Gait is influenced by peripheral circulation and neuro musculoskeletal system which can be affected by diabetes. Gait variations play an important role in increasing the peak plantar pressure in persons with diabetes. Biomechanical alterations in diabetic neuropathy could facilitate foot injuries, thus contributing to foot ulceration [1]. Understanding the gait characteristics in different category of diabetic population during walking can reveal the biomechanical factors which may collectively lead to foot pathology. 3-Dimensional (3D) Gait analysis was performed on 28 subjects with similar age, height, weight and Body Mass Index (BMI) (p > 0.05) with diabetes and without neuropathy (D), persons with diabetic neuropathy (DN) and persons who had a history of foot ulcer (DHU). Spatial and Temporal gait parameters along with kinematics and kinetics were compared between the three groups. The lower extremity gait data shows that DHU subjects show increased hip flexion throughout the gait cycle with delay in peak extension and DN subjects showing a slight delay in achieving peak hip extension. DHU show a significant deviation in hip, knee and ankle mechanics when compared to other two groups. There is a slight increase in dorsiflexion among diabetic subjects during the mid - stance phase. The ground reaction force (GRF) graphs shows that the breaking force and propelling force is less in magnitude for all the three groups when compared to normal. The vertical GRF data reveals there is no significant difference among the three groups but the graph shows delayed heel rocker during the gait. The compensation gait observed in DHU group may be due to the muscle weakness acquired in the past when there was active foot ulcer. This altered compensatory gait observed in DHU participants need to be addressed using proper corrective footwear and gait training sessions for preventing recurrence of ulcer. References [1] Katoulis EC, Ebdon-Parry M, Lanshammar H, Vileikyte L, Kulkarni J, Boulton AJM. Gait Abnormalities in Diabetic Neuropathy. Diabetes Care. 1997 Dec; 20(12): 1904-1907. Acknowledgements 1. M. V. Hospital for Diabetes, Royapuram, Chennai 2. CSIR – Central Leather Research Institute and Department of Science and Technology, India
Listed In: Gait

Disc function is mechanical, and measures of disc mechanical function are important to address spine function, degenerative disc disease, and low back pain. In vivo measures of disc mechanical function are needed, however the current standard in disc imaging is to acquire a single static image and classify the disc’s appearance using qualitative integer scales for degree of degeneration. Current grading standards are acknowledged as insufficient to identify symptomatic discs for treatment. In addition, static T2 weighted MRI cannot provide mechanical function information – mechanics must be measured as the change following a load or deformation perturbation. Because the disc experiences significant compression and height loss throughout the day, and because flexion-extension postures are often associated with low back pain, these physiological mechanical perturbations have potential to be used to quantify disc mechanics in vivo. The objective of this study was to use MRI-based methods to quantify in vivo disc function by measuring changes in disc geometry and T2 relaxation time with diurnal changes and with controllable posture. Quantification of in vivo disc mechanics by using diurnal loading or prescribed posture changes has potential to improve our ability to identify, evaluate, and treat degenerative disc disease. Symptomatic discs may have aberrant mechanics; if so, in vivo measurements of mechanical function may, with continued development, facilitate diagnosis of pathological discs.
Listed In: Biomechanical Engineering

Victims of improvised explosive devices (IEDs) that have presented spinal injury in recent conflicts have been shown to have a high incidence of lumbar spine fractures. Previous studies have shown that the initial positioning of spinal bone-disc-bone complexes affects their biomechanical response when loaded quasi-statically; such a correlation, however, has not been explored at appropriate high loading rate scenarios that simulate injury. This study aims to investigate the response of lumbar spine cadaveric segments in different postures under axial impact conditions. Three T11-L1 bi-segments were dissected and tested destructively in a drop tower under flexed/neutral/extended postures. Strains were measured on the vertebral body and the spinous process of T12. Forces were measured cranially using a 6-axis load cell, and a high-speed camera was used to capture displacements and fracture. The impacted specimens were CT-scanned to identify the fracture pattern. Whilst axial force to failure was similar for flexed and extended postures, the non-axial forces and the bending moments, however, were dissimilar between postures. Although all specimens showed a burst fracture pattern, the extended posture failed more posteriorly. This suggests that axial force alone is not adequate to predict injury severity in the lumbar spine. This insight would not have been possible without the use of the 6-axis load cell. As metrics for spinal injury in surrogates take into account only the axial force, this programme of work may provide data for a better injury criterion and allow for a mechanistic understanding of the effects of posture on injury risk.
Listed In: Biomechanical Engineering, Biomechanics, Mechanical Engineering, Orthopedic Research

Background: Gait abnormalities can influence surgical outcomes in people with severe knee osteoarthritis (OA) and thus a thorough understanding of gait abnormalities in these people prior to arthroplasty is important. Varus-valgus thrust is a characteristic linked to OA disease progression that has not yet been investigated in a cohort with severe knee OA awaiting knee arthroplasty. The aims of this study were to determine i) prevalence of varus and valgus thrust in a cohort with severe knee OA compared to an asymptomatic group, ii) whether the thrust magnitude differed between these groups iii) differences between varus and valgus thrusters within the OA cohort and iv) whether certain measures could predict thrust in the OA cohort. Methods: 40 patients with severe knee OA scheduled for primary TKR and 40 asymptomatic participants were recruited. Three-dimensional gait analysis was performed on all participants, with the primary biomechanical measures of interest being: varus and valgus thrust, knee adduction angle, peak KAM, and KAM impulse. Additionally, static knee alignment and quadriceps strength were assessed in the subgroup with knee OA. Findings: No difference was found in the prevalence of varus and valgus thrust between the severe OA and control groups (Pearson chi-square = 3.735, p value = 0.151). The OA varus thrust group had a significantly higher peak KAM (p=0.000), KAM impulse (p=0.001), static alignment (p=0.021), and lower quadriceps strength (p=0.041) than the valgus thrust group. Peak KAM and quadriceps strength were found to explain 34.9% of the variation in maximum thrust, such that an increase in KAM and a decrease in quadriceps strength were associated with an increase in maximum (varus) thrust. Interpretation: Few differences between the severe OA and control groups were seen, however dichotomizing the groups into varus and valgus cohorts revealed a number of biomechanical differences. Patients with severe OA are often treated as a homogenous cohort; however, by classifying which individuals have a varus or valgus thrust, we have identified a subset of patients with poorer biomechanics who could potentially be at a higher risk of a worse outcome after surgery.
Listed In: Biomechanics, Gait, Orthopedic Research

Introduction: Running is a popular form of physical activity linked to various lower extremity injuries. A commonly used technique for injury prevention and rehabilitation is taping. There is considerable research investigating running biomechanics, however, there has been limited to no research examining the effects of gender, speed, and the type of tape used on two-dimensional lower extremity kinematics. Therefore, the purpose of this pilot study was to investigate the effects of gender, speed, and tape on two-dimensional lower extremity kinematics and stride characteristics during running. Method: Eight healthy runners participated (4 males, 4 females). Taping interventions (Leukotape, Kinesio Tape, no tape) and speeds (2.35 m/s, 3.35 m/s) were randomized and lower extremity stride kinematics were obtained using the Peak Motus System at initial contact, midstance, and toe off of running. Comparisons were made using descriptive statistics. Results: Females exhibited greater hip (FIC= 164.04+1.99°; MIC= 167.54+2.12°) and knee flexion (FIC= 167.73+0.93°; MIC= 170.42+1.65°; FPK= 142.83+1.28°; MPK= 146.35+1.21°), while males had greater ankle dorsiflexion (FIC= 88.60+1.00°; MIC= 84.14+1.08°) and plantarflexion (FTO= 51.90+1.01°; MTO= 55.99+0.825°). Females spent more time in support (FCT= 0.28+0.03s; MCT= 0.26+0.02s) while males spent more time in the air (FFT= 0.45+0.02s; MFT= 0.48+0.01s). Faster speed was associated with greater hip flexion and extension (SIC= 167.57+1.95°; FIC= 164.01+2.11°; STO= 197.14+1.23°; FTO= 201.28+0.74°), peak knee flexion (SPK= 145.39+1.82°; FPK= 143.79+2.39°), and less time during contact (SIC = 0.30+0.01s; FIC= 0.25+0.00s). Conclusion: Gender and speed seem to have effects on lower extremity stride kinematics, whereas type of tape does not.
Listed In: Biomechanics, Gait, Other