Gait & posture最新文献

{"title":"Application of 3D motion analysis to quantify a clinical test method assessing wrist spasticity","authors":"Anna Pennekamp, Mirjam Thielen, Julia Glaser, Leila Harhaus, Ursula Trinler","doi":"10.1016/j.gaitpost.2023.07.196","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.196","url":null,"abstract":"Spasticity is a symptom that occurs in patients with acute or chronic damages of the central nervous system [1]. Quantification of such limitations is essential, for example for preoperative decision making. Though, objective measurement methods to assess upper limb (UL) spasticity are poorly applied in clinical practice. Due to the low interrater reliability of subjective scales (modified Ashworth scale (MAS), modified Tardieu scale (MTS) [2,3]), 3D motion analysis and synchronized surface EMG (sEMG) should be used as an alternative method to determine objective parameters. How do the results of the objective sEMG parameters during passive stretch correlate with the subjective values of MAS and MTS? Which differences exist in wrist kinematics and muscle activity during a passive stretch of the wrist flexors between healthy adults and patients with UL spasticity? 11 patients with UL spasticity (39 ± 18 years) and 5 healthy adults (10 arms, 35 ± 9 years) were included. All participants were analysed using 3D motion analysis (Qualisys, U.L.E.M.A [4]) and sEMG (Noraxon) on M. flexor carpi ulnaris and / or M. flexor carpi radialis and M. extensor carpi radialis brevis during passive stretch of the wrist (3 slow (LV) and 3 quick (HV) directed movements). sEMG data were normalised to maximum isometric contraction (MVIC) and examined over a defined period of time (200ms before reaching maximum velocity to 90% of max. extension [5]). The velocity of the passive stretch (30°/s slow, 180°/s fast) was standardized with a metronome. The maximum passive wrist extension, the sEMG parameters (EMGLV and EMGHV) as well as the sEMG difference between LV and HV (EMGchange) were compared between groups (Mann-Whitney-U-Test). MAS and MTS were clinically assessed and correlated with sEMG parameters (Spearman's rank correlation coefficient). Joint angles and sEMG parameters were significantly different between groups (Table 1a). Correlations between sEMG based parameters and the subjective values of MAS and MTS where low and not significant (Table 1b). Table 1: a): Differences between healthy adults and patients, b): Spearman's rank correlation coefficient between subjective Scales (MAS, MTS) and objective Parameters (EMGLV, EMGHV, EMGchange)Download : Download high-res image (74KB)Download : Download full-size image The objective measurement method, which has already been used for the elbow and lower limb, also shows promising results on the wrist. The comparison between healthy adults and spasticity patients clearly shows that the muscular activity of the wrist flexors during their passive stretch is high and velocity dependent in spasticity patients. Interestingly, neither MAS nor MTS values correlate to objective values at the wrist. Wrist flexor spasticity is not only caused by the wrist flexors, but also by the extrinsic finger flexors, which are not yet included in this model.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of subject’s physical properties on joint biomechanics: Hypermobility alters lower extremity biomechanics during knee-bearing activity","authors":"Shavkat Kuchimov, Mehmed Özkan, Adnan Apti, Nazif Ekin Akalan, Burcu Semin Akel, Karsten Hollander","doi":"10.1016/j.gaitpost.2023.07.134","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.134","url":null,"abstract":"Hypermobility is a physical specificity of the subject that refers to an increased range of motion in one or more joints beyond what is considered normal or expected for an individual's age, gender, and body type. The previous studies on hypermobility stated that generalized joint hypermobility (GJH) may cause joint instability and muscle weakness [1]. The knee joint structural integrity and function maintained essentially by the cruciate ligaments. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) work together to provide stability to the knee joint by preventing excessive movement of the tibia (shin bone) in relation to the femur (thigh bone). The more common ligament injury is ACL injury and non-contact ACL injuries remain a serious problem among athletes [2]. Activities demanding mechanical bearing on the knee joint recommended for classifying an athlete's anterior cruciate ligament injury risk [3]. Some biomechanical factors determined in these tests are associated with future injuries [4]. In order to protect the athlete from injury, it is necessary to determine the causes of biomechanical factors determined by functional tests. The aim of this study is to examine the effects of GJH on Pelvis and lower body joint biomechanics with Single Leg Landing (SLL) test. Does hypermobility alter lower extremity biomechanics? Eight healthy volunteers with no history of musculoskeletal injury or pain participated in this study (mean age: 16.6±4.2). Casual sports participants were divided into two equal groups (control ≤4, hypermobile ≥6) according to the Beighton score which measures GJH [5]. SLL tests were acquired for each subject using 3D motion analysis (6 Vantage 5 Camera, 2 Force Platforms, Vicon Motion Systems Ltd UK). Plug-in-gait model for lower extremity is utilized as marker set that described in the previous studies [4]. Three repetitive tests were evaluated for each leg side. An Independent t-test was used for statistical analysis. Participants with hypermobility exhibited higher peak angles of pelvic external rotation (p=0.01), hip adduction (p=0.03), and knee valgus (p=0.02) during the stance phase of knee-bearing activity (see Table 1). In contrast, peak values of pelvic posterior tilt angle (p=0.03), foot internal progression (p=0.05), and knee flexion moment (p=0.01) were found to be decreased in participants with hypermobility.Download : Download high-res image (113KB)Download : Download full-size image It has been determined that joint hypermobility can lead to alterations in lower extremity biomechanics during SLL test. Increase in peak hip adduction and knee valgus angles lead to both acute (ACL rupture factor) and overuse sport injuries [6]. Further studies are needed to investigate the effects of joint hypermobility using detailed marker set for better quantification of specifically knee joint movement.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing a novel protocol to investigate mechanisms of falls in children with cerebral palsy, informed by lived experiences","authors":"Rebecca Louise Walker, Tom D O'Brien, Gabor J Barton, Bernie Carter, David M Wright, Richard J Foster","doi":"10.1016/j.gaitpost.2023.07.262","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.262","url":null,"abstract":"Children with cerebral palsy (CwCP) regularly fall (35% fall daily), yet reasons for their falls are not well understood [1]. Stability and changes in walking behaviour of CwCP when negotiating challenging walking environments (e.g. uneven surfaces) have been accurately measured in laboratory settings [2], however these have not captured the real-world fall-risk that CwCP face daily. Walk-along interviews are a useful approach to capture the meaningful lived experiences of children whilst they are walking outside in challenging environments [3,4]. Previously, we co-designed a novel walk-along interview protocol by engaging with CwCP[5]. Real-world insights gathered from these walk-along interviews could enable us to design bespoke research protocols that explore the mechanisms of daily falls in CwCP. How do lived experiences of CwCP inform the development of a bespoke lab-based protocol to investigate the mechanisms of falls? Twelve CwCP (GMFCS I to III, 6 diplegia, 6 hemiplegia, 12±3 years old) and their parents took part in tailored walk-along interviews in which they discussed everyday fall experiences based on environments encountered on an outdoor walk. Chest-mounted cameras (Kaiser Baas X450) and wireless microphones (RODE GO II) captured environments and conversations. Walk-along interviews were analysed in NVivo using interpretive description[6]. Key insights from interviews (e.g. previous fall experiences) were used to determine the types of environments to be included in a bespoke walking protocol for assessing mechanisms of falls. Four CwCP and their parents were consulted about the findings from walk-along interviews to support protocol design. Walk-along interviews revealed that falls most often result when environmental challenges (“bumpy” surfaces) and sensory challenges (being “distracted” or “not looking”) are present together. Discussing previous falls or trips (Fig. 1) with CwCP and their parents informed the design of a bespoke walkway to investigate mechanisms of falls in challenging environments. The walkway includes common environmental challenges that cause falls (grass potholes and uneven pavements). To emulate the sensory challenges reported during walk-along interviews, randomly selected trials over the bespoke walkway will include a virtual distraction imitating noises and images of a busy street. Consultations with CwCP suggested these virtual distractions should include dogs barking and cars driving on busy roads. Download : Download high-res image (87KB)Download : Download full-size image We have designed a bespoke protocol that replicates the challenging environmental features and distractions faced daily by CwCP. Our protocol is unique because it was informed by the lived experiences of CwCP and their parents during novel walk-along interviews. We will next investigate, using 3D motion capture, potential indicators of high fall-risk (e.g. foot placement, decreased margins of stability) in CwCP compared to typicall","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of postural control with deprivation of visual system and somatosensorial perturbation in child with autism: case report","authors":"Juliana D.O.H. Mendes, Lorraine B. Cordeiro, Grazielly N. Santos, Fernanda B.D. Carvalho, Luanda A.C. Grecco, Pedro A.S. Ribeiro, Priscilla M. Moraes, Claudia Oliveira","doi":"10.1016/j.gaitpost.2023.07.176","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.176","url":null,"abstract":"Mental maturity is a state of preparation for physical, mental and social aspects of life.1 Individuals with autism spectrum disorder (ASD) have low mental maturity and deficits with regards to social interactions, language,1 motor skills and postural control.2 Postural control is achieved by the integration of three systems: visual, vestibular and somatosensorial.3 Postural perturbation increases the risk of falls and can exert a negative impact on the development of communication skills and social interactions.4 Children with autism are more susceptible due to deficits related to visual and somatosensorial feedback.5 Do deprivation of the visual system and somatosensorial perturbation alter postural control variables in a child with autism compared to a child with neurotypical development? This case report involved two male children aged seven years and four months – one with a diagnosis of ASD (22 kg, 132 cm) and another with neurotypical development (26.4 kg, 129 cm). The psychological evaluation (general reasoning capacity) was performed using the Columbia Mental Maturity Scale (CMMS-3). The motor assessment was performed using the SMART-D 140® system (BTS Engineering), which has two force plates (Kistler Platform, model 9286BA). Postural control was investigated under the following conditions: eyes open, eyes closed, without a mat and with a 5-cm foam rubber mat. Table 1 lists the results of the CMMS-3 and force plate variables. The child with ASD had average reasoning capacity. Both children exhibited oscillations in postural control, but the child with autism had poorer results in the occurrence of visual deprivation and somatosensorial perturbation. Table 1- Results of Columbia Mental Maturity Scale-3 and force plate variablesDownload : Download high-res image (94KB)Download : Download full-size image This study investigated whether mental maturity exerts an influence on postural control in a child with autism and whether the deprivation of the visual system and sensorial perturbation alter postural control variables. The results suggest that mental maturity (general reasoning capacity) exerts an influence on postural control, the understanding of the positioning on the force plate and the cognitive information process of maintaining a static position, especially with sensorial input caused by the foam rubber mat. Deprivation of the visual system and somatosensorial perturbation exert an influence on postural control in children with ASD,6,7 generating an increase in body sway and the area of displacement of the centre of plantar pressure.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced reciprocal inhibition during passive spasticity assessments is related with increased muscle co-activation during perturbations of standing balance","authors":"Jente Willaert, Lena H. Ting, Anja Van Campenhout, Kaat Desloovere, Friedl De Groote","doi":"10.1016/j.gaitpost.2023.07.269","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.269","url":null,"abstract":"Children with cerebral palsy (CP) often have balance impairments, but little is known about the relation between joint hyper-resistance (i.e., the most common symptom in spastic CP) and balance impairments (1). Both during clinical tests of joint hyper-resistance and when standing balance is perturbed, muscles are stretched. In children with CP, the stretch reflex in response to passive joint rotations is often hyper-excitable and reduced reciprocal inhibition has been observed in the antagonistic muscle (2). Furthermore, children with CP often have increased muscle co-activation during standing balance perturbations (3). Recently, we demonstrated that this increased muscle co-activation is not a useful compensation strategy and might therefore be a consequence of reduced reciprocal inhibition (4). Here, we investigated whether a reduction in reciprocal inhibition between plantarflexors and dorsiflexors in response to a passive stretching of the plantarflexors was related to higher levels of co-activation in response to toe-up rotational perturbations of standing balance. Twenty children with spastic CP participated in the study. We performed an instrumented spasticity assessment of the plantarflexors (5) followed by a standing balance assessment (Fig. 1, row1-2). During the instrumented spasticity assessment, the ankle was rotated as fast as possible from a plantar flexed position until the end of range of motion towards dorsiflexion. At least 7 seconds of rest were provided between different trials, five in total. Reactive standing balance was tested on a moving platform. Participants were instructed to maintain balance without stepping and the platform was rotated such that ankle dorsiflexion was elicited. Perturbations were repeated 8 times. Electromyography (EMG) from gastrocnemius lateralis (LG) and medialis (MG), soleus (SOL) and tibialis anterior (TA) was collected during both assessments. EMG was filtered and normalized to the maximal value across assessments (Fig. 1, row 3). We calculated the co-contraction index (CCI) as the overlap between TA and respectively LG, MG, and SOL EMG (6). We tested the relation between the CCI during passive joint rotations and reactive standing balance. The CCI between the plantarflexors and tibialis anterior during spasticity assessment was moderately correlated with the CCI during reactive balance responses (LG-TA: r=0.55; p= 0.02; MG-TA: r= 0.57, p=0.01; SOL-TA: r=0.54, p=0.02; Fig. 1, row 4). Fig. 1: Correlation between co-contraction index during instrumented spasticity assessment and perturbations of standing balance.Download : Download high-res image (242KB)Download : Download full-size image Our results suggest that deficits in spinal pathways governing the stretch reflex, and more specifically reduced reciprocal inhibition, might hinder reactive balance control. Successful postural control might therefore rely on compensations in supraspinal pathways to generate net balance correcting ankle momen","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle strength and equilibrium-maintaining ability in post-COVID women","authors":"Patrycja Bobowik, Ida Wiszomirska, Jan Gajewski, Michalina Błażkiewicz, Katarzyna Kaczmarczyk","doi":"10.1016/j.gaitpost.2023.07.113","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.113","url":null,"abstract":"The WHO declared COVID-19 a global pandemic [1], but the long-term consequences and aftermath of the disease remain unclear. The SARS-CoV-2 virus infects the respiratory system and probably also affects many other systems, including the musculoskeletal system [2–4]. In clinical practice, it has been observed that after recovering from COVID-19, a large number of seniors report prolonged general weakness and muscle fatigue. Falls, for instance, are a well-known consequence of reduced muscle strength [5,6]. Is COVID-19 infection associated with long-term reductions in muscle strength and balance ability in older women? The Study Group included 25 women, aged 65+, who declared they had recovered from SARS-CoV-2 infection. The Control Group consisted of women (n=30) of similar age, tested prior to the SARS-CoV-2 pandemic. Muscle torques were measured for the knee flexors (KF), knee extensors (KE), trunk flexors (TF), trunk extensors (TE), and elbow flexors (EF) under isometric conditions using a JBA Staniak® isometric torquemeter, by the maximum voluntary contraction method. Balance was assessed using a Biodex Balance System SD (BBS) platform. A static Postural Stability Test (PST) was performed using the stability platform with eyes open and eyes closed. A dynamic Fall Risk Test (FRT) was performed with eyes open at various levels of platform instability, and on this basis a fall risk index (FRI 6-2) was determined for each subject. Differences between the groups were assessed using the Mann-Whitney U test. A significance level of α=0.05 was assumed. Muscle torque values were normalized to the body weight of each subject. Statistical analysis showed higher values of EF, TF and TE for the Control Group. No statistical differences were found in static stabilographic parameters between groups. The Post-COVID Group did show higher results of the dynamic stabilographic index (FRI6-2) compared to the Control Group, which is indicative of poorer balance abilities. Results are presented in Table 1. Table 1 The results of the muscle toques of various muscle groups and fall risk in Post-COVID Group and Control GroupDownload : Download high-res image (88KB)Download : Download full-size image EF– elbow flexors torque; KF– knee flexors torque; KE– knee extensor torque; TF– trunk flexors torque; TE– trunk extensors torque; FRI– fall risk index; *n=24 We found FRI6-2 to be correlated with TE (r= -0.38) and TF (r= -0.37) for all participants, but this correlation was larger in the Post-COVID Group (r= -0.68 for TE and r= -0.55 for TF). Results indicate that post-COVID women exhibit impaired strength of various muscle groups and body balance in dynamic conditions. Post-COVID physiotherapy should therefore take into account not only respiratory problems but also musculoskeletal and equilibrium disorders, e.g. by using resistance training to improve muscle strength.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An approach to establishing the thresholds of plantar loading in obese children","authors":"Shiyang Yan, Yihong Zhao, Longbin Zhang, Luming Yang","doi":"10.1016/j.gaitpost.2023.07.273","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.273","url":null,"abstract":"Excessive weight-bearing positively affects the overloaded foot, which can induce multiple foot deformities [1]. Previous studies normalized maximum force to eliminate the influence of body weight on the mechanical loading of the foot [2]. To explore body weight itself to the change of the plantar pressure distribution, this study adopts a strategy of body weight scale to compare loading patterns between normal-weighted and obese children. It can acquire the exceeded foot loading data accurately for obese children compared to normal-weighted children, which could lead to finding the pressure threshold in obese children. Is there a method to grade the pressure thresholds of plantar overload in obese children? A cross-sectional study with a large sample size of 1170 participants aged 7-11 years was used to divide normal-weighted (n = 812) and obese children (n = 358) into eight groups based on the same weight class strategy: group 1 (25.5-30.4 kg), group 2 (30.5-35.4 kg), group 3 (35.5-40.4 kg), group 4 (40.5-45.4 kg), group 5 (45.5-50.4 kg), group 6 (50.5-55.4 kg), group 7 (55.5-60.4 kg), group 8 (60.5-65.4 kg). Dynamic plantar pressure data were collected using a Footscan® plantar pressure system (RSscan International, Belgium). Maximum forces were extracted from the main plantar region using principal component analysis. The change of obese children with the same weight grade compared with normal-weighted children was divided into six grades, to define the pressure threshold of obese children's plantar pressure compared with normal-weighted children. The assessment criteria of the pressure threshold level are set at 10 N (trivial effect), 10-20 N (very weak effect), 20-30 N (weak effect), 30-40 N (moderate effect), 40-50 N (strong effect) and 50-60 N (very strong effect). Table 1 shows the levels of the pressure threshold in obese children compared to normal-weighted children with the same weight class.Download : Download high-res image (64KB)Download : Download full-size image The results showed that the maximum force of obese children with 25.5-35.4 kg did not cause significant damage to the main stress area of the plantar, and there was no need for clinical intervention or other related foot decompression strategies. When the weight of obese children is greater than 35.5 kg, it is necessary to pay attention to the influence of excessive foot load on the development and health of obese children's feet. This study can provide data support for foot decompression protocols such as shoes or insoles and weight loss training.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test-retest reliability of 3D ultrasound to visualize the gross structures of the medial gastrocnemius","authors":"Babette Mooijekind, Louise S. van Muijlwijk, Annemieke I. Buizer, Marjolein M. van der Krogt, Lynn Bar-On","doi":"10.1016/j.gaitpost.2023.07.165","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.165","url":null,"abstract":"3D ultrasound (3DUS) can be used to visualize the gross morphology of the medial gastrocnemius (MG), including muscle belly, tendon and fascicle lengths, pennation angle and muscle volume [1]. Such information can be used to indicate, and evaluate the effects of treatments that target these structures, for example in children with cerebral palsy [2]. It is essential that 3DUS is sufficiently reliable to quantify changes due to treatment at the individual level. The test-retest reliability of MG 3DUS, particularly of the fascicles, is not well established. What is the test-retest reliability of 3DUS applied on the MG of healthy adults? The MG of 16 healthy adults (27.30±6 years, 10 women, 6 men) was visualized with 3DUS with the foot in an overhanging position (Fig. 1). Two scans were carried out and participants were asked to walk approximately 50 m between scans. Muscle belly, tendon and fascicle lengths, pennation angle and muscle volume were determined from 3D reconstructions using custom-made scripts [1]. Test-retest reliability was analyzed with Bland Altmann plots to visually determine systematic differences between scans and by calculating the intraclass correlation coefficient (ICC), the relative standard error of measurement ((SEM/mean)*100%) and the relative smallest detectable difference ((SDD/mean)*100%). An intraclass correlation coefficient <0.50 was interpreted as poor, 0.50–0.75 as moderate, 0.75–0.90 as good, and >0.90 as excellent reliability [3]. No systematic differences for the morphological variables were observed between scans based on the absence of clusters in the Bland Altmann plots. ICC values were excellent (0.91-1.00) for muscle belly, tendon, and fascicle lengths, and muscle volume and good for the pennation angle (0.82). The test re-test reliability of the tendon length was found to be most reliable (ICC 1.00) with a relative SEM and SDD of 0.99% and 2.75%, respectively. Muscle belly length (%SEM 2.45%, %SDD 6.78%) and volume (%SEM 3.83%, %SDD 10.62%) were found to have better reliability than fascicle length (%SEM 5.76%, %SDD 15.97%) and pennation angle (%SEM 7.61%, %SDD 21.08%). Based on previous literature [2], the SDD values of the current study may be small enough to detect the effects of MG surgical elongation on muscle belly length and volume in children with cerebral palsy using 3DUS. However, to further elucidate the sensitivity of 3DUS, reliability and sensitivity studies should be carried out on children with cerebral palsy. Further improvements could be made to increase the accuracy of fascicle length and pennation angle determination in 3D. Fig. 1. Schematic representation of measurement set-up and analysis.Download : Download high-res image (92KB)Download : Download full-size image","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of different postural conditions on velocity of the sternum during deep breathing in individuals with mild-to-moderate Covid-19 history","authors":"Halit Selçuk, İlke Kurt, Sezer Ulukaya, Gülnur Öztürk, Hilal Keklicek","doi":"10.1016/j.gaitpost.2023.07.225","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.225","url":null,"abstract":"The impact of Covid-19 has been significant worldwide and it is essential to clarify the long-term effects of Covid-19. However, even though that mobility and biomechanics of the thorax are essential components of fluent respiration, no study has yet examined the effects of Covid-19 on thorax biomechanics (1). How do different postural conditions affect the velocity of the sternum during deep breathing in individuals with mild to moderate Covid-19 history? Sedentary individuals with mild or moderate Covid-19 history that fully recovered (n=11) and sedentary individuals with no history of Covid-19 (n=11) were invited to the study. Inertial motion units (MTw, Xsens Technologies BV, Enschede, The Netherlands) were used to evaluate the movement of the sternum velocity. Individuals were instructed to breathe slowly and deeply for three consecutive respiratory cycles at sitting position and afterward repeat the same cycle at standing position. Data during deep breathing were calculated and compared as minimum values, maximum values, and maximum range (range) between the first and last point of movement. Movements in the anteroposterior direction were defined on the X-Axis and movements in the craniocaudal direction were defined on the Z-axis. Both Covid-19 and control groups showed similar minimum, maximum, and range values of velocity (p>0.05) at sitting position. However, when switched to the standing position, there were significantly greater minimum velocity (p=0.028), maximum velocity (p=0.028), and velocity range (p=0.010) values in the Z-axis in the Covid-19 group. There were also significantly greater maximum velocity (p=0.028) and velocity range (p=0.023) values in the X-axis for the Covid-19 group (Table 1).Download : Download high-res image (94KB)Download : Download full-size image These results showed that the individuals with a mild to moderate history of Covid-19 were able to perform deep breathing with similar sternum velocity in a sitting position but when switched to standing, a more demanding postural condition, the differences became prominent. These results indicate that individuals with a mild to moderate history of Covid-19 increased their respiratory rate to perform deep breathing.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does artificially reduced rectus femoris primered knee extensor muscle force alters the gait biomechanics in children with cerebral palsy?","authors":"Kubra Onerge, Rukiye Sert, Nazif Ekin Akalan, Shavkat Nadir, Fuat Bilgili","doi":"10.1016/j.gaitpost.2023.07.181","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.181","url":null,"abstract":"Stiff knee gait (SKG) is a common gait abnormality in children with spastic cerebral palsy (SCP) (1). The rectus femoris (RF) muscle is the most targeted treatment of SKG with surgical and neurological interventions (2,3). There is no study in the literature, as we are aware of, investigating the temporary effects of RF muscle weakness on gait in children with SPC. How does artificially reduced rectus femoris primered knee extensor muscle force alters the gait biomechanics of children with SCP? 4 children with SCP (GMFCS Level I-II; 3 females; 2 bilateral, 2 unilateral CP; age:12.75 ± 4.65 y.o., weight: 37.50 ± 12.44 kg, height: 143.88 ± 16.15 cm) were included in the study. To reduce the RF maximal isometric voluntary muscle contraction force (MIVMCF) temporarily, a stretching protocol (135 sec×13 repetitions with 5 sec. resting) was performed (4,5,6). Stretching severity is set as 7/10 discomfort level according to the visual analog scale. 3D gait analysis system (VICON, 6xVantage 5 + 2xAMTI force plates) was utilized before (BS) and after (AS) stretching. MIVMCF of knee-extensor muscles were measured in BS and AS conditions with a hand-held dynamometer (Lafayette 01165 A, US) 3 times at 30-second resting intervals in a sitting position. Interested kinematic and kinetic gait alterations were statistically compared with the paired statistical parametric mapping (SPM{t}) using MATLAB (p<0.05). The MIVMCF of knee-extensor muscles decreased by 15.59% (from 133.91 ± 59.89 N to 113.04 ± 46.35 N) in the AS period. No significant difference was observed between walking speeds (p=0.353). According to the SPM{t} analysis of the sagittal plane parameters of the knee between AS and BS, a significant difference was observed in the initial contact, loading response, and swing sub-phases. All interested gait parameters were compared in Table-1. Download : Download high-res image (255KB)Download : Download full-size image The stretching methodology was effective enough to temporarily reduce the MIVMCF of the knee extensors in children with SPC. As the first in the literature, the gait alterations of rectus femoris primered knee extensor muscle weakness in three planes were determined for children with SCP. As expected, the peak knee flexion and range improved in AS, although the peak knee flexion delay-related parameters did not significantly change. Although 2 of the 4 stiff knee parameters were improved, anterior pelvic tilt was not significantly reduced which may be related to stretching methodology partially involving other knee extensors such as three vastii. Therefore, this study demonstrated that, although the stretching methodology may be improved by surface EMG, it is capable to generate MIVMCF reduction to predict treatment on the knee extensors such as the application of neural agents or orthopedic surgery for SCPs.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}