despite the opportunity for patients to be more physically active postoperatively, patients were more sedentary, slept worse, and performed less physical activity at 2 years compared with preoperative levels. Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.GAITPOST.2012.11.010
Abstract: Confidence in 3D multi-segment foot models has been limited by a lack of repeatability data, particularly in older populations that may display unique functional foot characteristics. This study aimed to determine the intra and inter-observer repeatability of stance phase kinematic data from a multi-segment foot model described by Leardini et al. [2] in people aged 50 years or older. Twenty healthy adults participated (mean age 65.4 years SD 8.4). A repeated measures study design was used with data collected from four testing sessions on two days from two observers. Intra (within-day and between-day) and inter-observer coefficient of multiple correlations revealed moderate to excellent similarity of stance phase joint range of motion (0.621-0.975). Relative to the joint range of motion (ROM), mean differences (MD) between sessions were highest for the within-day comparison for all planar ROM at the metatarsus-midfoot articulation (sagittal plane ROM 5.2° vs. 3.9°, MD 3.1° coronal plane ROM 3.9 vs. 3.1°, MD 2.3° transverse plane ROM 6.8° vs. 5.16°, MD 3.5°). Consequently, data from the metatarsus-midfoot articulation in the Istituto Ortopedico Rizzoli (IOR) foot model in adults aged over 50 years needs to be considered with respect to the findings of this study.
Publisher: American Medical Association (AMA)
Date: 15-06-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.18478
Abstract: Low levels of physical activity during hospitalization are thought to contribute to a range of poor outcomes for patients. Using wearable activity trackers during hospitalization may help improve patient activity, sedentary behavior, and other outcomes. To evaluate the association of interventions that use wearable activity trackers during hospitalization with patient physical activity, sedentary behavior, clinical outcomes, and hospital efficiency outcomes. OVID MEDLINE, CINAHL, Embase, EmCare, PEDro, SportDiscuss, and Scopus databases were searched from inception to March 2022. The Cochrane Central Register for Controlled trials, ClinicalTrials.gov, and World Health Organization Clinical Trials Registry were also searched for registered protocols. No language restrictions were imposed. Randomized clinical trials and nonrandomized clinical trials of interventions that used wearable activity trackers to increase physical activity or reduce sedentary behavior in adults (aged 18 years or older) who were hospitalized were included. Study selection, data extraction, and critical appraisal were conducted in duplicate. Data were pooled for meta-analysis using random-effects models. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. The primary outcomes were objectively measured physical activity or sedentary behavior. Secondary outcomes included clinical outcomes (eg, physical function, pain, mental health), and hospital efficiency outcomes (eg, length of stay, readmission). Fifteen studies with a total of 1911 participants were included, representing various surgical cohorts (4 studies), stroke rehabilitation (3 studies), orthopedic rehabilitation (3 studies), mixed rehabilitation (3 studies), and mixed medical (2 studies). All studies were included in meta-analyses. There was a significant association between wearable activity tracker interventions with higher overall physical activity (standardized mean difference, 0.35 95% CI, 0.15 to 0.54 I 2 = 72% P & .002) and less sedentary behavior (mean difference, −35.46 min/d 95% CI, −57.43 to −13.48 min/d I 2 = 0 P = .002), and a significant association between wearable activity tracker interventions with improvements in physical function (standardized mean difference, 0.27 95% CI, 0.08 to 0.46 I 2 = 0 P = .006) compared with usual care. There was no significant association between wearable activity tracker interventions with pain, mental health, length of stay, or readmission risk. In this systematic review and meta-analysis, interventions that used wearable activity trackers with patients who are hospitalized were associated with higher physical activity levels, less sedentary behavior, and better physical functioning compared with usual care.
Publisher: Springer Science and Business Media LLC
Date: 20-03-2019
Publisher: Informa UK Limited
Date: 20-06-2022
DOI: 10.1080/02640414.2022.2089803
Abstract: This systematic review and meta-analysis aimed to synthesise and clarify the effect of running-induced fatigue on impact loading during running. Eight electronic databases were systematically searched until April 2021. Studies that analysed impact loading over the course of a run, in adult runners free of medical conditions were included. Changes in leg stiffness, vertical stiffness, shock attenuation, peak tibial accelerations, peak ground reaction forces (GRF) and loading rates were extracted. Subgroup analyses were conducted depending on whether participants were required to run to exhaustion. Thirty-six studies were included in the review, 25 were included in the meta-analysis. Leg stiffness decreased with running-induced fatigue (SMD -0.31, 95% CI -0.52, -0.08, moderate evidence). Exhaustive and non-exhaustive subgroups were different for peak tibial acceleration (Chi
Publisher: Wiley
Date: 09-01-2018
DOI: 10.1002/ACR.22797
Abstract: Lateral wedge insoles are intended to reduce biomechanical risk factors of medial knee osteoarthritis (OA) progression, such as increased knee joint load however, there has been no definitive consensus on this topic. The aim of this systematic review and meta-analysis was to establish the within-subject effects of lateral wedge insoles on knee joint load in people with medial knee OA during walking. Six databases were searched from inception until February 13, 2015. Included studies reported on the immediate biomechanical effects of lateral wedge insoles during walking in people with medial knee OA. Primary outcomes of interest relating to the biomechanical risk of disease progression were the first and second peak external knee adduction moment (EKAM) and knee adduction angular impulse (KAAI). Eligible studies were pooled using random-effects meta-analysis. Eighteen studies were included with a total of 534 participants. Lateral wedge insoles resulted in a small but statistically significant reduction in the first peak EKAM (standardized mean difference [SMD] -0.19 95% confidence interval [95% CI] -0.23, -0.15) and second peak EKAM (SMD -0.25 95% CI -0.32, -0.19) with a low level of heterogeneity (I(2) = 5% and 30%, respectively). There was a favorable but small reduction in the KAAI with lateral wedge insoles (SMD -0.14 95% CI -0.21, -0.07, I(2) = 31%). Risk of methodologic bias scores (quality index) ranged from 8 to 13 out of 16. Lateral wedge insoles cause small reductions in the EKAM and KAAI during walking in people with medial knee OA. Current evidence demonstrates that lateral wedge insoles appear ineffective at attenuating structural changes in people with medial knee OA as a whole and may be better suited to targeted use in biomechanical phenotypes associated with larger reductions in knee load.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.ARTH.2012.09.021
Abstract: A systematic literature review was conducted to identify the best available evidence describing the differences in clinical outcome associated with the different methods of total knee replacement (TKR) fixation. Randomized trials published between 1980 and January 2011 comparing differences in clinical outcome scores between groups allocated to either cemented or uncemented fixation for TKR were included. Nine of the 11 studies included in the review reported no significant differences in clinical outcomes between groups with either cemented or uncemented prosthesis components. Critical appraisal of methodological bias revealed consistent shortcomings in study design and execution. It is apparent that more rigorous studies with longer follow-up periods are required to verify which method of fixation may be preferable in enhancing clinical outcomes.
Publisher: Informa UK Limited
Date: 09-09-2019
DOI: 10.1080/02640414.2019.1665234
Abstract: The aim of this trial was to compare an eight-week in idual movement quality versus traditional resistance training intervention on movement quality and physical performance. Forty-six trained adults were randomised to a movement quality-focused training (MQ) or a traditional resistance training (TRAD) group, and performed two in idualised training sessions per week, for 8 weeks. Session-RPE (sRPE) was obtained from each session. Measures of movement quality (MovementSCREEN and Functional Movement Screen (FMS)) and physical performance were performed pre- and post-intervention. All measures improved significantly in both groups (3-14.5%, p = <0.005). The between-group difference in MovementSCREEN composite score was not statistically significant (0.3, 95% CI -3.4, 4.1, p = 0.852). However, change in FMS composite was significantly greater in MQ (1.3, 95% CI 0.8, 1.8, p < 0.001). There were no significant between-group differences in physical performance (p = 0.060-0.960). The mean sRPE was significantly lower in MQ (5.25, SD 1.2) compared to TRAD (6.6 SD 1.0, p = <0.001). Thus, although movement quality scores were not distinctly greater in the MQ group, a movement quality specific intervention caused comparable improvements in physical performance compared to traditional resistance training but at lower perceived training intensity.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Springer Science and Business Media LLC
Date: 17-05-2017
DOI: 10.1007/S00296-017-3743-0
Abstract: Body composition and poor mental health are risk factors for developing foot pain, but the role of different fat deposits and psychological features related to chronic pain are not well understood. The aim of this study was to investigate the association between body composition, psychological health and foot pain. Eighty-eight women participated in this study: 44 with chronic, disabling foot pain (mean age 55.3 SD 7.0 years, BMI 29.5 SD 6.7 kg/m
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.GAITPOST.2014.09.002
Abstract: To investigate in-shoe foot kinematics, holes are often cut in the shoe upper to allow markers to be placed on the skin surface. However, there is currently a lack of understanding as to what is an appropriate size. This study aimed to demonstrate a method to assess whether different diameter holes were large enough to allow free motion of marker wands mounted on the skin surface during walking using a multi-segment foot model. Eighteen participants underwent an analysis of foot kinematics whilst walking barefoot and wearing shoes with different size holes (15 mm, 20mm and 25 mm). The analysis was conducted in two parts firstly the trajectory of the in idual skin-mounted markers were analysed in a 2D ellipse to investigate total displacement of each marker during stance. Secondly, a geometrical analysis was conducted to assess cluster deformation of the hindfoot and midfoot-forefoot segments. Where movement of the markers in the 15 and 20mm conditions were restricted, the marker movement in the 25 mm condition did not exceed the radius at any anatomical location. Despite significant differences in the isotropy index of the medial and lateral calcaneus markers between the 25 mm and barefoot conditions, the differences were due to the effect of footwear on the foot and not a result of the marker wands hitting the shoe upper. In conclusion, the method proposed and results can be used to increase confidence in the representativeness of joint kinematics with respect to in-shoe multi-segment foot motion during walking.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for John Arnold.