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1 The Influence of Foot Morphology on Lower Limb Injury from the Aspect of Kinetic Chain 5010A077-0 Fujita, Motohiro
2 vs. vs
3
4 ,000 15m 30m 40 3m Randall et al NCAA % 25% 7% 10 18% 21% Randall et al., 2007 Alentorn-Geli, 2009 Borowski et al ATC 43% 45% Charles et al
5 % % Randallet al., 2007, Borowskiet al., 2008 Kofotolis et al P 45% -7-
6 Franco(1987 ) Vincent Set al., 2010 Leg Heel Alignment Nawoczenski et al. (1998) Nigg et al. (1993 ) -8-
7 Fig. 1-1 Foot Print Fig. 1-2 YokokuraMethos Fig. 1-3 Talo-Horizontal Angle 1-3 (Fig. 1-1) (Fig. 1-2) Vincent (2010) Talo-Horizontal Angle (Fig. 1-3) 3 PC 3-9-
8 Mosca,
9 Table 2-1 Table 2-1. The Number of Samples in Each Group Age group Chronological age The number of samples 12 years old yrs-old* 6 12 feet 13 years old yrs-old 7 14 feet 14 years old yrs-old feet 15 years old yrs-old feet 16 years old yrs-old feet 17 years old yrs-old feet 18 years old yrs-old feet 19 years old yrs-old feet Total feet *yrs-old = years old -11-
10 3 (Dream GP Fig. 2-1) Fig Fig Fig. 2-1 Three Dimensional Foot Scanner Ankle, dorsum pedis, calcaneal region, and end of fingers are measured at thirty thousand points with laser turning around the foot along the rail, and foot figure is replicated with three dimensional images. Fig. 2-2: The Image of Land marks on the foot Fig. 2-3 A example of three dimensional foot image -12-
11 % 40mm
12 Turkey
13 2-3 Fig Table Table ( < ( < ( <0.05 Table 2-2 The Value of the Length of Foot Chronological Age Average SD Significant Difference P value 12 yrs-old mm ,15,16,17,18,19 < yrs-old mm ,19 < yrs-old mm < yrs-old mm < yrs-old mm < yrs-old mm < yrs-old mm ,13 < yrs-old mm ,13 <
14 ( < ( < ( < ( < Table 2-3The Value of the Width of Foot Chronological Age Average SD Significant Difference P value 12yrs-old mm ,15,16,17,18,19 < yrs-old mm < yrs-old mm , 18 < yrs-old mm , 18 < yrs-old mm < yrs-old mm < yrs-old mm , 13, 14, 15 < yrs-old mm <
15 < < < Table 2-4The Value of the Circumference of Foot Chronological Age Average SD Significant Difference P value 12yrs-old 96.4 mm ,14,15,16,17,18,19 < yrs-old mm , 17 < yrs-old mm , 18 < yrs-old mm < yrs-old mm , 18 < yrs-old mm , 13 < yrs-old mm , 14, 16 < yrs-old mm <
16 <0.05 Fig. 2-7 The Width of Heel in Various Age Table 2-4 The Value of the Width of Heel Chronological Age Average SD 12yrs-old 65.1 mm yrs-old 66.5 mm yrs-old 67.6 mm yrs-old 66.6 mm yrs-old 66.5 mm yrs-old 66.6 mm yrs-old 67.1 mm yrs-old 68.6 mm
17 < <0.05, 18 <0.05 Fig. 2-8 The Height of Arch in Various Age Table 2-5 The Value of the Height of Arch Chronological Age Average SD 12yrs-old 40.5 mm yrs-old 41.6 mm yrs-old 44.0 mm yrs-old 46.2 mm yrs-old 46.4 mm yrs-old 43.7 mm yrs-old 46.9 mm yrs-old 45.8 mm
18 2-3-6 Fig. 2-9 The Rate of Height of Arch in Various Age Table 2-5 The Value of the Height of Arch Chronological Age Average SD 12yrs-old 16.7 % yrs-old 16.6 % yrs-old 17.0 % yrs-old 17.9 % yrs-old 17.9 % yrs-old 16.8 % yrs-old 17.6 % yrs-old 17.1 %
19 12 <0.05 Fig The Angle of Calcaneus in Various Age Table 2-5 The Value of the Height of Arch Chronological Age Average SD 12yrs-old yrs-old yrs-old yrs-old yrs-old yrs-old yrs-old yrs-old
20 Joseph, 1992, Forriol et al., mm 41.8 mm vs mm vs mm vs mm vs. David, 2010 (2010) -22-
21 (Bandholmet al., 2008, Ribeiroet al., 2011, Kaufmanet al., 1999) 15, Lanz (1972) , 2003 Ogden(1989)
22 Simonsen et al.(2006)
23 % 18.5% % 15% 90%, Fig m -25-
24 Fig. 3-2 Fig. 3-2 The Diagram of Experiment Court Fig m 9 50 cm 3 27 ASIS Fig. 3-3 Lindbergh Fig
25 Fig. 3-3 The Images of Markers on the Patient and Tapes Used as Marker EXILIM EX-F1 CASIO 4 Fig Flame Dias DKH Take off Phase Landing Phase 2 Phase Heel Strike/ Initial Contact Phase, Initial Cont. Phase Foot Flat Phase Max Flexion Phase, Max Flex. Phase 6 Table 3-1 Fig Table
26 Table 3-1. The Definitions of Each Phase for the Analyzed Motion Major phase Minor phase Definition Take off Heel Strike. First touch of the foot to step to the jump Foot Flat Max Flex. Touch the all planter part of the foot Flexion at the deepest angle Landing Initial Cont. First touch of the foot to land on Foot Flat Max Flex. Touch the all planter part of the foot Flexion at the deepest angle Fig. 3-4 The Split Image of One-Leg Running Jump -28-
27 Table3-2. The Definition of Analysis for Each Movement Analyzed Movement Basement Line Various Line Angle of knee flexion Abduction of pelvis Rotation of pelvis The rotation of knee joint Lateral cleavage lateral malleolus ASIS lateral cleavage Medial malleolus lateral malleolus Medial malleolus lateral malleolus Lateral cleavage greater trochanter ASIS opposite ASIS Opposite ASIS ASIS Medial cleavage lateral cleavage Center of knee joint variation X axis Center of knee joint Angle of calcaneus Z axis Bottom of center part of calcaneus top of center part of calcaneus vs. T Heel Strike Phase Initial Contact Phase Foot Flat vs. vs. T / / T 5% -29-
28
29 vs. vs. vs. vs. Fig vs. Fig. 3-5 Heel Strike Phase vs. ; 0.01±0.05 cmvs.-0.02±0.05 cm Foot FlatPhase -0.28±1.06 cmvs.0.40±1.95 cm Max Flex.Phase vs. ; cm vs cm Initial ContactPhase vs. ; cmvs cm Foot FlatPhase cm vs cm Max Flex.Phase vs. ; cm vs cm Initial ContactPhase Fig. 3-5 The Value of Center of Knee Joint by the Phases -31-
30 vs. Fig. 3-6 Initial ContactPhase Max Flex.Phase Heel Strike Phase vs. ; -0.02±0.04 cmvs.0.01 ±0.06 cm Foot Flat Phase vs. ; 0.02± 0.89 cmvs.0.13 ± 2.09 cm Max Flex. Phase vs. ; cm vs cm Initial Contact Phase vs. ; cm vs cm Foot Flat Phase vs. ; cm vs cm Max Flex. Phase vs. ; cm vs cm Fig. 3-6 The Value of the Center of Knee Joint at Flat Foot and Max Flex. in Take off Phase vs. -32-
31 Fig Heel StrikePhase vs. ; vs Foot FlatPhase vs Max Flex.Phase vs Initial Contact vs. ; vs Foot Flat vs p<0.05 Max Flex.Phase vs. ; vs Fig. 3-7 The Value of the Rotation of Knee Joint by the Phases -33-
32 vs. Fig. 3-8 Fig. 3-7 Heel Strike Max Flex. Initial ContactPhase Max. Flex.Phase Initial ContactPhase Max Flex.Phase Heel StrikePhase vs. ; 22.03±8.69 vs.7.67 ±8.64, Foot FlatPhase vs. ; 21.50± 9.48 vs.7.10 ±8.35 Foot Flat Phase vs. ; vs p<0.05 Max Flex. Phase vs. ; vs Initial Contact Phase vs. ; vs , Max Flex. Phase vs. ; vs Fig. 3-8 The Value of the Rotation of Knee Joint at Flat Foot and Max Flex. in Take off Phase -34-
33 vs. Fig Heel StrikePhase Initial ContactPhase Max Flex.Phase Heel StrikePhase vs. ; vs Foot FlatPhase vs Max Flex. Phase vs Initial Contact Phase vs. ; vs Foot FlatPhase vs Max Flex.Phase vs Fig. 3-9 The Value of the Angle of Calcaneus by the Phases -35-
34 vs. Fig Fig. 3-9 Heel StrikePhase Max Flex. Phase Heel Strike Phase vs. ; 12.92±4.41 vs ±10.98, Foot Flat Phase vs. ; 12.30± 1.94 vs ±7.75, Max Flex. Phase vs. ; vs Initial Contact Phase vs. ; vs , Foot Flat Phase vs. ; vs , Max Flex. Phase vs. ; vs Fig The Value of the Angle of Calcaneus at Flat Foot and Max Flex. in Take off Phase -36-
35 vs. Fig Heel StrikePhase vs. ; vs Foot FlatPhase vs Max Flex.Phase vs Initial ContactPhase vs. ; vs Foot FlatPhase vs. ; vs Max Flex.Phase vs Fig The Value of the Rotation of Pelvis by the Phases -37-
36 vs. Fig Fig Heel Strike vs. ; 35.69±10.04vs ±39.59, Foot Flat vs. ; 28.84± 8.04 vs ±41.49, Max Flex. Phase vs. ; vs Initial Contact Phase vs. ; vs , Foot Flat Phase vs. ; vs , Max Flex. Phase vs. ; vs Fig The Value of the Rotation of Pelvis at Flat Foot and Max Flex. in Take off Phase -38-
37 vs. Fig Heel StrikePhase Initial ContactPhase Max FlexPhase Heel StrikePhase vs. ; vs Foot FlatPhase vs Max Flex.Phase vs Foot FlatPhase p<0.05 Initial Contact Phase vs. ; vs Max Flex. Phase vs Fig The Value of the Flexion of Knee Joint by the Phases -39-
38 vs. Fig Fig Heel StrikePhase Initial ContactPhase Max Flex.Phase Heel Strike Phase vs. ; ±8.47 vs ±5.83, Foot Flat Phase vs. ; ±8.39 vs ±3.86, Max Flex. Phase vs. ; vs Initial Contact Phase vs. ; vs , Foot Flat Phase vs. ; vs , Max Flex. Phase vs. ; vs Fig The Value of the Flexion of Knee Joint at Flat Foot and Max Flex. in Take off Phase -40-
39 vs. Fig Heel StrikePhase vs. ; vs Foot Flat Phase vs Max Flex.Phase vs Initial Contact Phase vs. ; vs Foot FlatPhase vs Max Flex.Phase vs Fig The Value of the Abduction of Pelvis by the Phases -41-
40 vs. Fig Fig Heel Strike Phase vs. ; 93.57±12.48 vs ±25.91, Foot FlatPhase vs. ; 90.65±9.74 vs.86.78±25.77, Max Flex. Phase vs. ; vvs Initial Contact Phase vs. ; vs , Foot Flat Phase vs. ; vs , Max Flex. Phase vs. ; vs Fig The Value of the Abduction of Pelvis at Flat Foot and Max Flex. in Take off Phase -42-
41 3-3-2 The angle of calaneus The rotation of knee joint, The center of knee joint Heel Strike/ Initial Cont. Max Flex. Fig Fig Fig / / / vs. / ; 2.38±3.23 vs.1.91 ±6.14 / vs. / ; 9.68±8.03 vs.1.34±8.40 / / Fig The Variations between Flat foot and Inversion, and High arch and Eversion at Take off Phase -43-
42 Fig Fig / vs. / ; 0.11±7.40 vs ±8.59 / / / vs. / ; 5.29±7.41 vs ±3.51 / / p<0.05 Fig The Variations between Flat foot and Inversion, and High arch and Eversion at Landing Phase -44-
43 Fig / vs. / ; -3.94±6.04 cm vs.0.25 ±4.72 cm / / Fig The Variation between Flat foot and Inversion, and High arch and Eversion at Take off Phase -45-
44 Fig / vs. / ; ±15.14 cm vs ±6.58 cm / / Fig The Variation between Flat foot and Inversion, and High arch and Eversion at Landing Phase -46-
45 3-4 3 vs. vs vs. vs. 3 Kofotolis et al Powellet al vs. vs. vs. Initial Contact Foot Flat vs. Foot Flat vs. Initial Contact Max Flex. 6.1 vs.-5.0 vs. vs. 1.0 vs. 2.2 vs. Fig. 3-9, Fig Mosca,
46 Williams 2001 Fig Initial Contact Max Flex Initial Contact Max Flex. 6 Initial Contact Max Flex. 5 Khamis et al ACL -48-
47 Olsen 2004 Fig. 3-7, Fig Initial Contact Max Flex ACL Koga 2010 Initial Contact 40 msec ACL Initial Contact Foot Flat 5.5 ACL Zeller 2003 Initial Contact Max Flex. 4 1 Fig vs. vs. vs. -49-
48 -50-
49 Pfeiffer et al
50 14 Ogden 1982)
51 3 Hinterman et al Francoet al, 1987 Franco 1987 Beckett, 1992 Simonsen et al Kapandji
52 4-3 vs. vs. 2 vs. vs. vs. (Baker, 1984) (Khamis et al., 2007, Kaga et al., 2010) 5.5 Kaga et al.(2010) 8 Zeller (2003)
53 4-4 Siegler et al Wilkerson 2002 Khamis et al.,
54 F-marc 11+ Soligard et al.,
55
56 6 Alentorn-Geli, Eduard. Myer, Gregory D. Silvers, Holly J. Samitier, Gonzalo. Romero, Daniel. La zaro-haro, Cristina. Cugat, Ramo n. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: A review of prevention programs aimed to modify risk factors and to reduce injury rates. Knee Surg Sports Traumatol Arthrosc (2009) 17: Baker, C. L. Norwood, L. A. Hughston J. C. Acute Combined Posterior and Posterolateral Instability of the Knee. American Journal of Sports Medicine. 12: ,1984 Bandholm, Thomas. MSc. Boysen, Lisbeth PT. Haugaard, Stine PT. Kreutzfeldt Zebis, Mette PhD. Bencke, Jesper PhD. The American College of Foot and Ankle Surgeons 47(2):89 95, Beckett ME, Massie DL, Bowers KD, Stoll DA. Incidence of hyperpronation in the ACL injured knee: a clinical perspective. Journal of Athletic Traininig. 1992; 27: Borowski, Laurel A. MPH. Yard, Ellen E. MPH. Fields, Sarah K. JD, PhD. Comstock, R. Dawn. PhD. The Epidemiology of US High SchoolBasketball Injuries, The American Journal of Sports Medicine, Vol. 36, No Dorsey S. Williams III, Irene S. McClay, Joseph Hamill, and Thomas S. Buchanan. Lower Extremity Kinematic and Kinetic Differences in Runners With High and Low Arches. Journal of Applied Biomechanics, 2001, 17, Forriol F, Pascual J. Footprint analysis between three and seventeen years of age. Foot Ank le. 1990;11:
57 Franco, Abby Herzog. Pes Cavus and Pes Planus. Physical Therapy. Volume 67 / Number 5, May 1987,,,,,,,. Heel-Floor Angle. : Vol. 21, No. 6 ( George, Arangio. Alberic, Rogman. Reed James F. III. Hindfoot alignment valgus moment arm increases in adult flatfoot with Achilles tendon contracture. Foot and Ankle International 2009 Nov;30(11): PT 2007, 41(2): X ,. The journal of clinical sports medicine 23(4), , Hettinger Th. Isometriches Muskeltraining, Stuttgart. Thieme Aufl. 3, Hintermann, B. Knupp M. Injuries and dysfunction of the posterior tibial tendon. Orthodade 2010 Dec;39(12): Kapandji IA. Baltimore, MD. Williams. Wilkins. The Physiology of the Joints: Lower Limb. 1970, vol 2, pp Kaufman, Kenton R. PhD. Brodine, Stephanie K. CAPT, MC, USN. Shaffer, Richard A. CDR, MSC, USN. Johnson, Chrisanna W. MPH. Cullison, Thomas R. CAPT, MC, USN. The Effect of Foot Structure and Range of Motion on Musculoskeletal Overuse Injuries. The American Journal of Sports Medicine, 1999 Vol. 27, No. 5. ( ) 52(6), 797,
58 Khamis, Sam. Yizhar, Ziva. Effect of feet hyperpronation on pelvic alignment in a standing position. Gait & Posture 25 (2007) Kofotolis, Nikolaos. PhD. Kellis, Eleftherios. PhD. Ankle Sprain Injuries: A 2-Year Prospective Cohort Study in Female Greek Professional Basketball Players. Journal of Athletic Training 2007;42(3): Koga, Hideyuki. Nakamae, Atsuo. Shima, Yosuke. Iwasa, Junji. Myklebust, Grethe Engebretsen. Bahr, Lars Roald. Krosshaug, Tron. Mechanisms for Noncontact Anterior Cruciate Ligament Injuries : Knee Joint Kinematics in 10 Injury Situations From Female Team Handball and Basketball The American Journal of Sports Medicine, Vol. 38, No. 11 Lanz, J. Praktische Anatomie (Bein und Statik). p , Springer-Verlag, New York, Lundberg, Arne. Svensson, Olak. Nemeth, Gunnar. Goran, Selvik. The axis of rotation of the ankle joint British Editorial Society of Bone and Joint Surgery.., 2008 McClay, Irene. Manal, Kurt. A comparison of three-dimensional lower extremity kinematics during running between excessive pronators and normals. Clinical Biomechanics (Bristol. Avon) Apr;13(3): Mosca, Vincent S. Flexible flatfoot in children and adolescents. J Child Orthop 2010: EPOS 2010 Myklebust, Grethe. MSc, PT. Engebretsen, Lars. MD, PhD. Hoff Brækken, Ingeborg. MSc, PT. Skjølberg, Arnhild. PT. Olsen, Odd-Egil. MSc, PT. Bahr, Roald. MD, PhD. Prevention of Anterior Cruciate Ligament Injuries in Female Team -60-
59 Handball Players: A Prospective Intervention Study Over Three Seasons. Clinical Journal of Sport Medicine, : Nawoczenski, Deborah A. Saltzman, Charles L. Cook, Thomas M. The Effect of Foot Structure on the Three-Dimensional Kinematic Coupling Behavior of the Leg and Rear Foot. Physical Therapy. Volume 78. Number 4. April 1998 Nigg BM, Cole GK, Nachbauer W. Effects of arch height of the foot on angular motion of the lower extremities in running. Journal of Biomechanics Aug; 26(8): Ogden JA. Skeltal Injury in the Child Lea & Febiger, Philadelphis. Olsen,Odd-Egil PT, MSc. Myklebust, Grethe PT, PhD. Engebretsen, Lars MD, PhD. Bahr, Roald MD, PhD. Injury Mechanisms for Anterior CruciateLigament Injuries in Team Handball A Systematic The American Journal of Sports Medicine, Vol. 32, No American Orthopaedic Society for Sports Medicine. Panagiotis Stavlas, MD, Theodoros B. Grivas, MD, Constantinos Michas, MD, Elias Vasiliadis, MD, Vassilios Polyzois, MD. The Evolution of Foot Morphology in Children Between 6 and 17 Years of Age: A Cross-Sectional Study Based on Footprints in a Mediterranean Population. The Journal of Foot & Ankle Surgery 2005 Pfeiffer, Martin. MD. Kotz, Rainer. Prof MD. Ledl, Thomas. MSc. Hauser, Gertrude. Prof MD. Sluga, Maria. Prof MD. Prevalence of Flat Foot in Preschool-Aged Children. PEDIATRICS Volume 118, Number 2, August Powell, John W. PhD, ATC. Barber-Foss, Kim D. MS, ATC. Sex-Related Injury Patterns Among Selected High School Sports. The American Journal of Sports Medicine, -61-
60 2000 Vol. 28, No. 3. Randazzo, Charles. Nelson, Nicolas G. McKenzie, Lara B. Basketball-Related Injuries in School-Aged Children and Adolescents in American Academy of Pediatrics 2010; 126; 727; originally published online September 13, 2010 Ribeiro, Ana Paula. Trombini-Souza, Francis. Tessutti, Vitor. Lima, Fernanda Rodrigues. Isabel de Camargo Neves Sacco. Si lvia Maria Amado Joa o. Rearfoot alignment and medial longitudinal arch configurations of runners with symptoms and histories of plantar fasciitis. CLINICS 2011;66(6): , Vol. 19 No. 4, Scammon, R.E. The measurement of man. Harris, J.A., C.M. Jackson, D.G. Paterson & R.E. Scammon (ed) The measurement of the body in childhood. Univ. Mineota Press, Siegler S, Liu W, Sennett B, Nobilini RJ, Dunbar D. The three-dimensional passive support characteristics of ankle braces. The journal of orthopaedic and sports physical therapy Dec;26(6): Simonsen OH, Revald P, Kjaer IL, Christensen M, Mølgaard C, Lass P. Tibialis posterior tendon dysfunction. An often neglected cause of painful adult flatfoot. Ugeskr Laeger Sep 25;168(39): Danish. Soligard, Torbjørn. Nilstad, Agnethe. Steffen,Kathrin et al. Compliance with a comprehensive warm-up programme to prevent injuries in youth football. British Journal of Sports Medicine. (2010). doi: /bjsm Swedler, David I. Knapik, Joseph J. Tyson Grier. Bruce H. Jones. Validity of Plantar Surface Visual Assessment as an Estimate of Foot Arch Height The -62-
61 American College of Sports Medicine.,. M 2010 Vol Vol. 1 No UB, Joseph B. The influence of footwear on the prevalence of flat foot: a survey of 2300 children. J Bone Joint Surg Br. 1992;74: ,,,,., 28(supple2), 43, Volpon JB.: Footprint Analysis during the Growth Period., J Pediatr Orthop Jan-Feb; 14 (1): 83-5 Wilkerson, Gary B. Biomechanical and Neuromuscular Effects of Ankle Taping and Bracing. Journal of Athletic Training 2002;37(4): Williams III, Dorsey S. McClay, Irene S. Hamill, Joseph. Buchanan, Thomas S. Lower Extremity Kinematic and Kinetic Differences in Runners With High and Low Arches. JOURNAL OF APPLIED BIOMECHANICS, 2001, 17, Woodford-Rogers B, Cyphert L, Denegar CR. Risk factors for anterior cruciate ligament injury in high school and college athletes. J At hl Train. 1994;29: De Wit B, De Clercq D, Lenoir M. The Yuill, Erik A. DC, MSc, BSc, BPHE. MacIntyre, Ian G. DC, FCCSS(C), BSc. Posterior tibialis tendonopathy in an adolescent soccer player: a case report. The Journal of the Canadian Chiropractic Association December; 54(4): Zeller BL, McCrory JL, Kibler WB, Uhl TL. Differences in Kinematics and electromyographic activity between men and women during the single-legged -63-
62 squat. AM J Sports Med. 2003; 31:
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