Roland Zügner

University of Gothenburg, Orthopaedics, Graduate Student

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Papers by Roland Zügner

Reliability of F-Scan® in-shoe plantar pressure measurements in people with diabetes at risk of developing foot ulcers

The Foot, Sep 1, 2023

Surgical treatment of chronic Achilles tendon rupture results in improved gait biomechanics

Journal of Orthopaedic Surgery and Research, Feb 2, 2022

Background: Chronic Achilles tendon rupture is associated with persistent weakness at push-off wi... more Background: Chronic Achilles tendon rupture is associated with persistent weakness at push-off with the affected foot and poor balance, resulting in significant alterations to normal gait. Surgical repair is the most common treatment for improving gait in patients with a Chronic Achilles tendon rupture, but, to date, the outcomes have not been quantified in the literature. Methods: A total of 23 patients with a Chronic Achilles tendon rupture (mean age 61 ± 15 years) underwent threedimensional gait analysis according to a standardized protocol using an optical tracking system. Data of spatiotemporal, kinematic and kinetic variables were collected preoperatively and one year postoperatively. In addition, the postoperative gait biomechanics were compared with the gait biomechanics of a control group consisting of 70 healthy individuals (mean age 49 ± 20 years). The prospectively collected data were analyzed by an independent t test. Results: Postoperatively, increments were found in gait speed (mean difference − 0.12 m/s), stride length (− 0.12 m), peak ankle moment (− 0.64 Nm/kg), peak ankle power (− 1.38 W/kg), peak knee power (− 0.36 m) and reduced step width (0.01 m), compared with preoperative gait biomechanics (p < 0.014). Compared with the control group, patients with a Chronic Achilles tendon rupture exhibited slower postoperative gait speed (mean difference 0.24 m/s), wider step width (− 0.02 m), shorter stride length (0.16 m), longer relative stance phase (− 2.15%), lower peak knee flexion (17.03 degrees), greater peak knee extension (2.58 degrees), lower peak ankle moment (0.35 Nm/kg), peak ankle power (1.22 W/kg) and peak knee power (1.62 W/kg), (p < 0.010). Conclusion: Surgical intervention and postoperative rehabilitation can be an effective treatment for alterations in gait after a Chronic rupture of the Achilles tendon. However, at one year postoperatively, patients still exhibit impairments in spatiotemporal variables and knee and ankle power compared with healthy controls.

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Single-leg vertical jumping in young adults with spastic cerebral palsy

Gait & Posture

Experiences of using a digital tool, the D-foot, in the screening of risk factors for diabetic foot ulcers

Journal of Foot and Ankle Research

Background Individuals living with diabetes run an increased risk of developing diabetic foot ulc... more Background Individuals living with diabetes run an increased risk of developing diabetic foot ulcers (DFUs), leading to high costs to society and reduced quality of life for the individual. Regular screening is important to avoid complications. Aim To evaluate patients’ and clinicians’ experiences of using a digital tool, the D-Foot, in the screening of risk factors for developing DFUs. The secondary aims were to investigate whether patients had had their feet examined by a nurse or doctor during the past year, had been referred to podiatry and whether patients had received information about self-care. Methods A prospective study was carried out, comprising 90 patients with diabetes visiting a Department of Prosthetics and Orthotics (DPO). Two Certified Prosthetists and Orthotists (CPOs) were included, and they assessed foot status and the risk of developing DFUs with the D-Foot software, prior to prescribing footwear. The quality of services at the DPO was assessed by the patients ...

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Surgical Treatment of Chronic Achilles Tendon Rupture

The Journal of Foot and Ankle Surgery, 2009

Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atr... more Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atrophy, retraction, and short distal stumps. We undertook a retrospective investigation of 14 patients who were treated with the Ligament Advanced Reinforcement System (LARS) ligament for the treatment of chronic, neglected rupture of the Achilles tendon. The patients pursued a course of early functional rehabilitation, and postoperative outcome scores were obtained at 3, 6, and 12 months, based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and the Tegner Activity score. The minimum duration of follow-up was 36 months. After a minimum of 28 months postoperative, and up to 41 months postoperative, there was no observed incidence of rerupture or recurrent pain. The mean time to return to full activity was 18.

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Examination of differences in backward walking within a young and an old population: A quantitative cross-sectional survey

Gait & Posture, 2020

Motion analysis of the shoulder while performing the standardised functional test: Hand in Neck

Physiotherapy, 2015

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Loads at the Implant-Prosthesis Interface During Free and Aided Ambulation in Osseointegrated Transfemoral Prostheses

IEEE Transactions on Medical Robotics and Bionics, 2020

Bone-anchored attachment of amputation limb prostheses is increasingly becoming a clinically acce... more Bone-anchored attachment of amputation limb prostheses is increasingly becoming a clinically accepted alternative to conventional socket suspension. The direct transfer of loads demands that the percutaneous implant system and the residual bone withstand all forces and moments transferred from the prosthesis. This study presents load measurements recorded at the bone-anchored attachment in 20 individuals with unilateral transfemoral amputation performing the everyday ambulatory activities: level ground walking, stairs ascent/descent and slope ascent/descent. Mean peak values for the sample populations across activities ranged from 498-684 N for the resultant force, 26.5-39.8 Nm for the bending moment, and 3.1-5.5 Nm for the longitudinal moment. Significant differences with respect to level walking were found for the resultant force during stairs ascent, (higher, p = 0.002), and stairs descent, (lower, p = 0.005). Using a crutch reduced the peak resultant forces and the peak bending moments with averages ranging from 5.5-12.6 % and 13.2-15.6 %, respectively. Large inter-participant variations were observed and no single activity resulted in consistently higher loading of the bone-anchored attachment across the participants. Results from this study can guide future development of percutaneous osseointegrated implant systems for limb prostheses and their rehabilitation protocols.

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Gait and motion analysis of hip arthroplasty. Validity, reliability and longterm results

Introduction: Walking is one of the most fundamental activities of daily living in humans, when t... more Introduction: Walking is one of the most fundamental activities of daily living in humans, when the hip joints transfer power between the lower extremities and the pelvis. Hip osteoarthritis (OA) will more or less influence this function and is increasing in an ageing population. Total hip arthroplasty (THA) is a common treatment for patients diagnosed with hip osteoarthritis when non-surgical treatments have failed. Optical tracking systems (OTS) based on cameras and force plates mounted in the floor have been used since the 1960s. The technique includes attachment of reflective markers with double-adhesive tape to the skin of the patient. Marker positions are recorded when the patient walks through a calibrated measurement volume. Material and methods: In Study I, hip joint movements were measured with two different dynamic motion analysis systems, an optical tracking system and roentgen stereophotogrammetric analysis (RSA) in 16 patients with THA. In Study II, three patient group...

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Stable Fixation but Unpredictable Bone Remodelling Around the Lord Stem

by Bertil Romanus and Roland Zügner

The Journal of Arthroplasty, 2013

Early designs of uncemented hip implants turned out to be failures mainly because the prerequisit... more Early designs of uncemented hip implants turned out to be failures mainly because the prerequisites for durable implant fixation were unknown. One exception was the chrome-cobalt stem of the Madreporic Lord prosthesis. We prospectively studied this prosthetic design in 107 hips that underwent surgery in 1979-1986. At the last follow-up, five stems and 54 cups had been revised, corresponding to stem and cup survival rates of 92%±3% and 45%±5% at 26years. In all, 66 hips with remaining Lord stems were available for clinical follow-up 26years (24-29) after the index operation. The mean total Harris hip and pain scores were 81 (SD 14) and 41 (SD 5).

Greater heel-rise endurance is related to better gait biomechanics in patients surgically treated for chronic Achilles tendon rupture

Knee Surgery, Sports Traumatology, Arthroscopy

Purpose To determine the relationships among calf muscle function, tendon length and gait biomech... more Purpose To determine the relationships among calf muscle function, tendon length and gait biomechanics in patients surgically treated for chronic Achilles tendon rupture. Methods Twenty-one patients with chronic Achilles tendon rupture (mean age 62 ± 13 years) were evaluated by heel-rise endurance test, Achilles Tendon Resting Angle (ATRA), ultrasound measurement of tendon length and three-dimensional gait analysis. A bivariate two-sided correlation test was performed on all variables in all patients. Results Better performance across all parameters of the heel-rise endurance test correlated with faster walking speed (r = 0.52–0.55), greater peak ankle power (r = 0.56–0.64), shorter stance phase (r = −0.52 to −0.76) and less peak ankle dorsiflexion angle (r = −0.49 to −0.64) during gait. Greater ATRA correlated with longer stance time (r = 0.47), greater peak ankle dorsiflexion angle (r = 0.48), less heel-rise repetitions (r = −0.52) and less heel-rise total work LSI (r = −0.44 to −...

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Effectiveness of insoles provided to diabetic patients at risk of developing ulcers

Longitudinell uppföljning av inläggsförsörjning till patienter med diabetes

$Research paper thumbnail of Gait biomechanics in patients with intra-articular tibial plateau fractures – gait analysis at three months compared with age- and gender-matched healthy subjects$

Gait biomechanics in patients with intra-articular tibial plateau fractures – gait analysis at three months compared with age- and gender-matched healthy subjects

BMC Musculoskeletal Disorders

Introduction Tibial plateau fractures involve the knee joint, one of the most weight-bearing join... more Introduction Tibial plateau fractures involve the knee joint, one of the most weight-bearing joints in the body. Studies have shown that gait asymmetries exist several years after injury. Instrumental gait analysis, generating both kinematic and kinetic data from patients with tibial plateau fractures, is uncommon. Aim To examine walking ability and knee range of motion in patients suffering intra-articular tibial plateau fractures. Method Twenty participants, eight males and 12 females, aged 44 years (range 26–60), with unilateral isolated tibial plateau fractures, were examined 12 weeks (range 7–20) after injury. The investigation consisted of passive range of motion (ROM) using a goniometer, six-minute walking test (6 MW), pain estimation using the visual analogue scale (VAS), the “Knee injury and Osteoarthritis Outcome Score” (KOOS) self-assessment questionnaire and instrumental 3-dimensional gait analysis (3DGA). 3DGA included spatiotemporal variables (speed, relative stance ti...

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MRI in liver disease

Clinical Radiology, 2004

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Gait Kinematics and Spatiotemporal Variables after Enriched, Task-Specific Therapy in the Chronic Phase after Stroke. A Single-Subject Experimental Design Study

Archives of Clinical and Medical Case Reports, 2021

Objectives: In this single-subject experimental design study, we investigated the effect of late-... more Objectives: In this single-subject experimental design study, we investigated the effect of late-phase stroke rehabilitation on gait pattern. Methods: A subgroup from a previous clinical study, four men in the chronic phase after stroke, received 3 weeks of enriched and task-specific therapy (ETT) consisting of task-specific exercise, socialization, sensory and cognitive stimulation in a Mediterranean climate. Spatiotemporal gait variables, kinematics and symmetry were measured before and after the intervention in an advanced gait laboratory. Statistical significance was determined with the twostandard deviation band method.

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Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes

Environment, Development and Sustainability, 2020

There is an increasing demand to quantify the footprints, ecological, economic and social, in ter... more There is an increasing demand to quantify the footprints, ecological, economic and social, in terms of the effect of different interventions in healthcare. The aim of this study was to compare two systems providing patients with diabetes with insoles in terms of their ecological, economic and social footprints. Prefabricated insoles (PRI) were compared with custom-made insoles (CMI). Using a welfare-economic monetary approach, costs were estimated for (1) treatment, (2) travelling to and from the hospital in terms of both fuel and time consumed by the patients and (3) society through emissions contributing to climate change. The proportion of patients/year that could be supplied within the same budget, for each individual treatment, was calculated. The cost of the insoles was 825 SEK (PRI) and 1450 SEK (CMI), respectively. The cost, mean value/patient due to the consumption of patients’ time at the department, was 754 SEK (PRI) and 1508 SEK (CMI), respectively. Emissions, in terms o...

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Normalizing stance width

INTRODUCTION: In previous studies, stance widths are most often determined as a percentage of sho... more

Normalizing stance width

INTRODUCTION: In previous studies, stance widths are most often determined as a percentage of sho... more

Enter titleA two-year randomised trial comparing plantar pressure from three types of insoles

A two-year randomised trial comparing plantar pressure from three types of insoles. Ulla Hellstra... more A two-year randomised trial comparing plantar pressure from three types of insoles. Ulla Hellstrand Tang1,2, Roland Zügner1, Vera Lisovskaja3, Jon Karlsson1, Kerstin Hagberg1,2, Roy Tranberg1, 1Institute of Clinical Sciences, Sahlgrenska Academy, Department of Orthopaedics, 2Dept. of Prosthetics & Orthotics, 3Department of Mathematical Science/Mathematical Statistics, Chalmers University of Technology and University of Gothenburg Gothenburg, Sweden Background: Special insoles and shoes are frequently prescribed with the aim of avoiding high and repetitive pressure on specific regions of the foot soles in patients with diabetes. There is, however, a need for increased knowledge of a) the properties of the pressure distribution for insoles used over several months and b) the differences in peak pressure and pressure time integral for different types of insoles. This paper presents the first randomised study with the aim to compare peak plantar pressure and pressure time integral betwe...

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