Method of early diagnostics of pes valgus deformation of feet in children

FIELD: medicine.

SUBSTANCE: registration of biomechanical characteristics of the ankle joint work is performed by means of a hardware-software complex in the process of a step cycle with the application of a motion capture system, a dynamic stabiloplatform and electromyography (EMG). First, light-reflecting markers are fixed on the patient's body, devices of wireless EMG are fixed on anterior and posterior groups of the shin muscles. An individual three-dimensional static skeleton model of the patient, for which characteristics of the step cycle are determined by the patient walking on the stabilometric platform with the number of not fewer than 5 repetitions, is created by means of the motion capture system. The obtained biomechanical characteristics are used to calculate the power of the ankle joint work, the pronation angle and the supination angle by means of the complex software. Comparative analysis of the said parameters with the parameters of the norm, varying in the following ranges: power of work 3.01÷4.56 W/kg, pronation angle 3.89÷4.78 degrees, supination angle 2.98÷3.67 degrees, is carried out. Pes valgus deformation of feet is diagnosed if the power of the ankle joint work and the supination angle reduce, and the pronation angle increases in comparison with the norm.

EFFECT: method provides the complex accurate quantitative early diagnostics of pes valgus deformation of the foot in children in short terms, taking into account the biomechanics of walking.

2 ex

 

The invention relates to the field of medicine, namely to orthopedics, and can be used to identify the characteristics of gait inherent in the early stages for the talipes valgus in children.

The problem of early diagnosis of flatfoot in children today is quite relevant. Existing in this section of orthopedics diagnostic methods allow for a different degree of accuracy to detect only clinically expressed forms of flatfoot. Control of gait is performed by a podiatrist during routine inspection at the age of three and is visual only. Visual inspection allows to detect only advanced pathology and give a rough estimation of its extent. These same disadvantages suffers a method of photographing stop [1]. Method of odometry (measurement of height and length of the foot, the calculation photometrische index) [2] allows accurate diagnosis only in cases of anatomically overt signs of flatfoot. The disadvantage of x-ray method [3] is radiation exposure. If planography (determination of the bearing surface of the foot print on the paper) [4] results in 30-40% do not coincide with the clinical diagnosis due to the high vulnerability of the methodology and fuzziness of plantogram. Pedobarography (pressure measurement stop bearing at rest and when p�slichnih kinds of loads with subsequent computer processing of the results) [5] is a means of assessing the efficiency of full-contact insoles patients with flat feet, does not allow to assess the condition of the subtalar joint and muscle activity of the lower leg. Computer and optical diagnostics [6] (method of registration of the camcorder status of the lower extremities or reflected by a mirror image of the plantar surface of the foot from further processing of the received data on the computer) does not allow to analyze the work of the ankle joint in the dynamics.

The closest adopted for the prototype, is the method of pedobarography. However, it cannot be used to diagnose early stages of flatfoot, as it will not record the kinetic, kinematic characteristics of the ankle joint and the state of activity of the leg muscles, and also change the settings of the stepping cycle.

For any initial stages of deformation of the foot suffers the mechanics of the subtalar joint. The maximum load on the subtalar joint account at the time of the step cycle in the stance phase, when the foot is maximally spread and planiruetsya under the weight of the body. Therefore, it is necessary to investigate the work of the subtalar joint is in the process of walking, and not in a static position.

Normally, in the process of rolling of the foot, the subtalar joint forms an angle of 4 degrees in the frontal plane, alternately in the lateral and medial sides. When flat�algunos deformation increases this angle. In the initial stage of deformation are included compensatory mechanisms to correct the situation - the increase in the workload of the muscular system responsible for movement in the ankle joint, and, as a consequence, the increase in the workload of the joint. Point pressure weight when rolling of the foot is in a walking cycle forms a normal physiological trajectory that runs from the heel to the toe. If any violations of the biomechanics of the ankle joint this trajectory changes even in the absence of external signs of pathology.

A task that allows to solve the present invention is the diagnosis for the talipes valgus in children at early stages.

To solve this problem during routine inspection of children are encouraged to use the motion-capture system (Motion Capture), for the registration of the biomechanical performance of the ankle joint in the process of the step cycle by means of infrared cameras, dynamic stabilometry and electromyography to calculate in a short time quantitative characteristics of the ankle joint, namely

- the angle of rotation of the subtalar joint in the frontal plane in the reference period of the stepping cycle;

- the power output of the subtalar joint;

- the workload of the muscles, correcting the initial pathology in the joint;

trajectory t�chki pressure of body weight on the foot during the stance phase of the step cycle, as well as identifying the nature of these violations and, as a consequence, disturbances of gait.

The proposed method consists of the following sequence of actions:

1. The fixing of retro-reflective markers on the patient's body;

2. Fixation 4 devices for wireless electromyography of the lower extremity of the patient;

3. Calibration of a motion capture system;

4. The static entry models of the patient to create an individual skeletal model;

5. The implementation of the patient pass through the stabilometric platform (at least 5 repetitions);

6. Calculation using specialized software characteristics of the stepping cycle, the power output of the ankle joint; EMG of the muscles of the lower leg; the trajectory of the centre of pressure in a walking cycle; reaction force in support of the stepping cycle;

7. Comparative analysis of the obtained values with the parameters of normal, varied in the following ranges: the power of work - 3.01÷4.56 W/kg, the angle of pronation - 3.89÷4.78 degrees, the angle of supination - 2.98÷3.67 degrees for diagnosis for the talipes valgus.

The present invention is as follows: on the lower limb of the patient in a certain order are fixed retro-reflective markers (18 markers for the two limbs). Using 10 infrared and 2 video cameras data transmission�tsya to the control device and stored in a memory of the hardware-software complex, who with the help of specialized software builds individual three-dimensional model of the patient. To receive data from the computer at the anterior and posterior group of muscles of the lower leg is fixed wireless instrument for electromyography (minimum 4 pieces). Calibrated the system and the construction of three-dimensional skeletal model. After that the patient is on certain sections stabilometric platform (at least 5 times). Hardware transmits the received data for processing using specialized software to calculate key indicators and their analysis for the purpose of diagnosing ploskovalgusnaya deformation. The results of measurements and analyses are stored in the memory of the hardware-software complex and can be output in the form of a research report.

An example of a specific embodiment of the invention.

Example 1. The patient Alexey V. 14.07.2004 year of birth. The study of gait using motion capture system described method.

The research report: date of study 16.05.2013 G. the Capacity of the ankle joints was 1.79-2,33 W/kg, the angle of pronation 5.86, the angle of supination 1.12. Observed medial displacement of the trajectory of the point of pressure during the stance phase, increasing muscle activity goal�and, increasing the base of the stepping cycle. Diagnosis: Initial signs of ploskovalgusnaya deformity of both feet.

The diagnosis was subsequently confirmed by an orthopedic surgeon.

Example 2. The Patient Rodion A. 10.11. 2003 year of birth. The study of gait using motion capture system described method.

The research report: date of study 18.05.2013 G. the Capacity of ankle joints amounted to 3.22-4,23 W/kg, the angle of pronation 4,12, supination angle 3.12. Which corresponds to the parameters of normal, varied in the following ranges: the power of work 3,01-to 4.56 W/kg, the angle of pronation 3,89-4,78, the angle of supination 2,98-3,67. Diagnosis: Initial signs of flat feet is not identified.

The diagnosis was subsequently confirmed by an orthopedic surgeon.

Thus, the proposed diagnostic method allows to identify abnormalities of motor function and biomechanics of the ankle joint, inherent in the early stages for the talipes valgus in children, get them quantitative indicators and a comprehensive evaluation.

The list of references

1. Andreev P. S., Ryabchikov I. V. Digital computer photoplesmography in the practice of the doctor traumatologist-orthopedist. The First International. Conf. in surgery of the foot and ankle in Moscow. The book of abstracts (Moscow, 31.03-01.04 2006). M.; 2006. 10.

2. Under. Mayu B. V. Petrovsky Podometre. Pain�Aya medical encyclopedia. Publisher: Soviet encyclopedia, 1974.

3. Solomin, V., Ignatyev Yu. T., Fedotov V. K. Optoelectronic diagnostics as one of the methods of radiological imaging. Nevsky radiological forum "New horizons" (7-10 APR. 2007). SPb.: Albiceps.; 2007. 746.

4. Jawlensky O. N., Lisitsyn M. P., Neverkovich A. S. Computer planography in the treatment of pathologies of the feet. The First International. Conf. in surgery of the foot and ankle in Moscow. The book of abstracts (Moscow, 31.03-01.04 2006). M.; 2006. 111.4.

5. Gorokhov, S., Udovichenko O. V., Galstyan G. R. In-Shoe computed pedobarography as a new method of evaluating the effectiveness of orthopedic shoes in patients with diabetes mellitus. Diabetes 2009, No. 4.

6. Solomin, V., Fedotov V. K., Ignatyev Yu. T., Vyacheslav Solomin.Yu. Computer optical topography ka method of radiodiagnosis static deformities of the feet in children. Traumatology and orthopedics of the XXI century. The book of abstracts of the VIII Congress of traumatologists and orthopedists Russia: In 2 V. (Samara, 6-8 June 2006). Samara: Etching, Samara state medical University, 2006; II. 977-978.

Method of early diagnostics for the talipes valgus in children, including the use of hardware-software complex, which carry out registration of the biomechanical characteristics of the ankle joint in the process of step cycle with the use of a motion capture system, d�of namic stabilometry and electromyography (EMG), what is initially on the patient's body is fixed with reflective markers on the anterior and posterior group of muscles of the tibia is fixed in the device for a wireless EMG, using a motion capture system to create individual three-dimensional static skeletal model of the patient, which defines the characteristics of the stepping cycle by passage of a patient by stabilometric platform in the amount of not less than 5 reps, on the basis of biomechanical characteristics using the software calculate the complex power of the ankle joint, the angle of pronation and supination angle and conduct comparative analysis of these parameters with the parameters of normal, varied in the following ranges: the power of work 3,01÷4,56 W/kg, the pronation angle 3,89÷4,78 degree angle supination 2,98÷3,67 degrees, ploskovalgusnaya deformation of the foot is diagnosed when reducing the power output of the ankle joint and supination angle and the angle is increased pronation compared to the norm.



 

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