Clinical Biomechanics最新文献_第3页

Postural adjustments during activities of daily living with an upper limb prosthesis 使用上肢假体进行日常生活活动时的姿势调整

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-24 DOI: 10.1016/j.clinbiomech.2025.106745

Mira E. Mutnick , Susannah M. Engdahl , Alec McKheen , Christina Lee , Deanna H. Gates

Background

People with upper limb difference (ULD) using prostheses often use compensatory trunk movements to perform activities of daily living (ADL). Compensatory movements may provide additional challenges for the postural control system to maintain balance. However, no prior studies have quantified postural adjustments during ADLs in this population. The purpose of this study was to determine if upper limb prosthesis users make larger postural adjustments during ADLs compared to people without ULD.

Methods

Nine individuals with ULD and nine without ULD performed unimanual and bimanual ADLs. Participants with ULD wore their prescribed body-powered or myoelectric prostheses. For each ADL, postural adjustments derived from center of pressure (CoP) position were compared across limbs (control, prosthetic, and intact). The impact of additional factors including prosthetic type, etiology, and duration of prosthetic use was also explored.

Findings

When using only the prosthesis or using it asymmetrically to the intact limb, people with ULD had larger CoP motion than people without ULD (p < 0.012). Exploratory comparisons found that during tasks that required grasping larger objects, body-powered prosthesis users and people with acquired amputation had larger CoP motion than myoelectric prosthesis users and people with congenital limb difference, respectively (g > 0.642). When performing a bimanual symmetric task, people who had owned their prosthesis longer had less CoP motion (p = 0.032).

Interpretation

Overall, the study demonstrates that individuals with ULD make larger postural adjustments when performing ADLs that incorporate their prosthesis. The extent of these differences is affected by prosthesis type, limb difference etiology, and duration of prosthesis ownership.

使用假肢的上肢差异患者通常使用代偿性躯干运动来进行日常生活活动。补偿性运动可能会给姿势控制系统维持平衡带来额外的挑战。然而，之前没有研究量化这一人群在adl期间的姿势调整。本研究的目的是确定上肢假体使用者在ADLs期间是否比没有ULD的人做出更大的姿势调整。方法9例ULD患者和9例无ULD患者分别进行单手和双手adl。患有ULD的参与者戴着他们规定的身体动力或肌电假肢。对于每个ADL，比较四肢（对照组、假体和完整肢）的压力中心（CoP）位置的姿势调整。其他因素的影响，包括假体类型，病因，和假体使用的持续时间也进行了探讨。当仅使用假体或将假体与完整肢体不对称使用时，有ULD的人比没有ULD的人有更大的CoP运动（p < 0.012）。探索性比较发现，在需要抓取较大物体的任务中，肢体动力假肢使用者和后天截肢者的CoP运动分别大于肌电假肢使用者和先天性肢体差异者（g > 0.642）。当执行双手对称任务时，拥有假体时间较长的人CoP运动较少（p = 0.032）。总体而言，该研究表明，患有ULD的个体在进行合并假体的adl时，会进行更大的姿势调整。这些差异的程度受假体类型、肢体差异病因和假体所有权持续时间的影响。

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引用次数: 0

Importance of analyzing spasticity and co-activation as complementary biomarkers of gait in children with cerebral palsy 分析痉挛和共激活作为脑瘫儿童步态的补充生物标志物的重要性

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-24 DOI: 10.1016/j.clinbiomech.2025.106743

Gabriel Graffagnino , Benoît Sijobert , Karine Patte , Christine Azevedo-Coste , David Gasq

Background

Cerebral palsy (CP) is a neurological disorder characterized by motor impairments, including muscle spasticity, weakness, and abnormal co-activation leading to gait abnormalities. Understanding the relationship between these factors is essential for optimizing rehabilitation strategies but remains unclear, particularly in terms of phase-specific neuromuscular adaptations during gait. This study investigated the correlations between muscle spasticity, strength, co-activation, and gait variable scores (GVS) in children with CP during clinical gait analysis. Two muscle pairs were analyzed: Gastrocnemius Medialis-Tibialis Anterior (GM-TA) and Rectus Femoris-Semitendinosus (RF-ST).

Methods

We retrospectively analyzed 55 children with CP using surface electromyography and clinical scales (Modified Ashworth Scale for spasticity, Medical Research Council scale for strength). Co-activation was computed for stance and swing phases and compared to reference values from literature data about typically developing children. Correlations between variables were assessed using Spearman's coefficient and Chi-square tests evaluated categorical relationships between spasticity and abnormal co-activation.

Findings

No clear correlations between spasticity and co-activation were demonstrated, except for RF during swing (moderate correlation). GVS for ankle and hip flexion was moderately correlated with co-activation. Muscle strength negatively correlated with co-activation and deviations of joint angles relative to healthy gait.

Interpretation

These findings highlight partial correlations between clinical examination (i.e., spasticity and strength) and gait data (i.e., muscle co-activation and kinematic alterations), reinforcing the importance of assessing multiple biomarkers to better characterize gait abnormalities. Future rehabilitation protocols should comprehensively evaluate spasticity, muscle strength, co-activation, and GVS to better adapt interventions and optimize motor function in children with CP.

背景：脑瘫（CP）是一种以运动障碍为特征的神经系统疾病，包括肌肉痉挛、无力和导致步态异常的异常共激活。了解这些因素之间的关系对于优化康复策略至关重要，但目前尚不清楚，特别是在步态过程中特定阶段的神经肌肉适应方面。本研究在临床步态分析中探讨了CP患儿肌肉痉挛、力量、共激活和步态变量评分（GVS）之间的相关性。分析了两对肌肉：腓肠肌内侧-胫骨前肌（GM-TA）和股直肌-半腱肌（RF-ST）。方法采用表面肌电图和临床量表（改良Ashworth痉挛量表、医学研究委员会力量量表）对55例小儿脑瘫进行回顾性分析。计算了站立和摇摆阶段的共激活，并比较了典型发育儿童文献数据的参考值。使用Spearman系数评估变量之间的相关性，卡方检验评估痉挛和异常共激活之间的分类关系。结果：痉挛和共激活之间没有明显的相关性，除了摆动时的射频（中度相关性）。踝关节和髋关节屈曲的GVS与共激活中度相关。肌肉力量与共同激活和关节角度偏离相关的健康步态负相关。这些发现强调了临床检查（即痉挛和力量）和步态数据（即肌肉共激活和运动学改变）之间的部分相关性，加强了评估多种生物标志物以更好地表征步态异常的重要性。未来的康复方案应综合评估痉挛、肌力、共激活和GVS，以更好地适应干预措施并优化CP患儿的运动功能。

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引用次数: 0

Postural control in individuals with mental disorders: A systematic review and META-analysis 精神障碍患者的体位控制：一项系统综述和meta分析

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-20 DOI: 10.1016/j.clinbiomech.2025.106741

Carla Emilia Rossato , Aline Josiane Waclawovsky , Gabriela dos Santos de Souza , Debora Tornquist , Carlos Bolli Mota , Aron Ferreira da Silveira , Felipe Barreto Schuch

Background: Some evidence suggests that people with mental disorders presents postural balances, but there is a scarcity of meta-analyses summarizing the evidence comparing posture of people with mental disorders with paired controls. Objectives: The aim of this study was to summarize the evidence comparing postural balance between individuals with mental disorders and healthy controls. Methods: We searched databases (PubMed, PsycINFO, Embase, SportDiscus and Web of Science) from inception until June 3, 2025, for studies comparing postural balance, assessed by center of pressure (COP), in people with and without mental disorders. The primary outcome was the COP in different axes (X and Y), assessed under multiple conditions (eyes open/close, feet apart/together). Random effects meta-analyses calculated the mean differences (MD) between groups Whenever relevant; heterogeneity was explored by meta-regression and subgroup analyses. The risk of bias of the included studies was assessed using the Newcastle-Ottawa scale (NOS). The protocol was registered with PROSPERO (CRD42024554769). Findings: 33 studies were included, totaling 2.601 participants (1.424 with mental disorders [mean age = 39.30 ± 10.54 years, 43.05 % women] and 1.177 controls [mean age = 39.68 ± 10.35, 50.44 % women]. People with mental disorders showed greater COP area sway in the feet apart and eyes open (N = 12, MD = 0.20, 95 %CI 0.07, 0.32, I² = 62.67) and eyes closed conditions (N = 8, MD = 0.42, 95 %CI 0.15, 0.69, I² = 59.10) compared to controls. The majority of studies (96.96 %) had a low or moderate risk of bias. Interpretation: Individuals with mental disorders show alterations in postural balance compared to healthy controls.

背景：一些证据表明，精神障碍患者表现出姿势平衡，但缺乏荟萃分析，总结了精神障碍患者与配对对照者姿势的证据。目的：本研究的目的是总结比较精神障碍个体和健康对照者的姿势平衡的证据。方法：我们检索了数据库（PubMed, PsycINFO, Embase， SportDiscus和Web of Science），从成立到2025年6月3日，以比较有精神障碍和无精神障碍人群的姿势平衡，以压力中心（COP）评估。主要结果是不同轴（X和Y）的COP，在多种条件下（睁眼/闭眼，两脚分开/并拢）进行评估。随机效应荟萃分析计算各组间相关的平均差异（MD）；通过meta回归和亚组分析探讨异质性。纳入研究的偏倚风险采用纽卡斯尔-渥太华量表（NOS）进行评估。该协议已注册到PROSPERO （CRD42024554769）。结果：纳入33项研究，共纳入2.601名受试者，其中精神障碍患者1.424人[平均年龄= 39.30±10.54岁，女性43.05%]，对照组1.177人[平均年龄= 39.68±10.35岁，女性50.44%]。与对照组相比，精神障碍患者在两脚分开、睁眼（N = 12, MD = 0.20, 95% CI 0.07, 0.32, I2 = 62.67）和闭眼（N = 8, MD = 0.42, 95% CI 0.15, 0.69, I2 = 59.10）时的COP面积摆动更大。大多数研究（96.96%）具有低或中等偏倚风险。解释：与健康对照相比，患有精神障碍的个体表现出姿势平衡的改变。

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引用次数: 0

Load distribution between the radius and ulna through the forearm interosseous membrane: Effects of elbow flexion and Varus–Valgus alignment 通过前臂骨间膜在桡骨和尺骨之间的负荷分布：肘关节屈曲和内翻对准的影响

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-19 DOI: 10.1016/j.clinbiomech.2025.106742

Takahiro Yamazaki, Yusuke Matsuura, Takashi Nomoto, Seiji Ohtori, Takane Suzuki

Background

The forearm interosseous membrane helps distribute load between the radius and ulna, yet the combined influence of elbow flexion and varus–valgus alignment on load transfer remains unclear. This study aimed to quantify interosseous membrane-mediated load transfer across elbow flexion angles under varus and valgus loading.

Methods

Seven fresh-frozen cadaveric forearms were tested using a custom setup with tension/compression force sensors mounted to record loads transmitted through the radius and ulna. Specimens were positioned at multiple elbow flexion angles within 0–90° under controlled varus and valgus loading. The interosseous membrane load-transfer rate was calculated from synchronized force data, and conditions were compared statistically (Wilcoxon signed-rank test).

Findings

The interosseous membrane load-transfer rate was significantly greater under varus than valgus loading (mean ± SD: 24.4 ± 14.8 % vs 10.1 ± 7.9 %, p < 0.001). Across the tested elbow flexion angles, flexion had no significant effect on the load-transfer rate in either alignment condition.

Interpretation

Within the tested range, varus–valgus alignment, rather than elbow flexion angle, primarily determines the magnitude of interosseous membrane -mediated load transfer. These findings provide biomechanical insight relevant to understanding injury mechanisms and may inform alignment considerations during rehabilitation or immobilization.

背景：前臂骨间膜有助于在桡骨和尺骨之间分配负荷，但肘关节屈曲和外翻对准对负荷转移的综合影响尚不清楚。本研究旨在量化内翻和外翻载荷下肘关节屈曲角度骨间膜介导的载荷传递。方法采用特制的张力/压缩力传感器对7只新鲜冷冻前臂进行测试，以记录通过桡骨和尺骨传递的载荷。在控制的内翻和外翻载荷下，将标本放置在0-90°的多个肘关节屈曲角度。根据同步力数据计算骨间膜载荷传递率，并进行统计学比较（Wilcoxon sign -rank检验）。结果内翻载荷下骨间膜载荷传递率明显高于外翻载荷（平均±SD: 24.4±14.8% vs 10.1±7.9%,p < 0.001）。在测试的弯头弯曲角度中，弯曲对两种对齐条件下的负载传递率没有显著影响。在测试范围内，内翻对准，而不是肘关节屈曲角度，主要决定骨间膜介导的负荷转移的大小。这些发现提供了与理解损伤机制相关的生物力学见解，并可能为康复或固定期间的对齐考虑提供信息。

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引用次数: 0

Comparing participant recruitment methods in knee osteoarthritis: Implications for community recruitment and its effects on clinical and biomechanical outcomes 比较膝关节骨关节炎的参与者招募方法：社区招募的意义及其对临床和生物力学结果的影响。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-19 DOI: 10.1016/j.clinbiomech.2025.106740

Carson Halliwell , Aleksandra Budarick , Janie Astephen Wilson , Derek Rutherford , Meaghan Hannigan , Rebecca Moyer

Background

Community-based recruitment may relieve clinician-dependant strategies for participant recruitment in gait analyses for clinical populations. However, it is unknown whether individuals recruited through community-based self-report methods exhibit similar patient-reported outcomes and gait biomechanics to those clinically diagnosed by a healthcare provider. This study aims to explore the differences between self-reported and clinically diagnosed knee osteoarthritis in terms of pain, function, quality of life, and gait biomechanics.

Methods

Participants with self-reported knee osteoarthritis (n = 16) were recruited based on activity-related knee pain, while those with clinically diagnosed knee osteoarthritis (n = 16) diagnosed based on the American College of Rheumatology guidelines by an orthopaedic surgeon. Both groups completed the Knee Injury and Osteoarthritis Outcome Score and Intermittent and Constant Osteoarthritis Pain questionnaires. Gait analysis was performed using three-dimensional motion capture, with sagittal plane knee angles, and knee flexion and adduction moments. Independent t-tests and statistical parametric mapping were used for group comparisons.

Findings

No differences were found between groups for patient-reported outcomes. Compared to individuals with clinically diagnosed knee osteoarthritis, individuals with self-reported knee osteoarthritis walked with reduced knee flexion angles and reduced peak knee flexion and adduction moments.

Interpretation

While patient-reported outcomes were not different, the biomechanical characteristics indicate that individuals recruited using community-based self-reported methodology may walk with gait patterns more closely resembling severe knee osteoarthritis. Although neither recruitment strategy is superior, these data support that employing a community-based self-report recruitment criterion may yield individuals who walk with gait patterns more closely resembling severe knee osteoarthritis compared to those clinically diagnosed.

背景：以社区为基础的招募可以减轻临床人群步态分析中参与者招募的临床依赖策略。然而，通过社区自我报告方法招募的个体是否表现出与医疗保健提供者临床诊断的患者相似的患者报告结果和步态生物力学尚不清楚。本研究旨在探讨自我报告和临床诊断的膝关节骨性关节炎在疼痛、功能、生活质量和步态生物力学方面的差异。方法：根据与活动相关的膝关节疼痛招募自述膝骨关节炎的参与者（n = 16），而根据美国风湿病学会指南由骨科医生诊断的临床诊断膝骨关节炎的参与者（n = 16）。两组都完成了膝关节损伤和骨关节炎结局评分以及间歇性和持续性骨关节炎疼痛问卷调查。步态分析采用三维运动捕捉，膝关节矢状面角度，膝关节屈曲和内收力矩。组间比较采用独立t检验和统计参数映射。结果：两组患者报告的结果无差异。与临床诊断的膝关节骨性关节炎患者相比，自我报告的膝关节骨性关节炎患者行走时膝关节屈曲角度减小，膝关节屈曲峰值和内收力矩减小。解释：虽然患者报告的结果没有差异，但生物力学特征表明，使用社区自我报告方法招募的个体可能走路的步态模式更接近于严重的膝关节骨关节炎。尽管两种招募策略都没有优势，但这些数据支持采用基于社区的自我报告招募标准可能会产生与临床诊断的患者相比步态模式更接近于严重膝骨关节炎的个体。

{"title":"Comparing participant recruitment methods in knee osteoarthritis: Implications for community recruitment and its effects on clinical and biomechanical outcomes","authors":"Carson Halliwell , Aleksandra Budarick , Janie Astephen Wilson , Derek Rutherford , Meaghan Hannigan , Rebecca Moyer","doi":"10.1016/j.clinbiomech.2025.106740","DOIUrl":"10.1016/j.clinbiomech.2025.106740","url":null,"abstract":"<div><h3>Background</h3><div>Community-based recruitment may relieve clinician-dependant strategies for participant recruitment in gait analyses for clinical populations. However, it is unknown whether individuals recruited through community-based self-report methods exhibit similar patient-reported outcomes and gait biomechanics to those clinically diagnosed by a healthcare provider. This study aims to explore the differences between self-reported and clinically diagnosed knee osteoarthritis in terms of pain, function, quality of life, and gait biomechanics.</div></div><div><h3>Methods</h3><div>Participants with self-reported knee osteoarthritis (<em>n</em> = 16) were recruited based on activity-related knee pain, while those with clinically diagnosed knee osteoarthritis (n = 16) diagnosed based on the American College of Rheumatology guidelines by an orthopaedic surgeon. Both groups completed the Knee Injury and Osteoarthritis Outcome Score and Intermittent and Constant Osteoarthritis Pain questionnaires. Gait analysis was performed using three-dimensional motion capture, with sagittal plane knee angles, and knee flexion and adduction moments. Independent <em>t</em>-tests and statistical parametric mapping were used for group comparisons.</div></div><div><h3>Findings</h3><div>No differences were found between groups for patient-reported outcomes. Compared to individuals with clinically diagnosed knee osteoarthritis, individuals with self-reported knee osteoarthritis walked with reduced knee flexion angles and reduced peak knee flexion and adduction moments.</div></div><div><h3>Interpretation</h3><div>While patient-reported outcomes were not different, the biomechanical characteristics indicate that individuals recruited using community-based self-reported methodology may walk with gait patterns more closely resembling severe knee osteoarthritis. Although neither recruitment strategy is superior, these data support that employing a community-based self-report recruitment criterion may yield individuals who walk with gait patterns more closely resembling severe knee osteoarthritis compared to those clinically diagnosed.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106740"},"PeriodicalIF":1.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822017","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

Ultrasound for the assessment of muscle architecture in Parkinson's disease: A scoping review 超声评估帕金森病的肌肉结构：范围综述

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-19 DOI: 10.1016/j.clinbiomech.2025.106733

Mahyar Behraznia , Massimiliano Ditroilo , Tina Smith

Background

Parkinson's disease (PD) affects motor function and muscle performance, which are closely linked to muscle architecture (MA). Ultrasound (US) provides a non-invasive method to assess MA, yet its application in PD remains underexplored. This review aimed to map and synthesise existing research on US assessment of MA in individuals with PD to clarify how US imaging methodologies contribute to understanding muscle structure and function in this population.

Methods

This scoping review was conducted following established guidelines and searching these databases: Scopus, PubMed, Web of Science Core Collection, MEDLINE and CINAHL Ultimate.

Findings

Of the 913 records identified, 20 studies met the inclusion criteria. Research varied in design, US measurement methodology, and measurement and reporting approaches. The synthesis revealed that while MA at rest was largely preserved in PD with notable exceptions, muscle fascicle responsiveness during contraction was significantly impaired, potentially due to rigidity. MA differences were associated with PD clinical manifestations (i.e., bradykinesia and rigidity) and reduced functional performance. PD-related comorbidities including sarcopenia, camptocormia, and dysphagia were found to further affect MA, exacerbating muscle degradation and remodelling. Exercise was found to alter the structural characteristics of MA, suggesting beneficial adaptive potential.

Significance and interpretation

Despite consistent evidence of altered MA and muscle responsiveness in PD, methodological heterogeneity and small samples limit firm conclusions. Standardised US protocols and longitudinal studies are needed to clarify the relationship between MA, functional performance, and PD clinical features, and to evaluate the effects of exercise and rehabilitation on muscle structure and strength.

帕金森病（PD）影响运动功能和肌肉性能，这与肌肉结构（MA）密切相关。超声（US）提供了一种非侵入性评估MA的方法，但其在PD中的应用仍有待探索。本综述旨在绘制和综合PD患者MA的超声评估的现有研究，以阐明超声成像方法如何有助于了解该人群的肌肉结构和功能。方法采用Scopus、PubMed、Web of Science Core Collection、MEDLINE和CINAHL Ultimate等数据库进行文献综述。在确定的913项记录中，有20项研究符合纳入标准。研究在设计、美国测量方法、测量和报告方法上各不相同。综合结果显示，虽然PD患者的静止MA大部分保留，但肌肉束在收缩时的反应性明显受损，这可能是由于僵硬所致。MA差异与PD临床表现（即运动迟缓和僵硬）和功能表现下降有关。pd相关的合并症，包括肌肉减少症、喜树豆症和吞咽困难，被发现进一步影响MA，加剧肌肉退化和重塑。运动可以改变MA的结构特征，提示有益的适应潜力。尽管有一致的证据表明PD患者的MA和肌肉反应性改变，但方法的异质性和小样本限制了确切的结论。需要标准化的美国方案和纵向研究来阐明MA、功能表现和PD临床特征之间的关系，并评估运动和康复对肌肉结构和力量的影响。

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引用次数: 0

Anterior talofibular ligament laxity restricts deep deltoid ligament strain in a cadaveric model of acquired planus 'The deep deltoid paradoxical intact sign' 距腓骨前韧带松弛限制了获得性扁平肌尸体模型的深三角韧带劳损。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-13 DOI: 10.1016/j.clinbiomech.2025.106734

Zhikai Li , Gavin E. Jarvis , Tobia Nava , Zhiheng Li , Luke Maxwell , Cecilia Brassett , Stephanie Potten , Alan R. Norrish , Chandra S. Pasapula

Background

The Deep Deltoid Ligament (DDL) laxity development and subsequent rupture can occur in pes planus. Anteromedial drawer tests reveal reduced anteromedial anteroposterior (AP) ankle laxity with concurrent anterior talofibular ligament (ATFL) laxity. The paradoxical protection conferred by ATFL laxity to the DDL in progressive collapsing foot deformity (PCFD) warrants further investigation.

Aims

Investigate the effect of ATFL laxity on DDL laxity development in an experimental flat-foot model.

Methods

18 cadaveric feet were assigned to three experimental protocols: (1) control, (2) induced flat-foot, and (3) induced flat-foot with ATFL sectioned. The flat-foot model was induced by sectioning the plantar fascia, spring ligament (SL), and the plantar first tarsometatarsal ligament. Sectioning the SL due to the interconnectedness would result in defunctioning of the superficial deltoid. Positional markers were placed on the medial malleolus, fibula, and talus. Jig-mounted feet underwent 2000 loading cycles. Every 200 cycles, images were taken before and after antero-posterior force application and the markers used to determine anteromedial and anterolateral AP separation, modelled as a linear function of cycle number.

Findings

In ATFL-intact flat feet, antero-posterior force-induced anteromedial separation and thus DDL laxity increased by 3.45 ± 0.34 mm per 1000 cycles (mean ± SD), whereas in ATFL-sectioned and control feet, this was 0.64 ± 0.59 and 0.59 ± 0.32 mm per 1000 cycles respectively. Minimal cycle-induced change occurred in anterolateral separation in the three conditions. ATFL-sectioned feet had greater antero-posterior force-induced anterolateral separation (9.33 ± 1.42 mm) before cyclic loading than control (1.85 ± 0.85 mm) and ATFL-intact flat feet (1.85 ± 0.31 mm).

Interpretation

Sectioning ATFL in experimentally induced flat feet paradoxically reduces anteromedial separation/DDL laxity.

背景深三角韧带（DDL）松弛发展和随后的破裂可发生在扁平足。前内侧抽屉试验显示前内侧前后（AP）踝关节松弛减轻，并发距腓骨前韧带（ATFL）松弛。进行性塌陷足畸形（PCFD）中ATFL松弛对DDL的矛盾保护值得进一步研究。目的探讨足前屈韧带松弛对平足实验模型DDL松弛发展的影响。方法将18只尸体足分为3个实验方案：(1)对照，(2)诱导扁平足，(3)诱导扁平足与ATFL切片。采用切开足底筋膜、弹簧韧带（SL）和足底第一跗跖韧带的方法建立足平足模型。由于连通性而切开上尾肌会导致浅表三角肌功能丧失。在内踝、腓骨和距骨上放置位置标记。夹具安装的脚经历了2000次加载循环。每200个周期，拍摄前后前后的图像和用于确定前内侧和前外侧AP分离的标记物，建模为周期数的线性函数。结果发现，在atfl完整的平足中，前后力诱导的前内侧分离导致DDL松弛度每1000个周期增加3.45±0.34 mm（平均±SD），而在atfl切割和对照足中，每1000个周期分别增加0.64±0.59和0.59±0.32 mm。在三种情况下，前外侧分离发生最小的循环引起的变化。与对照组（1.85±0.85 mm）和完整的atfl平足（1.85±0.31 mm）相比，atfl切面足在循环加载前的前后力诱导前外侧分离（9.33±1.42 mm）更大。实验诱导的扁平足中ATFL的切开矛盾地减少了前内侧分离/DDL松弛。

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引用次数: 0

Relationship between hip flexor tightness and low back pain in non-care-seeking individuals 非求医个体髋屈肌紧绷与腰痛的关系。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-13 DOI: 10.1016/j.clinbiomech.2025.106739

Kira Eimiller , Matthew Vraa , Kemery Sigmund , Matthew Zellmer

Background

Low back pain (LBP) is a prevalent musculoskeletal condition with significant economic consequences (Wu et al., 2020). Despite evidence of functional limitations, non-care-seeking individuals with LBP remain an under-researched population (Vraa et al., 2022). Hip flexor tightness has been proposed as a potential contributor to LBP due to its role in altered biomechanics and compensatory lumbar movements (Kim & Shin, 2020). Tight hip flexors are frequently assumed to contribute to LBP, yet the nature of the relationship is unclear. The objective of this study was to examine the relationship between hip flexor tightness and LBP severity in individuals with and without LBP who have not sought medical care.

Methods

A cross-sectional study of 118 adults (aged 20–61) assessed hip flexor range of motion (ROM) using the Modified Thomas Test and low back pain severity using the Modified Oswestry Disability Index. Between-group comparisons and generalized linear models examined the relationship between ROM, LBP presence, and disability.

Findings

LBP participants had significantly reduced ROM (4 ± 9° vs. 8 ± 9°, p = 0.003). However, in the adjusted generalized linear model, only BMI remained a significant predictor of hip flexor ROM (p = 0.011), while LBP status was not independently associated with hip flexor ROM (p = 0.180).

Interpretation

Reduced hip flexor ROM was observed in non-care-seeking individuals with LBP but was not independently predictive after adjustment. BMI was the only significant factor associated with hip flexor ROM, underscoring the multifactorial nature of LBP.

背景：腰痛（LBP）是一种常见的肌肉骨骼疾病，具有显著的经济后果（Wu etal ., 2020）。尽管有功能限制的证据，但不寻求治疗的腰痛患者仍然是一个研究不足的人群（Vraa等人，2022）。髋关节屈肌紧绷被认为是腰痛的潜在因素，因为它在改变生物力学和补偿性腰椎运动中的作用（Kim & Shin, 2020）。紧臀屈肌通常被认为是导致腰痛的原因，但这种关系的本质尚不清楚。本研究的目的是在没有寻求医疗护理的有和没有腰痛的个体中检查髋屈肌紧绷和腰痛严重程度之间的关系。方法：对118名成年人（20-61岁）进行横断面研究，使用改良Thomas测试评估髋屈肌活动范围（ROM），使用改良Oswestry残疾指数评估腰痛严重程度。组间比较和广义线性模型检验了ROM、LBP存在和残疾之间的关系。结果：LBP患者的ROM显著降低（4±9°vs. 8±9°，p = 0.003）。然而，在调整后的广义线性模型中，只有BMI仍然是髋屈肌ROM的显著预测因子（p = 0.011），而腰痛状态与髋屈肌ROM没有独立相关性（p = 0.180）。解释：在没有求医的腰痛患者中观察到髋屈肌活动度降低，但调整后不能独立预测。BMI是与髋屈肌ROM相关的唯一重要因素，强调了腰痛的多因素性质。

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引用次数: 0

Effect of gait pattern on patellofemoral joint stress during walking in individuals with patellar instability 步态方式对髌骨不稳患者行走时髌骨股骨关节应力的影响。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-12 DOI: 10.1016/j.clinbiomech.2025.106738

Delaney M. McNeese , Caitlin E. Conley , Austin V. Stone , Cale Jacobs , Brian Noehren , Meredith K. Owen

Background

Patellar instability is a common injury among young, active individuals resulting in increased risk for future patellofemoral osteoarthritis. The purpose of this study is to quantify the effect of gait pattern on patellofemoral joint stress in those with patellar instability.

Methods

Individuals with patellar instability (n = 17) completed an instrumented gait analysis. A mathematical model, with sagittal plane knee angle and knee moment as inputs, was used to estimate patellofemoral joint stress during stance. Individuals were grouped by presenting with an extension dominant knee moment or a flexion dominant knee moment. Patellofemoral joint stress and knee and hip mechanics were compared between affected limbs. The injured limb of the extension dominant group was also compared to matched healthy control participants.

Findings

Extension dominant and flexion dominant groups had similar patellofemoral joint stress magnitudes (p = 0.37) throughout stance phase, but the flexion dominant group reached peak stress at a significantly later percentage of stance (p < 0.05) and at a smaller knee flexion angle (p < 0.05). There were no significant differences in peak or timing of patellofemoral joint stress or knee angle at peak stress between the extension dominant group and a matched set of healthy controls, but differences in other knee and hip mechanics were present.

Interpretation

The flexion dominant group's peak patellofemoral joint stress occurred later in stance placing it above the trochlear groove, perhaps loading cartilage unaccustomed to high magnitudes, and may contribute to the development of patellofemoral osteoarthritis through impaired adaptation to altered loading.

背景：髌骨不稳定是年轻人中常见的损伤，导致未来髌骨骨关节炎的风险增加。本研究的目的是量化步态模式对髌骨不稳患者髌骨股骨关节应力的影响。方法：髌骨不稳患者（n = 17）完成了器械步态分析。以矢状面膝关节角度和膝关节力矩为输入，建立数学模型估算站立时髌骨股骨关节应力。个体被分组，呈现以伸展为主的膝关节时刻或屈曲为主的膝关节时刻。髌骨股骨关节应力和膝关节及髋关节力学比较。伸展优势组的受伤肢体也与匹配的健康对照组进行了比较。结果：在整个站立阶段，伸展优势组和屈曲优势组的髌股关节应力大小相似（p = 0.37），但屈曲优势组在站立时达到峰值应力的比例明显较晚(p)。屈曲优势组髌骨股骨关节应力峰值发生在体位较晚的位置，置于滑车槽上方，可能是负载软骨不习惯高强度，并可能通过对改变负载的适应受损而导致髌骨股骨骨关节炎的发展。

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引用次数: 0

A novel method for screening diabetic peripheral neuropathy using fused surface electromyogram signal and mechanomyography signal 一种利用肌电信号和肌力图信号融合筛查糖尿病周围神经病变的新方法。

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics

Pub Date : 2025-12-11 DOI: 10.1016/j.clinbiomech.2025.106737

Yanbin Guo , Mingyue Wang , Guoping Wang , Wenxuan Sun , Xiao-Jian Han , Lingjuan Li , Xin-Hui Qu , Zibo Feng

Background

Diabetes peripheral neuropathy (DPN), one of the most common complications in people with diabetes, can seriously undermine their quality of life. Early detection and treatment of DPN is of great significance to the diabetes population. Nerve conduction studies, the gold standard for diagnosing DPN, causes substantial discomfort for people and requires specialized personnel and expensive equipment, making it challenging to implement as a mass screening tool for DPN.

Methods

Here, a novel, non-invasive and convenient screening method for DPN is proposed. In the proposed method, surface electromyography and mechanomyography data are acquired in a non-invasive and painless manner from people’ dorsalis pedis muscles. The acquired data are then processed by means of downsampling, motion data extraction, and subsequently converted into images, which are utilized for diagnosing DPN or non-DPN by a convolutional neural network.

Findings

The proposed method is developed based on actual data from 167 people with diabetes. After 4-fold cross validation of the method, the mean accuracy, sensitivity and specificity are evaluated to be 96.15 %, 91.39 % and 98.78 % with variances of 0.003 %, 0.017 % and 0.00014 %, respectively. Furthermore, the method is preliminary tested on 21 people with diabetes, resulting in accuracy, sensitivity and specificity of 95.48 %, 90.91 % and 98.88 %, respectively. Notably, the screening process for a single diabetic using this method can be completed in under 10 min. The results above demonstrate the efficacy of the method in diagnosing DPN.

Interpretation

The proposed method has the considerable potential for noninvasive and convenient screening of DPN without requiring professionals or expensive equipment.

背景：糖尿病周围神经病变（DPN）是糖尿病患者最常见的并发症之一，严重影响患者的生活质量。DPN的早期发现和治疗对糖尿病人群具有重要意义。神经传导研究是诊断DPN的金标准，但它会给患者带来很大的不适，需要专业人员和昂贵的设备，因此很难将其作为DPN的大规模筛查工具。方法：提出一种新颖、无创、方便的DPN筛查方法。在提出的方法中，以非侵入性和无痛的方式从人的足背肌肉中获得表面肌电图和肌力图数据。采集到的数据通过下采样、运动数据提取等方式进行处理，随后转换成图像，通过卷积神经网络用于诊断DPN或非DPN。研究结果：提出的方法是基于167名糖尿病患者的实际数据开发的。方法经4倍交叉验证，平均准确度为96.15%，灵敏度为91.39%，特异度为98.78%，方差分别为0.003%,0.017%,0.00014%。并对21例糖尿病患者进行了初步试验，准确度为95.48%，灵敏度为90.91%，特异性为98.88%。值得注意的是，使用这种方法对单个糖尿病患者的筛选过程可以在10分钟内完成。以上结果证明了该方法诊断DPN的有效性。该方法在不需要专业人员或昂贵设备的情况下，具有非侵入性和方便的DPN筛查的巨大潜力。

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引用次数: 0