ECSS Paris 2023: CP-BM06
INTRODUCTION: The prevalence of type 2 diabetes (T2D) is increasing, placing a burden on both individuals and healthcare systems. T2D accounts for approximately 90% of all diabetes cases, making it a priority for improved prevention and management. T2D is associated with various pathological complications, including those affecting the neuromuscular system. Previous research suggests that individuals with T2D often exhibit slower walking speeds, altered gait patterns, decreased muscle strength and impaired mobility compared to non-diabetic individuals. The aim of this study was to examine how strength, balance, ankle range of motion and step length are associated with self-selected walking speed (SS) and maximum walking speed (MS) among males with T2D. METHODS: This cross-sectional study included 18 males diagnosed with T2D (age 62.5 ± 10.6, body height 177.1 ± 5.4 cm, body weight 94.7 ± 16.7 kg), recruited from the Department of Endocrinology at the University Hospital, Reykjavik, Iceland and 10 non-diabetic males, (age 67.6 ± 3.3, body height 182.3 ± 6.8 cm, body weight 98.8 ± 11.1 kg), recruited via convenience sampling. Walking speed was assessed at SS and MS by walking between two gates placed 10 meters apart. Balance was measured using a 15-second single-leg stand on VALD ForceDecks. Maximum voluntary contraction (MVC) of plantar flexors was tested using VALD ForceFrame and MVC of knee extensors using VALD DynaMo. Step length and ankle range of motion during walking were analyzed using video recordings of treadmill walking and Dartfish software. Independent samples t-tests in Jamovi software were used to compare SS, MS, strength, balance, ankle range of motion and step length between males with and without T2D. The significance level was set at α = 0.05 and effect sizes were reported using Cohen´s d. RESULTS: Males with T2D had significantly lower MS (p = 0.012, d= -1.11) and knee extensor strength (p = 0.006, d = -1.27), compared to non-diabetic males. Mean values suggested that males with T2D had lower SS, shorter step-length, slightly lower ankle angles at toe-off and heel strike at SS and MS (except for a slightly higher angle at toe-off during MS), greater center-of-pressure range during single leg stance and lower plantar flexor strength compared to males without T2D. However, these differences were not statistically significant. CONCLUSION: Results of this ongoing study indicate differences in physical performance of males with and without T2D in Iceland, with significant reductions in MS and knee extensor strength in people with T2D. These findings highlight the potential impact of T2D on strength and mobility, emphasizing the importance of screening for functional limitations and implementing targeted interventions to improve the quality of life in individuals with T2D.
Read CV Steinunn Bára BirgisdóttirECSS Paris 2023: CP-BM06
INTRODUCTION: Gait asymmetry after anterior cruciate ligament reconstruction (ACLR) is frequently reported, potentially raising the risk of re-injury and posttraumatic knee osteoarthritis (KOA). Conventional assessment methods focus on the sagittal-plane knee angles and moments, which are key parameters influenced by ACLR, but require complex equipment such as optical motion capture and force plates. With advancements in wearable sensor technology, gait analysis has become widely accessible in recent years. We have developed shoes with embedded sensors (smart shoes), which are more comfortable to wear and easy to calculate gait parameters based on foot movements. We hypothesised that ACLR-related asymmetry could be detected in the sagittal-plane foot movement measured by smart shoes, and observed the symmetry of the strike angle (the angle between the ground and the foot in the sagittal plane at initial ground contact) during the postoperative rehabilitation period. This study aimed to quantify strike angle symmetry in ACLR patients from 2 to 6 months post-surgery, comparing them with healthy controls to identify changes over time. We hypothesized that early postoperative asymmetry would decrease, approaching healthy levels by 6 months. METHODS: Eight ACLR patients and 12 healthy participants wore smart shoes and walked on a treadmill at 4 km/h for 3 minutes. ACLR patients executed this task at 2, 3, 4, and 6 months postoperatively. Three-dimensional foot acceleration and angular velocity data (200 Hz) during walking were measured by smart shoes, and processed with gait analysis software ORPHE ANALYTICS to calculate the strike angle for each step. The symmetry index (SI) of the strike angle was computed for each participant. The effect of postoperative time (2, 3, 4 and 6 months) on the SI was tested by one-way ANOVA (α = 0.05). The SI of each postoperative time was compared to the SI of healthy participants using Wilcoxon rank sum test with significance level α = 0.05/4. RESULTS: A significant main effect of postoperative time on SI was identified (p = 0.021). The SI decreased as postoperative time progressed (2 months: 22.19 ± 13.09 %, 3 months: 14.03 ± 8.09 %, 4 months: 10.50 ± 5.00 %, 6 months: 9.61 ± 4.58 %). While at 2 months, ACLR patients had a significantly larger SI than healthy participants (6.57 ± 5.95 %; p = 0.0015), no significant differences emerged at 3 (p = 0.047), 4 (p = 0.115) or 6 months (p = 0.208) compared to healthy controls. CONCLUSION: We quantified the change in gait symmetry over time in ACLR patients by gait analysis with smart shoes. The symmetry of the strike angle changed over time, and no statistically significant difference was observed already at 3 months postoperatively, indicating that the ACLR patients may have reacquired a level of symmetry like that of the healthy controls. Although strike angle symmetry alone may not be sufficient to assess the symmetry of kinetics inducing KOA, it may lead to the development of a new screening modality that is versatile in clinical practice.
Read CV Uno YukiECSS Paris 2023: CP-BM06
INTRODUCTION: Wireless insoles offer a field-viable alternative to traditional, laboratory-based force plate measurements, enabling ecological assessment of mechanical loading during physical activity. While foot-ground and shoe-ground interactions are well studied [1,2] in-shoe plantar forces remain poorly characterised. This study examined kinetic parameters associated with lower limb injury aetiologies, [3,4] using force-measuring insoles. We aimed to characterise in-shoe loading profiles of military relevant ambulation to enhance understanding of in-shoe loading dynamics. METHODS: Seven members of the United Kingdom armed forces (age: 20.6 ± 3.5 years, body mass: 81.2 ± 6.2 kg, height: 1.80 ± 0.04 m, shoe sizes 9-13) walked (1.5 m·s⁻¹) and ran (3.6 m·s⁻¹) along a 10-m runway with a designated foot-strike target. Trials were performed whilst wearing military-issue boots (BOOT) and military-issue training shoes (SHOE) under body-worn loading conditions: 0 kg, 20 kg, and 40 kg during walking and 0 kg and 20 kg during running. Force data were recorded wirelessly at 200 Hz using proprietary software. Data analyses included initial impact peak (iGRF), propulsive force (pGRF), loading rate (LR), impulse (IMP) and stance time (ST). Differences between footwear types, loading states and modes of locomotion were assessed using paired sample t-tests (p<0.05). RESULTS: Increased load significantly increased: iGRF, 1.19 ± 0.15 [0 kg], 1.46 ± 0.17 [20 kg], 1.75 ± 0.16 [40 kg] times BW; pGRF, 1.16 ± 0.14 [0 kg], 1.43 ± 0.15 [20 kg], 1.62 ± 0.20 [40 kg] times BW; IMP, 452.3 ± 48.4 [0 kg], 556.1 ± 54.1 [20 kg], 663.7 ± 71.7 [40 kg] N.s⁻¹; LR, 7.7 ± 0.8 [0 kg], 11.1 ± 1.8 [20 kg], 13.5 ± 2.5 [40 kg] BW.s⁻¹ and ST, 0.70 ± 0.02 [0 kg], 0.71 ± 0.3 [20 kg] and 0.72 ± 0.03 [40 kg] seconds (p<0.05). Compared with walking, running increased iGRF, pGRF, IMP and LR and decreased ST (p<0.05). During walking trials, iGRF was higher (p=0.01), ST shorter (p=0.02) and LR higher (p<0.005) in the SHOE vs the BOOT condition. During running trials, LR was significantly higher in the BOOT vs SHOE condition (p=0.02). CONCLUSION: This study quantified injury-relevant in-shoe kinetics during walking and running in two standard issue military footwear types. Load carriage increased kinetic parameters associated with injury aetiology. Training shoes were associated with higher loading rates and iGRFs across walking trials compared with boots. This study has demonstrated the utility of in-shoe force measuring insoles, which can be used in field studies to quantify walking and running kinetics. Future work will assess how in-shoe kinetic differences influence the mechanical loading of the lower limbs and their potential impact on injury risk. REFERENCES: 1. Keller et al. (1996); 2. Racic et al. (2009); 3. Johnson et al. (2020); 4. Bigouette et al. (2016).
Read CV Joe HoganECSS Paris 2023: CP-BM06