Pub Date : 2024-11-26DOI: 10.1016/j.clinbiomech.2024.106400
Hongmiao Zhang , Zi Wang , Zhaohua Yuan , Sui Liang , Hua Zhang , Xianzeng Li
Background
To investigate the asymmetry of paravertebral muscles during the superman exercise in patients with adolescent idiopathic scoliosis, and to analyze the applicability of this exercise for the rehabilitation of these patients from the perspective of muscle electromyographic activity.
Methods
37 patients with adolescent idiopathic scoliosis are selected for this study. Surface electromyography signals of the bilateral paravertebral muscles during the daily sitting and the superman exercise are recorded. The differences in Surface electromyography of the bilateral paravertebral muscles are analyzed using the root mean square method and the paraspinal muscle symmetry index.
Findings
The results show that there is no significant difference in the paraspinal muscle symmetry index between the two states. Specifically, 29 patients exhibit the same paraspinal muscle symmetry index, 2 patients have similar indices, and 6 patients display different indices. The root mean square of the convex side paravertebral muscles is generally higher than that of the concave side.
Interpretation
In this study, the activation level of paravertebral muscles during the superman exercise is similar to that during the daily sitting, with the activation level on the convex side being higher than that on the concave side. This indicates that the superman exercise is not suitable for the rehabilitation of patients with adolescent idiopathic scoliosis and may even exacerbate the condition.
{"title":"Symmetrical analysis of paravertebral muscles during superman exercise in patients with adolescent idiopathic scoliosis","authors":"Hongmiao Zhang , Zi Wang , Zhaohua Yuan , Sui Liang , Hua Zhang , Xianzeng Li","doi":"10.1016/j.clinbiomech.2024.106400","DOIUrl":"10.1016/j.clinbiomech.2024.106400","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the asymmetry of paravertebral muscles during the superman exercise in patients with adolescent idiopathic scoliosis, and to analyze the applicability of this exercise for the rehabilitation of these patients from the perspective of muscle electromyographic activity.</div></div><div><h3>Methods</h3><div>37 patients with adolescent idiopathic scoliosis are selected for this study. Surface electromyography signals of the bilateral paravertebral muscles during the daily sitting and the superman exercise are recorded. The differences in Surface electromyography of the bilateral paravertebral muscles are analyzed using the root mean square method and the paraspinal muscle symmetry index.</div></div><div><h3>Findings</h3><div>The results show that there is no significant difference in the paraspinal muscle symmetry index between the two states. Specifically, 29 patients exhibit the same paraspinal muscle symmetry index, 2 patients have similar indices, and 6 patients display different indices. The root mean square of the convex side paravertebral muscles is generally higher than that of the concave side.</div></div><div><h3>Interpretation</h3><div>In this study, the activation level of paravertebral muscles during the superman exercise is similar to that during the daily sitting, with the activation level on the convex side being higher than that on the concave side. This indicates that the superman exercise is not suitable for the rehabilitation of patients with adolescent idiopathic scoliosis and may even exacerbate the condition.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106400"},"PeriodicalIF":1.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721633","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}
Pub Date : 2024-11-22DOI: 10.1016/j.clinbiomech.2024.106399
Gongxin Chen , Yanlong Zhong , Zhihui Peng , Jun Liu , Zizhen Zhang , Jie Yang , Shaofeng Chen , Ke Xiao , Guoan Li , Haoqun Yao , Zongmiao Wan
Background
This study aimed to analyze the three-dimensional cervical motion characteristics in patients who underwent posterior atlantoaxial fusion surgeries using cone beam computed tomography and 3D3D registration technology.
Methods
The study selected 20 patients who underwent posterior atlantoaxial fusion surgery and 20 healthy people as the control group. All subjects underwent cone beam computed tomography scans of the occipital and cervical spine in 7 different functional positions, then 3D3D registration of Occipital-C7 was performed at each functional position to calculate the motion characteristics of each segment. The ranges of motion of the entire cervical spine and each segment were obtained in each functional position.
Findings
In the experimental group, ranges of motion of C1-C7 in flexion-extension and left-right twisting were significantly lower compared to controls (41.9° ± 13.8° vs. 56.6° ± 11.6°, 29.3° ± 9.6° vs. 91.2° ± 13.7°, respectively, P < 0.05). In the occipital-atlas segment, range of motion in flexion-extension was significantly smaller in the experimental group than controls (10.7° ± 3.2° vs. 19.4° ± 4.2°, P < 0.001), but it was larger in twisting (5.3° ± 4.2° vs. 2.1° ± 1.8°, P < 0.05). The twisting range of motion of C2-C3 was 4.7° ± 2.0° in the experimental group and 3.1° ± 1.6° in the control group (P < 0.05). Additionally, the alteration in ranges of motion during flexion-extension was primarily characterized by less extension.
Interpretation
The posterior atlantoaxial fusion surgery induced biomechanical changes in the cervical spine. Following the procedure, the movement of C1-C7 during flexion-extension and twisting was significantly lower, with varying degrees of impact on adjacent and lower cervical segments. Moreover, the surgery had a greater effect on cervical extension than flexion.
{"title":"Three-dimensional kinematic analysis of the cervical spine following posterior atlantoaxial fusion under physiological loading: An in vivo study","authors":"Gongxin Chen , Yanlong Zhong , Zhihui Peng , Jun Liu , Zizhen Zhang , Jie Yang , Shaofeng Chen , Ke Xiao , Guoan Li , Haoqun Yao , Zongmiao Wan","doi":"10.1016/j.clinbiomech.2024.106399","DOIUrl":"10.1016/j.clinbiomech.2024.106399","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to analyze the three-dimensional cervical motion characteristics in patients who underwent posterior atlantoaxial fusion surgeries using cone beam computed tomography and 3D<img>3D registration technology.</div></div><div><h3>Methods</h3><div>The study selected 20 patients who underwent posterior atlantoaxial fusion surgery and 20 healthy people as the control group. All subjects underwent cone beam computed tomography scans of the occipital and cervical spine in 7 different functional positions, then 3D<img>3D registration of Occipital-C7 was performed at each functional position to calculate the motion characteristics of each segment. The ranges of motion of the entire cervical spine and each segment were obtained in each functional position.</div></div><div><h3>Findings</h3><div>In the experimental group, ranges of motion of C1-C7 in flexion-extension and left-right twisting were significantly lower compared to controls (41.9° ± 13.8° vs. 56.6° ± 11.6°, 29.3° ± 9.6° vs. 91.2° ± 13.7°, respectively, <em>P</em> < 0.05). In the occipital-atlas segment, range of motion in flexion-extension was significantly smaller in the experimental group than controls (10.7° ± 3.2° vs. 19.4° ± 4.2°, <em>P</em> < 0.001), but it was larger in twisting (5.3° ± 4.2° vs. 2.1° ± 1.8°, P < 0.05). The twisting range of motion of C2-C3 was 4.7° ± 2.0° in the experimental group and 3.1° ± 1.6° in the control group (P < 0.05). Additionally, the alteration in ranges of motion during flexion-extension was primarily characterized by less extension.</div></div><div><h3>Interpretation</h3><div>The posterior atlantoaxial fusion surgery induced biomechanical changes in the cervical spine. Following the procedure, the movement of C1-C7 during flexion-extension and twisting was significantly lower, with varying degrees of impact on adjacent and lower cervical segments. Moreover, the surgery had a greater effect on cervical extension than flexion.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106399"},"PeriodicalIF":1.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744476","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}
Pub Date : 2024-11-20DOI: 10.1016/j.clinbiomech.2024.106396
Victoria Joppin , Arthur Jourdan , David Bendahan , Andréa Soucasse , Maxime Guye , Catherine Masson , Thierry Bège
Background
In vivo mechanical behaviour of the abdominal wall has been poorly characterised and important details are missing regarding the occurrence and post-operative recurrence rate of hernias which can be as high as 30 %. This study aimed to assess the correlation between abdominal wall displacement and intra-abdominal pressure, as well as abdominal compliance.
Methods
Eighteen healthy participants performed audio-guided passive (breathing) and active (coughing, Valsalva maneuver) exercises. Axial dynamic changes of abdominal muscles and visceral area were measured using MRI, and intra-abdominal pressure with ingested pressure sensor.
Findings
Correlations between abdominal wall displacement and intra-abdominal pressure were specific to participant, exercise, and varying between rectus abdominis and lateral muscles. Strong correlations were found between rectus abdominis displacement and intra-abdominal pressure during breathing (r = 0.92 ± 0.06), as well as lateral muscles displacement with intra-abdominal pressure during coughing and Valsalva maneuver (r = −0.98 ± 0.03 and − 0.94 ± 0.05 respectively). The abdominal pseudo-compliance varied greatly among participants during muscular contraction, the coefficient of variation reaching up to 70 %.
Interpretation
The combination of intra-abdominal pressure and dynamic MRI measurements enables the identification of participant-specific behaviour pattern. Intra-abdominal pressure and abdominal wall dynamic undergo consistent and predictable interactions. However, this relationship is subject-specific and may not be extrapolated to other individuals. Therefore, both intra-abdominal pressure and abdominal wall motion must be measured in the same participant in order to accurately characterise the abdominal wall behaviour. These results are of great importance for mesh design, surgical decision-making, and personalised healthcare.
{"title":"Towards a better understanding of abdominal wall biomechanics: In vivo relationship between dynamic intra-abdominal pressure and magnetic resonance imaging measurements","authors":"Victoria Joppin , Arthur Jourdan , David Bendahan , Andréa Soucasse , Maxime Guye , Catherine Masson , Thierry Bège","doi":"10.1016/j.clinbiomech.2024.106396","DOIUrl":"10.1016/j.clinbiomech.2024.106396","url":null,"abstract":"<div><h3>Background</h3><div><em>In vivo</em> mechanical behaviour of the abdominal wall has been poorly characterised and important details are missing regarding the occurrence and post-operative recurrence rate of hernias which can be as high as 30 %. This study aimed to assess the correlation between abdominal wall displacement and intra-abdominal pressure, as well as abdominal compliance.</div></div><div><h3>Methods</h3><div>Eighteen healthy participants performed audio-guided passive (breathing) and active (coughing, Valsalva maneuver) exercises. Axial dynamic changes of abdominal muscles and visceral area were measured using MRI, and intra-abdominal pressure with ingested pressure sensor.</div></div><div><h3>Findings</h3><div>Correlations between abdominal wall displacement and intra-abdominal pressure were specific to participant, exercise, and varying between rectus abdominis and lateral muscles. Strong correlations were found between rectus abdominis displacement and intra-abdominal pressure during breathing (<em>r</em> = 0<em>.</em>92 ± 0<em>.</em>06), as well as lateral muscles displacement with intra-abdominal pressure during coughing and Valsalva maneuver (<em>r</em> = −0<em>.</em>98 ± 0<em>.</em>03 and − 0<em>.</em>94 ± 0<em>.</em>05 respectively). The abdominal pseudo-compliance varied greatly among participants during muscular contraction, the coefficient of variation reaching up to 70 %.</div></div><div><h3>Interpretation</h3><div>The combination of intra-abdominal pressure and dynamic MRI measurements enables the identification of participant-specific behaviour pattern. Intra-abdominal pressure and abdominal wall dynamic undergo consistent and predictable interactions. However, this relationship is subject-specific and may not be extrapolated to other individuals. Therefore, both intra-abdominal pressure and abdominal wall motion must be measured in the same participant in order to accurately characterise the abdominal wall behaviour. These results are of great importance for mesh design, surgical decision-making, and personalised healthcare.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106396"},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744478","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}
Pub Date : 2024-11-20DOI: 10.1016/j.clinbiomech.2024.106393
Prakruti Patel, Anjali Tiwari, Neha Lodha
Background
While over 60 % of adults with stroke fall each year, the risk is greatest in high-functioning individuals with mild motor impairments and greater physical mobility. We lack sensitive predictors of falls in this population. Therefore, our study aimed to determine the relative contribution of gait variability and widely used tests of balance and mobility in predicting real-life falls in high-functioning adults with stroke.
Methods
Twenty-four adults with stroke who had the ability to walk independently, Fugl-Meyer lower-extremity score of ≥19/34, and Frenchay Activities Index ≥16/45 performed overground walking, Timed-up and go, and Berg balance scale. We quantified the gait speed, and gait variability for stride length and stride time. We recorded the history of falls in the past one year.
Findings
The incidence rate of past falls was 50 %. Stride length variability and Berg balance scale score were associated with previous falls in univariate analyses and were subsequently included in the multivariate model. Multivariate analyses showed that only stride length variability significantly predicted past falls (OR = 2.73, 95 % CI 1.05–7.08, p = 0.03). A cut-off of 3.98 % for stride length variability had 75 % sensitivity and 91.7 % specificity in predicting previous falls (AUC = 0.83, 95 % CI 0.64–1.00, p < 0.001).
Interpretation
In high-functioning adults with stroke, stride length variability during overground walking is a strong predictor of the past incidence of falls compared with traditional balance and mobility tests. Our findings highlight the importance of gait variability in accurately determining fall risk among high-functioning post-stroke individuals.
{"title":"Gait variability predicts real-life falls in high-functioning stroke survivors","authors":"Prakruti Patel, Anjali Tiwari, Neha Lodha","doi":"10.1016/j.clinbiomech.2024.106393","DOIUrl":"10.1016/j.clinbiomech.2024.106393","url":null,"abstract":"<div><h3>Background</h3><div>While over 60 % of adults with stroke fall each year, the risk is greatest in high-functioning individuals with mild motor impairments and greater physical mobility. We lack sensitive predictors of falls in this population. Therefore, our study aimed to determine the relative contribution of gait variability and widely used tests of balance and mobility in predicting real-life falls in high-functioning adults with stroke.</div></div><div><h3>Methods</h3><div>Twenty-four adults with stroke who had the ability to walk independently, Fugl-Meyer lower-extremity score of ≥19/34, and Frenchay Activities Index ≥16/45 performed overground walking, Timed-up and go, and Berg balance scale. We quantified the gait speed, and gait variability for stride length and stride time. We recorded the history of falls in the past one year.</div></div><div><h3>Findings</h3><div>The incidence rate of past falls was 50 %. Stride length variability and Berg balance scale score were associated with previous falls in univariate analyses and were subsequently included in the multivariate model. Multivariate analyses showed that only stride length variability significantly predicted past falls (OR = 2.73, 95 % CI 1.05–7.08, <em>p</em> = 0.03). A cut-off of 3.98 % for stride length variability had 75 % sensitivity and 91.7 % specificity in predicting previous falls (AUC = 0.83, 95 % CI 0.64–1.00, <em>p</em> < 0.001).</div></div><div><h3>Interpretation</h3><div>In high-functioning adults with stroke, stride length variability during overground walking is a strong predictor of the past incidence of falls compared with traditional balance and mobility tests. Our findings highlight the importance of gait variability in accurately determining fall risk among high-functioning post-stroke individuals.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106393"},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721636","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}
Pub Date : 2024-11-19DOI: 10.1016/j.clinbiomech.2024.106392
Clara Jobic-Deprez , Gavin Williams , Annie Chappell , Benjamin F. Mentiplay
Background
While leg stiffness during running has been shown to be lower in children with cerebral palsy compared to their typically developing peers, no studies have examined leg stiffness during running in adults with traumatic brain injury. The aim of this study was to compare leg stiffness during running in adults with traumatic brain injury to healthy controls.
Methods
Sixty-one adults with traumatic brain injury and 20 healthy controls were included. Participants ran overground while three-dimensional kinematic and kinetic data were recorded. Leg stiffness was calculated during the stance phase of running. Statistical analyses to compare leg stiffness between limbs and between groups were conducted using t-tests.
Findings
There was a large range of leg stiffness in adults with traumatic brain injury during running (affected leg median = 21.56 [range 11.07 to 57.44] kN/m; less affected leg =20.87 [9.38 to 54.72] kN/m) compared to healthy controls (20.94 [13.40 to 31.50] kN/m). However, there were no statistically significant differences in leg stiffness during running between the affected and less affected limbs (p = 0.59, effect size [ES] =0.08) nor between both traumatic brain injury limbs and healthy controls (affected limb; p = 0.44, ES =0.12; less affected limb; p = 0.47, ES =0.11).
Interpretation
Although no statistical significance was found on a group level, the results demonstrated high variability in leg stiffness in traumatic brain injury compared to healthy controls. Further research is needed to determine which factors influence leg stiffness during running and how this measure relates to clinical outcomes in traumatic brain injury.
{"title":"Leg stiffness during running in adults with traumatic brain injury: A comparative study with healthy adults","authors":"Clara Jobic-Deprez , Gavin Williams , Annie Chappell , Benjamin F. Mentiplay","doi":"10.1016/j.clinbiomech.2024.106392","DOIUrl":"10.1016/j.clinbiomech.2024.106392","url":null,"abstract":"<div><h3>Background</h3><div>While leg stiffness during running has been shown to be lower in children with cerebral palsy compared to their typically developing peers, no studies have examined leg stiffness during running in adults with traumatic brain injury. The aim of this study was to compare leg stiffness during running in adults with traumatic brain injury to healthy controls.</div></div><div><h3>Methods</h3><div>Sixty-one adults with traumatic brain injury and 20 healthy controls were included. Participants ran overground while three-dimensional kinematic and kinetic data were recorded. Leg stiffness was calculated during the stance phase of running. Statistical analyses to compare leg stiffness between limbs and between groups were conducted using <em>t</em>-tests.</div></div><div><h3>Findings</h3><div>There was a large range of leg stiffness in adults with traumatic brain injury during running (affected leg median = 21.56 [range 11.07 to 57.44] kN/m; less affected leg =20.87 [9.38 to 54.72] kN/m) compared to healthy controls (20.94 [13.40 to 31.50] kN/m). However, there were no statistically significant differences in leg stiffness during running between the affected and less affected limbs (<em>p</em> = 0.59, effect size [ES] =0.08) nor between both traumatic brain injury limbs and healthy controls (affected limb; <em>p</em> = 0.44, ES =0.12; less affected limb; <em>p</em> = 0.47, ES =0.11).</div></div><div><h3>Interpretation</h3><div>Although no statistical significance was found on a group level, the results demonstrated high variability in leg stiffness in traumatic brain injury compared to healthy controls. Further research is needed to determine which factors influence leg stiffness during running and how this measure relates to clinical outcomes in traumatic brain injury.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106392"},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1016/j.clinbiomech.2024.106381
Erin M. Florkiewicz , Kyle H. East , Michael S. Crowell , Amy N. Weart , Gregory M. Freisinger , Donald L. Goss
Background
In-clinic gait retraining has been effective in modifying suspected biomechanical risk factors for running injury, but its feasibility is often limited by multiple clinic visits. This randomized clinical trial investigated the effects of a telehealth-based gait retraining intervention on running biomechanics, pain, and function in previously injured runners.
Methods
Twenty-three participants recovering from lower extremity injuries were randomized to a control or intervention group. The intervention group completed 4 to 6 telehealth gait retraining sessions over 8 to 10 weeks, consisting of visual and verbal cues to transition to a non-rearfoot strike pattern and increase step rate. The control group received standard physical therapy. Biomechanics, pain, and function were assessed pre- and post-intervention using a 2 × 2 mixed model analysis of variance.
Findings
Half of the participants (55 %) in the intervention group successfully transitioned to a non-rearfoot strike pattern. No significant differences were observed between groups in step rate, biomechanics, or function. A significant group-by-time interaction for pain was observed (F = 10.55, P = 0.004), with the intervention group reporting greater reductions in pain compared to the control group (mean difference 2.52, 95 % CI 0.91 to 4.12).
Interpretation
Despite only half of participants adopting the desired gait pattern, telehealth gait retraining may offer a low-risk, accessible, and convenient alternative for select patients who lack in-person care options or have not responded to other pain reduction methods when returning to running from a lower extremity injury.
{"title":"The effects of telehealth running gait retraining on biomechanics, pain, and function in patients with lower extremity injuries: A randomized clinical trial","authors":"Erin M. Florkiewicz , Kyle H. East , Michael S. Crowell , Amy N. Weart , Gregory M. Freisinger , Donald L. Goss","doi":"10.1016/j.clinbiomech.2024.106381","DOIUrl":"10.1016/j.clinbiomech.2024.106381","url":null,"abstract":"<div><h3>Background</h3><div>In-clinic gait retraining has been effective in modifying suspected biomechanical risk factors for running injury, but its feasibility is often limited by multiple clinic visits. This randomized clinical trial investigated the effects of a telehealth-based gait retraining intervention on running biomechanics, pain, and function in previously injured runners.</div></div><div><h3>Methods</h3><div>Twenty-three participants recovering from lower extremity injuries were randomized to a control or intervention group. The intervention group completed 4 to 6 telehealth gait retraining sessions over 8 to 10 weeks, consisting of visual and verbal cues to transition to a non-rearfoot strike pattern and increase step rate. The control group received standard physical therapy. Biomechanics, pain, and function were assessed pre- and post-intervention using a 2 × 2 mixed model analysis of variance.</div></div><div><h3>Findings</h3><div>Half of the participants (55 %) in the intervention group successfully transitioned to a non-rearfoot strike pattern. No significant differences were observed between groups in step rate, biomechanics, or function. A significant group-by-time interaction for pain was observed (F = 10.55, <em>P</em> = 0.004), with the intervention group reporting greater reductions in pain compared to the control group (mean difference 2.52, 95 % CI 0.91 to 4.12).</div></div><div><h3>Interpretation</h3><div>Despite only half of participants adopting the desired gait pattern, telehealth gait retraining may offer a low-risk, accessible, and convenient alternative for select patients who lack in-person care options or have not responded to other pain reduction methods when returning to running from a lower extremity injury.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106381"},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1016/j.clinbiomech.2024.106382
Robert G. Crowther , Aaron Robertson , Malindu E. Fernando , Peter A. Lazzarini , Kunwarjit S. Sangla , Jonathan Golledge
Background
Diabetes-related foot ulcers pose substantial health risks globally, yet the biomechanical intricacies underlying their development remain incompletely understood. This study aimed to evaluate lower limb gait joint coordination variability in individuals with diabetes-related foot ulcers compared to those with diabetes (without diabetes-related foot ulcers) and healthy controls.
Methods
A total of 99 participants (diabetes-related foot ulcers cases – 16, Diabetes controls – 50, Health controls – 33) compared three self-paced walking trials. Vector coding, a technique quantifying movement coordination, was employed, analysing hip-knee, knee-ankle, and hip-angle joint couplings in the sagittal plane.
Findings
No significant differences in coordination variability were found among the groups. However, distinct coupling pattern frequencies emerged, with diabetes-related foot ulcers cases exhibiting unique anti-phase hip and ankle coupling frequency counts compared to healthy controls.
Interpretation
These findings challenge conventional understandings of diabetes-related foot ulcers biomechanics and underscore the complexity of gait in this population.
{"title":"Lower limb gait joint coordination variability in people with diabetes-related foot ulcers","authors":"Robert G. Crowther , Aaron Robertson , Malindu E. Fernando , Peter A. Lazzarini , Kunwarjit S. Sangla , Jonathan Golledge","doi":"10.1016/j.clinbiomech.2024.106382","DOIUrl":"10.1016/j.clinbiomech.2024.106382","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes-related foot ulcers pose substantial health risks globally, yet the biomechanical intricacies underlying their development remain incompletely understood. This study aimed to evaluate lower limb gait joint coordination variability in individuals with diabetes-related foot ulcers compared to those with diabetes (without diabetes-related foot ulcers) and healthy controls.</div></div><div><h3>Methods</h3><div>A total of 99 participants (diabetes-related foot ulcers cases – 16, Diabetes controls – 50, Health controls – 33) compared three self-paced walking trials. Vector coding, a technique quantifying movement coordination, was employed, analysing hip-knee, knee-ankle, and hip-angle joint couplings in the sagittal plane.</div></div><div><h3>Findings</h3><div>No significant differences in coordination variability were found among the groups. However, distinct coupling pattern frequencies emerged, with diabetes-related foot ulcers cases exhibiting unique anti-phase hip and ankle coupling frequency counts compared to healthy controls.</div></div><div><h3>Interpretation</h3><div>These findings challenge conventional understandings of diabetes-related foot ulcers biomechanics and underscore the complexity of gait in this population.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106382"},"PeriodicalIF":1.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-17DOI: 10.1016/j.clinbiomech.2024.106383
Jennifer Weichmann , Jan Siad El Barbari , Laura Cosima Siegwart , Svetlana Hetjens , Aidan Hogan , Paul Alfred Grützner , Ursula Trinler
Background
Age-related changes can influence gait and contribute to a higher fall risk. Other influencing factors might be certain anesthetic procedures which affect therapeutic decisions. The study's goal was to evaluate whether brachial plexus blockade impacts the postoperative fall risk in adults ≥60 years.
Methods
40 adults ≥60 years without predisposing fall risk factors receiving brachial plexus blockade were included. Gait parameters during single- and dual-task conditions were assessed using the GAITRite® walkway at three measurement points: preoperatively, within 24 h, and two weeks postoperatively. Additionally, a geriatric assessment including Berg Balance Scale, Timed Up and Go test and Montreal Cognitive Assessment was conducted, alongside pain intensity via Numeric Rating Scale. Statistical analysis involved ANOVA with repeated measures.
Findings
All gait parameters showed a performance reduction within 24 h. Significant changes occurred during single-task in stride length (P = 0.018) and stride width variability (P < 0.01), further during dual-task in stride width (P = 0.015) and velocity (P = 0.039). Notable changes were also observed in the Berg Balance Scale (P < 0.0001), the Timed Up and Go test (P < 0.001), and Montreal Cognitive Assessment (P = 0.037). After two weeks the study parameters returned to the performance prior to surgery. Performance declined with increasing age. Pain intensity remained low.
Interpretation
While brachial plexus blockade offers various advantages for patients due to its tolerability and controllability an increased gait instability and thus fall risk within the first postoperative day must be considered especially in older adults.
{"title":"Influence of regional anesthesia on fall risk in adults over 60 years","authors":"Jennifer Weichmann , Jan Siad El Barbari , Laura Cosima Siegwart , Svetlana Hetjens , Aidan Hogan , Paul Alfred Grützner , Ursula Trinler","doi":"10.1016/j.clinbiomech.2024.106383","DOIUrl":"10.1016/j.clinbiomech.2024.106383","url":null,"abstract":"<div><h3>Background</h3><div>Age-related changes can influence gait and contribute to a higher fall risk. Other influencing factors might be certain anesthetic procedures which affect therapeutic decisions. The study's goal was to evaluate whether brachial plexus blockade impacts the postoperative fall risk in adults ≥60 years.</div></div><div><h3>Methods</h3><div>40 adults ≥60 years without predisposing fall risk factors receiving brachial plexus blockade were included. Gait parameters during single- and dual-task conditions were assessed using the GAITRite® walkway at three measurement points: preoperatively, within 24 h, and two weeks postoperatively. Additionally, a geriatric assessment including Berg Balance Scale, Timed Up and Go test and Montreal Cognitive Assessment was conducted, alongside pain intensity via Numeric Rating Scale. Statistical analysis involved ANOVA with repeated measures.</div></div><div><h3>Findings</h3><div>All gait parameters showed a performance reduction within 24 h. Significant changes occurred during single-task in stride length (<em>P</em> = 0.018) and stride width variability (<em>P</em> < 0.01), further during dual-task in stride width (<em>P</em> = 0.015) and velocity (<em>P</em> = 0.039). Notable changes were also observed in the Berg Balance Scale (<em>P</em> < 0.0001), the Timed Up and Go test (<em>P</em> < 0.001), and Montreal Cognitive Assessment (<em>P</em> = 0.037). After two weeks the study parameters returned to the performance prior to surgery. Performance declined with increasing age. Pain intensity remained low.</div></div><div><h3>Interpretation</h3><div>While brachial plexus blockade offers various advantages for patients due to its tolerability and controllability an increased gait instability and thus fall risk within the first postoperative day must be considered especially in older adults.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106383"},"PeriodicalIF":1.4,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706286","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}
Pub Date : 2024-11-17DOI: 10.1016/j.clinbiomech.2024.106378
Nicolas Haelewijn , Alice Gelaude , Lize Allemeersch , Filip Staes , Evie Vereecke , Valentien Spanhove , Roel De Ridder , Kevin Deschamps
Background
The aim of this systematic review was to summarize the existing literature on evaluation methods developed to measure intrinsic foot muscle strength in both symptomatic and asymptomatic individuals. The specific objectives was to provide an overview of the evaluation methods with their protocols and reliability.
Methods
Five databases (PubMed, Embase, Web of Science, Cochrane Library and SPORTDiscus) were searched up to August 2023. Studies reporting direct or indirect measures of intrinsic foot muscle evaluation with no limitation to sex, BMI or ethnicity were included. The inclusion criteria were applied systematically, and the methodological quality of the selected articles was assessed using The Downs and Black Checklist.
Findings
Sixteen studies provided results of direct measures of intrinsic foot muscle strength, while indirect measures were reported in 19 articles. Direct measurement methods such as dynamometry (ICC 0.75–0.99) and plantar pressure (ICC 0.75–0.95) show high reliability. Among the indirect methods, both MRI (ICC 0.99) and ultrasound showed mostly high (ICC 0.66–0.99) reliability values.
Interpretation
Direct methods like dynamometry and plantar pressure show excellent reliability, but validity is uncertain. MRI is considered gold standard among indirect measurement techniques. However, portable ultrasound devices have gained popularity due to their strong agreement with MRI.
{"title":"Reliability of direct and indirect measures of intrinsic foot muscle strength in adults: A systematic review","authors":"Nicolas Haelewijn , Alice Gelaude , Lize Allemeersch , Filip Staes , Evie Vereecke , Valentien Spanhove , Roel De Ridder , Kevin Deschamps","doi":"10.1016/j.clinbiomech.2024.106378","DOIUrl":"10.1016/j.clinbiomech.2024.106378","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this systematic review was to summarize the existing literature on evaluation methods developed to measure intrinsic foot muscle strength in both symptomatic and asymptomatic individuals. The specific objectives was to provide an overview of the evaluation methods with their protocols and reliability.</div></div><div><h3>Methods</h3><div>Five databases (PubMed, Embase, Web of Science, Cochrane Library and SPORTDiscus) were searched up to August 2023. Studies reporting direct or indirect measures of intrinsic foot muscle evaluation with no limitation to sex, BMI or ethnicity were included. The inclusion criteria were applied systematically, and the methodological quality of the selected articles was assessed using The Downs and Black Checklist.</div></div><div><h3>Findings</h3><div>Sixteen studies provided results of direct measures of intrinsic foot muscle strength, while indirect measures were reported in 19 articles. Direct measurement methods such as dynamometry (ICC 0.75–0.99) and plantar pressure (ICC 0.75–0.95) show high reliability. Among the indirect methods, both MRI (ICC 0.99) and ultrasound showed mostly high (ICC 0.66–0.99) reliability values.</div></div><div><h3>Interpretation</h3><div>Direct methods like dynamometry and plantar pressure show excellent reliability, but validity is uncertain. MRI is considered gold standard among indirect measurement techniques. However, portable ultrasound devices have gained popularity due to their strong agreement with MRI.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106378"},"PeriodicalIF":1.4,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689583","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}
Pub Date : 2024-11-16DOI: 10.1016/j.clinbiomech.2024.106384
Guoshuai Liu , Han Wang , Ziteng Guo , Yuchen Liu , Yang Lu , Tian Ma , Jian Lv , Fei Liu
Background
All-inside cruciate ligament reconstruction is an emerging technique for treating anterior cruciate ligament and posterior cruciate ligament injuries. The all-inside technique uses a 4-stranded graft made of a single tendon that wraps around itself. Four strands of the graft must be immobilized to form a closed loop, and the free ends of the graft must be attached using a suture technique. There is currently no “optimal” or “standard” suture technique for attaching the free ends of grafts.
Methods
Twenty porcine flexor tendons retrieved from hind limbs were prepared for quadrupled-strand grafts using four different methods:1. using the whipstitch technique and a new suture technique with a side-to-side graft configuration (w-s graft, new SS graft), 2. using the Krackow suture technique and Kessler suture technique with an end-to-end graft configuration (Krackow graft, Kessler graft). Followed by tensile testing (including preconditioning).
Finding
Among the tested techniques, the quadrupled-strand grafts formed with the new suture technique performed best in terms of ultimate failure load (931.03 ± 20.53 N) and stiffness (236.85 ± 9.73 mm), with a statistically significant difference between side-to-side grafts and end-to-end grafts in terms of ultimate failure load in both groups. The new side-to-side graft (5.30 min) showed the shortest graft preparation time.
Interpretation
There is no doubt that the new suture technique described here has higher tensile and breaking forces than other four-strand suture techniques and is superior to other technologies in terms of preparation time, and side-to-side grafts performed better biomechanically than the end-to-end graft configuration.
{"title":"Biomechanical comparison of different surgical suture techniques for four-stranded all-inside cruciate ligament grafts","authors":"Guoshuai Liu , Han Wang , Ziteng Guo , Yuchen Liu , Yang Lu , Tian Ma , Jian Lv , Fei Liu","doi":"10.1016/j.clinbiomech.2024.106384","DOIUrl":"10.1016/j.clinbiomech.2024.106384","url":null,"abstract":"<div><h3>Background</h3><div>All-inside cruciate ligament reconstruction is an emerging technique for treating anterior cruciate ligament and posterior cruciate ligament injuries. The all-inside technique uses a 4-stranded graft made of a single tendon that wraps around itself. Four strands of the graft must be immobilized to form a closed loop, and the free ends of the graft must be attached using a suture technique. There is currently no “optimal” or “standard” suture technique for attaching the free ends of grafts.</div></div><div><h3>Methods</h3><div>Twenty porcine flexor tendons retrieved from hind limbs were prepared for quadrupled-strand grafts using four different methods:1. using the whipstitch technique and a new suture technique with a side-to-side graft configuration (w-s graft, new S<img>S graft), 2. using the Krackow suture technique and Kessler suture technique with an end-to-end graft configuration (Krackow graft, Kessler graft). Followed by tensile testing (including preconditioning).</div></div><div><h3>Finding</h3><div>Among the tested techniques, the quadrupled-strand grafts formed with the new suture technique performed best in terms of ultimate failure load (931.03 ± 20.53 N) and stiffness (236.85 ± 9.73 mm), with a statistically significant difference between side-to-side grafts and end-to-end grafts in terms of ultimate failure load in both groups. The new side-to-side graft (5.30 min) showed the shortest graft preparation time.</div></div><div><h3>Interpretation</h3><div>There is no doubt that the new suture technique described here has higher tensile and breaking forces than other four-strand suture techniques and is superior to other technologies in terms of preparation time, and side-to-side grafts performed better biomechanically than the end-to-end graft configuration.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"121 ","pages":"Article 106384"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683443","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}
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