Clinical Biomechanics

Clinical Biomechanics is a research group within the Movement Science department of the Muenster Sport Institute focusing on orthopedics and sport therapy. The aim of the research is to induce a movement from evidence based therapeutic approaches towards science based therapeutic approaches in conservative and surgical treatment in orthopedic, rehabilitation and sports medicine.

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  Many factors play a role in rehabilitation after impairment of body structures or functions: Physiological factors, such as the amount of tissue damage, or mechanical factors, such as tissue loading, will influence tissue regeneration and preservation. However, also psychological factors, such as coping with or fear of pain, will influence the ability of the patient to restore body structures and function.

  Therefore, we apply a multi-disciplinary translational approach, combining knowledge and insights from clinicians, therapists, biomechanical engineers, psychologists and physiological researchers. Additionally, a large variation of research methods is at our disposal and combining these, provides us insight in degenerative and rehabilitation factors and mechanisms. Our approach enables fundamental research into degeneration, restoration and preservation mechanisms of body structures and functions to optimise the patients quality of life.

  Finally, improving our understanding of WHY and HOW specific factors influence rehabilitation, and how these are related to therapies yielding positive or negative results, will lead to improved patient specific therapeutic management. Ongoing research topics include multi-disciplinary studies of ankle instability after inversion trauma and efficiency of daily hand-cycling.

Current Projects

• Kinematic analysis

  Role of foot and ankle segments in balance and gait

  This project investigated the motion of the foot segments using the Ghent Foot Model in healthy subjects to understand what happens during balance maintenance.

  Multi Segmented Foot

  A computer model which includes detailed foot and ankle segments with corresponding joints can be used to study topics such as the effects of foot posture, muscle atrophy and delay in or absence of sensory input on balance performance.

• Force analysis

  Balance Performance

  We aim to assess different balance parameters based on the position and velocities of centre of pressure and centre of mass.

• EMG analysis

  Muscle Foot

  Foot and ankle muscle activity increases when balance tasks become more challenging. However, we know little about how these activities change over time, for example after injury or with training.

• Clinical assessment and questionnaires

  Rehab After Ankle Trauma

  In this project, we aim to analyse how function, activities and participation change during the rehabilitation process after ankle inversion trauma.

Reviews performed as part of MSc M6 module

• A systematic review on Foot Posture Classifications: Implementation of Pathological or Non-Pathological Differentiations

  By Lena Fennen, September 2019

  ABSTRACT
  Introduction: This systematic literature review evaluated the abilities of foot and ankle assessments and their classifications to differentiate between non-pathological or pathological differences in foot posture. Indicating the need of this differentiation for advanced understanding of foot misalignments and their need of treatment.
  Methods: Pubmed, Web of Science and Scopus have been utilized as search engines. Results: 15 articles were included. No ability to differentiate between pathologies and non-pathological physics was found. Inconsistent usage of classifications was identified and supported by previous research, as well as inefficient use of classifications designations.
  Conclusion: The creation of an assessment which differentiates between non-pathological physics or pathologies and is able to represent detailed information about the foot’s alignment by the classification should be targeted. Additional research is needed.

• Comparing different Balance assessment tools and their mathematical parameters: A systematic Review

  By Svenja Wald, September 2019

  ABSTRACT
  Nowadays, the market of achievable balance assessment tools is growing as the market for consumer electronic devices is. The traditional devices like force plates or motion capture system are more and more replaced by Smart phones, game consoles and other techniques. The assessments are less expensive, more mobile and can be used at home. Falls are a major health concern therefore there is a need of reliable and accurate balance assessment tools. The aim of the review is to get an overview of the existing assessment tools and new methods and to point out their advantages and disadvantages. A systematic review was conducted. A total of 1802 articles were retrieved on the database PubMed. After removal of all duplicates, 20 articles were included in the study meeting all the inclusion criteria. Results show that home-based video games, smartphones and tablets are getting more and more established in monitoring balance. Different ways to calculate the non-stationary Center of Pressure are introduced and improved balance assessment tools.

   

• Systematic review: What types of foot muscle training have been reported and what are their effects?

  By Fulya Gerçek, May 2021

  INTRODUCTION (preliminary version)
  The foot is one of the most complex structures of the human body with 26 bones, 29 muscles, 108 ligaments and 30 joints, that each contribute to the stabilisation as well as mobility in movement. (Riegger, 1988). Foot muscle activity has been found to directly correlate with balance and foot posture: According to a study conducted by Kelly and colleagues in 2012, plantar intrinsic foot muscle activation has been found to increase when the need of postural control increases. Reduced foot muscle strength or volume has been related to increased fall risk in the elderly population (Mickle, 2009), and to increased injury proneness and prevalence of pathologies (Soysa, 2012), such as plantar fasciitis (Cheung, 2016), and pain (Latey, 2017). On the other hand, intrinsic foot muscles for example are mostly ignored by clinicians (McKeon, 2014). However, the above findings show that, training of foot muscles, may have a positive effect on reducing injury risk or improving performance for a wide range of application fields such as ageing, and work or sport.

• Systematic review: Older and younger adults performance during challenging dynamic tasks.

  By Yu Yuan Lee, June 2021

  INTRODUCTION (preliminary version)
  It is undeniable, that falling is a serious and common issue for people, especially for older adults. Their fall incidence has been shown to be between 20 to 50% each year, depending on age.(Sattin, 1990). Additionally, Steinweg has shown that 30 percent of community-dwelling adults aged than 65 years old fall each year and which increase to 50 percent for the elderly aged older than 75 (Steinweg 1997). Thus, it is true that fall risk is highly correlated to ageing. Furthermore, according to the data from World Health Organization, 2007, the frequency of falling and falling related injuries increase along with ageing. Among the elderly aged 65 years and older, the relative falling rates increase with approximately 5 percent per year (Anstey, 2008).
  When elderly fall, consequently 15% will sustain an injury. Fall related injuries include fractures of the lower and upper extremity, open wounds, intracranial injuries, and other impairments, which depend on the type of fall (Sattin, 1990). The fall related injuries result in high costs for, among others acute health care and rehabilitation. Heinrich et al., 2009 reported that, around the world, the mean costs per fall victim, per fall and per fall-related hospitalization ranged from $1,059 to $42,840 U.S. dollar purchasing power parties (PPP, converts different currencies to a common one and equalizes the purchase power of different currencies). In conclusion, falls within the elderly population are frequent, impairing with a significant consequence for quality of live and are very costly.