Gait & posture最新文献_第6页

Online control ability affects precision fitting performances of long-term Tai Chi practitioners in older adults 在线控制能力影响老年人长期太极拳练习者的精准拟合表现。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-24 DOI: 10.1016/j.gaitpost.2024.12.021

Hui Tang , Jiahao Pan , Li Li

Background

Age-related decline in goal-directed behavior could be risky for older adults to maintain daily activities. Our previous studies have shown that long-term Tai Chi (TC) practice could improve motor performance and postural control during goal-directed tasks. However, there was a paucity of studies examining TC’s effects on online control of goal-directed action.

Research question

Do long-term TC practitioners have different kinematic characteristics in online control of goal-directed behavior compared to our control groups during precision fitting tasks?

Methods

36 older adults were recruited for sedentary (SE), brisk walking (BW), and TC groups based on their exercise habits. Participants were required to fit a block (90 × 90 mm) through two different openings (130 × 130 mm and 100 × 100 mm) at two different distances (arm’s length or 130 % of arm’s length). Hand, trunk, and center of pressure (CoP) data were collected and analyzed, where velocities and timing variables were used to evaluate the manual motor control.

Results

We observed that: (1) TC group used significantly less time of completion in all three phases than SE and BW groups, especially in the ADJ phase when condition with more task constraints; (2) TC group demonstrated faster average hand velocity in all three phases than SE and BW groups; (3) TC group had a faster average trunk velocity than SE and BW groups and faster average CoP velocity than the BW group in the ADJ phase.

Significance

The long-term TC practitioners might exhibit better online control ability in the precision fitting task than the SE and BW groups, leading to more smooth and effortless goal-directed movement executions. Therefore, the long-term TC practice could be an effective intervention for maintaining precision manual motor control among older adults.

背景：与年龄相关的目标导向行为的下降可能对老年人维持日常活动有风险。我们之前的研究表明，长期太极拳练习可以改善目标导向任务中的运动表现和姿势控制。然而，关于TC对目标导向行为在线控制的影响的研究却很少。研究问题：在精确拟合任务中，与对照组相比，长期TC从业者在在线控制目标导向行为方面是否具有不同的运动学特征？方法：招募36名老年人，根据他们的运动习惯分为久坐组（SE）、快走组（BW）和TC组。参与者被要求符合一个街区(90 ×90 毫米)通过两个不同的开口(130 × 130 毫米和100 ×  100毫米)在两个不同的距离(距离或130 %手臂的长度)。收集并分析了手、躯干和压力中心（CoP）数据，其中使用速度和定时变量来评估手动电机控制。结果：我们观察到：(1)TC组在三个阶段的完成时间均显著少于SE和BW组，特别是在任务约束较多的ADJ阶段；(2) TC组3个阶段的平均手速度均快于SE组和BW组；(3)在ADJ阶段，TC组平均躯干速度快于SE组和BW组，平均CoP速度快于BW组。意义：长期TC练习者在精确拟合任务中表现出比SE组和BW组更好的在线控制能力，从而使目标导向动作执行更加流畅和轻松。因此，长期的TC练习可能是维持老年人精确手动运动控制的有效干预措施。

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引用次数: 0

Evaluating the use of electromyography in UK and European gait laboratories for the assessment of cerebral palsy and other neurological and musculoskeletal conditions 评估在英国和欧洲的步态实验室使用肌电图来评估脑瘫和其他神经和肌肉骨骼疾病。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-21 DOI: 10.1016/j.gaitpost.2024.12.018

H. Shepherd , J. Reeves , C. Stewart

Background

Electromyography (EMG) can estimate the magnitude and timing of muscle activation during walking in those with gait disorders. Despite the potential of EMG use in assessment and clinical decision-making, there are reports of declining use of EMG within gait laboratories. Technical and educational barriers to EMG usage in clinics in Italy were recently suggested.

Research question

What is the current EMG practice and associated knowledge and barriers to EMG usage in UK and European clinical gait labs?

Methods

Semi-structured interviews were conducted online with 16 participants recruited from 13 gait laboratories across the UK and wider Europe, 11 participants used EMG routinely in clinical service and five did not. Participants held various professions including physiotherapists, clinical scientists, a lab manager, biomechanist, orthopaedic surgeon and a biomedical engineer. Interviews were transcribed and analysed using reflexive thematic analysis.

Results

EMG training was often completed in-house informally by colleagues. Findings show EMG was currently used for assessing muscle activation timings, spasticity, co-contraction in patients and often used as a confirmatory tool. Challenges of using EMG included: justifying the effort, distinguishing true deviations from the norm, capacity to collect good quality data and feasibility with a given patient.

Significance

The challenge of interpreting EMG signals, patient readiness and time requirements were consistent between the gait labs reflecting previous reports from Italy. There were also large variations in types of EMG training and education in agreement with previous findings. In contrast to previous findings, cost was not considered important within this study.

Conclusion

For EMG to be more widely and routinely used, the perceived effort of staff and patients would need to be justified by a clear link to the treatment planning and decision-making through further published evidence and training.

背景：肌电图（EMG）可以估计步态障碍患者行走时肌肉激活的幅度和时间。尽管肌电图在评估和临床决策中的应用具有潜力，但有报道称，在步态实验室中肌电图的使用正在减少。最近提出了在意大利诊所使用肌电图的技术和教育障碍。研究问题：英国和欧洲临床步态实验室目前的肌电图实践和相关知识以及肌电图使用的障碍是什么？方法：在线进行半结构化访谈，从英国和更广泛的欧洲的13个步态实验室招募了16名参与者，11名参与者在临床服务中常规使用肌电图，5名没有。参加者从事不同的职业，包括物理治疗师、临床科学家、实验室经理、生物力学家、骨科医生和生物医学工程师。访谈记录和分析使用反身性主题分析。结果：肌电训练通常由同事非正式地在公司内部完成。研究结果显示，肌电图目前用于评估患者的肌肉激活时间、痉挛、共收缩，并经常用作确认工具。使用肌电图的挑战包括：证明工作的合理性，区分与常规的真正偏差，收集高质量数据的能力以及对特定患者的可行性。意义：解释肌电图信号、患者准备状态和时间要求的挑战在步态实验室之间是一致的，反映了意大利先前的报告。与之前的研究结果一致，肌电训练和教育的类型也存在很大差异。与之前的研究结果相反，本研究认为成本并不重要。结论：为了更广泛和常规地使用肌电图，工作人员和患者的感知努力需要通过进一步公布的证据和培训来证明与治疗计划和决策的明确联系。

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引用次数: 0

Investigation the effect of rigid taping on knee and hip joint kinematics in chronic stroke patients with knee hyperextension gait 研究慢性脑卒中患者膝关节过伸步态中硬带对膝关节和髋关节运动学的影响。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-20 DOI: 10.1016/j.gaitpost.2024.12.016

Süleyman Korkusuz , Ayla Fil-Balkan , Büşra Seçkinoğulları Korkusuz , Nihat Özgören , Serdar Arıtan , Ali Naim Ceren , Mehmet Akif Topçuoğlu

Background

Although stroke patients gain an advantage in gait due to the knee hyperextension that occurs during the stance phase, this situation disrupts the biomechanical structure of the knee and increases the risk of injury to the capsular and ligamentous structures. The aim of this study was to examine the effects of rigid taping on hyperextension control and pelvic kinematics in stroke patients with knee hyperextension during the stance phase of gait.

Research question

Does rigid taping have an effect on hyperextension control and pelvic kinematics in stroke patients with knee hyperextension?

Methods

Thirty stroke patients aged between 40 and 70 were included in this pre-postintervention study. Kinematic assessment of gait was performed using a motion analysis system (Vicon Ltd, Bilston). Then, the rigid taping was applied to the patients using the hyperextension taping technique, and the kinematic analysis of the gait was repeated with the motion analysis system.

Results

It was found that the rigid taping for the knee hyperextension significantly reduced the knee hyperextension (p < 0.05). Additionally, it was observed that the rigid taping significantly reduced the pelvic retraction (p < 0.05). However, no change was observed in the pelvic drop with the rigid taping application.

Significance

Our results showed that the rigid taping effectively controlled the knee hyperextension. It was thought that the rigid taping application contributed to reducing knee hyperextension and pelvic retraction because it mechanically gave the knee a flexion moment and provided proprioceptive input.

背景：虽然中风患者在站立阶段由于膝关节过伸而获得步态优势，但这种情况破坏了膝关节的生物力学结构，增加了关节囊和韧带结构损伤的风险。本研究的目的是检查刚性胶带对卒中患者膝关节过伸的控制和骨盆运动学在站立阶段步态的影响。研究问题：刚性胶带对卒中患者膝关节过伸的过伸控制和骨盆运动有影响吗？方法：30例年龄在40 ~ 70岁的脑卒中患者纳入干预前和干预后研究。使用运动分析系统（Vicon Ltd, Bilston）对步态进行运动学评估。然后，采用超伸展贴带技术对患者进行刚性贴带，并使用运动分析系统对步态进行运动学分析。结果：我们发现膝关节过伸的硬性胶带能明显减少膝关节过伸（p ）。意义：我们的结果表明，硬性胶带能有效地控制膝关节过伸。人们认为，刚性胶带的应用有助于减少膝关节过伸和骨盆内收，因为它机械地给予膝关节屈曲力矩并提供本体感觉输入。

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引用次数: 0

Frequency analyses of postural sway demonstrate the use of sounds for balance given vestibular loss 姿势摇摆的频率分析表明，在前庭功能丧失的情况下，声音可用于保持平衡。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-14 DOI: 10.1016/j.gaitpost.2024.12.013

Anat V. Lubetzky , Maura Cosetti , Daphna Harel , Katherine Scigliano , Marlee Sherrod , Zhu Wang , Agnieszka Roginska , Jennifer Kelly

Purpose

To investigate how adults with unilateral vestibular hypofunction and healthy controls incorporate visual and auditory cues for postural control in an abstract visual environment.

Methods

Participants stood on foam wearing the HTC Vive, observing an immersive 3-wall display of ‘stars’ that were either static or dynamic (moving front to back at 32 mm, 0.2 Hz) with no sound, static white noise, or moving white noise played via headphones. Each 60-second condition repeated twice. We recorded the center-of-pressure variance, and its power spectral density [PSD, cm²] components in low [0, 0.25 Hz], mid [0.25, 0.5 Hz] and high [0.5, 1 Hz] frequencies in the anterior-posterior direction. We used linear mixed-effects models to compares healthy controls (n = 41, mean age 52 years, range 22–78) to participants with unilateral peripheral vestibular hypofunction (n = 28, 61.5, 27–82), adjusting for age.

Results

Variance and low PSD: we observed a significant vestibular by visual load interaction in the presence of sounds, such that the vestibular group had significantly higher sway than controls only on dynamic visuals in the presence of sounds. Mid PSD: the vestibular group had significantly higher sway than controls regardless of condition. High PSD: the vestibular group had significantly higher sway than controls, except for the presence of sounds on static visuals.

Conclusions

Patients with vestibular hypofunction used sounds to reduce sway in a static abstract environment and were somewhat destabilized by it in a dynamic environment. This suggests that sounds, when played from headphones, may function as an auditory anchor under certain level of challenge and specific tasks regardless of whether it’s stationary or moving. Our results support that increased sway in middle frequencies reflects vestibular dysfunction.

目的：研究单侧前庭功能减退的成年人和健康对照组如何在抽象的视觉环境中结合视觉和听觉线索进行姿势控制：参与者佩戴 HTC Vive，站在泡沫上，观察沉浸式三面墙的 "星星 "显示，这些 "星星 "可以是静态的，也可以是动态的（前后移动 32 毫米，0.2 赫兹），同时通过耳机播放无声、静态白噪声或移动白噪声。每个 60 秒的条件重复两次。我们记录了压力中心方差及其前后方向低频[0，0.25 Hz]、中频[0.25，0.5 Hz]和高频[0.5，1 Hz]的功率谱密度[PSD，cm2]成分。我们使用线性混合效应模型将健康对照组（n = 41，平均年龄 52 岁，范围 22-78 岁）与患有单侧外周前庭功能减退症的参与者（n = 28，61.5，27-82 岁）进行了比较，并对年龄进行了调整：差异和低 PSD：我们观察到在有声音时，前庭与视觉负荷之间存在显著的交互作用，因此在有声音时，前庭组仅在动态视觉上的摇摆明显高于对照组。中 PSD：无论在什么条件下，前庭组的摇摆都明显高于对照组。高 PSD：前庭组的摇摆明显高于对照组，但有声音的静态视觉效果除外：结论：前庭功能减退患者在静态抽象环境中使用声音来减少摇摆，而在动态环境中则会受到声音的影响。这表明，在一定程度的挑战和特定任务下，无论声音是静止的还是移动的，用耳机播放的声音都能起到听觉锚的作用。我们的研究结果证明，中频摇摆增加反映了前庭功能障碍。

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引用次数: 0

Effects of age/gender profiles and physical activity level on symmetry of lumbar muscle activation in pain-free older adults during various spinal movements 年龄/性别特征和体力活动水平对无痛老年人各种脊柱运动中腰肌激活对称性的影响。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-13 DOI: 10.1016/j.gaitpost.2024.12.012

Chih-Hsiu Cheng , Asghar Rezaei , Kenton Kaufman

Background

Back muscles simultaneously drive spinal movements and stabilize the trunk. Paraspinal muscle activity is presumed to be symmetric and gender-insensitive, and more activated with aging to protect the spine during functional tasks.

Research question

Does over-activated and asymmetric behaviors exist in the pain-free elderly population which is affected by their physical activity levels?

Methods

Forty healthy participants (aged 64.8 ± 9.9 years, 20 males and 20 females) were recruited for this cross-sectional study. They completed the International Physical Activity Questionnaire (IPAQ) to quantify their self-reported physical activity measures including the total physical activity in MET-min/week and time spent sitting. Surface electromyographic activity of bilateral paraspinal muscles at L3 level was measured. Subjects were instructed to perform functional tasks including symmetric movements as well as right- and left-side rotation/bending. Asymmetry in muscle activation between the two sides was calculated. A multiple linear regression model was used to assess the association of muscle activations with age and gender. Pearson correlation analysis was used to verify the relationship between the asymmetry and physical activity measures.

Results and significance

The results showed a downtrend of paraspinal muscle activations with aging and the decreasing rate could differ between genders. Left-side muscle activations were generally higher than those of the right-side muscles. Muscle asymmetrical activation correlated with sitting time but not total physical activity. This study highlighted aging and gender effects on the paraspinal muscle activations as well as muscle imbalance during different movement paradigms. Future work is needed to verify the underlying mechanism for declining and asymmetrical muscle activation and its link to back disorders.

背景：背部肌肉同时驱动脊柱运动和稳定躯干。棘旁肌的活动被认为是对称的和性别不敏感的，并且随着年龄的增长而更加活跃，以保护脊柱在功能性任务中。研究问题：无痛老年人是否存在过度激活和不对称行为，这与他们的身体活动水平有关？方法：本横断面研究招募40名健康受试者（年龄64.8 ± 9.9岁，男20名，女20名）。他们完成了国际体育活动问卷（IPAQ），以量化他们自我报告的体育活动措施，包括每周MET-min的总体育活动和坐着的时间。测量双侧L3水平棘旁肌的表面肌电活动。受试者被要求完成功能性任务，包括对称运动以及左右旋转/弯曲。计算了两侧肌肉激活的不对称性。使用多元线性回归模型来评估肌肉激活与年龄和性别的关联。使用Pearson相关分析验证不对称性与体力活动测量之间的关系。结果与意义：研究结果显示，随着年龄的增长，脊髓旁肌活动呈下降趋势，且下降幅度在性别间存在差异。左侧肌肉的激活程度普遍高于右侧肌肉。肌肉不对称激活与静坐时间相关，但与总体力活动无关。本研究强调了年龄和性别对不同运动模式下棘旁肌激活和肌肉失衡的影响。未来的工作需要验证肌肉激活下降和不对称的潜在机制及其与背部疾病的联系。

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引用次数: 0

Effects of habitual foot strike patterns on patellofemoral joint and Achilles tendon loading in recreational runner 休闲跑步者习惯性足部撞击方式对髌股关节和跟腱负荷的影响。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-13 DOI: 10.1016/j.gaitpost.2024.12.017

Xini Zhang , Baisheng Fu , Yuxin Li , Liqin Deng , Weijie Fu

Background

Most running biomechanics studies have focused on either the patellofemoral joint (PFJ) or Achilles tendon (AT) alone, generating fragmented understanding of how these structures interact as components of an integrated kinetic chain during running. This study was to investigate concurrent biomechanical changes in the PFJ and AT in recreational runners.

Methods

The recreational runners who are accustomed to run with rearfoot strike (RFS, n = 15) and forefoot strike (FFS, n = 15) patterns were recruited. They were instructed to run at 10 km/h in cushion shoes with their habitual strike patterns on an instrumented split-belt treadmill. Kinematics of the ankle and knee joints in the sagittal plane and ground reaction forces were recorded simultaneously. The contact force and stress at the PFJ, as well as the force, loading rate, impulse, and stress of the AT, were calculated.

Results

The habitual RFS runners had significantly higher peak extension moment (p = 0.019, ES = 0.906), peak quadriceps force (p = 0.010, ES = 1.008), PFJ contact force (p = 0.007, ES = 1.056) and stress (p = 0.042, ES = 0.958) than habitual FFS runners. The peak plantar flexion moment (p < 0.001, ES = 2.692), peak AT force (p < 0.001, ES = −1.788), average (p < 0.001, ES = −2.337) and peak AT loading rate (p < 0.001, ES =-1.996), AT impulse (p = 0.002, ES = −1.246) and stress (p = 0.006, ES = −1.082) of the habitual RFS runners were significantly lower than those of the habitual FFS runners.

Conclusion

The FFS pattern could decrease PFJ load but simultaneously increased the mechanical load on the AT. Conversely, the RFS pattern increased PFJ load, but imposed less load on the AT.

背景：大多数跑步生物力学研究都只关注髌股关节（PFJ）或跟腱（AT），对这些结构在跑步过程中作为综合运动链的组成部分如何相互作用的认识比较零散。本研究旨在调查休闲跑步者 PFJ 和 AT 同时发生的生物力学变化：方法：招募习惯用后脚掌着地（RFS，n = 15）和前脚掌着地（FFS，n = 15）模式跑步的休闲跑步者。指导他们在带仪器的分带式跑步机上以 10 公里/小时的速度穿着缓冲鞋，以他们习惯的击球方式跑步。同时记录矢状面上踝关节和膝关节的运动学特性以及地面反作用力。计算了 PFJ 的接触力和应力，以及 AT 的力、加载率、冲量和应力：结果：习惯 RFS 跑者的伸展力矩峰值（p = 0.019，ES = 0.906）、股四头肌力峰值（p = 0.010，ES = 1.008）、PFJ 接触力（p = 0.007，ES = 1.056）和应力（p = 0.042，ES = 0.958）均明显高于习惯 FFS 跑者。跖屈力矩峰值（p 结论：FFS 模式可降低 PFF 接触力（p = 0.007）和压力（p = 0.042）：FFS 模式可减少 PFJ 负荷，但同时增加了 AT 的机械负荷。相反，RFS 模式增加了 PFJ 负荷，但对 AT 的负荷较小。

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引用次数: 0

Effects of ankle dorsiflexion training on anticipatory postural adjustments during gait initiation in patients with Parkinson’s disease 踝关节背屈训练对帕金森病患者步态起始期预期体位调整的影响。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-12 DOI: 10.1016/j.gaitpost.2024.12.015

Atsushi Nagai , Kohei Marumoto , Kota Ohata , Shoma Takasaki , Hideki Moriyama

Background

Freezing of gait (FOG) during gait initiation in patients with Parkinson's disease (PD) is associated with anticipatory postural adjustments (APAs) with diminishing amplitude, leading to a risk of falls. Assistance with ankle dorsiflexion function by external devices improve APAs during gait initiation, however, the effect of training to improve ankle dorsiflexion function on APAs during gait initiation is unclear.

Research question

Does ankle dorsiflexion training improve APAs and FOG during gait initiation in patients with PD?

Method

This 4-week prospective controlled trial included 30 patients with PD, who were divided into two groups: the control group, which received only conventional inpatient rehabilitation, and the intervention group, which received ankle dorsiflexion training in addition to inpatient rehabilitation. Ankle dorsiflexion training consisted of strengthening ankle dorsiflexion muscles and transferring weight backwards while standing. The primary outcomes were displacement of the center of pressure (COP) and electromyography of the tibialis anterior muscle during gait initiation as APAs. The secondary outcome was the New freezing of gait questionnaire (NFOGQ) to determine the severity of FOG. We analyzed differences in treatment effects between groups and within groups.

Result

In the intervention group, the anteroposterior component of COP displacement and muscle activity of the tibialis anterior muscle increased significantly and NFOGQ decreased after the intervention. After intervention, the anteroposterior component of COP displacement showed a significant intervention effect.

Significance

Ankle dorsiflexion training for patients with PD improves APAs and FOG during gait initiation and may reduce the risk of falls.

背景：帕金森病（PD）患者步态开始时的步态冻结（FOG）与幅度递减的预期姿势调整（APAs）相关，导致跌倒的风险。通过外部装置辅助踝关节背屈功能改善步态启动过程中的APAs，然而，改善踝关节背屈功能的训练对步态启动过程中APAs的影响尚不清楚。研究问题：踝关节背屈训练是否能改善PD患者步态起始期的APAs和FOG ？方法：30例PD患者进行为期4周的前瞻性对照试验，将患者分为两组：对照组仅接受常规住院康复治疗，干预组在住院康复治疗的基础上接受踝关节背屈训练。踝关节背屈训练包括加强踝关节背屈肌肉和站立时向后转移重量。主要结果是压力中心位移（COP）和胫骨前肌肌电图在步态开始时作为APAs。次要结果是新的步态冻结问卷（nfoq），以确定FOG的严重程度。我们分析了组间和组内治疗效果的差异。结果：干预组在干预后，COP位移的前后分量和胫骨前肌的肌肉活动明显增加，NFOGQ明显降低。干预后，COP位移的正向分量显示出显著的干预效果。意义：PD患者踝关节背屈训练可改善步态起始时的APAs和FOG，并可降低跌倒风险。

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引用次数: 0

Revisiting sources of variability in gait analysis 重新审视步态分析中的变异性来源。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-12 DOI: 10.1016/j.gaitpost.2024.11.005

Emily Leary , Jinpu Li , Jamie Hall , Trent Guess

Background

Gait analyses in clinical populations must be considered differently, as variation in measurements may be related to the clinical condition and not just factors of interest. However, measurements taken from gait also have natural variability and this variability is further compounded when multiple factors may be of clinical interest.

Research question

Do current methods properly assign and quantify the amount of variability in gait data?

Methods

Simulated data were utilized to identify subject and therapist effects using multiple gait trials; data were simulated with and without multiple sessions with therapists. Five different statistical designs were considered that allow within-subject, within-therapist, and between-therapist errors. These are (1) a series of nested models, (2) a single model with interaction effects and nested structure, (3) cross-sectional ANOVA with fixed effects, (4) cross-sectional ANOVA with random effects, and (5) nested ANOVA. All modeling considered different therapists, trials, and subjects, and considered models were identified from gait literature. Ratios between estimated variances and the overall statistical errors were calculated; ratios were averaged and considered correctly identified when the estimated variance or variance component was greater than the random errors.

Results

The series of nested models identified therapist and session effects for all simulated outcomes but failed to account for subject and interaction effects. Estimates from the single model with interaction effects and nested structure exhibited a broader range of averaged ratios. The cross-sectional ANOVA with fixed effects accurately identified the sources of variability and can better quantify the source of variation, compared to all other considered models.

Significance

Accurately identifying and assigning sources of variability is imperative to accurately interpret gait which may influence or change clinical interpretation or understanding. The appropriate statistical design allows one to partition variation to accomplish this purpose.

背景：临床人群的步态分析必须考虑不同，因为测量的变化可能与临床状况有关，而不仅仅是感兴趣的因素。然而，步态测量也有自然的可变性，当多种因素可能引起临床兴趣时，这种可变性会进一步复杂化。研究问题：当前的方法是否正确分配和量化步态数据的可变性量？方法：通过多次步态试验，利用模拟数据来确定受试者和治疗师的效果；数据在有和没有与治疗师进行多次治疗的情况下进行模拟。考虑了五种不同的统计设计，允许受试者内部、治疗师内部和治疗师之间的错误。这些是(1)一系列嵌套模型，(2)具有相互作用效应和嵌套结构的单一模型，(3)固定效应的横截面方差分析，(4)随机效应的横截面方差分析，以及(5)嵌套方差分析。所有的建模都考虑了不同的治疗师、试验和受试者，并从步态文献中确定了考虑的模型。计算估计方差与总体统计误差之间的比值；当估计的方差或方差成分大于随机误差时，比率被平均并认为是正确识别的。结果：一系列嵌套模型确定了治疗师和会话对所有模拟结果的影响，但未能解释受试者和相互作用的影响。具有相互作用效应和嵌套结构的单一模型的估计显示出更大的平均比率范围。与所有其他考虑的模型相比，具有固定效应的横截面方差分析准确地识别了变异的来源，并且可以更好地量化变异的来源。意义：准确识别和分配变异性的来源对于准确解释可能影响或改变临床解释或理解的步态至关重要。适当的统计设计允许对变化进行分区以实现这一目的。

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引用次数: 0

Distinguishing the activity of flexor digitorum brevis and soleus across standing postures with deep learning models 利用深度学习模型区分屈指肌和比目鱼肌在不同站立姿势下的活动。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-11 DOI: 10.1016/j.gaitpost.2024.12.014

Alireza Kamankesh , Negar Rahimi , Ioannis G. Amiridis , Chrysostomos Sahinis , Vassilia Hatzitaki , Roger M. Enoka

Background

Electromyographic (EMG) recordings indicate that both the flexor digitorum brevis and soleus muscles contribute significantly to the control of standing balance, However, less is known about the adjustments in EMG activity of these two muscles across different postures.

Research question

The purpose of our study was to use deep-learning models to distinguish between the EMG activity of the flexor digitorum brevis and soleus muscles across four standing postures.

Methods

Deep convolutional neural networks were employed to classify standing postures based on the temporal and spatial features embedded in high-density surface EMG signals. The EMG recordings were obtained with grid electrodes placed over the flexor digitorum brevis and soleus muscles of healthy young men during four standing tasks: bipedal, tandem, one-leg, and tip-toe.

Results and significance

Two-way repeated-measures analysis of variance demonstrated that the model achieved significantly greater classification accuracy, particularly during tandem stance, using EMG data from flexor digitorum brevis compared with soleus muscle. Average classification accuracy was 84.6 % for flexor digitorum brevis and 79.1 % for soleus. The classification accuracy of both muscles varied across the four postures. There were significant differences in classification accuracy for flexor digitorum brevis between bipedal and tandem stances compared with one-leg and tip-toe stances. In contrast, the EMG data for soleus were only significantly different between bipedal stance and one-leg stance. These findings indicate that flexor digitorum brevis exhibited more distinct adjustments than soleus in the temporo-spatial features of EMG activity across the four postures.

背景：肌电图（EMG）记录表明，趾屈肌和比目鱼肌对站立平衡的控制有重要作用，然而，人们对这两块肌肉在不同姿势下的EMG活动调整知之甚少：我们研究的目的是利用深度学习模型来区分屈指肌和比目鱼肌在四种站立姿势下的肌电图活动：根据高密度表面肌电信号的时间和空间特征，采用深度卷积神经网络对站立姿势进行分类。EMG记录是通过放置在健康年轻男性屈指肌和比目鱼肌上的网格电极在四种站立任务中获得的，这四种站立任务是：双足站立、双人站立、单腿站立和踮脚站立：双向重复测量方差分析表明，与比目鱼肌相比，该模型使用屈指肌与比目鱼肌的肌电图数据，分类准确率明显更高，尤其是在双人站立时。前屈肌的平均分类准确率为 84.6%，比目鱼肌为 79.1%。在四种姿势中，两块肌肉的分类准确率各不相同。与单腿站立和踮脚站立相比，双足站立和串联站立对拇屈肌的分类准确率存在明显差异。相比之下，比目鱼肌的肌电图数据仅在双足站立和单足站立之间存在显著差异。这些发现表明，与比目鱼肌相比，屈指肌在四种姿势中的肌电图活动的时空特征表现出更明显的调整。

{"title":"Distinguishing the activity of flexor digitorum brevis and soleus across standing postures with deep learning models","authors":"Alireza Kamankesh , Negar Rahimi , Ioannis G. Amiridis , Chrysostomos Sahinis , Vassilia Hatzitaki , Roger M. Enoka","doi":"10.1016/j.gaitpost.2024.12.014","DOIUrl":"10.1016/j.gaitpost.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Electromyographic (EMG) recordings indicate that both the flexor digitorum brevis and soleus muscles contribute significantly to the control of standing balance, However, less is known about the adjustments in EMG activity of these two muscles across different postures.</div></div><div><h3>Research question</h3><div>The purpose of our study was to use deep-learning models to distinguish between the EMG activity of the flexor digitorum brevis and soleus muscles across four standing postures.</div></div><div><h3>Methods</h3><div>Deep convolutional neural networks were employed to classify standing postures based on the temporal and spatial features embedded in high-density surface EMG signals. The EMG recordings were obtained with grid electrodes placed over the flexor digitorum brevis and soleus muscles of healthy young men during four standing tasks: bipedal, tandem, one-leg, and tip-toe.</div></div><div><h3>Results and significance</h3><div>Two-way repeated-measures analysis of variance demonstrated that the model achieved significantly greater classification accuracy, particularly during tandem stance, using EMG data from flexor digitorum brevis compared with soleus muscle. Average classification accuracy was 84.6 % for flexor digitorum brevis and 79.1 % for soleus. The classification accuracy of both muscles varied across the four postures. There were significant differences in classification accuracy for flexor digitorum brevis between bipedal and tandem stances compared with one-leg and tip-toe stances. In contrast, the EMG data for soleus were only significantly different between bipedal stance and one-leg stance. These findings indicate that flexor digitorum brevis exhibited more distinct adjustments than soleus in the temporo-spatial features of EMG activity across the four postures.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"117 ","pages":"Pages 58-64"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In vivo kinematic changes of the medial longitudinal arch during barefoot and high-heeled shoes walking 赤足和穿高跟鞋行走时内侧纵弓的活体运动学变化。

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2024-12-10 DOI: 10.1016/j.gaitpost.2024.12.002

Mengling Hu , Zhuman Li , Ling Zhang , Cong Wang , Danni Wu , Xuan Zhao , Tsung-Yuan Tsai , Shaobai Wang

Background

The medial longitudinal arch (MLA) is crucial for maintaining balance and center of gravity stability during human walking. High-heeled shoes (HHS) will affect the kinematics of the MLA which further affects the overall function of the foot. However specific motion effects of HHS on MLA during walking remain unclear. Therefore, this study aimed to use dynamic biplane radiography (DBR) to explore the angle and six-degrees-of-freedom (6DOF) kinematic changes of MLA in barefoot and HHS conditions.

Methods

Fourteen healthy women without HHS experience were recruited. All subjects are required to undergo foot and ankle MRI scans for 3D modeling. Then DBR captured 2D fluorescence images of MLA throughout the stance phase during barefoot and HHS walking. MLA angle and 6DOF kinematics of the first metatarsal relative to the calcaneus were calculated using 3D-2D alignment technique in MATLAB. The MLA kinematics in 6DOF and MLA angle were compared between barefoot and HHS.

Results

During the stance phase, compared to barefoot, the MLA’s maximum lateral (9.8 ± 2.4 mm vs 7.9 ± 0.9 mm, p = 0.01), and anterior (10.0 ± 1.8 mm vs 8.1 ± 0.9 mm, p = 0.002) displacement; medial-lateral ROM(7.7 ± 2.1 mm vs 5.8 ± 1.7 mm, p = 0.004) were significantly smaller in the HHS condition. The MLA’s maximum flexion (2.4 ± 1.5° vs 7.3 ± 1.9°, p < 0.001), supination (-1.7 ± 2.3° vs 0.6 ± 1.9°, p = 0.009) were significantly larger in the HHS condition. The adduction-abduction ROM (10.2 ± 2.0° vs 7.1 ± 2.0°, p < 0.001) of the MLA was significantly smaller in the HHS condition. No significant differences (p > 0.05) were observed in peak MLA angle change and ROM after wearing HHS.

Conclusion

DBR quantifies the kinematics of the MLA during HHS walking. The results indicated that HHS decreased the MLA angle, limiting joint translation while enhancing supination and flexion angles. It may increase the risk of MLA damage during walking. These findings deepen our understanding of HHS's influence on MLA kinematics and clarify its impact on foot health.

背景：内侧纵弓（MLA）是人体行走过程中保持平衡和重心稳定的关键。高跟鞋（HHS）会影响内侧纵弓的运动学，从而进一步影响足部的整体功能。然而，高跟鞋在行走过程中对MLA的具体运动影响仍不清楚。因此，本研究旨在使用动态双平面X光摄影术（DBR）探讨赤足和HHS条件下MLA的角度和六自由度（6DOF）运动学变化：招募了 14 名没有 HHS 经验的健康女性。所有受试者均需接受足踝核磁共振成像扫描，以进行三维建模。然后，在赤足和HHS行走过程中，DBR采集了MLA在整个站立阶段的二维荧光图像。使用 MATLAB 中的 3D-2D 对齐技术计算出 MLA 角度和第一跖骨相对于小腿骨的 6DOF 运动学特性。比较了赤足行走和HHS行走的MLA运动学6DOF和MLA角度：在站立阶段，与赤足相比，HHS 条件下 MLA 的最大侧向（9.8 ± 2.4 mm vs 7.9 ± 0.9 mm，p = 0.01）和前向（10.0 ± 1.8 mm vs 8.1 ± 0.9 mm，p = 0.002）位移；内外侧 ROM（7.7 ± 2.1 mm vs 5.8 ± 1.7 mm，p = 0.004）明显较小。穿戴 HHS 后，MLA 的最大屈曲度（2.4 ± 1.5° vs 7.3 ± 1.9°，p 0.05）在 MLA 角度变化峰值和 ROM 中均有观察到：结论：DBR可量化穿着HHS行走时MLA的运动学特性。结果表明，HHS 减少了 MLA 角度，限制了关节平移，同时增强了上翻和屈曲角度。这可能会增加行走过程中 MLA 受损的风险。这些发现加深了我们对 HHS 对 MLA 运动学影响的理解，并阐明了其对足部健康的影响。

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引用次数: 0