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Subgroups of Foot-Ankle Movement Patterns Can Influence the Responsiveness to a Foot-Core Exercise Program: A Hierarchical Cluster Analysis.

ABSTRACT: The purpose of this study is to identify homogenous subgroups of foot-ankle (FA) kinematic patterns among recreational runners and further investigate whether differences in baseline movement patterns can influence the mechanical responses to a foot-core exercise intervention program. This is a secondary analysis of data from 85 participants of a randomized controlled trial (clinicaltrials.gov - NCT02306148) investigating the effects of an exercise-based therapeutic approach focused on FA complex. A validated skin marker-based multi-segment foot model was used to acquire kinematic data during the stance phase of treadmill running. Kinematic features were extracted from the time-series data using a principal component analysis, and the reduced data served as input for a hierarchical cluster analysis to identify subgroups of FA movement patterns. FA angle time series were compared between identified clusters and the mechanical effects of the foot-core exercise intervention was assessed for each subgroup. Two clusters of FA running patterns were identified, with cluster 1 (n = 36) presenting a pattern of forefoot abduction, while cluster 2 (n = 49) displayed deviations in the proximal segments, with a rearfoot adduction and midfoot abduction throughout the stance phase of running. Data from 29 runners who completed the intervention protocol were analyzed after 8-weeks of foot-core exercises, resulting in changes mainly in cluster 1 (n = 16) in the transverse plane, in which we observed a reduction in the forefoot abduction, an increase in the rearfoot adduction and an approximation of their pattern to the runners in cluster 2 (n = 13). The findings of this study may help guide individual-centered treatment strategies, taking into account their initial mechanical patterns.

SUBMITTER: Watari R

PROVIDER: S-EPMC8217875 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundDiabetic polyneuropathy (DPN) negatively affects foot and ankle function (strength and flexibility), which itself affects the daily physical activity and quality of life of patients. A physical therapy protocol aiming to strengthen the intrinsic and extrinsic foot muscles and increase flexibility may be a promising approach to improve lower-extremity function, prevent further complications, and improve autonomy for daily living activities in these patients. Thus, the inclusion of a specific foot-related exercises focused on the main musculoskeletal impairments may have additional effects to the conventional interventions in the diabetic foot.Methods/designA prospective, parallel-group, outcome-assessor blinded, randomized controlled trial (RCT) will be conducted in 77 patients with DPN who will be randomly allocated to usual care (control arm) or usual care with supervised foot-ankle exercises aiming to increase strengh and flexibility twice a week for 12 weeks and remotely supervised foot-ankle exercises for a year through a web software. Patients will be evaluated 5 times in a 1 year period regarding daily physical activity level, self-selected and fast gait speeds (primary outcomes), foot ulcer incidence, ulcer risk classification, neuropathy testing, passive ankle range of motion, quality of life, foot health and functionality, foot muscle strength, plantar pressure, and foot-ankle kinematics and kinetics during gait.DiscussionThis study aims to assess the effect of a foot-ankle strength and flexibility program on a wide range of musculoskeletal, activity-related, biomechanical, and clinical outcomes in DPN patients. We intend to demonstrate evidence that the year-long training program is effective in increasing gait speed and daily physical activity level and in improving quality of life; foot strength, functionality, and mobility; and biomechanics while walking. The results will be published as soon as they are available.Trial registrationThis study has been registered at ClinicalTrials.gov as NCT02790931 (June 6, 2016) under the name "Effects of foot muscle strengthening in daily activity in diabetic neuropathic patients".

Project description:Running practice could generate musculoskeletal adaptations that modify the body mechanics and generate different biomechanical patterns for individuals with distinct levels of experience. Therefore, the aim of this study was to investigate whether foot-ankle kinetic and kinematic patterns can be used to discriminate different levels of experience in running practice of recreational runners using a machine learning approach. Seventy-eight long-distance runners (40.7 ± 7.0 years) were classified into less experienced (n = 24), moderately experienced (n = 23), or experienced (n = 31) runners using a fuzzy classification system, based on training frequency, volume, competitions and practice time. Three-dimensional kinematics of the foot-ankle and ground reaction forces (GRF) were acquired while the subjects ran on an instrumented treadmill at a self-selected speed (9.5-10.5 km/h). The foot-ankle kinematic and kinetic time series underwent a principal component analysis for data reduction, and combined with the discrete GRF variables to serve as inputs in a support vector machine (SVM), to determine if the groups could be distinguished between them in a one-vs.-all approach. The SVM models successfully classified all experience groups with significant crossvalidated accuracy rates and strong to very strong Matthew's correlation coefficients, based on features from the input data. Overall, foot mechanics was different according to running experience level. The main distinguishing kinematic factors for the less experienced group were a greater dorsiflexion of the first metatarsophalangeal joint and a larger plantarflexion angles between the calcaneus and metatarsals, whereas the experienced runners displayed the opposite pattern for the same joints. As for the moderately experienced runners, although they were successfully classified, they did not present a visually identifiable running pattern, and seem to be an intermediate group between the less and more experienced runners. The results of this study have the potential to assist the development of training programs targeting improvement in performance and rehabilitation protocols for preventing injuries.

Project description:Thermal taste is a phenomenon whereby some individuals, known as thermal tasters (TT) experience taste sensations when their tongue is warmed or cooled. It was first reported in 2000 by Cruz and Green [1] and since then, most research has focused on comparing TT to thermal non-tasters (TnT; individuals who do not experience thermally-elicited sensations). As TT rate the intensity of taste stimuli higher than TnT, understanding the nature of this difference may help inform how individual differences in taste perception impact consumer liking and consumption of food and beverages. However, as the mechanism(s) underlying thermal tasting are yet to be fully elucidated, it is unclear if TT should be considered a homogeneous group or if subgroups exist. We created a dataset to help determine if the orosensory advantage is universal across all TT, or if it is mainly attributable to one or more subgroups of TT. To this end, the thermal taste screening data of 297 TT from 12 previous recruitment drives ('cohorts') was combined. This created the largest dataset of TT reported to date in a single study, allowing for an in-depth analysis of the differences between TT. After training on appropriate scale use, participants were familiarized with common taste and chemesthetic stimuli (sweet, sour, salty, bitter, umami, astringent and metallic). Using a sip-and-spit protocol, participants rinsed with the stimuli and rated the maximum intensity each stimulus elicited on a generalized Visual Analogue Scale (gVAS) or a generalized Labeled Magnitude Scale (gLMS). To account for minor methodological differences between the cohorts, ratings from each cohort were first converted to z-scores before being combined into the overall dataset. Next, participants underwent a series of 12 trials that assessed response to a thermal elicitation device during which each combination of two temperature regimes (warming and cooling) and three lingual sites (tongue tip, 1 cm to left, 1 cm to the right) were examined in duplicate. Participants were asked to rate the maximum intensity of any sensations experienced during each trial. TT were classified into subgroups based on the type of thermally-elicited taste reported (typically sweet, sour, salty, bitter, metallic), the temperature regime during which the sensation was elicited (warming or cooling) and the location on the tongue tested at which the sensation was experienced. Figures are provided that show the mean intensity ratings of aqueous solutions of chemical stimuli and corresponding standard errors for each of the TT subgroups. In addition, the TT Subgroup Naming Conventions provided should allow for a consistent and clear use of terminology across future thermal taste research. Readers are referred to Homogeneity of thermal tasters and implications for mechanisms and classification[2] for a full discussion of how these findings inform our understanding of the mechanism(s) underlying thermal taste and the practical implications of methodological differences in determining thermal taste status.

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Subgroups of Foot-Ankle Movement Patterns Can Influence the Responsiveness to a Foot-Core Exercise Program: A Hierarchical Cluster Analysis.

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