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Background: Hallux valgus (HV) is a gait-altering orthopedic deformity, somewhat more prevalent in women, which often affects both limbs. Although surgery is a commonly applied treatment, there is no consensus in the literature on how invasive HV correction affects spatiotemporal gait parameters, or how quickly improvement can be expected. We investigated gait parameters in female HV patients who underwent bilateral surgical correction of hallux valgus, both preoperatively and 18 weeks following surgery (a timeframe relevant from the perspective of physical therapy), and also in relation to a non-HV control group. Methods: A total of 23 women aged 40–70 years, with moderate to severe HV deformity in both feet, were assessed preoperatively and 18 weeks postoperatively, and an age-matched control group of 76 healthy women was also assessed. A total of 22 spatiotemporal parameters were collected during 30 s walks over an electronic walkway (Zebris Medical System). Results: Of the 22 parameters analyzed, significant differences between the preoperative experimental and control groups were found only in 4 parameters (Velocity, Right step time, Total double support and Stride time), but in 16 parameters between the postoperative experimental and control groups (the greatest impact being found for: Left and Right Step time, Stride time, Cadence, Right Foot rotation, Left Step length (%leg length) and Stride length (%leg length)). Conclusions: Women after bilateral HV correction did not exhibit improved (i.e., more normal) gait parameters at 18 weeks postoperatively; rather, they showed more gait abnormalities than preoperatively. These findings urge longer-term planning of postoperative rehabilitation, involving continual evaluation of gait improvement.

Introduction: Achilles tendon rupture is an injury resulting from occasional excessive physical activity that is undertaken in the absence of an adequate level of preparation. The calcaneal tendon forms the end of the triceps surae muscle which consists of the gastrocnemius and the soleus. The aim of the research was to evaluate the level of functional performance of the operated limb one and two years after the Achilles tendon reconstruction surgery. Material and methods: The study group comprised of 20 men (age-47.2±8.3 years; height-182±7cm; weight-88±12kg) who have undergone the Achilles tendon reconstruction surgery. The measurement of plantar flexor and dorsiflexor muscle torques was conducted in both extended-and flexed-knee position under isometric and isokinetic conditions. Results: The measurements of the plantar flexor and dorsiflexor muscle torques in the extended knee position performed one and two years after the surgery did not reveal any significant differences between the healthy and operated limb. The tests performed one year after the surgery in the flexed-knee position showed significantly lower values of the plantar flexor and dorsiflexor muscle torques in the operated limb measured under isokinetic conditions. The results obtained two years after the reconstruction surgery proved that muscular deficit was still visible; however, there were no statistically significant differences. Conclusions: The angular knee joint position affects the plantar flexor muscle torque in the operated limb. Due to the muscle strength deficit observed two years after the surgery, additional training should be implemented after the rehabilitation has been completed. The main focus should be on dynamic exercises performed in the flexed-knee position which help to rebuild deep muscles such as the soleus.

Background: The aims of this study have been 2-fold: to attempt to reduce the number of spatiotemporal parameters used for describing gait through the factor analysis and component analysis; and to explore the critical age of decline for other gait parameters for healthy women. Material and Methods: A total of 106 women (aged ≥ 40 years old (N = 76) and ≤ 31 years old (N = 30)) were evaluated using a pressure-sensitive mat (Zebris Medical System, Tübingen, Germany) for collecting spatiotemporal gait parameters. Results: The factor analysis identified 2 factors -labelled Time and Rhythm -that accounted for 72% of the variation in significant free-gait parameters; the principal component analysis identified 4 of these parameters that permit full clinical evaluation of gait quality. No difference was found between the groups in terms of the values of parameters reflecting the temporal nature of gait (Rhythm), namely step time, stride time and cadence, whereas significant differences were found for total double support phase (p < 0.001). Next, seeking evidence of a critical decline in gait, we selected 3 parameters: total double support, stride time and velocity. We concluded that the women taking part in the experiment manifested significant signs of senile gait after the age of 60 years old, with the first symptoms thereof already manifesting themselves after 50 years of age. Conclusions: We show that among 26 spatiotemporal parameters that may be used for characterizing gait, at least a half of them may be omitted in the assessment of gait correctness; a finding that may be useful in clinical practice. The finding that the onset of senile gait occurs in the case of women after the age of 60 years old, in turn, may be useful in evaluating the ability for performing types of physical work that mainly require ambulation. Med Pr 2017;68(4):441-448

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