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Lothar Thorwesten

Publications and source records attributed to Lothar Thorwesten.

6 recordsLinked to original sources

The influence of external ankle braces on subjective and objective parameters of performance in a sports-related agility course.

With lateral ankle sprains being the most frequent sports-related injury, there is an evident demand for the preventive measures in active individuals with chronic ankle instability. Braces are commonly used for prevention and treatment of ankle injuries. Various investigations-mostly performed with healthy subjects-focused on this problem, yet they often compared only a few models or used only limited testing procedures. However, controversy exists whether braces affect sports performance. The purpose of the present study was to compare the effects of ten different ankle braces-one rigid, five semirigid, four soft models-in a comprehensive evaluation with multiple testing procedures in 34 subjects with self-reported chronic ankle instability. The multiple testing procedures evaluated objective performance-related parameters and subjective parameters related to comfort and stability. The subjects performed an agility course with maximal effort. The course included a vertical jump and a cutting maneuver, both on a force platform, a single leg hopping test on level and inclined plates, a combined straight and curve sprint and sidesteps. Three valid trials were measured and averaged for each brace and every subject. Subjective aspects were evaluated with a questionnaire about handling, perceived restrictions, support and comfort; it was completed after each brace was worn and tried. With regard to the objective parameters, no significant differences were found between the braces except for the rigid brace which showed decreased values for the vertical jump and longer times for the other tests compared to all other braces. The subjective evaluation of the braces revealed significant differences with respect to comfort and handling and therefore, permitted a distinction between semirigid and soft braces. Although significant differences between braces were found in subjective performance restriction, no significant differences were revealed in the objective evaluation. From that point of view, patients could choose a brace model according to their individual needs. A comfortable brace might have a positive influence on the athlete's state of mind although other aspects like the brace's stabilizing effect play an additional role and should also be taken into account for recommendation of braces.

Adolescent↗

Reduced plantar sensation causes a cautious walking pattern.

The aim of this study was to investigate the influence of reduced plantar sensation on gait patterns during walking in 20 healthy subjects (25.9 +/- years, 61.6 +/- 11.5 kg, 178 +/- 9.5 cm) with no history of sensory disorders. Force plate measurements, electromyography (EMG) measurements and a three-dimensional movement analysis were performed simultaneously during barefoot walking before and after reduction of plantar sensation using an ice immersion technique. The results show that reduced plantar sensation leads to significant changes in gait patterns that are present at the ankle, knee and hip joint and indicate a more cautious ground contact and push-off with modified EMG and motion patterns.

Adult↗

Proprioception of the shoulder joint after surgical repair for Instability: a long-term follow-up study.

BACKGROUND: Proprioceptive capabilities play an important role in stability of the shoulder joint. HYPOTHESIS: Decreased proprioceptive capabilities can improve by surgical repair of shoulder instability. STUDY DESIGN: Prospective long-term study. METHODS: The proprioceptive capabilities of 14 patients with recurrent anterior shoulder instability were examined preoperative and with a minimum follow-up of 5 years postoperative using the angle reproduction test. The patients' data were compared to a healthy control group. RESULTS: The joint position sense improved significantly in abduction, flexion, and rotation (P <.05). The preoperative difference from the target joint position was 9.3 degrees (SD, 4.6 degrees ) for the summarized positions in abduction, 9.1 degrees (SD, 4.5 degrees ) in flexion, and 10.1 degrees (SD, 5.1 degrees ) in rotation. Postoperatively, it improved to 5.6 degrees (SD, 2.9 degrees ) in abduction, 5.6 degrees (SD, 2.7 degrees ) in flexion, and 5.0 degrees (SD, 1.8 degrees ) in rotation. The joint position sense of the uninvolved contralateral shoulder improved too. CONCLUSIONS: Five years after surgical repair for shoulder instability, the joint position sense improved significantly, to a level of normal, healthy shoulders.

Adolescent↗

Modified pressure distribution patterns in walking following reduction of plantar sensation.

The aim of the present study was to investigate the influence of reduced plantar sensation on pressure distribution patterns during gait of 40 healthy subjects (25.3+/-3.3 yr, 70.8+/-10.6 kg and 176.5+/-7.8 cm) with no history of sensory disorders. Plantar sensation in the subjects was reduced by using an ice immersion approach, and reduced sensitivity was tested with Semmes-Weinstein monofilaments. All subjects performed six trials of barefoot walking over a pressure distribution platform under normal as well as iced conditions. Plantar cutaneous sensation was significantly reduced after the cooling procedure (p<0.0001). Pressure distribution analysis showed substantially modified plantar pressure distribution patterns during the roll-over process (ROP) under iced conditions. Analysis of peak pressures revealed significant reductions under the toes and under the heel (p<0.001). The contact time and the relative impulse for the whole foot did not change significantly between the two conditions. For the different areas, a significant load shift from the heel and toes towards the central and lateral forefoot and the lateral midfoot was observed. The results indicate the strong influence of reduced afferent information of the sole of the foot on the ROP in walking.

Adult↗

Comprehensive testing of 10 different ankle braces. Evaluation of passive and rapidly induced stability in subjects with chronic ankle instability.

OBJECTIVE: The aim of the present investigation was to test the stability of 10 different ankle braces under passive and rapidly induced loading conditions in a population suffering from chronic ankle instability in order to provide objective information to choose or recommend an appropriate model for specific needs. In addition, the relationship between passive and rapidly induced testing of the stabilizing effect against inversion was evaluated to identify if passive support characteristics of braces are reflected under rapidly induced conditions. DESIGN: An experimental in vivo study with a repeated-measures design was used. BACKGROUND: Ankle braces are commonly used for treatment, rehabilitation, and prevention of ankle injuries. A variety of products exists but there is few information available to assist clinicians, physiotherapists and coaches as well as consumers in choosing a brace on a basis of objective information. Furthermore, there is a lack of studies that provide data for both passively and rapidly induced movement of the ankle joint when using different ankle braces. METHODS: Twenty-four subjects with chronic ankle instability participated in the project. Passive ankle range of motion measurements were performed in a custom-built fixture and simulated inversion sprains were elicited on a tilting platform. RESULTS: The tested braces restrict range of motion significantly compared to the no-brace condition for both the passively and rapidly induced inversion and marked differences between braces were revealed. A close relationship between passive and rapidly induced test results for inversion was found. CONCLUSIONS: Passive as well as rapidly induced stability tests provide a basis of objective information to describe the characteristics of different ankle braces. Combined results of passive and rapidly induced inversion as well as correlation between results demonstrate that passive support characteristics of braces are reflected under rapidly induced conditions but the amount of restriction is reduced. Therefore, caution should be taken when recommending braces for applications under dynamic circumstances only on the basis of passive support characteristics. RELEVANCE: A basis of information regarding the stability characteristics of different ankle braces under passive and rapidly induced conditions will help the clinician and consumer in choosing the most appropriate brace model for specific use. The results also provide more insights into factors that influence stability characteristics of ankle braces.

Adult↗

Characteristic plantar pressure distribution patterns during soccer-specific movements.

PURPOSE: To characterize in-shoe pressure measurements during different soccer-specific maneuvers on two playing surfaces to identify the main loading areas of the foot. METHODS: Twenty-one experienced male soccer players participated in the study (25.5 +/- 1.8 years, 78.7 +/- 5.4 kg, and 182.9 +/- 5.7 cm). The Pedar Mobile system was used to collect plantar pressure information inside the soccer shoe. Four soccer-specific movements were performed (normal run, cutting maneuver, sprint, and goal shot) on both a grass and a red cinder surface. RESULTS: Results showed characteristic pressure distribution patterns with specific loading areas of the foot that correspond to the evaluated movements. In addition, loading patterns with higher pressure values than those observed during normal run were found. In cutting, the medial part of the foot; in sprinting, the first and second ray; and in kicking, the lateral part of the foot are predominantly loaded. No global effect of the two surfaces on pressure parameters was found. CONCLUSION: The results of the present investigation suggest that the high load in soccer in combination with a high repetition may have an important influence in the development of overuse injuries.

Adult↗