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      The impact of tibial torsion measurements on gait analysis kinematics

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          Abstract

          Objective:

          To measure and compare tibial torsion values as assessed by goniometry and three-dimensional kinematics. In addition, the impact of each one of these measurements on kinematic and kinetic results for normal gait was determined.

          Methods:

          Twenty-three healthy and fully ambulatory patients were assessed, 11 women and 12 men, from 20 to 40 years old. Data were collected at a laboratory for the three-dimensional analysis of movement with 10 cameras and two force plates. Tibial torsion measurements were obtained using goniometry and three-dimensional kinematics based on the Plug-in Gait model. Afterwards, both procedures were compared, and the impact of each result was assessed on the kinematic and kinetic modeling of the knee and ankle.

          Results:

          Pearson's linear correlation coefficient (r=0,504) showed a moderate correlation between the three-dimensional kinematics and goniometry, and between the changes in the measurements. Regarding the processed kinematic and kinetic results for every torsion position, no significant differences were noticed among any of the studied variables (p>0.05).

          Conclusion:

          Although statistical correlation among tibial torsion angles by goniometry and three-dimensional kinematic were moderate, kinematic and kinetic analysis of the joints did not reveal any significant changes. Level of Evidence I, Diagnostic Studies - Investigating a Diagnostic Test.

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          Most cited references74

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          Sample size requirements for estimating intraclass correlations with desired precision.

          A method is developed to calculate the approximate number of subjects required to obtain an exact confidence interval of desired width for certain types of intraclass correlations in one-way and two-way ANOVA models. The sample size approximation is shown to be very accurate. Copyright 2002 John Wiley & Sons, Ltd.
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            The reliability of three-dimensional kinematic gait measurements: a systematic review.

            Three-dimensional kinematic measures of gait are routinely used in clinical gait analysis and provide a key outcome measure for gait research and clinical practice. This systematic review identifies and evaluates current evidence for the inter-session and inter-assessor reliability of three-dimensional kinematic gait analysis (3DGA) data. A targeted search strategy identified reports that fulfilled the search criteria. The quality of full-text reports were tabulated and evaluated for quality using a customised critical appraisal tool. Fifteen full manuscripts and eight abstracts were included. Studies addressed both within-assessor and between-assessor reliability, with most examining healthy adults. Four full-text reports evaluated reliability in people with gait pathologies. The highest reliability indices occurred in the hip and knee in the sagittal plane, with lowest errors in pelvic rotation and obliquity and hip abduction. Lowest reliability and highest error frequently occurred in the hip and knee transverse plane. Methodological quality varied, with key limitations in sample descriptions and strategies for statistical analysis. Reported reliability indices and error magnitudes varied across gait variables and studies. Most studies providing estimates of data error reported values (S.D. or S.E.) of less than 5 degrees , with the exception of hip and knee rotation. This review provides evidence that clinically acceptable errors are possible in gait analysis. Variability between studies, however, suggests that they are not always achieved.
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              Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait.

              The repeatability of gait variables is an important consideration in the clinical use of results of quantitative gait analysis. Statistical measures were used to evaluate repeatability of kinematic, kinetic, and electromyographic data waveforms and spatiotemporal parameters of 40 normal subjects. Subjects were evaluated three times on each test day and on three different test days while walking at their preferred or natural speed. Intrasubject repeatability was excellent for kinematic data in the sagittal plane both within a test day as well as between test days. For joint angle motion in the frontal and transverse planes, the repeatability was good within a test day and poor between test days. Poor between-day repeatability of joint angle motion in the frontal and transverse planes was noted to be partly due to variabilities in the alignment of markers. Vertical reaction and fore-aft shear forces were more repeatable than the mediolateral shear force. Sagittal plane joint moments were more repeatable than frontal or transverse plane moments. For electromyographic data, repeatability within a day was slightly better than between test days. In general, the results demonstrate that with the subjects walking at their natural or preferred speed, the gait variables are quite repeatable. These observations suggest that it may be reasonable to base significant clinical decisions on the results of a single gait evaluation.
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                Author and article information

                Journal
                Acta Ortop Bras
                Acta Ortop Bras
                aob
                Acta Ortopedica Brasileira
                Sociedade Brasileira de Ortopedia e Traumatologia
                1413-7852
                1809-4406
                2014
                : 22
                : 5
                : 278-282
                Affiliations
                [1 ]Universidade Nove de Julho, São Paulo, SP, Brazil, Universidade Nove de Julho, São Paulo, SP, Brazil
                [2 ]Universidade de São Paulo, São Paulo, SP, Brazil, Universidade de São Paulo, São Paulo, SP, Brazil
                [3 ]Hospital Israelita Albert Einstein, São Paulo, SP, Brazil, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
                [4 ]Universidade Federal de São Paulo, São Paulo, SP, Brazil, Universidade Federal de São Paulo, São Paulo, SP, Brazil
                Author notes
                Correspondence: Rua Vergueiro, 235, Liberdade, 01504-001, São Paulo, SP, Brasil. paulolucareli@ 123456uninove.br

                All the authors declare that there is no potential conflict of interest referring to this article.

                Article
                10.1590/1413-78522014220500579
                4199647
                25328438
                21779a5d-a9fb-4859-bead-3c2a41dcc1c1

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 December 2011
                : 07 May 2012
                Page count
                Figures: 3, Tables: 1, References: 25, Pages: 5
                Categories
                Original Article

                tibia,torsion abnormality,biomechanical phenomena
                tibia, torsion abnormality, biomechanical phenomena

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