Knee and Hip Kinematics during Gait following 12- week Conservative Interventions in a Case with Lower Limb Stiffness

Document Type : Case Report

Authors
F. Khorramroo
S. H. Mousavi
H. Minoonejad
Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.
10.22034/IJMPP.9.3.1065
Abstract
Aims: This case study aims to manage the post-operative complications in a patient with excessive ankle stiffness using Instrument Assisted Soft Tissue Mobilization (IASTM) and Faradic Electrical Stimulation (FES) and investigate the effects on knee and hip kinematics during gait.

Method and Materials: A 41-year-old female with post-operation complications including decreased right ankle Range of Motion (ROM) and strength, underwent a 12-week of IASTM and FES. Gait analysis was performed before and after the intervention. Knee and hip angles and velocities in 3 dimensions were measured using a motion analysis system before and after the intervention.

Findings: Results showed increased knee adduction, decreased peak knee external rotation at the late swing phase, increased peak frontal plane knee velocity, frontal and transverse plane hip excursion, and peak velocities in the transverse and frontal plane.

Conclusion: A 12-week IASTM and FES can improve knee and hip gait mechanics in a patient with excessive ankle stiffness.

Keywords

Subjects

1. Hedrick EA, Malcolm P, Wilken JM, Takahashi KZ. The effects of ankle stiffness on mechanics and energetics of walking with added loads: a prosthetic emulator study. J Neuroeng Rehabil [Internet]. 2019;16(1):148. Available from: [doi.org/10.1186/s12984-019-0621-x]
2. Neumann DA. Kinesiology of the musculoskeletal system-e-book: foundations for rehabilitation. Elsevier Health Sciences; 2016. 664 p.
3. Mousavi SH, Hijmans JM, Rajabi R, Diercks R, Zwerver J, van der Worp H. Kinematic risk factors for lower limb tendinopathy in distance runners: A systematic review and meta-analysis. Gait Posture. 2019 Mar;69:13–24.
4. Ota S, Ueda M, Aimoto K, Suzuki Y, Sigward SM. Acute influence of restricted ankle dorsiflexion angle on knee joint mechanics during gait. Knee. 2014;21(3):669–75.
5. Rao Y, Yang N, Gao T, Zhang S, Shi H, Lu Y, et al. Effects of peak ankle dorsiflexion angle on lower extremity biomechanics and pelvic motion during walking and jogging. Front Neurol. 2023;14:1269061.
6. Khorramroo F, Mousavi SH. The Effects of Minimal Shoes on Ankle Kinematics During Running: A Systematic Review. J Adv Sport Technol. 2022;6(2):20–38.
7. Khorramroo F, Mousavi SH, Minoonejad H, Sorkhabi M. Managing Post-Operative Complications in a Patient with Excessive Ankle Stiffness: A Case Study Addressing Balance, Muscle Strength and Quality of Life. Int J Mot Control Learn. 2024;5(4):e146340.
8. Mousavi SH, Khorramroo F, Minoonejad H, Zwerver J. Effects of biofeedback on biomechanical factors associated with chronic ankle instability: a systematic review with meta-analysis. BMC Sports Sci Med Rehabil. 2023;15(1):168.
9. Mousavi SH, Khorramroo F, Jafarnezhadgero A. Gait retraining targeting foot pronation: A systematic review and meta-analysis. PLoS One. 2024;19(3):e0298646.
10. Khorramroo F, Mousavi SH, Minoonejad H, Sorkhabi M. Managing post-operative complications in a patient with excessive ankle stiffness: A case study addressing gait biomechanics and EMG. Sport Sci Heal Res. 2023;15(2):145–58.
11. Baniasad M, Farahmand F, Arazpour M, Zohoor H. Coordinated activities of trunk and upper extremity muscles during walker-assisted paraplegic gait: A synergy study. Hum Mov Sci. 2018;62:184–93.
12. Kim YK, Cho SY, Lee KH. Effects of transcutaneous electrical nerve stimulation and instrument-assisted soft tissue mobilization combined treatment on chronic low back pain: A randomized controlled trial. J Back Musculoskelet Rehabil. 2021;34(5):895–902.
13. Coelho BAL, das Neves Rodrigues HL, Almeida GPL, João SMA. Immediate Effect of Ankle Mobilization on Range of Motion, Dynamic Knee Valgus, and Knee Pain in Women With Patellofemoral Pain and Ankle Dorsiflexion Restriction: A Randomized Controlled Trial With 48-Hour Follow-Up. J Sport Rehabil [Internet]. 2021;30(5):697–706. Available from: https://journals.humankinetics.com/view/journals/jsr/30/5/article-p697.xml
14. Leung J, Smith R, Harvey LA, Moseley AM, Chapparo J. The impact of simulated ankle plantarflexion contracture on the knee joint during stance phase of gait: a within-subject study. Clin Biomech. 2014;29(4):423–8.
15. Pietraszewski B, Woźniewski M, Jasiński R, Struzik A, Szuba A. Changes in Gait Variables in Patients with Intermittent Claudication. Biomed Res Int. 2019;2019:7276865.
International Journal of Musculoskeletal Pain Prevention
Volume 9, Issue 3
July 2024
Pages 1065-1069