Shank rotation is associated with increased risk in lower limb injuries of weight-bearing sport activity. Straight-line running injury prevention research proposes a 'bottom-up' approach to minimising injury risk to the knee. This prophylactic recommendation is due to the observed distal-proximal coupling relationship between rearfoot and shank rotations. However, the coupling relationship between the calcaneus and shank is unknown in sports with high intensity decelerations, frequent changes of direction, associated with increased anterior cruciate ligament (ACL) injury risk. The aim of this study was to determine whether the movement of the calcaneus has a potential effect on the internal and external rotational movement of the shank, associated with ACL injury risk. We implemented a modified vector coding technique using segmental velocities in a local, anatomical reference frame to quantify the coupling relationship between the individual tri-planar calcaneus rotations and transverse plane shank rotations. During the loading phase, a distal-proximal coupling relationship between calcaneus eversion deceleration, abduction acceleration, and shank internal rotation deceleration was observed amongst most subjects. The distal-proximal coupling found between the calcaneus and shank justifies exploring interventions geared towards manipulating calcaneus motion to affect shank rotational movements during unanticipated change of direction tasks associated with ACL injury risk.
Thoroughbred racehorses are often affected by musculoskeletal injuries, leading to involuntary rest, early retirement or death. Hardness and consistency of the track surface have been implicated as major risk factors for limb injury. The purpose was to test the utility of a preliminary AnyBody musculoskeletal model of the equine forelimb for its responses on two perturbing surfaces. A musculoskeletal model was developed using CT, muscle, tendon and ligament properties, and kinematic data were applied from ridden trials using five Thoroughbred horses. Horses were ridden at trot and canter on a baseline sand surface, and through two perturbation pits containing a harder and a softer surface for one stance phase. In response to the hard perturbation, the proximal limb was more compliant at trot and canter, as measured by increased shoulder flexion in the perturbed stance phase and increased elbow and carpal flexion in the subsequent swing phase. The suspensory ligaments and muscle-tendon units were less strained while lacertus fibrosus was more strained. In response to the soft perturbation, the coffin joint was more flexed and the elbow was more extended in the acute stance phase at trot, resulting in increased strain to the DDF, extensor branches and lacertus fibrosus. At canter, the coffin was more flexed, the fetlock less hyperextended and so the suspensory structures were less strained in the perturbed stance phase, but more strained in the second stance phase. Changes in ground surface affect both the perturbed stance phase, and the following stance phase.
Background and objectives: The active and passive structures of the foot act in unison to not only be compliant enough to assist in ground reaction force attenuation but also resist deformation to provide a stable base of support. A foot that is unable to adjust to the imposed demands during high-intensity sporting activities may alter the moments and forces acting on the joints, increasing the risk of non-contact anterior cruciate ligament ruptures (ACLR) and lateral ankle sprains (LAS). Prophylactic strengthening programs are often used to reduce the risk of these injuries, but at present, very few prophylactic programs include foot-specific strengthening strategies. The aim of this theoretical review is to ascertain the prophylactic role strengthening muscles acting on the foot may have on ACLR and LAS injury risk. Methods: Literature relating to risk factors associated with ACLR and LAS injury and the anatomy and biomechanics of normal foot function was searched. In addition, ACLR and LAS injury prevention programs were also sought. A theoretical, narrative approach was followed to synthesize the information gathered from the articles. Results: The foot segments are governed by the congruity of the articulations and the activity of the foot muscles. As such, there is a coupling effect between shank, calcaneus, midfoot, and hallux movement which play a role in both ACLR and LAS injury risk. Conclusions: Strengthening the muscles acting on the foot may have a significant impact on ACLR and LAS injury risk.
Musculoskeletal injuries in horses are the main cause of retirement, rest, and death. To understand these injuries, it is necessary to study loads in muscles, tendons and ligaments. A musculoskeletal model makes it possible to consider all structures simultaneously and avoids invasive measurements. At present, most computational models of the equine limb described in the literature have been limited to the distal limb. The aim of this study was to create a preliminary musculoskeletal model of the whole equine forelimb and to run it with kinematic data collected during gait. The model was developed with the AnyBody Modelling System. It includes six limb segments, 11 muscle groups and 17 ligaments. Kinematic data were collected from the right forelimb of four Thoroughbreds at trot, right and left lead canter, and were then used in the model to compute sagittal plane joint excursions and ligament and tendon strains. The modelled joint excursions were in reasonable agreement with previous reports in the literature despite breed, gait and surface differences. Strain patterns of the tendons of the suspensory apparatus agreed with the literature, with maxima in mid-stance or at the end of stance. Strains in the distal palmar ligaments peaked in mid-stance, while strain in lacertus fibrosus peaked at the stance-swing transition. Tendon and ligament strains at canter were greatest when the measured forelimb was the trailing limb. Strain amplitudes varied against earlier models and these differences are discussed in relation to variations in methods, and especially in relation to attachment points of tendons and ligaments.
During transport, horses are subjected to acceleration in three dimensions, rapid braking, turning, noise, and other stressors. The animal's ability to make postural corrections may be insufficient to prevent injury or distress, and so knowledge of the compensatory motion patterns of the horse in the trailer is a necessary precondition for smart design of transport systems. A custom two-horse trailer was built for this project. It had a horse compartment 1.85 m wide by 3.95 m long, with adjustable bulkheads and a centre divider separating the horses. The floor was instrumented with 24 shearbeam load cells to measure the vertical load imposed by each horse and its horizontal motion. Two horses were driven on a 56 km trip on both rural and urban roads. Load data were collected at 100 Hz for the 58-minute trip and were filtered with a cut-off frequency of 5 Hz using a Butterworth low-pass filter and then vertical acceleration computed. A pivot table counted sign reversals in the vertical acceleration signal, and vertical displacement was calculated using the fundamental frequency of the resulting acceleration data. Total vertical motion was calculated by making the negative displacements absolute and summing these with the positive displacements, and vertical work done was calculated by multiplying the force by the displacement measures. Horizontal motion was calculated by averaging the transverse and cranio-caudal position of the centre of pressure every second and adding the resultant displacements. Absolute vertical displacement of the two horses was 69.55 m and 97.56 m. In addition to the work done by standing, vertical work done in response to vibration was 322.4 kJ and 443.2 kJ. Horizontal excursion was 227.1 m and 243.0 m. This is a first effort to quantify the additional workload imposed on animals during transport, which will aid in the design of smart transport vehicles that will minimize the stress to horses.
Accelerometry has been used to measure treatment efficacy in dogs with osteoarthritis, although interpretation is difficult. Simplification of the output into speed or gait categories could simplify interpretation. We aimed to determine whether collar-mounted accelerometry could estimate the speed and categorise dogs' gait on a treadmill. Eight Huntaway dogs were fitted with a triaxial accelerometer and then recorded using high-speed video on a treadmill at a slow and fast walk, trot, and canter. The accelerometer data (delta-G) was aligned with the video data and records of the treadmill speed and gait. Mixed linear and logistic regression models that included delta-G and a term accounting for the dogs' skeletal sizes were used to predict speed and gait, respectively, from the accelerometer signal. Gait could be categorised (pseudo-R2 = 0.87) into binary categories of walking and faster (trot or canter), but not into the separate faster gaits. The estimation of speed above 3 m/s was inaccurate, though it is not clear whether that inaccuracy was due to the sampling frequency of the particular device, or whether that is an inherent limitation of collar-mounted accelerometers in dogs. Thus, collar-mounted accelerometry can reliably categorise dogs' gaits into two categories, but finer gait descriptions or speed estimates require individual dog modelling and validation. Nonetheless, this accelerometry method could improve the use of accelerometry to detect treatment effects in osteoarthritis by allowing the selection of periods of activity that are most affected by treatment.
Preventing lateral ankle sprain injuries (LAS) in females competing in court sports is a high priority, as an athlete’s risk for re-injury and developing long term dysfunction increases significantly after sustaining an acute LAS. Stability to the ankle joint is passively provided by the joint congruity and ligaments, and actively by the muscles acting on the foot. The ankle joint is most stable when loaded and dorsiflexed. However, during unanticipated changes of direction, typical in court sports, the foot is often in a vulnerable unloaded, plantarflexed position. Stability of the forefoot and controlling rearfoot movement to avoid excessive ankle inversion and adduction thus becomes imperative. Information regarding the coupling relationship between the forefoot (hallux and metatarsal segments) and the rearfoot (calcaneus segment) during unanticipated changes of direction is lacking. The aim of this study was to supplement current LAS prophylactic knowledge by describing and quantifying hallux-calcaneus and metatarsal-calcaneus coupling. The coupling angles between sagittal plane hallux, tri-planar metatarsal and frontal- and transverse plane calcaneus movement, respectively, were calculated with a modified vector coding technique which used segmental velocities in a local, anatomical reference frame instead of segmental angles in a global reference frame. Coupling relationships revealed anti-phase movement between sagittal- metatarsal and frontal plane calcaneus movement throughout stance. During loading, sagittal- and frontal plane metatarsal acceleration/deceleration were coupled with frontal-transverse plane calcaneus acceleration/deceleration respectively. The remainder of the braking phase was characterized by calcaneus eversion deceleration. During propulsion, the hallux and metatarsal segments increased plantar flexion velocity in response to calcaneus inversion and adduction acceleration. As the forefoot was the only point of contact during stance, the coupling between segments were most likely neuromuscular. Strengthening intrinsic and extrinsic foot muscles may thus contribute to foot and ankle stability, adding to current prophylactic LAS strategies.
A case-control study with 6 months of patient follow up. This study sought to determine if surgery followed by rehabilitation for patellar instability could restore normal gait function. A previous study has established abnormalities in gait pattern and joint congruence in patients with a history of patellar instability. We hypothesised that surgery for patellofemoral instability would improve knee function. Eight human patients (mean age 29, range 17-42) who were awaiting patella stabilisation surgery (5 tibial tuberosity osteotomy, 2 medial patellofemoral ligament reconstruction, 1 trochleoplasty) were compared against eight normal Controls (mean age 28, range 19-31). Patients were assessed pre-operatively and six months after surgery by biomechanical gait analysis. Gait trials involved simultaneous collection of kinematic and force data. Patients were grouped into two subgroups pre-operatively based on knee joint net moment during stance, and their joint moments during stance pre- and post-operatively were compared against the Control subjects. In pre-operative gait analysis, four patients (P1) produced some extensor moment in early stance and four (P2) demonstrated a severe gait deficiency with failure to generate a knee extensor moment during stance. Normalisation in gait pattern was observed in all patients post-operatively. Those who had the most severe gait abnormality (P2) demonstrated the most improvement in their knee joint moments. Improvements were observed in the milder (P1) cases, but these were less dramatic. Patella stabilisation by surgery can restore normal gait function. Normalising the anatomy of the knee extensor mechanism is the objective of surgery. Normal anatomy facilitates the rehabilitation objectives of optimising extensor function during the weight-bearing phase of gait.
Affective states are key determinants of animal welfare. Assessing such states under field conditions is thus an important goal in animal welfare science. The rapid Defence Cascade (DC) response (startle, freeze) to sudden unexpected stimuli is a potential indicator of animal affect; humans and rodents in negative affective states often show potentiated startle magnitude and freeze duration. To be a practical field welfare indicator, quick and easy measurement is necessary. Here we evaluate whether DC responses can be quantified in pigs using computer vision. 280 video clips of induced DC responses made by 12 pigs were analysed by eye to provide ‘ground truth’ measures of startle magnitude and freeze duration which were also estimated by (i) sparse feature tracking computer vision image analysis of 200 Hz video, (ii) load platform, (iii) Kinect depth camera, and (iv) Kinematic data. Image analysis data strongly predicted ground truth measures and were strongly positively correlated with these and all other estimates of DC responses. Characteristics of the DC-inducing stimulus, pig orientation relative to it, and ‘relaxed-tense’ pig behaviour prior to it moderated DC responses. Computer vision image analysis thus offers a practical approach to measuring pig DC responses, and potentially pig affect and welfare, under field conditions.
OBJECTIVE To evaluate the elastic modulus of various ligaments of the forelimbs of cadaveric horses. SAMPLE 408 ligaments from 37 forelimbs of 10 Thoroughbred cadavers and cadavers of 9 other horse breeds. PROCEDURES Collateral ligaments and straight and oblique sesamoid ligaments were harvested from the proximal interphalangeal, metacarpophalangeal, carpal, and elbow joints of both forelimbs of all 19 horses. Ligament dimensions were measured, and the elastic modulus was determined by tensile testing the ligaments with a strain rate of 1 mm.s(-1). RESULTS Elastic modulus of the ligaments differed significantly among joints. Highest mean +/- SE elastic modulus was for the medial collateral ligament of the metacarpophalangeal joints of Thoroughbreds (68.3 +/- 11.0 MPa), and the lowest was for the lateral collateral ligament of the elbow joints of other breeds (2.8 +/- 0.3 MPa). Thoroughbreds had a significantly higher elastic modulus for the collateral ligaments of the proximal interphalangeal and metacarpophalangeal joints, compared with values for the other breeds. There was large variation in elastic modulus. Elastic modulus was negatively affected by age. In the ligaments in the distal aspect of the forelimbs, elastic modulus was negatively affected by height at the highest point of the shoulders (ie, withers). CONCLUSIONS AND CLINICAL RELEVANCE Cross-sectional area and elastic modulus of collateral ligaments in the forelimbs of equine cadavers differed between breeds and among joints, which may have been reflective of their relative physiologic function under loading during exercise.
Extracorporeal shockwave therapy (ESWT) is a novel therapeutic modality and its use in promoting connective tissue repair and analgesic effect has been advocated in the literature. It is convenient, cost-effective, and has negligible complications; it therefore bypasses many of the problems associated with surgical interventions. This paper reviews the proposed mechanisms of action in promoting tissue repair and regeneration as well as analysing its efficacy providing an analgesic effect in clinical applications. Further research will be required to not only identify the underlying mechanisms more precisely, but will also be critical for ensuring consistency across the literature so that the most beneficial treatment protocol can be developed. Extracorporeal shockwave therapy stands as a promising alternative modality in promoting tissue repair.
AIMS: To determine the frontal plane position of the ground reaction force vector at its centre of pressure under the hoof of walking horses, and its projection through the distal limb joints, and to relate this to hoof geometric measurements.METHODS: Reflective markers were glued to the forelimb hooves and skin of 26 horses, over palpable landmarks representing centres of the coffin, fetlock and carpal joints, and the dorsal toe at its most distal point. A 4-camera kinematic system recorded the position of these markers as the horse walked in hand across a force platform, to generate a frontal plane representation of the ground reaction force vector passing between the markers at the joints. The position of the vector was calculated as the relative distance between the lateral (0%) and medial (100%) markers at each joint. Digital photos were taken of the hoof in frontal and sagittal views to determine hoof geometric measurements. Associations between these and the position of the force vector at each joint were examined using Pearson correlation coefficients.RESULTS: Mean vector position for both forelimbs at the toe, coffin, fetlock and carpal joint was 50.1 (SD 8.9), 53.0 (SD 9.2), 54.6 (SD 11.4) and 50.5 (SD17.3)%, respectively, of the distance between the lateral and medial sides of the joint in the frontal plane. Across all four joints, the vector position was slightly more medial (2-4%) for the right than left limb (p>0.05). Medial hoof wall angle was correlated (p<0.05) with force vector position at the fetlock (r=-0.402) and carpal (r=-0.317) joints; lateral hoof wall angle with vector position at the toe (r=0.288) and carpal (r=-0.34) joint, and medial hoof wall height with vector position at the fetlock (r=-0.306) and carpal (r=-0.303) joints.CONCLUSION: The position of the two-dimensional frontal plane ground reaction force vector at the toe, and at the fetlock and carpal joints was associated with hoof shape. Mediolateral hoof balance has been shown in vitro to affect articular forces, which may be a factor in development of joint disease. The effect of hoof shape needs to be evaluated at faster gaits to determine the potential for joint injury in the presence of larger forces.
PURPOSE:To classify patients with patellofemoral (PF) instability on the basis of their mechanical gait characteristics, and to relate gait deficits to patellofemoral congruence.METHODS:Thirteen patients awaiting patellar stabilisation surgery were recruited for gait analysis and magnetic resonance imaging, MRI assessment of PF congruence. Patients were grouped into two subgroups (P1, P2) based on knee joint moment during stance, and their total support moments (TSMs) during stance were compared against eight healthy Control subjects. PF congruence was compared between groups from MRI data captured at 0, 20 and 40° of passive knee flexion and during dynamic extension.RESULTS:Five patients were classified into group P1 because they demonstrated a knee extensor moment during early stance, and eight patients into group P2 because they did not. The TSM of the more affected limb in group P1 was not significantly different from Control values in early stance but the difference was significant (P<.05) in late stance. In group P2, both the less and more affected limbs were significantly different from Control TSM values in early stance, but only the more affected limb in late stance. Patellofemoral contact areas as measured by MRI were greatest for the Control patients, and least for patient group P2 especially during the active extension trials.CONCLUSIONS:Patients with patellofemoral pain and instability walked with a slightly flexed knee, avoiding extension. The MRI measurements of joint contact agreed with the patient groupings according to gait mechanics. Cartilage contact across the PF joint can be an objective measure of instability.
A six-year-old German Shorthaired Pointer was presented with a 12 month history of left pelvic limb lameness following trauma. Clinical examination revealed marked thickening and reduced range-of-motion of the left stifle and radiographs were suggestive of a non-union type B3 tibial plateau fracture with severe secondary osteoarthritis. Total knee replacement was performed with adjunctive stabilization of the proximal tibial fracture fragment. Clinical follow-up at six and 12 months with quantitative gait analysis revealed significant improvement in limb function.
Summary In order to apply hinged transarticular external skeletal fixation for stabilization of the injured canine tarsal joint, knowledge of the three-dimensional (3D) location and orientation of the transverse axis is necessary. This method of immobilization may be used as a primary or adjunctive method of stabilisation for a large number of traumatic conditions. Using pin-mounted markers in the cadaveric Greyhound crus and talus, a closed-form solution of absolute orientation was used to identify, on radiographs, the lateral and medial locations of the transverse axis by tracking the 3D excursions of the markers during flexion and extension. A line was drawn across the dorsal aspect of the calcaneus from the most dorsal point on the distal articular surface (proximal intertarsal joint: PIJ) to the most dorsal point on its proximal articulation with the body of the talus, and the location of the centre of rotation was expressed in terms of the length of that line. In seven Greyhound tarsal joints, the medial end of the axis was located 73 ± 10% proximal to the PIJ and 11 ± 7% dorsal to the line. The lateral end was 73 ± 9% proximal to the PIJ and -2 ± 3% plantar to the line.
Leg health of intensively reared broiler chickens is a significant problem, yet little is known regarding the nature of lameness-associated pain. Kinematic changes in gait have been reported in naturally lame broilers following subcutaneous non-steroidal anti-inflammatory drug (NSAID) administration, compared to a placebo group. In the current study, an extensive range of gait parameters were defined using a commercial motion-capturing system to record three-dimensional temporospatial information from walking broilers pre- and post-treatment. Data analysis, performed using multi-level models, revealed gait modifications in broilers receiving NSAID, but not in those receiving saline. The effect of walking velocity was accounted for retrospectively. An increase in velocity following NSAID treatment (carprofen: P<0.001; meloxicam: P=0.044) indicated improved walking ability. For several measures, the polarity of the treatment effect depended upon walking speed. At slow speeds certain parameters become more like those of non-lame broilers, which may have been indicative of improved stability: stride length and duration (both NSAIDs), transverse back displacement (meloxicam), and vertical leg displacement (carprofen). However, these same parameters also revealed that NSAID treatment caused imbalance at faster speeds, which may have signified an excessive dosage. Although doses employed were not conclusively effective, evidence was provided that factors besides body conformation influenced mobility in the test cohort. The study showed that the model would be useful in future studies to increase our understanding of pain associated with specific lameness types in broiler chickens.
OBJECTIVE To devise a kinematic technique to objectively ascertain the location and orientation of the centre of rotation of the canine elbow and to compare this axis following arthroplasty with the first generation TATE™ prosthesis in an ex vivo model. METHODS Five pairs of cadaveric forelimbs were obtained and proximal limb soft tissues removed. Pin-mounted reflective markers were applied to the humerus and ulna. Limbs were mounted on a frame and six trials of the elbow manually cycled through its sagittal range of motion captured using 4 Qualisys cameras at 120 Hz. Radiography was performed to identify marker position. TATE™ cartridges were implanted and kinematic analysis repeated. Kinematic data were imported into custom software and the three-dimensional joint centre of rotation defined using a closed-form solution for absolute orientation. Paired t tests were performed to determine if the centre of rotation of the elbow differed significantly (P<0·05) pre- and postoperatively and between left and right limbs. RESULTS There was no significant difference in three-dimensional orientation of the elbow axis between pre and postoperative measurements or between left and right limbs. CLINICAL SIGNIFICANCE A critical factor in obtaining a successful functional outcome following elbow arthroplasty in humans is accurate reconstruction of the anatomic centre of rotation. The first generation TATE canine elbow arthroplasty cartridge and its instrumentation accurately reconstructed the anatomic centre of rotation in 8 of the 10 elbows assessed in this ex vivo model.
OBJECTIVETo evaluate, using inverse dynamic analysis, the biomechanical outcome from tibial tuberosity advancement (TTA) surgery in dogs affected by unilateral cranial cruciate ligament failure (CCLF).STUDY DESIGNRetrospective case series.ANIMALSDogs (n = 13) 11-20 months after surgery.METHODSKinematic and force data were collected from 13 dogs 11-20 months after TTA and inverse dynamics analysis of the dogs' pelvic limb mechanical function performed. Angle, moment, and power were calculated for each joint. Total support moment (TSM) was calculated.RESULTSSix dogs were affected on the right side (Raff) and 7 on the left (Laff). Peak stifle flexor moment was significantly larger for the right stifle compared with the left in Laff dogs, but similar in Raff dogs. Peak stifle extensor moment was significantly larger for the left stifle compared with the right in Raff dogs, and was also larger for the left stifle compared with the right in Laff dogs. Stifle power in early stance was larger on the left in Raff dogs and significantly larger on the right in Laff dogs. TSM was larger on the right in Raff dogs and significantly larger on the right in Laff dogs.CONCLUSIONSAffected limbs had a reduction in power of the stifle flexors. Irrespective of the side of CCLF, TSM was larger on the right side and the stifle extensor moment in late stance was larger on the left, perhaps indicating a mechanical limb dominance effect.