Zu Einfluss der Rückfußadduktion und -eversion auf die Innenrotation der Tibia: In-vivo- und in-vitro Untersuchungen am humanen Sprunggelenkkomplex

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Running increased in popularity during the 1970’s and is well known for its positive influence on cardiovascular diseases and the general well being. Along with the increasing number of runners, a negative side effect is the high incidence of running related overuse injuries. It has been estimated that up to 79.3% of runners are affected by at least one running injury within one year. The knee joint is the most common site of injuries, with the patella femoral pain syndrome and the iliotibial band syndrome most frequently reported. Among other extrinsic and intrinsic risk factors, individual running biomechanics have been associated with increased loading of biological tissue. In this context, excessive tibial rotation is considered to promote the development of both knee injuries. Due to the anatomical characteristics of the ankle joint complex rearfoot eversion is mechanically coupled via talus adduction to tibial rotation. Numerous biomechanical studies have examined the concept of coupling between foot and shank. These studies have focused solely on the movement transfer between rearfoot eversion and tibial rotation, ignoring the influence of rearfoot movement within other planes. Recent research demonstrated a considerable amount of rearfoot movement within the transverse plane (rearfoot adduction). Descriptions of ankle joint coupling mechanisms, based on rearfoot eversion, might therefore be incomplete and the influence of rearfoot movement within the transverse plane on tibial rotation remains unclear. Therefore the aims of the present dissertation were (a) to quantify the magnitude of global rearfoot adduction during running and to (b) investigate its relationship to tibial rotation. Another aim was (c) to determine the isolated strength of ankle joint coupling of calcaneal adduction and calcaneal eversion to tibial rotation by means of an in-vitro approach. To analyze joint kinematics an infrared based motion capture system (Vicon Nexus, Vicon Motion Systems, Oxford, Great Britain) was used. In study 1, range of motion values of the shank, rearfoot and medial metatarsal segment of 104 participants were determined by means of an on skin marker set. To validate the results of study 1, in study 2 the bone movement of the foot and shank was investigated using bone anchored marker triads in three runners during slow running. The in-vitro approach used in study 3 was necessary to quantify the isolated coupling mechanisms of calcaneal adduction and calcaneal eversion on tibial rotation. Bone orientations were obtained using bone pin marker triads. To analyze segmental orientation within the same plane of movement a global segment orientation approach was applied in all three studies. The results of this dissertation imply that: a) in running a considerable amount of global rearfoot adduction up to 7.8° (study 2) could be determined, which is similar to the magnitude of rearfoot eversion. b) global rearfoot eversion (partial correlation: r= -0.24, p= 0.015) as well as rearfoot adduction (partial correlation: r= 0.37, p < 0.001) were significantly related to tibial rotation. c) not only calcaneal eversion (Coupling coefficient: 0.68), but to an even greater extent calcaneal adduction (Coupling coefficient: 0.99) was transferred into tibial rotation. The results presented, show that rearfoot adduction is significantly coupled to tibial rotation. Controlling rearfoot adduction might therefore be a mechanism to control shank movement. Future investigations on the genesis of overuse running injuries should include not only the amount of rearfoot movement within the frontal and transverse plane, but also the strength of ankle joint coupling mechanisms. The potential of traditional shoe constructions on controlling rearfoot adduction seems to be limited. Future motion control shoes need to be designed to also control rearfoot adduction. In scientific studies the actual influence of those shoe designs to reduce rearfoot adduction and thereby reduce tibial rotation needs to be addressed.
Original languageGerman
Place of PublicationKöln
PublisherDeutsche Sporthochschule Köln
Number of pages85
Publication statusPublished - 2018

ID: 3407234

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