Faculty Collaboration Database

Sagittal Subtalar and Talocrural Joint Assessment During Ambulation With Controlled Ankle Movement (CAM) Boots. Foot Ankle Int 2017 Nov;38(11):1260-1266

Date

08/13/2017

Pubmed ID

28800714

DOI

10.1177/1071100717723129

Scopus ID

2-s2.0-85033443004 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

BACKGROUND: The purpose of the current study was to determine sagittal plane talocrural and subtalar kinematic differences between barefoot and controlled ankle movement (CAM) boot walking. This study used fluoroscopic images to determine talar motion relative to tibia and calcaneal motion relative to talus.

METHODS: Fourteen male subjects (mean age 24.1 ± 3.5 years) screened for normal gait were tested. A fluoroscopy unit was used to collect images at 200 Hz during stance. Sagittal motion of the talocrural and subtalar joints were analyzed barefoot and within short and tall CAM boots.

RESULTS: Barefoot talocrural mean maximum plantar and dorsiflexion were 9.2 ± 5.4 degrees and -7.5 ± 7.4 degrees, respectively; short CAM boot mean maximum plantar and dorsiflexion were 3.2 ± 4.0 degrees and -4.8 ± 10.2 degrees, respectively; and tall CAM boot mean maximum plantar and dorsiflexion were -0.2 ± 3.5 degrees and -2.4 ± 5.1 degrees, respectively. Talocrural mean range of motion (ROM) decreased from barefoot (16.7 ± 5.1 degrees) to short CAM boot (8.0 ± 4.9 degrees) to tall CAM boot (2.2 ± 2.5 degrees). Subtalar mean maximum plantarflexion angles were 5.3 ± 5.6 degrees for barefoot walking, 4.1 ± 5.9 degrees for short CAM boot walking, and 3.0 ± 4.7 degrees for tall CAM boot walking. Mean minimum subtalar plantarflexion angles were 0.7 ± 3.2 degrees for barefoot walking, 0.7 ± 2.9 degrees for short CAM boot walking, and 0.1 ± 4.8 degrees for tall CAM boot walking. Subtalar mean ROM decreased from barefoot (4.6 ± 3.9 degrees) to short CAM boot (3.4 ± 3.8 degrees) to tall CAM boot (2.9 ± 2.6 degrees).

CONCLUSION: Tall and short CAM boot intervention was shown to limit both talocrural and subtalar motion in the sagittal plane during ambulation. The greatest reductions were seen with the tall CAM boot, which limited talocrural motion by 86.8% and subtalar motion by 37.0% compared to barefoot. Short CAM boot intervention reduced talocrural motion by 52.1% and subtalar motion by 26.1% compared to barefoot.

CLINICAL RELEVANCE: Both short and tall CAM boots reduced talocrural and subtalar motion during gait. The short CAM boot was more convenient to use, whereas the tall CAM boot more effectively reduced motion. In treatments requiring greater immobilization of the talocrural and subtalar joints, the tall CAM boot should be considered.

Author List

McHenry BD, Exten EL, Cross JA, Kruger KM, Law B, Fritz JM, Harris G

Authors

Janelle A. Cross PhD Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University
Karen Kruger PhD Research Assistant Professor in the MU-MCW Department of Biomedical Engineering department at Marquette University

MESH terms used to index this publication - Major topics in bold

Adult
Ankle Joint
Biomechanical Phenomena
Fluoroscopy
Foot Orthoses
Healthy Volunteers
Humans
Male
Range of Motion, Articular
Reference Values
Sampling Studies
Subtalar Joint
Walking
Weight-Bearing
Young Adult