Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Pronation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed1997

The effect of subtalar joint posting on patellar glide position in subjects with excessive rearfoot pronation.

It has been postulated that patellar position is influenced by subtalar joint mechanics. The purpose of this study was to compare the patellar alignment observed by radiographic analysis in subjects with excessive rearfoot pronation, both pre- and post-placement of semirigid rearfoot posting. Sixteen asymptomatic patellofemoral joints were contributed from 12 female subjects (four bilaterally). The amount of subtalar joint posting each subject received was related to the amount of rearfoot pronation present. The subjects' patellofemoral joints were radiographed in full weight-bearing, tangential view, both pre- (resting calcaneal stance position) and post- (neutral calcaneal stance position) placement of the posting material. The paired t test revealed a statistically significant change in patellar positioning (medial glide) after placement of semirigid posting (p < or = .05). This finding has structural implications for utilization of orthotics in the treatment of patients with patellofemoral pain syndrome with requisite excessive rearfoot pronation.

Adult↗
PubMedDate not supplied

The effect of three alternative keyboard designs on forearm pronation, wrist extension, and ulnar deviation: a meta-analysis.

The growth of computer keyboard use in the workplace is believed to be one important determinant of the increased prevalence of work-related musculoskeletal disorders of the upper extremity (MSD-UE). One possible contributing factor to the development of MSD-UE is the flat standard keyboard, which places the forearm and wrist in biomechanically awkward postures. This meta-analysis examines the efficacy of three alternative keyboard designs, adjustable slope (AS), split fixed-angle (FA), and adjustable open-tented (AT), in reducing forearm pronation, wrist extension, and ulnar deviation. Analyses of pooled effect size from six studies indicated that the AT had a large effect on pronation (r= 0.85) and ulnar deviation whereas the FA had a large effect only on ulnar deviation (r= 0.79). The AS was found to have a large effect (r= 0.66) on wrist extension. The FA had a moderate effect on pronation (r= 0.33) and wrist extension (r= 0.30). None of these keyboards were found to have a significant effect on all three postures. This meta-analysis has implications for clinicians by providing objective information that may assist with the selection of an alternative keyboard that best reduces an identified problematic posture.

Biomechanical Phenomena↗
PubMedDate not supplied

Influence of treadmill design on rearfoot pronation during gait at different speeds.

Understanding the dynamic function of the rearfoot is necessary for recognizing and treating several types of mechanical foot dysfunction. Although the motion of the rearfoot is often measured during treadmill locomotion, the effect of different types of treadmills on the motion of the foot is unclear. In this study, the kinematics of the right subtalar joint in 24 volunteers walking at three speeds on two motorized treadmills were examined. The two treadmills (a wide width and a soft surface versus a narrow width and a hard surface) were selected to maximize motion differences. Maximal change in angular position (positive: supination; negative: pronation) about each volunteer's subtalar joint axis was estimated during three gait phases: weight acceptance, midstance, and push-off. A factorial, repeated-measures analysis of variance determined that the treadmill design had a significant effect on subtalar joint position (F = 5.423; P = .029), albeit with moderate power (0.61). Descriptively, collapsed over all speeds, the subject's feet on the narrow/hard compared with the wide/soft treadmill showed more pronation (0.44 degrees ), less pronation (0.46 degrees ), and more supination (1.44 degrees ) during weight acceptance, midstance, and push-off, respectively. We conclude that treadmill design can affect an individual's rearfoot kinematics.

Biomechanical Phenomena↗
PubMed1992

The medial heel skive technique. Improving pronation control in foot orthoses.

A new method of foot orthosis modification that enhances the pronation controlling ability of foot orthoses is presented. The medial heel skive technique involves selectively removing small amounts of the medial portion of the plantar heel of the positive cast of the foot to create a unique varus wedging effect within the heel cup of the foot orthosis. The resulting increase in supination moment across the subtalar joint axis of the foot clinically produces significantly improved pronation control on pediatric flexible flat feet, posterior tibial dysfunction, and other types of excessively pronated feet.

Biomechanical Phenomena↗
PubMed1999

Pronation and supination of the scaphoid.

The objective of this study was to identify and classify longitudinal rotations of the scaphoid on clinical radiographs of normal wrists. The concept of scaphoid recumbency was defined in terms of the orientation of the palmar tubercle. Pronation and supination of the scaphoid were identified in a set of 130 posteroanterior films of structurally normal wrists in neutral position. Normal variations in scaphoid recumbency and lunate posture were classified. It was found that the scaphoid is in neutral recumbency in 62%, pronation in 32%, and supination in 7% of structurally normal wrists. Neutral scaphoid recumbency and neutral lunate posture occur together in 45% of normal wrists. Rarely, scaphoid supination and lunate flexion occurred together, simulating a collapse pattern often seen in inflammatory arthritis. Scaphoid supination and lunate extension did not occur together. An anatomic basis for this incompatibility of scaphoid recumbency and lunate posture is suggested. We conclude that longitudinal rotation of the scaphoid (ie, pronation and supination) may be seen on clinical radiographs of structurally normal wrists. These rotations are exaggerated in certain types of carpal instability.

Carpal Bones↗
PubMed2000

[Awake pronation of surgical patients with cervical spinal lesions].

Positioning of patients with cervical spinal lesions under general anesthesia may lead to serious neurological complications. The authors attempted awake pronation in eighteen patients to minimize the risks. In all patients, cervical instability or cervical spinal cord compression was diagnosed, and posterior fusion or laminoplasty under general anesthesia was planned. Naso-tracheal intubation was performed by broncho-fiberoptic scope under topical anesthesia and light sedation. After tracheal intubation, pronation was completed while patients were still awake. Twelve patients could change their position almost by themselves, and needed only a little assistance of the medical staff. After the patients settled in appropriate position, general anesthesia was induced. Neurological status was assessed before and after the intubation, and just before the induction of general anesthesia, to prove the absence of complications. Operations were accomplished without major troubles in all patients. During post anesthetic interviews, eight patients had memory of the positioning, but none of them had any complaints about the procedure. Awake pronation may be useful to minimize the risk of neurological complications related to positioning of surgical patients, and also need less assistance by medical staff.

Anesthesia, General↗
PubMed2000

Risk factors that may adversely modify the natural history of the pediatric pronated foot.

Flatfoot is one of the most common conditions seen in pediatric podiatry practice. There is no universally accepted definition for flatfoot. Flatfoot is a term used to describe a recognizable clinical deformity created by malalignment at several adjacent joints. Clinically, a flatfoot is one that has a low or absent longitudinal arch. Determining flexibility (physiologic) or rigidity (pathologic) is the first step in management. A flexible flat foot will have an arch that is present in open kinetic chain (off weight-bearing) and lost in closed kinetic chain (weight-bearing). A rigid flatfoot has loss of the longitudinal arch height in open and closed kinetic chain. According to Mosca, "The anatomic characteristics of a flatfoot are excessive eversion of the subtalar complex during weight-bearing with plantarflexion of the talus, plantarflexion of the calcaneus in relation to the tibia, a dorsiflexed and abducted navicular and a supinated forefoot." Normally developing infants have a flexible flatfoot and gradually develop a normal arch during the first decade of life. When evaluating an infant for a pronated condition, the examiner must also consider other risk factors that may affect the foot in its overall development. These contributing factors will play a role in the development of a treatment plan. The risk factors include ligamentous laxity, obesity, rotational deformities, tibial influence, pathological tibia varum, equinus, presence of an os tibiale externum, and tarsal coalitions. The authors realize other less significant factors exist but are not as detrimental to the foot as the primary ones discussed in depth. The primary risk factors that affect the pronated foot have been outlined. The clinician should always examine for these conditions when presented with a child exhibiting pronatory changes. A thorough explanation to the parents as to the consequential effects of these risk factors and their effects on the pediatric pronated foot is paramount to providing an acceptable comprehensive treatment program. Children often are noncompliant with such treatments as stretching and orthotic maintenance. The support of the parents is crucial to maintaining an effective treatment program continued at home.

Child↗
PubMed1998

Influence of landing on the supination and pronation in the foot joint.

The purpose of this study was to measure the changes of supination and pronation in the ankle joint at landing to quantify the influence of shock attenuation during landing. The subjects did two different motions, jumping down on the force platform from posterior and lateral views. The rear view of single foot contact in a jump from height of 30 and 60 cm showed a landing on the inside of the rear part of the foot (pronation) followed after about 0.03 sec by a rolling outward of the foot (supination). The variables describing changes in three angles of the ankle joint indicated that the standing position was more sensitive on the pronation and supination during ground contact.

Adult↗
PubMed2004

Pronator syndrome: a retrospective study of median nerve entrapment at the elbow in female machine milkers.

Pronator syndrome (median nerve entrapment at the elbow) is a rare condition, but it is more common among women than men. A long-term retrospective follow-up study evaluating the outcome of surgical release of the median nerve for female machine milkers has never been carried out before, nor has a long-term study of non-treated female milkers with pronator syndrome. In the present study, two groups of machine milkers (surgical and non-surgical) were compared. The clinical examination focused on two parameters: focal tenderness and individual muscle strength. The results showed that the surgical group had no focal tenderness on palpation over the median nerve at the elbow and no selective weakness in the muscles examined, as compared to what was found before surgery. In the non-surgical group, focal tenderness was found in 12 out of 14, and 10 out of 14 showed the same weakness as in an earlier examination. While this study has limitations in sample size, surgical release of the median nerve at the elbow level, in cases of pronator syndrome, appears to provide an immediate as well as long-term return to normal strength of FPL and FDP II, along with a significant improvement in subjective status. In the non-surgical group, spontaneous improvement of the strength of FPL and FDP II was found in only four out of the 14 cases.

Adult↗
PubMed2005

An anatomical study of the anterior interosseous nerve and its innervation of the pronator quadratus muscle.

This anatomical study of 40 upper limbs from cadavers investigated the branching pattern of the anterior interosseous nerve in its distal part using the operating microscope. An articular branch to the wrist joint and/or the distal radioulnar joint was only found in seven of the 40 specimens and was always a small terminal continuation of the anterior interosseous nerve after the nerve had passed through the pronator quadratus and innervated it. Therefore, we do not recommend division of the anterior interosseous nerve from the dorsal approach through the interosseous membrane before it gives off its muscular branches to the pronator quadratus. This risks damage of the innervation of this muscle of importance for initiation of hand pronation.

Forearm↗
PubMed1997

The anatomical basis of the vascularized pronator quadratus pedicled bone graft.

The vascular supply of the pronator quadratus was studied in 25 cadaveric dissections following coloured latex injections. This showed that the main blood supply of the pronator quadratus came from the anterior interosseous artery. There was, however, a rich anastomosis between the branches of the anterior interosseous artery and those of the radial and ulnar arteries. It was possible to raise a corticocancellous bone graft from the anterior surface of the radial styloid on a pedicle of the lower fibres of the pronator quadratus muscle. This muscle pedicle had a constant branch of the anterior interosseous artery which vascularized the bone graft. Such a vascularized pedicled bone graft may be useful in the treatment of non-union of the scaphoid and Kienböck's disease.

Bone Transplantation↗
PubMed2001

Pronator syndrome.

Although pronator syndrome is often misdiagnosed and does not occur as frequently as carpal tunnel syndrome, its clinical features are well described, and the diagnosis should be made if the clinical features are understood and reasonable suspicion exists. The differentiating features between carpal tunnel syndrome and pronator syndrome should be understood, and evaluation for one site of compressive neuropathy of the median nerve always should include the other potential sites. When the correct diagnosis is made, pronator syndrome can be successfully treated nonoperatively or surgically, if necessary.

Cumulative Trauma Disorders↗
PubMed1995

The pronator quadratus: a distinct forearm space?

The pronator quadratus sign is associated with fractures of the distal radius and ulna and is believed to be due to accumulation of fluid within the pronator quadratus muscle. This anatomic study based on dye injection and x-ray film examination shows that the pronator quadratus occupies a distinct forearm space without intramuscular communication.

Cadaver↗
PubMed1976

Pronator syndrome: clinical and electrophysiological features in seven cases.

The clinical and electrophysiological picture of seven patients with the pronator syndrome is contrasted with other causes of median nerve neuropathy. In general, these patients have tenderness over the pronator teres and weakness of flexor pollicis longus as well as abductor pollicis brevis. Conduction velocity of the median nerve in the proximal forearm is usually slow but the distal latency and sensory nerve action potential at the wrist are normal. Injection of corticosteroids into the pronator teres has produced relief of symptoms in a majority of patients.

Adrenal Cortex Hormones↗
PubMed2006

Establishing normal values of the proximal median motor nerve-a study of the pronator teres and flexor carpi radialis in healthy volunteers.

The importance of normative peripheral nerve data is increasing due to advances in medical implantation, microsurgical suturing, and tubulization repair techniques. Because the median nerve is often affected, its normal values must be reliable. Although the distal portion of the median nerve has been well studied using electrodiagnostic methods, the proximal forearm segment has not. This study establishes a normative database for median nerve conduction to the pronator teres (PT) and to the flexor carpi radialis (FCR). Two hundred-eight asymptomatic subjects were studied using proximal median motor stimulation at 10 cm. Latencies, amplitudes, areas, and durations were recorded. To the pronator teres: The upper limit for normal (ULN) motor latency was 3.5 ms (2.9 +/- 0.3 ms). The side-to-side latency difference was </= 0.5 ms. Overall, the lower limit of normal (LLN) amplitude was 2.2 mV. However, this decreased to 1.5 mV in the over-50 age group. To the flexor carpi radialis: The ULN motor latency was 3.6 ms (2.8 +/- 0.4 ms). The side-to-side latency difference was </= 0.7 ms. Overall, the LLN amplitude was 2.3 mV. However, this decreased to 1.7 mV in the over-50 group. This study produced a large database of normal results for the median motor nerve conduction to the pronator teres and to the flexor carpi radialis. The 10-cm techniques are easily reproducible and helpful when evaluating this portion of the median nerve.

Journal Article↗
PubMed2004

Pronator syndrome and other nerve compressions that mimic carpal tunnel syndrome.

The purpose of this clinical commentary is to provide a comprehensive review of compressive neuropathies that may mimic carpal tunnel syndrome, provide the clinician with information to differentially diagnose these median nerve compression sites, and provide an evidence-based opinion regarding conservative intervention techniques for the various compression syndromes. While rare in comparison to carpal tunnel syndrome, pronator syndrome and anterior interosseous nerve syndrome are proximal median nerve compressions that may be suspected if a patient with carpal tunnel syndrome fails to respond to conservative or surgical intervention. Differential diagnosis is based largely on the symptoms, patterns of paresthesia, and specific patterns of muscle weakness. Due to the relative rarity of pronator syndrome and anterior interosseous nerve syndrome, few controlled studies exist to determine the most effective treatment techniques. Based on sound anatomical and biomechanical considerations, anecdotal experience, and available research, however, treatment strategies for pronator syndrome and anterior interosseous nerve syndrome compression neuropathies can be divided into 4 major categories: (1) rest/immobilization, (2) modalities, (3) nerve gliding, and (4) nonconservative treatment.

Carpal Tunnel Syndrome↗
PubMed1993

Modified exposure for pronator syndrome decompression: a preliminary experience.

Because hypertrophic and symptomatic scarring is not infrequent from a lazy S incision across the antecubital fossa, a new surgical approach to the pronator tunnel has been developed. Preliminary experience with this modified incision has proven to be encouraging in seven cases (five patients). The exposure is composed of two off-set linear incisions which allow visualization of the median nerve and brachial artery distal and proximal to the lacertus fibrosis. An intact bridge of skin at the antecubital fossa protects the medial cutaneous nerves of the arm and forearm from injury. The median nerve is exposed by splitting the pronator teres along its length, and fractional step cutting of the pronator aponeurosis relaxes the muscle. Postoperative scar management with a compressive wrap and elastomer insert is helpful for cosmetic healing of the incisions.

Adult↗
PubMed2003

Subtalar Pronation Does Not Influence Impact Forces or Rate of Loading During a Single-Leg Landing.

OBJECTIVE: To identify the influence of static subtalar pronation (as measured by weight-bearing navicular drop [ND]) on ground impact forces and rate of loading during a single-leg landing. DESIGN AND SETTING: Subjects were grouped (n = 16 per group) on the basis of weight-bearing ND scores (supinators, <5 mm; neutral, 5-10 mm; pronators, >10 mm). Subjects performed 5 single-leg landings, dropping from a 0.3-m height onto a force platform. An electrogoniometer simultaneously recorded sagittal knee range of motion during the landing task. SUBJECTS: Forty-eight healthy volunteers participated. MEASUREMENTS: Peak vertical force was defined as the highest force recorded in the F(z) direction during landing. Rate of loading was defined as the peak vertical force divided by the time to reach the peak vertical force. Knee-flexion excursion was defined as the change in knee-flexion range from initial contact to peak vertical force. RESULTS: Peak vertical force (P =.769) and rate of loading (P =.703) did not differ among groups. Although secondary analyses identified significant negative correlations between peak force and rate of loading with knee excursion, the amount of knee excursion was similar among groups (P =.744). CONCLUSIONS: Our results de-emphasize the influence of static anatomical foot alignment on impact forces and absorption during a single-leg drop landing and provide further support for the role of knee flexion in dissipation of landing forces. Further investigations are needed to fully elucidate the role of subtalar pronation and other lower extremity alignment factors in force dissipation during dynamic functional activities.

Journal Article↗