Gait Analysis During Level and Uphill Walking After Lengthening Osteotomy of the Lateral Column

NCT03487497 | Completed

• 1 other identifier: 2015-00254
• Study Type: observational
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

A common surgical treatment for posterior tibial tendon dysfunction (and the resulting flat foot) is the correction through a calcaneal lengthening osteotomy of the lateral column (LLC). Clinical studies showed pain relief and functional improvements through different scores. However, according to clinical experience, some patients complain about a limited ankle dorsiflexion after LLC surgery. Several joints of the foot (talocrural, subtalar, talonavicular, calcaneocuboid) contribute to the overall range of motion in foot plantarflexion/dorsiflexion and pronation/supination. Changes in the range of motion in one joint can affect all the other joints. For instance, it was shown that a fusion of the talonavicular joint removes most of the residual hindfoot motion in plantarflexion/dorsiflexion and pronation/supination. Because the lengthening of the lateral column presumably decreases the mobility of the medial column and thus of the talonavicular joint, this surgery can influence the range of motion of the other joints, and hence contribute to the reported decreased ankle dorsiflexion motion. Patients after LLC have less plantarflexion of the first metatarsal throughout stance of level walking and less inversion of the hindfoot during push-off compared to healthy subjects. Uphill walking requires more ankle plantarflexion and dorsiflexion than level walking. A limitation of the ankle joint mobility especially in dorsiflexion could therefore lead to additional or greater changes in gait patterns (hindfoot and forefoot kinematics) during uphill walking. The primary objective is:

• To compare differences in hindfoot and forefoot kinematics between level and uphill treadmill walking in relation to passive range of motion The secondary objectives are:
• To compare lower leg muscle activation during level and uphill treadmill walking between patients after LLC and healthy subjects
• To test the association between muscle strength, muscle activation patterns and hindfoot and forefoot kinematics during level and uphill walking and heel rise
• To relate clinical outcome of LLC surgery by functional scores to passive range of motion

Conditions

Osteotomy; Lengthening; Leg

Keywords

gait analysis; electromyography; strength test; walking

Outcome Measures

Primary Outcomes (1)

• Passive plantarflexion and dorsiflexion range of motion

  measured using a Biodex

  0 months

Secondary Outcomes (5)

• 3D hindfoot and forefoot range of motion during level and uphill walking

  0 months

• Isokinetic strength in plantarflexion, dorsiflexion, inversion, and eversion

  0 months

• Lower leg muscle activation

  0 months

• Clinical outcome

  0 months

• Functional outcome

  0 months

Study Arms (2)

Patients

Patients who underwent lateral column lengthening osteotomy

Procedure: Lateral column lengthening osteotomy

Healthy subjects

Healthy subjects without intervention

Interventions

Lateral column lengthening osteotomy PROCEDURE

Lengthening osteotomy of the lateral column of the foot

Patients

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

20 patients who had undergone lengthening osteotomy of the lateral column of the foot 2 to 10 years prior and 20 age and sex matched healthy subjects

You may qualify if:

• age \> 18 years
• age \< 70 years
• Patients:
• Unilateral surgery for posterior tibial tendon dysfunction by flexor digitorum longus transfer and lateral lengthening osteotomy of the calcaneus
• Minimum of 2 years postoperatively

You may not qualify if:

• Neuromuscular disorders affecting gait
• Cardiovascular disease
• Diabetes
• Pregnancy (if unknown, a pregnancy test (urine test) will be performed)
• Body mass index \> 35 kg/m2
• Patients:
• Additional pathologies that influence the mobility of the ankle joint
• Bilateral surgery
• Use of walking aids
• Healthy control group:
• Lower extremity surgery
• Pain in the lower extremities within the last 6 months

Sponsors & Collaborators

• University Hospital, Basel, Switzerland: lead

Study Sites (1)

University Hospital Basel

Basel, Canton of Basel-City, 4031, Switzerland

Location

Study Officials

• Corina Nüesch, PhD

  University Hospital, Basel, Switzerland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 28, 2018
• First Posted: April 4, 2018
• Study Start: November 20, 2017
• Primary Completion: December 31, 2018
• Study Completion: December 31, 2018
• Last Updated: March 2, 2020

Record last verified: 2020-02

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)