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At least 469 records · Page 26Linked to original sources
PubMed2006

Effect on spasticity after performance of dynamic-repeated-passive ankle joint motion exercise in chronic stroke patients.

Spasticity associated with abnormal muscle tone is a common motor disorder following stroke, and the spastic ankle may affect ambulatory function. The purpose of this study was to investigate the short-term effect of dynamic-repeated-passive ankle movements with weight loading on ambulatory function and spastic hypertonia of chronic stroke patients. In this study, 12 chronic stroke patients with ankle spasticity and inefficient ambulatory ability were enrolled. Stretching of the plantar-flexors of the ankle in the standing position for 15 minutes was performed passively by a constant-speed and electrically powered device. The following evaluations were done before and immediately after the dynamic-repeated-passive ankle movements. Spastic hypertonia was assessed by the Modified Ashworth Scale (MAS; range, 0-4), Achilles tendon reflexes test (DTR; range, 0-4), and ankle clonus (range, 0-5). Improvement in ambulatory ability was determined by the timed up-and-go test (TUG), the 10-minute walking test, and cadence (steps/minute). In addition, subjective experience of the influence of ankle spasticity on ambulation was scored by visual analog scale (VAS). Subjective satisfaction with the therapeutic effect of spasticity reduction was evaluated by a five-point questionnaire (1 = very poor, 2 = poor, 3 = acceptable, 4 = good, 5 = very good). By comparison of the results before and after intervention, these 12 chronic stroke patients presented significant reduction in MAS and VAS for ankle spasticity, the time for TUG and 10-minute walking speed (p < 0.01). The cadence also increased significantly (p < 0.05). In addition, subjective satisfaction with the short-term therapeutic effect was mainly good (ranging from acceptable to very good). In conclusion, 15 minutes of dynamic-repeated-passive ankle joint motion exercise with weight loading in the standing position by this simple constant-speed machine is effective in reducing ankle spasticity and improving ambulatory ability.

Adult↗
PubMed2001

Anatomical reconstruction of ruptured lateral ligaments of upper ankle joint.

BACKGROUND AND AIMS: It seems that a certain patient population after conservatively treated ankle distorsions later develops chronic symptoms such as instability, pain and swelling. MATERIAL AND METHODS: The present study comprised 20 such patients, who underwent an anatomical reconstruction of ruptured ankle ligament(s) (FC, FTA and/or FTP). Patients were followed in average for 22 months postoperatively. RESULTS: Sixteen of them had excellent or good results. Clinically 5 and radiologically 4 patients had instability of the operatively treated ankle joint at the follow-up. Instability and subjective patient satisfaction did not correlate at all. CONCLUSION: Anatomical reconstruction of ruptured ankle ligaments in chronic posttraumatic instability syndrome is technically possible to perform in almost all cases. The present method of anatomical ligament reconstruction usually results in good stability, diminishes symptoms and in most cases leads into a normal functional capacity.

Adult↗
PubMed1997

A method to determine bone movement in the ankle joint complex in vitro.

An experimental set-up has been developed to quantify motion of bone structures in the ankle joint complex of human cadaver specimens under conditions approximating physiological joint loading. The device allows to load the foot/leg specimen along the axis of the tibia, and muscle forces can be simulated by clamping the extrinsic tendons of the foot. Additionally, an axial moment can be applied to the tibia. A variety of foot movements can be induced by rotating a foot plate around an arbitrary axis in the horizontal plane. The input force which produces the movement at the foot is applied to the entire sole of the foot. A forefoot fixation allows for the natural adaptation of the midfoot and hindfoot which occurs during loading of the specimen. Bone pins were placed in the tibia, talus, calcaneus and navicular, and three reflective markers were attached to each pin in order to record the bone movements with a video system. Intersegmental rotations in the talo-crural, talo-calcaneal, and talo-navicular joints were calculated in three dimensions, compared for different loading and ligament integrity conditions, and related to a functionally/anatomically described foot position. Repeated measurements of relative bone orientations indicated a reproducibility better than 2 degrees; the slope of the curves, representing the kinematic coupling, was virtually identical between repetitions. It is proposed that this method simulates multidirectional AJC compression similar to loading situations during locomotion.

Aged↗
PubMedDate not supplied

[Sonographic studies of the lateral ligament of the proximal ankle joint in recent ligament rupture and chronic ligamental instability].

For diagnosis of instability in case of ruptures of the lateral ankle joint ligaments a special ultrasound examination technique was established. In 41 patients with acute ruptures and 8 patients with chronic instabilities a prospective preoperative sonographic instability-testing was performed and compared to intraoperative result. A sensitivity of 0.96 for injuries of the lig. fib. tal. ant. and 0.79 for the lig. fib. calc. proves the exactness of this method. This technique is easy to perform and the result can be documented. This examination is accepted by the patients.

Ankle Injuries↗
PubMed2005

Lumbar extensor fatigue and circumferential ankle pressure impair ankle joint motion sense.

Fatigue of the lumbar extensor muscles has been associated with a degradation of balance, but the mechanism is not well understood. The ankle plays a major role in upright standing, and loss of proprioceptive acuity at the ankle could contribute to a degradation of balance. Therefore, the first objective of this study was to investigate the effect of lumbar extensor fatigue on ankle proprioceptive acuity. The second objective was to investigate the effect of circumferential ankle pressure (CAP) on ankle proprioceptive acuity to evaluate CAP as a potential intervention to mitigate any loss of proprioceptive acuity at the ankle with lumbar extensor fatigue. To address these objectives, ankle joint motion sense was evaluated with and without CAP, both before and after the lumbar extensors were fatigued. Results showed an impairment in joint motion sense with both fatigue and CAP. These results indicate that lumbar extensor fatigue impairs ankle proprioceptive acuity, which may help explain observed increases in postural sway subsequent to lumbar extensor fatigue.

Adaptation, Physiological↗
PubMed1997

Influence of plyometric training on the mechanical impedance of the human ankle joint.

The objective of this work was to study the effects of plyometric training on the mechanical properties of the ankle joint in humans. Changes in the mechanical parameters of this musculo-articular structure were quantified with the aid of a sinusoidal perturbation technique. This technique allowed the expression of the mechanical impedance of the musculo-articular system in terms of stiffness, viscosity and inertia. Measurements were performed under passive conditions and when the subject performed plantar flexion. A 7-week period of training induced a decrease in the slope of the relationship between stiffness and plantar flexion torque, whereas passive stiffness was increased. A slight decrease in viscosity and an invariability in inertia were also found. These results are interpreted in terms of the possible adaptations of the musculo-articular structure and ultrastructure involved in the performance of plantar flexion.

Adult↗
PubMed1999

A preliminary study determining the feasibility of electromagnetic tracking for kinematics at the ankle joint complex.

OBJECTIVE: To determine the feasibility of using electromagnetic tracking (EMT) for quantifying three-dimensional kinematics at the ankle joint complex (AJC). METHODS: AJC kinematics were recorded in 10 normal healthy adults, and 10 rheumatoid arthritis patients presenting with AJC instability and deformity who were undergoing footwear and orthotic intervention. RESULTS: Kinematics in normal subjects had strong face validity, curve shape showing moderate (n=9), good (n=8) or excellent (n=4) agreement with data from seven published studies. The range of motion about the x-axis (15.2 degrees ) was similar to reference values (17.0 degrees ), but our technique underestimated rotations about the y- (8.1 degrees vs 14.0 degrees ) and z-axes (7.7 degrees vs 12.2 degrees ). In the rheumatoid arthritis pronated foot group, eversion and internal rotation during the stance phase of gait were between 2 and 5 times greater than for normal subjects. The use of a corrective foot orthosis in this group restored normal kinematics, reducing maximum eversion and internal rotation by 57 and 68%, respectively. CONCLUSION: A new technique for measuring kinematics at the AJC is described. Based upon the findings of this pilot study, EMT may be useful for diagnosing AJC dysfunction and quantifying the mechanical efficacy of footwear and orthosis interventions.

Adult↗
PubMed1985

Sensory receptors in ankle joint capsules of normal and arthritic rats.

The responses of afferent fibers innervating the capsule of the ankle joint have been investigated in 34 normal and 19 arthritic anaesthetised rats. Afferent fiber diameter and conduction velocity were in the same range in normal and arthritic rats. All receptors examined were excited by mechanical stimulation of the joint capsule and the majority adapted slowly. A resting discharge was absent in normal rats in contrast to the arthritic animals where it was present in about 25% of the sample. The mechanical thresholds of the responses, measured using either von Frey hairs or the force transducer, ranged from 4.6 mN to 65 mN for 11 units recorded in normal and exceeded 80 mN for 11 others. For 30 units recorded in arthritic animals the thresholds ranged from 0.4 to 46 mN. When tested, pressure on the ankle or small degrees of flexion or extension produced a high rate of discharge in receptors of arthritics while similar stimuli were ineffective in normals. Repeated indentation at short intervals caused a progressive reduction in response to 10 to 15% of control values in normal and almost to extinction in arthritic rats. Recovery occurred within minutes in normals but was delayed in arthritics. These results suggest that the changes in responsiveness of somatosensory neurons and in behaviour, previously described in arthritic rats, can be partly accounted for in terms of the altered properties of the joint capsule receptors.

Adaptation, Physiological↗
PubMedDate not supplied

Sonography of pigmented villonodular synovitis in the ankle joint.

Pigmented villonodular synovitis is a benign proliferative disorder of the synovium that results in villous nodule formation in joints, tendon sheaths, and bursae. We present a case of pigmented villonodular synovitis of the ankle joint that was diagnosed by sonography with color Doppler imaging. The sonograms revealed hypoechoic synovial proliferation, and hypervascularity was visible on color Doppler images. The differential diagnosis of a synovial thickening or mass is also discussed.

Adult↗
PubMed2002

Differences in ankle-joint complex motion during the stance phase of walking as measured by superficial and bone-anchored markers.

Bones of the ankle-joint complex are difficult to represent with superficial markers and an invasive approach is required to quantify skin movement artifact. Three-dimensional coordinates during gait were first calculated from sets of three superficial markers located on both the lower leg and heel. Intracortical pins equipped with external marker arrays were subsequently inserted in the tibia, talus and calcaneus for further trials. Tibiocalcaneal and talocalcaneal joint helical axis component rotations were calculated. Intersubject motion patterns were comparable. Root mean square (RMS) differences were chosen to describe discrepancies between temporal intracortical pin and superficial marker curves. Results for the tibiocalcaneal rotations inversion/eversion, plantarflexion/ dorsiflexion and abduction/adduction were 2.5 degrees, 1.7 degrees and 2.8 degrees respectively. Inversion/eversion about the talocalcaneal joint showed an RMS difference of 2.1 degrees. A systematic over- or underestimation of superficial relative to bone-anchored markers could not be determined.

Adult↗
PubMed1990

[Secondary interventions in malunited fractures of the ankle joint].

When pain persists and activity is limited as a result of lack of union in a fracture of the upper ankle joint, for us this is a clear indication for a secondary procedure. The goal, of course, is to reconstruct the normal anatomy and correct any deformities present. The time interval between the trauma and secondary reconstruction is no contraindication. The arthrosis present and the patient's age are also not drawbacks. The only contraindication is how severely is function impaired. The final result is not dependent on the degree of malposition nor the arthrosis present before the procedure. In general, this is not predictable. Therefore, secondary reconstruction is the first step in the treatment of post-traumatic malpositioning. Other therapeutic measures such as nettoyage (cleaning up), extra-articular osteotomy, and arthrodesis must be implemented where indicated on an individual basis.

Ankle Injuries↗
PubMed2005

Differential acoustic properties of early cartilage lesions in living human knee and ankle joints.

OBJECTIVE: Although numerous studies have been performed to determine whether there are histologic, biochemical, biomechanical, and metabolic differences between knee and ankle cartilage, none have investigated the presence of such differences in living human cartilage. We previously developed an ultrasonic evaluation system for articular cartilage that analyzes the A-mode echogram using wavelet transformation. The current study was undertaken to determine whether the acoustic properties of living human cartilage differ between knee and ankle joints. METHODS: Twenty-eight patients were subjected to ultrasonic evaluation under arthroscopy. After arthroscopic grading, the cartilage was measured using an ultrasonic probe. Two quantitative parameters were used, i.e., the maximum magnitude and the echo duration at the 95% interval of the maximum magnitude. RESULTS: In intact cartilage, the maximum magnitude and echo duration did not differ between the knee and the ankle. In lesional cartilage, in contrast, the maximum magnitude was higher, and the echo duration was shorter, in the ankle than in the knee. These differences were statistically significant. CONCLUSION: Ultrasound findings could be used to judge the degree of early cartilage degeneration in vivo on the basis of objective data such as the maximum magnitude and echo duration. Because we were unable to quantitatively analyze the biochemical and biomechanical properties of the cartilage in this study, our biochemical and biomechanical findings are based only on qualitative assessment. Nevertheless, the results indicate that this ultrasonic evaluation system may be useful for elucidating the processes of articular cartilage degeneration in osteoarthritis.

Acoustics↗
PubMed2000

Squeeze-film lubrication of the human ankle joint with synovial fluid filtrated by articular cartilage with the superficial zone worn out.

A squeeze-film lubrication model of the human ankle joint in standing that takes into account the fluid transport across the articular surface is presented. Articular cartilage is a biphasic mixture of the ideal interstitial fluid and an elastic permeable isotropic homogeneous intrinsically incompressible matrix. The simple homogeneous model for articular cartilage models the case of early osteoarthritis, when the intact superficial zone of the normal articular cartilage, much stiffer in tension than the bulk material, has been already disrupted or worn out. The calculations indicate for this case that in normal approach motion the lubricating fluid film is quickly depleted and turned into a synovial gel film that is supposed to serve as a boundary lubricant if sliding motion follows

Ankle Joint↗
PubMed1983

Benign giant cell tumor of the ankle joint.

Benign giant cell tumors are usually found on the hand, however, the authors discuss a case in which the tumor occurred on the ankle joint. Treatment is complete surgical excision because a relatively high recurrence rate has been reported in the literature.

Adult↗
PubMed1991

Biomechanical changes at the ankle joint after stroke.

The resistance of the relaxed ankle to slow displacement over the joint movement range was measured on both sides of a group of hemiparetic stroke patients, in whom spasticity had been established for at least one year and who showed no clinical signs of contractures. The ankle joints of the age-matched normal subjects were flexible over most of the movement range, showing dramatically increasing stiffness only when the foot was dorsiflexed beyond 70 degrees, with a neutral range between 90-100 degrees, and a less dramatic increase in stiffness during plantarflexion. Hemiparetic patients showed identical curves to the normal subjects on the "healthy" side, ipsilateral to the causative cerebral lesion, but were significantly stiffer in dorsiflexion on the contralateral side, without change in the minimum stiffness range or during plantarflexion. Therefore significant changes in passive biomechanical properties occur at the affected ankle of hemiparetic subjects, predominantly as the result of a loss of compliance in the Achilles tendon, although an increase in the passive stiffness of the triceps surae may also occur. The contribution of these changes to the locomotor disability of hemiparetic patients is discussed.

Ankle Joint↗
PubMed1991

[Does performance of a stress roentgen image of the upper ankle joint in acute fibular capsule ligament lesion entail an operation? An experimental study].

In an experimental study the sequelae of performing stress films on the ruptured lateral ligaments of the ankle joint are documented. It is shown that stress films may cause further damage on the ankle capsule when there is ligamentous disruption. After performance of stress studies a sufficient realignment of the interrupted ligaments by immobilization of the foot in a neutral (right angle) position can not be achieved. This makes, at least for younger patients, operative therapy after positive stress films advisable.

Ankle Injuries↗
PubMed1997

The influence of antagonist muscle control strategies on the isometric frequency response of the cat's ankle joint.

This study investigated the effect of various strategies to control the interaction between agonist and antagonist muscles on the frequency response of the isometric cat ankle joint actuated by the tibialis anterior (TA) and soleus (SOL) muscles. Some strategies were based on the physiologic need for increasing joint stability during forceful contractions; with these strategies, the proportional rate of physiologic antagonist activity was termed antagonist gain. Other strategies were based on the electrical stimulation literature, which advocates co-contraction at low force levels. The range of crossover of antagonist activity to the agonist's domain was termed overlap. Strategies consisting of 0%, 10%, and 20% antagonist gain were combined with 0%, 50%, and 100% overlap for a total of nine strategies. These were applied to the TA and SOL using sinusoidal input signals varying in frequency from 0.4 to 6 Hz. Gain and phase Bode plots were constructed through the use of the fast Fourier transforms (FFT's); and analysis of variance determined the significance of differences in gain and phase across frequencies. Best-fit models consisting of four poles and two zeroes were used to fit the experimental data and compared against an analytical model of muscles acting independently across the joint. Harmonic distortion was calculated to evaluate signal quality. It was found that changing the overlap and the antagonist gain produces significant changes in the dynamic response of the two-muscle joint system. The analytical approach to modeling such a system tends to consistently overestimate gain. It is suggested that signal quality is optimal when a moderate amount of antagonist gain (10%) is engaged, with overlap of 50% to smooth transitions between opposing movements. It is expected that this type of strategy will achieve optimum signal quality while preserving the long-term integrity of the joint.

Analysis of Variance↗