The ice skaters wobbly foot syndrome.

Schalkwijk, A.H.P. (2014) The ice skaters wobbly foot syndrome. thesis, Medicine.

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Abstract

Background: The ‘wobbly ice skaters foot’ is a dreaded movement disorder of unknown aetiology among ice skaters afflicting their performance on ice. The name of the condition is derived from the appearance of a ‘wobbly’ movement deviation in the gait of one of the afflicted’s legs. Although the phenomenon is notorious among skaters and has been amply covered in media, it has received scarce scientific attention, and as a result insights into the utterance, development, course and causative mechanisms remain lacking. Sole literature about this subject finds the disorder skating specific, influenced by the performed skating technique. Furthermore signs of balance difficulties surrounding the event of deviation were noticed. We hypothesise that the ‘wobbly ice skaters foot’ is either caused by a task-specific ice skating dystonia or an automatic motor correction upon impending balance difficulties. Aim: This study aimed at increasing the general understandings of this syndrome by acquiring key characteristics of multiple skaters who suffer from this affliction, focussing on patient characteristics, visual descriptors and kinematics of the syndrome. Methods: Between June-July 2014 a multiple case-study was conducted on five ice skaters who suffer from a ‘wobbly ice skaters foot’. The study was coordinated from the University Hospital in Groningen, the Netherlands (UMCG), a motion analysis was carried out at Thialf Ice Skating Stadium in Heerenveen, the Netherlands. A questionnaire focussing on the origination, development and possible contributors of the affliction was conducted. The subjects were videoed while skating a regular routine and one where weight (0.75 kg) was added to the foot/skate system. Simultaneously an Inertial Motion Capturing (IMC) device recorded the endured rate of turn and acceleration of both feet. For assessing the role of active muscle involvement, comparative testing between the deviation’s angular frequencies of both routines was performed. Results: The disorder arose suddenly after many years of skating practise, altering the sensation in the leg which was mostly described as a feeling of lessened control. Exertion has been identified as main aggravating trigger, recuperation and the use of other skating techniques have been reported to reduce symptoms. The deviation predominantly presents itself as an exorotation in the latest moments of the swing phase. For one subject we found signs of a deviant movement pattern earlier in his swing. Further gait dissimilarities between legs is observed where all participants show an inadequate situated centre of mass (COM) during push off towards the affected side. Inertial readings further display asynchronicity concerning stride-and gait phase length. No alteration in angular frequencies between the weighted and non-weighted routine is observed. Conclusion: This study finds that the ‘wobbly ice skaters foot syndrome’ is a chronic task-specific skating condition which presents itself as a patterned, repetitive, actively driven movement deviation. Evidence suggest that not all movement deviations occur during the same gait cycle phase, giving cause to suspect that the mechanism behind these phenomena do not act in identical ways, possibly being different aetiologies altogether. Additional research will be necessary to further clarify the causative mechanisms. To enhance distinction between movement deviation and regular gait variation, comparative data in the form of a healthy unaffected control group is deemed necessary.

Item Type:	Thesis (Thesis)
Supervisor name:	Koning-Tijssen, Professor doctor M.A.J. de and Otten, Professor doctor E.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:49
Last Modified:	25 Jun 2020 10:49
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/990

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