Functional hallux limitus and its relationship to gait efficiency

Dananberg, Howard J

doi:10.7547/87507315-76-11-648

Cited by 94 publications

(41 citation statements)

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“…18 The ability to efficiently transfer weight during double support allows effective transfer of momentum from one limb to the other and the uninterrupted use of the kinetic energy which is created by the swing limb activity of the offloaded limb. 18,20 If weight transfer is delayed, the kinetic energy created by the swing limb is not utilized; it must be generated by added compensatory mechanisms that are less efficient and will decrease walking speed. 18 The limb-loading and propulsive phases of the gait cycle are inefficient in individuals with hemiplegia.…”

Section: Introductionmentioning

confidence: 99%

“…12,16 During gait, conservation of momentum allows for the continued forward progress of the body while the system recycles for the next power phase. 18,19 Successful transfer of momentum during gait occurs as forefoot weight bearing decreases in the trailing limb and more weight is transferred to the anterior weight acceptance limb. 20 Weight transfer in the trailing limb occurs proximal to distal in an efficient manner.…”

Section: Introductionmentioning

confidence: 99%

“…18,20 If weight transfer is delayed, the kinetic energy created by the swing limb is not utilized; it must be generated by added compensatory mechanisms that are less efficient and will decrease walking speed. 18 The limb-loading and propulsive phases of the gait cycle are inefficient in individuals with hemiplegia. [21][22][23] This is often due to inefficient weight bearing on the affected side causing non-linear limb load transfer.…”

Section: Introductionmentioning

confidence: 99%

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Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Nolan

Yarossi²

2011

Prosthetics &Amp; Orthotics International

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Background: Identifying and understanding the changes in transfer of momentum that are directly affected by orthotic intervention are significant factors related to the improvement of mobility in individuals with hemiplegia. Objectives: The purpose of this investigation was to use a novel analysis technique to objectively measure weight transfer during double support (DS) in healthy individuals and individuals with hemiplegia secondary to stroke with and without an ankle foot orthosis. Study design: Prospective, Repeated measures, case-controlled trial. Methods: Participants included 25 adults with stroke-related hemiplegia >6 months using a prescribed ankle foot orthosis and 12 age-matched healthy controls. Main outcome measures included the weight transfer point timing (WTP, %DS), maximum total force timing (MTF, %DS), timing difference between WTP and MTF (MTF-WTP, %DS) and the linearity of loading (LOL, R 2 ) during the DS phase of the gait cycle. Results: The WTP and LOL were significantly different between conditions with and without the ankle foot orthosis for the affected and unaffected limb in post-stroke individuals, p 0.01. The MTF and difference in timing between MTF-WTP were significantly different during affected limb loading with and without the ankle foot orthosis in the stroke group, p 0.0001 and p ¼ 0.03, respectively. MTF, MTF-WTP and LOL were significantly different between individuals with stroke (during affected limb loading) and healthy controls (during right limb loading). Conclusions: This research established a systematic method for analysing weight transfer during walking to evaluate the effect of an ankle foot orthosis on loading during double support in hemiplegic gait. This novel method can be used to elucidate biomechanical mechanisms behind orthosis-mediated changes in gait patterns and quantify functional mobility outcomes in rehabilitation. Clinical relevanceThis novel approach to orthotic assessment will provide the clinician with needed objective evidence to select the most effective orthotic intervention to maximize functional recovery for individuals with hemiplegia secondary to stroke.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Nolan

Yarossi²

2011

Prosthetics &Amp; Orthotics International

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“…12,15,40 Injuries to the first MPJ can result in long-term sequelae such as chronic pain, loss of range of motion (ROM), and loss of function. Clanton and Ford 12 reported that 50% of the athletes they studied had persistent symptoms 5 years after the initial injury.…”

mentioning

confidence: 99%

The Effect of Sesamoid Mobilization, Flexor Hallucis Strengthening, and Gait Training on Reducing Pain and Restoring Function in Individuals With Hallux Limitus: A Clinical Trial

Shamus¹,

Shamus²,

Gugel³

et al. 2004

J Orthop Sports Phys Ther

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Study Design: Clinical trial. Objective: To determine the effect of 2 conservative intervention approaches for functional hallux limitus. Background: Metatarsophalangeal joint (MPJ) sprains are common and can result in long-term sequelae such as persistent pain and loss of range of motion (ROM) secondary to bony proliferation and articular degeneration. It is important to determine the most effective intervention for functional hallux limitus to decrease pain and restore function. Methods and Measures: Twenty individuals with first MPJ pain, loss of motion, and weakness participated in the study. All patients received whirlpool, ultrasound, first MPJ mobilizations, calf and hamstring stretching, marble pick-up exercise, cold packs, and electrical stimulation. Ten of the 20 patients (experimental group) also received sesamoid mobilizations, flexor hallucis strengthening exercises, and gait training. Treatment was provided 3 times a week for 4 weeks. Measurements of first MPJ extension ROM, flexor hallucis strength, and subjective pain level were performed on the first and last visits. Results: Following the 12 therapy sessions, the experimental group achieved significantly greater MPJ extension ROM and flexor hallucis strength and had significantly lower pain levels as compared to the control group (PϽ.001). Conclusions: These results suggest that sesamoid mobilization, flexor hallucis strengthening, and gait training should be included in the plan of care when treating an individual with functional hallux limitus.

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“…sus publicaciones 18,19 estudia el movimiento en el plano sagital y los 3 Rockers de la marcha como puntos de pivotaje del pie. Explica el concepto y la clasificación del Hallux limitus e introduce la cuña cinética.…”

Section: Paradigma Biomecánicounclassified

Las lesiones por sobrecarga en las extremidades inferiores desde el punto de vista biomecánico

Agustin¹,

Mora

Castells³

et al. 2016

Rev. Int. Cienc. Podol.

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Los autores declaran no tener ningún tipo de interés económico o comercial. RESUMENEste trabajo realiza un recorrido por las principales lesiones deportivas por sobrecarga de las extremidades inferiores desde el punto de vista biomecánico. Al mismo tiempo, repasa los principales paradigmas biomecánicos en podología y la aplicación de las teorías biomecánicas emergentes en el estudio de estas lesiones. Con la legislación actual, los estudios biomecánicos clínicos de la marcha deben de realizarse en centros sanitarios y los únicos profesionales sanitarios que pueden realizarlos son los podólogos y los médicos (porque ambas tienen la capacidad de diagnosticar), quedando reservado para los licenciados en educación física, los estudios que se realizan en el terreno de juego o en la pista con la finalidad exclusiva de mejorar el rendimiento deportivo, pero nunca con finalidad de tratar una patología por sobrecarga. Palabras clave: paradigma biomecánica; lesión; sobrecarga; pie. ABSTRACTThis work studies the major sports overload injuries of the lower extremities from the biomechanical point of view. At the same time, the main paradigms of podiatric biomechanics and the application of new biomechanical theories in the study of these lesions are reviewed. With current legislation, clinical gait biomechanical studies should be carried out in health centres and the only health professionals who can perform them are podiatrists and doctors (because they http://dx

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Functional hallux limitus and its relationship to gait efficiency

Cited by 94 publications

References 0 publications

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

The Effect of Sesamoid Mobilization, Flexor Hallucis Strengthening, and Gait Training on Reducing Pain and Restoring Function in Individuals With Hallux Limitus: A Clinical Trial

Las lesiones por sobrecarga en las extremidades inferiores desde el punto de vista biomecánico

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