Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current ev...Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current evidence on diagnostic protocols and management strategies,highlighting optimal approaches and emerging trends.Initial care emphasizes soft tissue assessment,often guided by the Tscherne classification,and fracture classification systems.External fixation may be required in open injuries,while early open reduction and internal fixation within six days is linked to improved outcomes.Minimally invasive techniques for the lateral malleolus,including intramedullary nailing and locking plates,are effective,while medial malleolus fractures are commonly managed with screw fixation or tension-band wiring.Posterior malleolus fragments involving more than 25%of the articular surface usually warrant fixation.Alternatives to syndesmotic screws,such as cortical buttons or high-strength sutures,reduce the need for secondary procedures.Arthroscopic-assisted open reduction and internal fixation benefits younger,active patients by enabling concurrent management of intra-articular and ligamentous injuries.Postoperative care prioritizes early weight-bearing and validated functional scores.Despite advances,complications remain common,and further research is needed to refine surgical strategies and improve outcomes.展开更多
BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affectin...BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affecting the alignment,such as ankle joint alignment,should be considered.AIM To determine CPAK distribution in the North African(Egyptian)population with knee osteoarthritis and to assess ankle joint line orientation(AJLO)adaptations across different CPAK types.METHODS A cross-sectional study was conducted on patients with primary knee osteoarthritis and normal ankle joints.Radiographic parameters included the mechanical lateral distal femoral angle,medial proximal tibial angle,and the derived calculations of joint line obliquity(JLO)and arithmetic hip-knee-ankle angle(aHKA).The tibial plafond horizontal angle(TPHA)was used for AJLO assessment,where 0°is neutral(type N),<0°is varus(type A),and>0°is valgus(type B).The nine CPAK types were further divided into 27 subtypes after incorporating the three AJLO types.RESULTS A total of 527 patients(1054 knees)were included for CPAK classification,and 435 patients(870 knees and ankles)for AJLO assessment.The mean age was 57.2±7.8 years,with 79.5%females.Most knees(76.4%)demonstrated varus alignment(mean aHKA was-5.51°±4.84°)and apex distal JLO(55.3%)(mean JLO was 176.43°±4.53°).CPAK types I(44.3%),IV(28.6%),and II(10%)were the most common.Regarding AJLO,70.2%of ankles exhibited varus orientation(mean TPHA was-5.21°±6.45°).The most frequent combined subtypes were CPAK type I-A(33.7%),IV-A(21.5%),and I-N(6.9%).A significant positive correlation was found between the TPHA and aHKA(r=0.40,P<0.001).CONCLUSION In this North African cohort,varus knee alignment with apex distal JLO and varus AJLO predominated.CPAK types I,IV,and II were the most common types,while subtypes I-A,IV-A,and I-N were commonly occurring after incorporating AJLO types;furthermore,the AJLO was significantly correlated to aHKA.展开更多
BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instabilit...BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.展开更多
Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall ...Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall joint flexibility.At the same time,frozen or hardened ground surfaces heighten impact forces while impairing the body's shock-absorption and adaptive response mechanisms.As a result,injuries such as ankle sprains(ligament tears),tendonitis,and stress fractures become more prevalent.Prevention is therefore essential and should focus on comprehensive warm-up routines,use of thermal and supportive equipment-including ankle braces-selection of footwear with adequate traction,and timely replacement of damp socks after exercise to maintain foot warmth and dryness.展开更多
BACKGROUND Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness.Preliminary evidence has shown that blood flow restriction(BFR)rehabilitation c...BACKGROUND Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness.Preliminary evidence has shown that blood flow restriction(BFR)rehabilitation can increase muscle strength and stability,helping to restore physical function and prevent repeated injury.AIM To determine whether BFR is more effective than traditional rehabilitation in improving muscle strength,size,and stability after foot and ankle injury.METHODS A systematic review and meta-analysis were performed.Articles were retrieved from MEDLINE,EMBASE,and CENTRAL databases.Included studies compared the effectiveness of BFR rehabilitation to traditional foot and ankle rehabilitation exercises.Eligible patients were those with a history of foot or ankle injury.Muscle strength,size,and dynamic balance were assessed by comparing impro vements in peak torque,cross-sectional area,and percent muscle activation.Methodological quality assessments were performed using the PEDro scale and Methodological Index for Non-Randomized Studies(MINORS).RESULTS Ten studies met the inclusion criteria.Five studies were of good to excellent quality according to the PEDro scale,and 5 studies were of moderate quality as per the MINORS criteria.Two studies compared the effect of BFR and non-BFR rehabilitation on muscle strength;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Two studies analyzed muscle activation following BFR and non-BFR rehabilitation;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Data on dynamic balance was synthesized from two studies;the mean difference between the BFR and control groups was 1.23[95%CI:(-1.55,4.01);P=0.39].CONCLUSION BFR rehabilitation is more effective than non-BFR rehabilitation at improving muscle strength and activation following foot and ankle injury.Additional studies are needed to develop a standardized BFR training protocol.展开更多
Ankle snapping occurs when tendons or retinacular structures abruptly move or slip over adjacent anatomical structures,often due to anatomical variations,pathological conditions,or acute injury.This phenomenon can cau...Ankle snapping occurs when tendons or retinacular structures abruptly move or slip over adjacent anatomical structures,often due to anatomical variations,pathological conditions,or acute injury.This phenomenon can cause pain and discomfort,ranging from mild irritation to debilitating symptoms that potentially disrupt daily activities and athletic pursuits.Considering the anatomy of the ankle,these snapping phenomena can be categorized into four regional groups:(1)Lateral;(2)Medial;(3)Anterior;and(4)Posterior.Lateral ankle snapping,a common occurrence,typically results from peroneal tendon subluxation due to compromise of the superior and inferior peroneal retinacula,or from intrasheath subluxation,characterized by abnormal tendon motion within an otherwise intact retromalleolar groove and retinaculum.Medial ankle snapping primarily affects the posterior tibial tendon and can involve the flexor digitorum longus tendon.Anterior ankle snapping results from abnormal gliding of the tibialis anterior tendon,extensor digitorum longus tendon,peroneus tertius tendon,and inferior extensor retinaculum.Posterior ankle snapping typically involves the plantaris tendon and flexor hallucis longus(hallux saltans).This mini-review comprehensively explores these snapping phenomena and their related pathologies in the foot and ankle,emphasizing the crucial roles of anatomical knowledge,thorough clinical assessment,and appropriate diagnostic and treatment approaches.展开更多
BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion defici...BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion deficits.Strengthening programs targeting evertor/invertor and dorsiflexor/plantar flexor balance help reduce injury recurrence.Bilateral neuromuscular deficits compromise the contralateral side,rendering healthy limbs unsuitable as recovery references.Defining normative healthy ankle parameters is crucial for establishing precise limits in nonsurgical treatments and sports return criteria.While the limb symmetry index(LSI)is used for knees with a cutoff of>90%,no such standardization exists for the ankle.AIM To comprehensively evaluate isokinetic ankle strength profiles in non-athletic individuals.METHODS This is a cross-sectional study.Two hundred ankles were evaluated using the Biodex 3 System to assess eversion,inversion,dorsiflexion,and plantar flexion.Healthy individuals with an active lifestyle and no previous injuries were evaluated.The Maximum Torque,Agonist/Antagonist Ratio,LSI,and Muscular Deficiency Index(MDI)and the correlation with demographic variables were evaluated.RESULTS The mean age(mean±SD)was 38.5±13.5 years,and the body mass index(BMI)was 25.8±4.2 in 69 men and 31 women.The mean maximum torque values by gender were(mean±SD):22.3±6.6 female(F)and 33.4±9.9 male(M)N/m for eversion;30.10±10.0(F)and 37.0±11.6 N/m(M)for inversion,37.4±10.0(F)and 53.6±13.0 N/m(M)for dorsiflexion,and 100.4±37.2(F)and 158.1±33.4(M)N/m for flexion.There was no correlation between age or BMI and maximum torque.The evertors/invertors ratio was 88.8%,and the dorsiflexors/plantar flexors ratio was 36.1%.The MDI and LSI were balanced between sides for every movement,having an average global difference of less than 10%.CONCLUSION These findings provide gender-specific normative isokinetic values for the ankle in healthy,physically active adults.These reference parameters—especially LSI and MDI above 90%—can support clinical decision-making in rehabilitation planning and return-to-sport assessment,offering objective benchmarks for functional recovery.展开更多
BACKGROUND Psychological comorbidities,such as anxiety and depression,in patients with chronic ankle instability(CAI)may impede ankle function improvement,although the precise nature of this association warrants furth...BACKGROUND Psychological comorbidities,such as anxiety and depression,in patients with chronic ankle instability(CAI)may impede ankle function improvement,although the precise nature of this association warrants further investigation.AIM To analyze the correlation of anxiety and depression with ankle function in patients with CAI and discussing the risk factors.METHODS This study included 116 patients with CAI,who were admitted to our hospital from July 2022 to July 2024.Anxiety and depression states of patients were assessed with the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively,and their ankle joint function was assessed with the anklehindfoot function score of the American Orthopedic Foot and Ankle Society.Further,the ankle function of patients with CAI with different anxiety and depression states was discussed.Furthermore,the Pearson correlation coefficient was used to analyze the correlation of anxiety and depression with ankle joint function in such patients.Univariate and multivariate analyses were conducted to investigate the factors affecting ankle joint function in patients with CAI.RESULTS Among the 116 patients with CAI,97,13,5,and 1 cases demonstrated none,mild,moderate,and severe anxiety,whereas 95,15,6,and 0 cases showed none,mild,moderate,and severe depression,respectively.The average ankle joint function score was 74.82±6.93 points.The ankle joint function in patients with CAI presented a significant downward tendency as the degree of anxiety and depression increased.Correlation analysis revealed that both the SAS and SDS scores of patients with CAI were significantly negatively correlated with the ankle joint function score.Univariate and multivariate analyses indicated that the risk factors affecting patients’ankle joint function included early functional rehabilitation,visual analog scale,and SDS.CONCLUSION A substantial number of patients with CAI suffer from anxiety and depression,and these negative emotions,to a certain extent,harm the smooth rehabilitation of ankle joint function.展开更多
Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).Th...Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.展开更多
Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop la...Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop landing activity in subjects with chronic ankle instability (CAI)compared to healthy subjects with no history of CAI.Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects,respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace ( NB),ElementTM brace and ASO brace.Simultaneous recording of three-dimensional kinematic (240 Hz)and GRF (1200 Hz) data were performed.Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of ElementTM against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy coutrols.The ASO brace reduced the first peak vertical GRF whereas ElementTM increased 2nd peak vertical GRF.ElementTM brace reduced eversion range of motion (ROM) and peak eversion velocity compared to NB and ASO.In addition,ElementTM reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO.Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for ElementTM.展开更多
Purpose We aimed to investigate the effects of running shoe longitudinal bending stiffness(LBS)and midsole energy return on running economy and ankle mechanics and energetics.Methods PubMed,Scopus,SPORTDiscus,Embase,C...Purpose We aimed to investigate the effects of running shoe longitudinal bending stiffness(LBS)and midsole energy return on running economy and ankle mechanics and energetics.Methods PubMed,Scopus,SPORTDiscus,Embase,CINAHL,and Web of Science were systematically searched for this meta-analysis.Crossover studies comparing the effects of running shoe LBS and/or midsole energy return on at least 1 of the following outcomes:running economy,ankle plantarflexion moment,work,power,or angular velocity were included.Results Of the 2453 studies screened,48 were included(n=878).Results indicated that advanced footwear technologies(AFTs)significantly reduced oxygen consumption(standardized mean difference=–0.44,95%confidence interval:–0.60 to–0.28),p<0.001)as well as peak ankle moments and positive/negative ankle work and power.However,neither LBS nor midsole energy return alone significantly affected oxygen consumption,ankle moments,positive and negative work,or positive power.The effects of AFTs were moderated by the training status and speed of the runner.The quality of evidence for all outcomes were low or very low for all outcomes except the effect of LBS on negative ankle work.Conclusion AFT may improve running economy by minimizing ankle moments,work,and power.The absence of significant independent effects of LBS and midsole energy return suggests that the benefits of AFTs arise from the interaction of these properties.Further research is necessary to understand the mechanisms for improved running performance in AFTs.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rate...BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.展开更多
With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.I...With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.展开更多
BACKGROUND Arabic-speaking patients are underrepresented in orthopedic clinical studies,particularly in foot and ankle trauma research.The lack of validated Arabic language tools hinders their inclusion,creating a nee...BACKGROUND Arabic-speaking patients are underrepresented in orthopedic clinical studies,particularly in foot and ankle trauma research.The lack of validated Arabic language tools hinders their inclusion,creating a need for culturally and linguistically adapted instruments.The American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire(AAOS-FAOQ)is a widely used tool but has not been adapted for Arabic-speaking patients.AIM To translate,cross-culturally adapt,and validate the AAOS-FAOQ for Arabicspeaking patients with traumatic foot and ankle injuries.METHODS The cross-cultural adaptation followed established guidelines,involving forward and backward translations,expert review,and pre-testing.The final Arabic version was administered alongside the Arabic Short-Form 36(SF-36)to 100 patients for validity testing.Reliability was assessed through test-retest methods with 20 patients completing the questionnaire twice within 48 hours.Pearson correlation coefficients measured convergent and divergent validity with SF-36 subscales,while Cronbach's alpha and intraclass correlation coefficients(ICC)determined internal consistency and reliability.RESULTS Out of 100 patients,92 completed the first set of questionnaires.The Arabic AAOS-FAOQ showed strong correlations with the SF-36 subscales,particularly in physical function and bodily pain(r>0.6).Test-retest reliability was robust,with ICCs of 0.69 and 0.66 for the Global Foot and Ankle Scale and Shoe Comfort Scale,respectively.Cronbach's alpha for internal consistency ranged from 0.7 to 0.9.CONCLUSION The Arabic version of the AAOS-FAOQ demonstrated validity and reliability for use in Arabic-speaking patients with traumatic foot and ankle injuries.This adaptation will enhance the inclusion of this population in orthopedic clinical studies,improving the generalizability of research findings and patient care.展开更多
Objective:To evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation(TEAS)for muscle atrophy in patients with immobilization after surgical fixation of foot and ankle fractures.Methods:This ...Objective:To evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation(TEAS)for muscle atrophy in patients with immobilization after surgical fixation of foot and ankle fractures.Methods:This was a two-arm randomized controlled trial wherein 80 patients were recruited and divided into control(n=40)and intervention(n=40)groups.The control group received conventional orthopedic treatment,whereas the intervention group received TEAS and conventional treatment.The intervention group received TEAS 3 times a week for 30 min each time for 8 weeks.The primary out-comes were muscle thickness(MT)and cross-sectional area(CSA)of the rectus femoris and gastroc-nemius muscles,whereas the secondary outcome measure was echo intensity(EI).Data were collected before the fixation operations(baseline assessment)and 4 and 8 weeks after intervention.Results:Compared with baseline,the MT and CSA were reduced in both groups by the end of treatment,whereas EI increased in both groups.At week 4,the reduction in the rectus femoris CSA in the inter-vention group was significantly lower than that in the control group(P=0.02);however,the between-group differences in the MT and EI(all P>0.05)were not significant.No serious adverse events were observed in either group.Conclusion:Our study showed that TEAS can improve muscle atrophy by attenuating the decline in the muscle CSA.Because this was only a pilot trial,subsequent studies will need longer follow-ups and larger sample sizes.展开更多
Background:Early weight bearing can accelerate the recovery of ankle function,but the timing of weight bearing has not been clarifi ed.In this study,the effi cacy and safety of weight-bearing at 1 week and 4 weeks aft...Background:Early weight bearing can accelerate the recovery of ankle function,but the timing of weight bearing has not been clarifi ed.In this study,the effi cacy and safety of weight-bearing at 1 week and 4 weeks after ankle fracture were further investigated.Methods:Forty-six postoperative ankle fracture patients were enrolled and divided into 1-week group(23)and 4-week group(23)according to randomized numerical table method.All patients underwent routine rehabilitation.On this basis,weight-bearing was started at 1 week after surgery in the 1-week group and at 4 weeks after surgery in the 4-week group.Both groups underwent a 6-week trial intervention.Ankle pain and function were assessed by VAS,AOFAS,and OMAS scales at 2,4,and 6 weeks after treatment.Results:There was no statistically signifi cant diff erence in the general data of patients in the 2 groups before surgery(P>0.05).At 2 weeks postoperatively,the VAS of the 1-week group was higher than that of the 4-week group,and the scores of the Pain item in AOFAS and Swelling item in OMAS were lower than that of the 4-week group.At 4 weeks postoperatively,the VAS was higher in the 1-week group than in the 4-week group.At 6 weeks postoperatively,the VAS was lower in the 1-week group than in the 4-week group,and the scores of the Pain,Maximum walking distance,and Sagittal motion items in the AOFAS,and the scores of the Stiff ness and Swelling items in the OMAS were higher than in the 4-week group.Conclusions:A rehabilitation strategy of early weight-bearing implemented 1 week after surgery in patients with ankle fractures can eff ectively reduce the degree of ankle stiff ness and accelerate the recovery of ankle function in patients.展开更多
OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this man...OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation. METHODS:Forty patients with lateral ankle sprains were randomly divided into two groups in a 1∶1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment. RESULTS:Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment(P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment(P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group(P < 0.05). CONCLUSIONS:The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.展开更多
Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 wer...Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 42 cases in each group.The control group received routine nursing,while the observation group received orthopedic nursing clinical pathway on the basis of traditional nursing.We analyzed and scored the nursing satisfaction and nursing effect of the two groups.Results:Compared with the control group,the observation group had a higher total nursing satisfaction rate,shorter time to get out of bed,shorter hospital stay,and lower hospitalization cost.The Barid score and AOFAS score of the observation group were higher than those of the control group,while the NRS score was lower.Conclusion:The application of orthopedic nursing clinical pathway in patients with ankle fractures significantly improves their quality of life,promotes better recovery of ankle function,and shortens the rehabilitation time.展开更多
Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclus...Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI characteristics.Methods'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic regression.Results'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p < 0.001, OR = 53& 95% confidence interval (CI): 3.84—7.53). Perceived ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p < 0.001;age: /2 = 30.37,p < 0.001;unilateral ankle sprains: /2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders.Conclusion-. The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap incurrent knowledge about the impact of pain in people with CAI, and this topic needs further investigation.展开更多
文摘Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current evidence on diagnostic protocols and management strategies,highlighting optimal approaches and emerging trends.Initial care emphasizes soft tissue assessment,often guided by the Tscherne classification,and fracture classification systems.External fixation may be required in open injuries,while early open reduction and internal fixation within six days is linked to improved outcomes.Minimally invasive techniques for the lateral malleolus,including intramedullary nailing and locking plates,are effective,while medial malleolus fractures are commonly managed with screw fixation or tension-band wiring.Posterior malleolus fragments involving more than 25%of the articular surface usually warrant fixation.Alternatives to syndesmotic screws,such as cortical buttons or high-strength sutures,reduce the need for secondary procedures.Arthroscopic-assisted open reduction and internal fixation benefits younger,active patients by enabling concurrent management of intra-articular and ligamentous injuries.Postoperative care prioritizes early weight-bearing and validated functional scores.Despite advances,complications remain common,and further research is needed to refine surgical strategies and improve outcomes.
基金approved by Institutional Review Board of Faculty of Medicine in Assiut University,No.04-2024-300470.
文摘BACKGROUND In an era leaning toward a personalized alignment of total knee arthroplasty,coronal plane alignment of the knee(CPAK)phenotypes for each population are studied;furthermore,other possible variables affecting the alignment,such as ankle joint alignment,should be considered.AIM To determine CPAK distribution in the North African(Egyptian)population with knee osteoarthritis and to assess ankle joint line orientation(AJLO)adaptations across different CPAK types.METHODS A cross-sectional study was conducted on patients with primary knee osteoarthritis and normal ankle joints.Radiographic parameters included the mechanical lateral distal femoral angle,medial proximal tibial angle,and the derived calculations of joint line obliquity(JLO)and arithmetic hip-knee-ankle angle(aHKA).The tibial plafond horizontal angle(TPHA)was used for AJLO assessment,where 0°is neutral(type N),<0°is varus(type A),and>0°is valgus(type B).The nine CPAK types were further divided into 27 subtypes after incorporating the three AJLO types.RESULTS A total of 527 patients(1054 knees)were included for CPAK classification,and 435 patients(870 knees and ankles)for AJLO assessment.The mean age was 57.2±7.8 years,with 79.5%females.Most knees(76.4%)demonstrated varus alignment(mean aHKA was-5.51°±4.84°)and apex distal JLO(55.3%)(mean JLO was 176.43°±4.53°).CPAK types I(44.3%),IV(28.6%),and II(10%)were the most common.Regarding AJLO,70.2%of ankles exhibited varus orientation(mean TPHA was-5.21°±6.45°).The most frequent combined subtypes were CPAK type I-A(33.7%),IV-A(21.5%),and I-N(6.9%).A significant positive correlation was found between the TPHA and aHKA(r=0.40,P<0.001).CONCLUSION In this North African cohort,varus knee alignment with apex distal JLO and varus AJLO predominated.CPAK types I,IV,and II were the most common types,while subtypes I-A,IV-A,and I-N were commonly occurring after incorporating AJLO types;furthermore,the AJLO was significantly correlated to aHKA.
文摘BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.
基金supported by the Fund for 2023 Heilongjiang Provincial Health Commission Science and Technology Plan(No.20230404070193).
文摘Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall joint flexibility.At the same time,frozen or hardened ground surfaces heighten impact forces while impairing the body's shock-absorption and adaptive response mechanisms.As a result,injuries such as ankle sprains(ligament tears),tendonitis,and stress fractures become more prevalent.Prevention is therefore essential and should focus on comprehensive warm-up routines,use of thermal and supportive equipment-including ankle braces-selection of footwear with adequate traction,and timely replacement of damp socks after exercise to maintain foot warmth and dryness.
文摘BACKGROUND Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness.Preliminary evidence has shown that blood flow restriction(BFR)rehabilitation can increase muscle strength and stability,helping to restore physical function and prevent repeated injury.AIM To determine whether BFR is more effective than traditional rehabilitation in improving muscle strength,size,and stability after foot and ankle injury.METHODS A systematic review and meta-analysis were performed.Articles were retrieved from MEDLINE,EMBASE,and CENTRAL databases.Included studies compared the effectiveness of BFR rehabilitation to traditional foot and ankle rehabilitation exercises.Eligible patients were those with a history of foot or ankle injury.Muscle strength,size,and dynamic balance were assessed by comparing impro vements in peak torque,cross-sectional area,and percent muscle activation.Methodological quality assessments were performed using the PEDro scale and Methodological Index for Non-Randomized Studies(MINORS).RESULTS Ten studies met the inclusion criteria.Five studies were of good to excellent quality according to the PEDro scale,and 5 studies were of moderate quality as per the MINORS criteria.Two studies compared the effect of BFR and non-BFR rehabilitation on muscle strength;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Two studies analyzed muscle activation following BFR and non-BFR rehabilitation;the overall mean difference between the BRF and non-BFR groups was 0.09[95%CI:(0.05,0.12),P<0.0001].Data on dynamic balance was synthesized from two studies;the mean difference between the BFR and control groups was 1.23[95%CI:(-1.55,4.01);P=0.39].CONCLUSION BFR rehabilitation is more effective than non-BFR rehabilitation at improving muscle strength and activation following foot and ankle injury.Additional studies are needed to develop a standardized BFR training protocol.
文摘Ankle snapping occurs when tendons or retinacular structures abruptly move or slip over adjacent anatomical structures,often due to anatomical variations,pathological conditions,or acute injury.This phenomenon can cause pain and discomfort,ranging from mild irritation to debilitating symptoms that potentially disrupt daily activities and athletic pursuits.Considering the anatomy of the ankle,these snapping phenomena can be categorized into four regional groups:(1)Lateral;(2)Medial;(3)Anterior;and(4)Posterior.Lateral ankle snapping,a common occurrence,typically results from peroneal tendon subluxation due to compromise of the superior and inferior peroneal retinacula,or from intrasheath subluxation,characterized by abnormal tendon motion within an otherwise intact retromalleolar groove and retinaculum.Medial ankle snapping primarily affects the posterior tibial tendon and can involve the flexor digitorum longus tendon.Anterior ankle snapping results from abnormal gliding of the tibialis anterior tendon,extensor digitorum longus tendon,peroneus tertius tendon,and inferior extensor retinaculum.Posterior ankle snapping typically involves the plantaris tendon and flexor hallucis longus(hallux saltans).This mini-review comprehensively explores these snapping phenomena and their related pathologies in the foot and ankle,emphasizing the crucial roles of anatomical knowledge,thorough clinical assessment,and appropriate diagnostic and treatment approaches.
文摘BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion deficits.Strengthening programs targeting evertor/invertor and dorsiflexor/plantar flexor balance help reduce injury recurrence.Bilateral neuromuscular deficits compromise the contralateral side,rendering healthy limbs unsuitable as recovery references.Defining normative healthy ankle parameters is crucial for establishing precise limits in nonsurgical treatments and sports return criteria.While the limb symmetry index(LSI)is used for knees with a cutoff of>90%,no such standardization exists for the ankle.AIM To comprehensively evaluate isokinetic ankle strength profiles in non-athletic individuals.METHODS This is a cross-sectional study.Two hundred ankles were evaluated using the Biodex 3 System to assess eversion,inversion,dorsiflexion,and plantar flexion.Healthy individuals with an active lifestyle and no previous injuries were evaluated.The Maximum Torque,Agonist/Antagonist Ratio,LSI,and Muscular Deficiency Index(MDI)and the correlation with demographic variables were evaluated.RESULTS The mean age(mean±SD)was 38.5±13.5 years,and the body mass index(BMI)was 25.8±4.2 in 69 men and 31 women.The mean maximum torque values by gender were(mean±SD):22.3±6.6 female(F)and 33.4±9.9 male(M)N/m for eversion;30.10±10.0(F)and 37.0±11.6 N/m(M)for inversion,37.4±10.0(F)and 53.6±13.0 N/m(M)for dorsiflexion,and 100.4±37.2(F)and 158.1±33.4(M)N/m for flexion.There was no correlation between age or BMI and maximum torque.The evertors/invertors ratio was 88.8%,and the dorsiflexors/plantar flexors ratio was 36.1%.The MDI and LSI were balanced between sides for every movement,having an average global difference of less than 10%.CONCLUSION These findings provide gender-specific normative isokinetic values for the ankle in healthy,physically active adults.These reference parameters—especially LSI and MDI above 90%—can support clinical decision-making in rehabilitation planning and return-to-sport assessment,offering objective benchmarks for functional recovery.
文摘BACKGROUND Psychological comorbidities,such as anxiety and depression,in patients with chronic ankle instability(CAI)may impede ankle function improvement,although the precise nature of this association warrants further investigation.AIM To analyze the correlation of anxiety and depression with ankle function in patients with CAI and discussing the risk factors.METHODS This study included 116 patients with CAI,who were admitted to our hospital from July 2022 to July 2024.Anxiety and depression states of patients were assessed with the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively,and their ankle joint function was assessed with the anklehindfoot function score of the American Orthopedic Foot and Ankle Society.Further,the ankle function of patients with CAI with different anxiety and depression states was discussed.Furthermore,the Pearson correlation coefficient was used to analyze the correlation of anxiety and depression with ankle joint function in such patients.Univariate and multivariate analyses were conducted to investigate the factors affecting ankle joint function in patients with CAI.RESULTS Among the 116 patients with CAI,97,13,5,and 1 cases demonstrated none,mild,moderate,and severe anxiety,whereas 95,15,6,and 0 cases showed none,mild,moderate,and severe depression,respectively.The average ankle joint function score was 74.82±6.93 points.The ankle joint function in patients with CAI presented a significant downward tendency as the degree of anxiety and depression increased.Correlation analysis revealed that both the SAS and SDS scores of patients with CAI were significantly negatively correlated with the ankle joint function score.Univariate and multivariate analyses indicated that the risk factors affecting patients’ankle joint function included early functional rehabilitation,visual analog scale,and SDS.CONCLUSION A substantial number of patients with CAI suffer from anxiety and depression,and these negative emotions,to a certain extent,harm the smooth rehabilitation of ankle joint function.
基金supported by the General Administration of Sport of China(23QN009)the National Natural Science Foundation of China(12102235)。
文摘Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.
基金supported in part by DeRoyal Industries, Inc.,Powell,TN,USA
文摘Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop landing activity in subjects with chronic ankle instability (CAI)compared to healthy subjects with no history of CAI.Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects,respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace ( NB),ElementTM brace and ASO brace.Simultaneous recording of three-dimensional kinematic (240 Hz)and GRF (1200 Hz) data were performed.Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of ElementTM against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy coutrols.The ASO brace reduced the first peak vertical GRF whereas ElementTM increased 2nd peak vertical GRF.ElementTM brace reduced eversion range of motion (ROM) and peak eversion velocity compared to NB and ASO.In addition,ElementTM reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO.Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for ElementTM.
基金supported by a National Health and Medical Research Council(NHMRC)Investigator Grant Emerging Leadership Level 1(Grant No.2017012).
文摘Purpose We aimed to investigate the effects of running shoe longitudinal bending stiffness(LBS)and midsole energy return on running economy and ankle mechanics and energetics.Methods PubMed,Scopus,SPORTDiscus,Embase,CINAHL,and Web of Science were systematically searched for this meta-analysis.Crossover studies comparing the effects of running shoe LBS and/or midsole energy return on at least 1 of the following outcomes:running economy,ankle plantarflexion moment,work,power,or angular velocity were included.Results Of the 2453 studies screened,48 were included(n=878).Results indicated that advanced footwear technologies(AFTs)significantly reduced oxygen consumption(standardized mean difference=–0.44,95%confidence interval:–0.60 to–0.28),p<0.001)as well as peak ankle moments and positive/negative ankle work and power.However,neither LBS nor midsole energy return alone significantly affected oxygen consumption,ankle moments,positive and negative work,or positive power.The effects of AFTs were moderated by the training status and speed of the runner.The quality of evidence for all outcomes were low or very low for all outcomes except the effect of LBS on negative ankle work.Conclusion AFT may improve running economy by minimizing ankle moments,work,and power.The absence of significant independent effects of LBS and midsole energy return suggests that the benefits of AFTs arise from the interaction of these properties.Further research is necessary to understand the mechanisms for improved running performance in AFTs.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
文摘BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.
基金the National Natural Science Foundation of China(No.52075264)。
文摘With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.
文摘BACKGROUND Arabic-speaking patients are underrepresented in orthopedic clinical studies,particularly in foot and ankle trauma research.The lack of validated Arabic language tools hinders their inclusion,creating a need for culturally and linguistically adapted instruments.The American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire(AAOS-FAOQ)is a widely used tool but has not been adapted for Arabic-speaking patients.AIM To translate,cross-culturally adapt,and validate the AAOS-FAOQ for Arabicspeaking patients with traumatic foot and ankle injuries.METHODS The cross-cultural adaptation followed established guidelines,involving forward and backward translations,expert review,and pre-testing.The final Arabic version was administered alongside the Arabic Short-Form 36(SF-36)to 100 patients for validity testing.Reliability was assessed through test-retest methods with 20 patients completing the questionnaire twice within 48 hours.Pearson correlation coefficients measured convergent and divergent validity with SF-36 subscales,while Cronbach's alpha and intraclass correlation coefficients(ICC)determined internal consistency and reliability.RESULTS Out of 100 patients,92 completed the first set of questionnaires.The Arabic AAOS-FAOQ showed strong correlations with the SF-36 subscales,particularly in physical function and bodily pain(r>0.6).Test-retest reliability was robust,with ICCs of 0.69 and 0.66 for the Global Foot and Ankle Scale and Shoe Comfort Scale,respectively.Cronbach's alpha for internal consistency ranged from 0.7 to 0.9.CONCLUSION The Arabic version of the AAOS-FAOQ demonstrated validity and reliability for use in Arabic-speaking patients with traumatic foot and ankle injuries.This adaptation will enhance the inclusion of this population in orthopedic clinical studies,improving the generalizability of research findings and patient care.
基金supported by the funded project(HYZHX M05005)in the field of space medical experiments of manned spaceflight engineering.
文摘Objective:To evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation(TEAS)for muscle atrophy in patients with immobilization after surgical fixation of foot and ankle fractures.Methods:This was a two-arm randomized controlled trial wherein 80 patients were recruited and divided into control(n=40)and intervention(n=40)groups.The control group received conventional orthopedic treatment,whereas the intervention group received TEAS and conventional treatment.The intervention group received TEAS 3 times a week for 30 min each time for 8 weeks.The primary out-comes were muscle thickness(MT)and cross-sectional area(CSA)of the rectus femoris and gastroc-nemius muscles,whereas the secondary outcome measure was echo intensity(EI).Data were collected before the fixation operations(baseline assessment)and 4 and 8 weeks after intervention.Results:Compared with baseline,the MT and CSA were reduced in both groups by the end of treatment,whereas EI increased in both groups.At week 4,the reduction in the rectus femoris CSA in the inter-vention group was significantly lower than that in the control group(P=0.02);however,the between-group differences in the MT and EI(all P>0.05)were not significant.No serious adverse events were observed in either group.Conclusion:Our study showed that TEAS can improve muscle atrophy by attenuating the decline in the muscle CSA.Because this was only a pilot trial,subsequent studies will need longer follow-ups and larger sample sizes.
文摘Background:Early weight bearing can accelerate the recovery of ankle function,but the timing of weight bearing has not been clarifi ed.In this study,the effi cacy and safety of weight-bearing at 1 week and 4 weeks after ankle fracture were further investigated.Methods:Forty-six postoperative ankle fracture patients were enrolled and divided into 1-week group(23)and 4-week group(23)according to randomized numerical table method.All patients underwent routine rehabilitation.On this basis,weight-bearing was started at 1 week after surgery in the 1-week group and at 4 weeks after surgery in the 4-week group.Both groups underwent a 6-week trial intervention.Ankle pain and function were assessed by VAS,AOFAS,and OMAS scales at 2,4,and 6 weeks after treatment.Results:There was no statistically signifi cant diff erence in the general data of patients in the 2 groups before surgery(P>0.05).At 2 weeks postoperatively,the VAS of the 1-week group was higher than that of the 4-week group,and the scores of the Pain item in AOFAS and Swelling item in OMAS were lower than that of the 4-week group.At 4 weeks postoperatively,the VAS was higher in the 1-week group than in the 4-week group.At 6 weeks postoperatively,the VAS was lower in the 1-week group than in the 4-week group,and the scores of the Pain,Maximum walking distance,and Sagittal motion items in the AOFAS,and the scores of the Stiff ness and Swelling items in the OMAS were higher than in the 4-week group.Conclusions:A rehabilitation strategy of early weight-bearing implemented 1 week after surgery in patients with ankle fractures can eff ectively reduce the degree of ankle stiff ness and accelerate the recovery of ankle function in patients.
基金the National Traditional Chinese Medicine Inheritance and Innovation Team Project:Traditional Chinese Medicine Innovation Team for Prevention and Treatment of Bone and Joint Degenerative Diseases (No. ZYYCXTD-C-202003)National Natural Science Foundation of China:the study on the Quantification and Mechanism of the rotating-pulling-poking manipulation in the Treatment of Lateral Ankle Sprain (No. 81473694)China Academy of Chinese Medical Sciences Science and Technology Innovation Project:Establishment and Promotion of a Simulation Operation Evaluation System for Rotating-pulling-poking Manipulation (CI2021A02015)。
文摘OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation. METHODS:Forty patients with lateral ankle sprains were randomly divided into two groups in a 1∶1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment. RESULTS:Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment(P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment(P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group(P < 0.05). CONCLUSIONS:The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.
文摘Objective:This study investigates the effect of orthopedic nursing in patients with ankle fractures.Methods:A total of 84 patients with ankle fractures treated in our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 42 cases in each group.The control group received routine nursing,while the observation group received orthopedic nursing clinical pathway on the basis of traditional nursing.We analyzed and scored the nursing satisfaction and nursing effect of the two groups.Results:Compared with the control group,the observation group had a higher total nursing satisfaction rate,shorter time to get out of bed,shorter hospital stay,and lower hospitalization cost.The Barid score and AOFAS score of the observation group were higher than those of the control group,while the NRS score was lower.Conclusion:The application of orthopedic nursing clinical pathway in patients with ankle fractures significantly improves their quality of life,promotes better recovery of ankle function,and shortens the rehabilitation time.
基金supported by a Ph.D.scholarship from Najran University in Najran,Saudi Arabia
文摘Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI characteristics.Methods'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic regression.Results'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p < 0.001, OR = 53& 95% confidence interval (CI): 3.84—7.53). Perceived ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p < 0.001;age: /2 = 30.37,p < 0.001;unilateral ankle sprains: /2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders.Conclusion-. The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap incurrent knowledge about the impact of pain in people with CAI, and this topic needs further investigation.
