CompletedNot Applicable

Gait Analysis During Level and Uphill Walking After Lengthening Osteotomy of the Lateral Column

Switzerland32 participantsStarted 2017-11-20

Plain-language summary

A common surgical treatment for posterior tibial tendon dysfunction (and the resulting flat foot) is the correction through a calcaneal lengthening osteotomy of the lateral column (LLC). Clinical studies showed pain relief and functional improvements through different scores. However, according to clinical experience, some patients complain about a limited ankle dorsiflexion after LLC surgery. Several joints of the foot (talocrural, subtalar, talonavicular, calcaneocuboid) contribute to the overall range of motion in foot plantarflexion/dorsiflexion and pronation/supination. Changes in the range of motion in one joint can affect all the other joints. For instance, it was shown that a fusion of the talonavicular joint removes most of the residual hindfoot motion in plantarflexion/dorsiflexion and pronation/supination. Because the lengthening of the lateral column presumably decreases the mobility of the medial column and thus of the talonavicular joint, this surgery can influence the range of motion of the other joints, and hence contribute to the reported decreased ankle dorsiflexion motion. Patients after LLC have less plantarflexion of the first metatarsal throughout stance of level walking and less inversion of the hindfoot during push-off compared to healthy subjects. Uphill walking requires more ankle plantarflexion and dorsiflexion than level walking. A limitation of the ankle joint mobility especially in dorsiflexion could therefore lead to additional or greater changes in gait patterns (hindfoot and forefoot kinematics) during uphill walking. The primary objective is: • To compare differences in hindfoot and forefoot kinematics between level and uphill treadmill walking in relation to passive range of motion The secondary objectives are: * To compare lower leg muscle activation during level and uphill treadmill walking between patients after LLC and healthy subjects * To test the association between muscle strength, muscle activation patterns and hindfoot and forefoot kinematics during level and uphill walking and heel rise * To relate clinical outcome of LLC surgery by functional scores to passive range of motion

Who can participate

Age range

18 Years – 70 Years

Sex

ALL

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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * age \> 18 years * age \< 70 years * Patients: * Unilateral surgery for posterior tibial tendon dysfunction by flexor digitorum longus transfer and lateral lengthening osteotomy of the calcaneus * Minimum of 2 years postoperatively Exclusion Criteria: * Neuromuscular disorders affecting gait * Cardiovascular disease * Diabetes * Pregnancy (if unknown, a pregnancy test (urine test) will be performed) * Body mass index \> 35 kg/m2 * Patients: * Additional pathologies that influence the mobility of the ankle joint * Bilateral surgery * Use of walking aids * Healthy control group: * Lower extremity surgery * Pain in the lower extremities within the last 6 months

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What they're measuring

Passive plantarflexion and dorsiflexion range of motion

Timeframe: 0 months

Trial details

NCT IDNCT03487497

SponsorUniversity Hospital, Basel, Switzerland

Sponsor typeOTHER

Study typeOBSERVATIONAL

Primary completion2018-12-31

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