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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_11 | Pages 3 - 3
1 Jun 2017
Tennant S Douglas C Thornton M
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Purpose

This study aimed to objectively define gait derangements and changes before and after Tibialis Anterior Tendon Transfer surgery in a group of patients treated using the Ponseti method.

Methods

21 feet in 13 patients with Ponseti treated clubfoot who showed supination in swing on clinical examination, underwent gait analysis before, and approximately 12 months after, Tibialis Anterior Tendon transfer. 3–4 weekly casts were applied prior to the surgery, which was performed by transfer of the complete TA tendon to the lateral cuneiform. A parental satisfaction questionnaire was also completed.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_13 | Pages 68 - 68
1 Mar 2013
Aftab S Davis S Smitham P Thornton M McCarthy I Goldberg A
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Axial musculoskeletal control (AMC) is a widely used concept and has been shown to be an important factor in physical performance, the pathophysiology of back pain and other MSK conditions. However, there is no agreement on a definition of AMC, nor a validated test for AMC and its application in clinical practice. Our aim was to develop a test for AMC using the Delphi method from a panel of experts with video and analysis of the footage. We found that the most commonly used tests were the maintenance of neutral pelvic position in single leg stance, single leg stance with eyes closed and single leg squat. We aim to further validate our findings by comparing this to surface EMG recordings and centre of gravity measurements in stress situations.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_13 | Pages 3 - 3
1 Mar 2013
Monda MK Goldberg A Richards R Smith A Smitham P Thornton M McCarthy I
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We have investigated whether a system of four inertial measurement units (IMUs) attached to the segments of the lower limbs could provide useful information about the kinematics of limb segment movement in gait in a healthy population. Four IMUs were attached to participants over their clothes. Participants then walked at their self-selected speed for 10 metres along a corridor and back. IMUs were removed, data downloaded on to a computer and ranges of motion were calculated for thigh, calf and knee, in addition to stride duration. 128 participants were recruited aged 18–97. There was little variation in most angle parameters up to age of 80. The relationships between angle and age are non-linear. There was a slight increase in stride duration with age of about 0.1% per year. The study concentrated on active subjects, with no specific co-morbidities that might affect gait. Results obtained may represent what is achievable for any given age, and approximate to changes that occur due to primary ageing. We propose that, after the age 80, peak muscle power declines below a threshold, such that muscular activity required to move a limb approaches the peak power available, and that it is the decline in peak muscle power that ultimately limits gait in active older people. Walking ability is important in maintaining independence as people age. It would be more effective to encourage exercises to maintain normal gait at a much earlier age. Deviations from the normal range could be identified early, and appropriate intervention given.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVI | Pages 70 - 70
1 Aug 2012
Monda M McCarthy I Thornton M Smitham P Goldberg A
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Introduction

Knowledge of knee kinetics and kinematics contributes to our understanding of the patho-mechanics of knee pathology and rehabilitation and a mobile system for use in the clinic is desirable.

We set out to assess validity and reliability of ambulatory Inertial Motion Unit (IMU) Sensors (Pegasus¯) against an established optoelectronic system (CODA¯).

Pegasus¯ uses inertial sensors placed on subjects' thighs and lower leg segments to directly measure orientation of these segments with respect to gravity. CODA¯) models the position of joint centres based on tracked positions of optical markers placed on a subject, providing 3D kinematics of the subject's hips, knees and ankles in all three planes.

Methods

Intra observer reliability of the Pegasus¯ system was tested on 6 volunteers (4 male; 2 female) with no previous lower limb or knee pathology. IMU's were placed on the long axis of the lateral aspects of both thighs and lower leg segments. A test re-test protocol was used with sagittal data angle collected around a standard circuit.

Inter-observer reliability was tested by placement of IMU's by 5 different testers on a single volunteer.

To test validity, we collected simultaneous sagittal knee angle data from Pegasus¯ and CODA¯ in two subjects. The presence of IMU's did not compromise positioning of optical markers.