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Integration of Wearable Sensors Into the Evaluation of Running Economy and Foot Mechanics in Elite Runners.
Muniz-Pardos, B, Sutehall, S, Gellaerts, J, Falbriard, M, Mariani, B, Bosch, A, Asrat, M, Schaible, J, Pitsiladis, YP
Current sports medicine reports. 2018;(12):480-488
Abstract
Running economy, known as the steady-state oxygen consumption at a given submaximal intensity, has been proposed as one of the key factors differentiating East African runners from other running communities around the world. Kenyan runners have dominated middle- and long-distance running events and this phenomenon has been attributed, in part at least, to their exceptional running economy. Despite such speculation, there are no data on running mechanics during real-life situations such as during training or competition. The use of innovative wearable devices together with real-time analysis of data will represent a paradigm shift in the study of running biomechanics and could potentially help explain the outstanding performances of certain athletes. For example, the integration of foot worn inertial sensors into the training and racing of athletes will enable coaches and researchers to investigate foot mechanics (e.g., an accurate set of variables such as pitch and eversion angles, cadence, symmetry, contact and flight times or swing times) during real-life activities and facilitate feedback in real-time. The same technological approach also can be used to help the athlete, coach, sports physician, and sport scientist make better informed decisions in terms of performance and efficacy of interventions, treatments or injury prevention; a kind of "telesport" equivalent to "telemedicine." There also is the opportunity to use this real-time technology to advance broadcasting of sporting events with the transmission of real-time performance metrics and in doing so enhance the level of entertainment, interest, and engagement of enthusiasts in the broadcast and the sport. Such technological advances that are able to unobtrusively augment personal experience and interaction, represent an unprecedented opportunity to transform the world of sport for participants, spectators, and all relevant stakeholders.
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2.
Plantar pressure measurements and running-related injury: A systematic review of methods and possible associations.
Mann, R, Malisoux, L, Urhausen, A, Meijer, K, Theisen, D
Gait & posture. 2016;:1-9
Abstract
Pressure-sensitive measuring devices have been identified as appropriate tools for measuring an array of parameters during running. It is unclear which biomechanical characteristics relate to running-related injury (RRI) and which data-processing techniques are most promising to detect this relationship. This systematic review aims to identify pertinent methodologies and characteristics measured using plantar pressure devices, and to summarise their associations with RRI. PubMed, Embase, CINAHL, ScienceDirect and Scopus were searched up until March 2015. Retrospective and prospective, biomechanical studies on running using any kind of pressure-sensitive device with RRI as an outcome were included. All studies involving regular or recreational runners were considered. The study quality was assessed and the measured parameters were summarised. One low quality, two moderate quality and five high quality studies were included. Five different subdivisions of plantar area were identified, as well as five instants and four phases of measurement during foot-ground contact. Overall many parameters were collated and subdivided as plantar pressure and force, plantar pressure and force location, contact area, timing and stride parameters. Differences between the injured and control group were found for mediolateral and anteroposterior displacement of force, contact area, velocity of force displacement, relative force-time integral, mediolateral force ratio, time to peak force and inter-stride correlative patterns. However, no consistent results were found between studies and no biomechanical risk patterns were apparent. Additionally, conflicting findings were reported for peak force in three studies. Based on these observations, we provide suggestions for improved methodology measurement of pertinent parameters for future studies.
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3.
Vancouver Experience of Recombinant Human Platelet-Derived Growth Factor.
Younger, A, Penner, M, Montijo, HE
Foot and ankle clinics. 2016;(4):771-776
Abstract
Joint arthrodesis utilizing autogenous bone graft remains the gold standard of treatment in fusion procedures of the foot and ankle. Graft harvest, however, has been associated with increased morbidity to patients as well as increased costs. With this in mind, multiple clinical studies have evaluated the efficacy of recombinant human platelet-derived growth factor (rh-PDGF-BB) with beta-tricalcium phosphate (B-TCP) to augment in foot and ankle arthrodesis with favorable results. These factors have led to the increased use of rh-PDGF-BB with B-TCP in Vancouver with good clinical results.
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4.
Efficacy of preparation solutions and cleansing techniques on contamination of the skin in foot and ankle surgery: A systematic review and meta-analysis.
Yammine, K, Harvey, A
The bone & joint journal. 2013;(4):498-503
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Abstract
We report a systematic review and meta-analysis of published randomised and quasi-randomised trials evaluating the efficacy of pre-operative skin antisepsis and cleansing techniques in reducing foot and ankle skin flora. The post-preparation culture number (Post-PCN) was the primary outcome. The data were evaluated using a modified version of the Cochrane Collaboration’s tool. We identified eight trials (560 participants, 716 feet) that met the inclusion criteria. There was a significant difference in the proportions of Post-PCN between hallux nailfold (HNF) and toe web spaces (TWS) sites: 0.47 vs 0.22, respectively (95% confidence interval (CI) 0.182937 to 0.304097; p < 0.0001). Meta-analyses showed that alcoholic chlorhexidine had better efficacy than alcoholic povidone-iodine (PI) at HNF sites (risk difference 0.19 (95% CI 0.08 to 0.30); p = 0.0005); a two-step intervention using PI scrub and paint (S&P) followed by alcohol showed significantly better efficacy over PI (S&P) alone at TWS sites (risk difference 0.13 (95% CI 0.02 to 0.24); p = 0.0169); and a two-step intervention using chlorhexidine scrub followed by alcohol showed significantly better efficacy over PI (S&P) alone at the combined (HNF with TWS) sites (risk difference 0.27 (95% CI 0.13 to 0.40); p < 0.0001). No significant difference was found between cleansing techniques.
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5.
Recombinant human PDGF-BB in foot and ankle fusion.
DiGiovanni, CW, Lin, S, Pinzur, M
Expert review of medical devices. 2012;(2):111-22
Abstract
Autogenous bone graft (autograft) is currently the gold standard for augmenting bone repair and fusion procedures of the foot and ankle. The time, cost and morbidity involved in obtaining autograft, however, are well documented and legitimate concerns remain surrounding this intervention. Endogenous human PDGF is chemotactic and mitogenic for osteoblasts and undifferentiated osteoprogenitor cells, and upregulates expression of cytokines necessary for osseous and soft tissue healing and regeneration. The BB isoform of PDGF, and the biosynthetic replica recombinant human PDGF-BB, is a key regulatory molecule in bone homeostasis, repair and regeneration. When combined with a β-tricalcium phosphate osteoconductive matrix, recombinant human PDGF-BB mitigates a number of problems associated with the use of autograft and, based on its preclinical performance and early clinical success, appears to be an equally effective and perhaps an even safer alternative to autograft for foot and ankle fusion (arthrodesis) procedures.
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Use of poly(ether ether ketone) cages in foot and ankle surgery.
Niño Gomez, D, Eslava, S, Federico, A, Diego, Y, Arrondo, G, Joannas, G
Foot and ankle clinics. 2012;(3):449-57
Abstract
PEEK cages are an effective alternative when structural bone graft is needed for different fusions around the foot and ankle. Bone fusion rates are high when PEEK cages are filled with autologous bone. No difference in consolidation time in patients was noticed between the cages fixed with staples and those fixed with cannulated screws. Nerve damage, residual pain at the donor site, and cosmetic problems are avoided with the use of PEEK cages. There is no risk of transmission of hepatitis B, hepatitis C, and HIV when using PEEK cages.
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Stem cells in bone grafting: Trinity allograft with stem cells and collagen/beta-tricalcium phosphate with concentrated bone marrow aspirate.
Guyton, GP, Miller, SD
Foot and ankle clinics. 2010;(4):611-9
Abstract
The orthopedic foot and ankle surgeon needs bone grafts in the clinical situation of fracture healing and in bone-fusion procedures. This article briefly outlines thought processes and techniques for 2 recent options for the surgeon. The Trinity product is a unique combination of allograft bone and allograft stem cells. The beta-tricalcium phosphate and collagen materials provide an excellent scaffold for bone growth; when combined with concentrated bone marrow aspirate, they also offer osteoconductive and osteoinductive as well as osteogenerative sources for new bone formation.
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High-risk foot and ankle patients.
Padanilam, TG, Donley, BG
Foot and ankle clinics. 2003;(1):149-57
Abstract
The surgical treatment of complicated foot and ankle problems requires recognition and appreciation of patient and disease characteristics that may compromise surgical results. Appropriate patient selection is an important factor in obtaining a successful outcome. Modulation and management of these patient characteristics are critical in minimizing complications that are associated with treatment.
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Current trends in preoperative patient evaluation and management for podiatric surgeons.
Skully, R, Beasley, CA, Lutz, KW
Clinics in podiatric medicine and surgery. 2003;(2):213-35, vii
Abstract
In preparation for elective foot and ankle surgery, the podiatric surgeon often will refer the patient for a preoperative evaluation. Surgeons rely on the input of that consultant to provide a determination as to the operative risk for the patient. This article reviews the fundamental parts of the preoperative evaluation, perioperative patient management, and recent changes and trends within this arena.
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10.
Perioperative pain control.
Davy, TA, Sharp, C, Lynch, S
Clinics in podiatric medicine and surgery. 2003;(2):257-67
Abstract
There are many options for perioperative pain control available to surgeons. Given these options, adequate levels of analgesia should be achieved and maintained in all surgical patients. Data suggest that analgesia may be improved by combining different analgesic approaches. To avoid high-dose requirements, dose-dependent adverse effects, and potential toxicity associated with reliance on one agent or technique, "balanced" or multimodal analgesic regimens have been advocated. A multimodal recovery program consists of three major components: (1) early mobilization, (2) complete perioperative analgesia, and (3) early oral nutrition. The goal of multimodal programs is to accelerate patient rehabilitation and reduce hospital stays. Balanced multimodal programs are the present and future of perioperative pain control and will enhance patient care.