[Purpose] To investigate the relationship between isokinetic knee muscle strength and kinematic, kinetic and spatiotemporal gait parameters of patients with multiple sclerosis (MS). [Subjects and Methods] Twenty-nine MS patients (mean age 31.5±6.5) were investigated in this study. The isokinetic knee muscle strength and gait parameters of MS patients with moderate and severe disability, as determined by the expanded disability status scale (EDSS): EDSS=1-4.5 (n=22, moderate disability) and EDSS>4.5 (n=7, severe disability) were measured. [Results] Isokinetic knee muscle strength, kinematic, kinetic and spatiotemporal gait parameters differed between moderate (EDSS=1-4.5, n=22) and severe disability (EDSS>4.5, n=7). The correlation between each of gait speed, stride length, total range of knee joint movement and the four strength parameters (minimum and maximum quadriceps and hamstring muscle strengths) were significant for the MS group as a whole. Within subgroups, the correlation between minimum hamstring strength and total range of knee movement was significant only in group EDSS>4.5; minimum hamstring correlated with peak knee extensor moment in group EDSS=1-4.5, but at a reduced level of significance. [Conclusion] The present study revealed significant correlations between gait characteristics and isokinetic strength parameters of the quadriceps and hamstring muscles. Our study suggests that rehabilitation protocols for MS patients should include a critical strength training programme particularly for the hamstring and quadriceps muscles.

[Purpose] The application of kinesio taping may improve strength and performance, inhibit and facilitate motor activity, and increase range of motion. The aim of this study was to compare the effects of kinesio taping facilitation and inhibition applications on spatiotemporal knee kinematics and kinetics during walking activity in healthy subjects. [Subjects and Methods] A three-dimensional quantitative gait evaluation was performed without tape and with, facilitation and inhibition kinesio taping application on the knee. Sixteen healthy female college students (age, 19.7 ± 0.4 years; height, 1.64 ± 3.4 cm; body mass, 51.5 ± 4.8 kg) participated in the study. [Results] Spatiotemporal parameters (cadence, walking speed, stride length) were significantly different among the trials. Knee joint sagittal plane range of motion was not different with either kinesio taping application. Knee external flexion moment during the early stance phase decreased significantly with facilitation kinesio taping and increased with the inhibition kinesio taping. Knee external extension moment during the mid-stance phase increased with facilitation kinesio taping. Knee power parameters, eccentric activity in the rectus femoris during the pre-swing phase was significantly increased with inhibition kinesio taping application, while eccentric activity of the hamstrings during the terminal swing of gait was decreased. [Conclusion] These findings showed that facilitation kinesio taping application affected the terminal stance phase and that inhibition kinesio taping influenced the terminal swing phase compared with the no tape condition.

Infantile tibia vara is an acquired form of tibial deformity associated with tibial varus and internal torsion. Several methods have been described for orthotics treatment. The purpose of this study was to determine the effectiveness of orthotics treatment in infantile tibia vara. Controlled trial. The aim of this study was to compare the effect of different types of orthoses and correction methods on decreasing the curve in children with severe genu varum. Three different types of knee–ankle–foot orthoses were applied to 35 lower extremities of 22 pediatric participants who were 19–38 months of age. The same orthotic design principles were used to correct the femur, while different designs were applied to correct the tibia. The orthoses used on 20 participants were evaluated for differences among them and their effects on the treatment process. In addition, methods used in the treatment, problems encountered, production of different types of orthoses, convenience of application of the orthoses, and degree of patients satisfaction are discussed in this article. The mean duration of treatment of the participants until completion of treatment was 25.3 ± 9.7 weeks with a minimum of 9 weeks and a maximum of 41 weeks. No statistically significant correlation was found between the duration of orthotic use in patients with a successful outcome and percentile height and percentile weight. When the duration of treatment using the different types of orthoses was analyzed, significant differences were found between Type 1 and Type 2, and Type 1 and Type 3 orthoses (p < 0.05), while no difference was observed between Type 2 and Type 3 orthoses (p > 0.05). We found that bracing is an effective form of treatment for infantile tibia vara up to 38 months of age. We conclude that full-time use of knee–ankle–foot orthoses exerting corrective forces from five points along the full length of the limb was effective. The localization of the distal tibial correction, the quality of the midtibial correction band, and the importance of the application of corrective forces from five points with rigid methods were found.

Between the years 1986–2001, 135 patients who have had traumatic radial nerve injury, were supplied with dynamic wristhand orthoses (WHOs). The aim of this study is to examine the applied splints,...

Rience of 12 metacarpal distractions in thumb amputated patients. Twelve male patients who had thumb amputation due to gunshot wounds were included in the study. Before the operation, aesthetic hand prostheses were made for 5 of the12 patients. Callus distraction was performed with the use of a mini Ilizarov type external fixator in 7 cases and uniplanar dynamic mini external fixator in 5 cases too. External fixators were removed after the completion of the radiographic consolidation. Five patients whose prosthesis had been made before the operation wore their prosthesis for an average 6.8 months (5 – 14) due to poor appearance and poor construction. Union of the lengthened segment was observed in all cases. Average lengthening was 28.9 mm (range from 25 – 37). Average healing time was 2.1 months (range from 1.8 – 2.5). Average healing index was 0.73 month/cm (range from 0.65 – 0.88). Pin tract infection was seen in 7 cases (58.3%). Volar angulation developed after removing the external fixator in 1 case. Webplasty was performed in all cases. Patients were evaluated by means of Disability of the Arm, Shoulder and Hand (DASH) score and pick-up test. It was concluded that the metacarpus lengthening by callus distraction technique may be a functionally and cosmetically effective reconstruction method for traumatic thumb amputations. It is believed that the possibility for a functionally and aesthetically acceptable fabrication of a thumb prosthesis, by providing a suction suspension with distraction and/or webplasty procedures....

This study aims to determine the effect of insoles with arch support on gait patterns in patients with multiple sclerosis (MS) and somatosensory impairment. Ten patients (7 females, 3 males; mean age 34.9±6.8 years; range, 48 to 35 years) with clinically definite relapsing remitting MS and age- and sex-matched 10 healthy volunteers (7 females, 3 males; mean age 33.8±3.2; range, 40 to 31 years) were included in the study between January 2011 and January 2012. A medial longitudinal arch and transverse arch supporting polyurethane insole covered with foam shaped using plantar sensory feedback was used. Three-dimensional gait analysis was performed via a Vicon 612 system with six cameras. The participants initially walked barefoot and, then, wore the insoles in their short slipper socks. All participants were evaluated in terms of kinetics, kinematics, and temporospatial parameters with a gait analysis system. The patients with MS showed improvements in cadence and walking speed when using the insoles. Sagittal plane angles of the hip and knee were increased while using insoles (p<0.05) and ankle plantar flexion was found to be decreased, compared to barefoot walking (p<0.05). Our study results suggest that insole with arch support affects gait cycle, but does not improve gait impairments in patients with MS. Insoles may ensure plantar sensory feedback in feet during walking, which increases pressure in the mid-forefoot area.