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Carvalho A, Vanrenterghem J, Cabral S, Assunção A, Fernandes R, Veloso AP, Moniz-Pereira V. Markerless three-dimensional gait analysis in healthy older adults: test-retest reliability and measurement error. J Biomech 2024; 174:112280. [PMID: 39153296 DOI: 10.1016/j.jbiomech.2024.112280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 08/02/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024]
Abstract
In older adults, gait analysis may detect changes that signal early disease states, yet challenges in biomechanical screening limit widespread use in clinical or community settings. Recently, a markerless method from multi-camera video data has become accessible, making screenings less challenging. This study evaluated the test-retest reliability and measurement error of markerless gait kinematics and kinetics in healthy older adults. Twenty-nine healthy older adults performed gait analysis on two occasions, at preferred walking speed, using their everyday clothes. Lower limb angles and moments were averaged from 8 gait cycles. Integrated pointwise indices [Intraclass Correlation Coefficient (ICCA,K) and Standard Error of Measurement (SEM)] were calculated for curve data, as well as ICCA,K, and SEM [95 % confidence intervals] for selected peaks. Generally, kinematic ICCs were good (>0.75) and reasonably stable throughout the gait cycle, except for the hip kinematics during the swing phase in the sagittal plane and pelvis tilt and rotation. The integrated and peaks SEM were <2.4°. The reliability of kinetics was similar (ICC>0.75), except for the transverse hip moment and abduction peak, fluctuating more during the swing than through the stance phase. SEM were < 0.07Nm/Kg. In conclusion, these results showed good overall test-retest reliability for markerless gait kinematics and kinetics for the hip, knee, and ankle joints, moderate for the pelvis angles, and error levels of ≤5°, and SEM%≤5% for the sagittal plane. This supports this method's use in assessing gait in healthy older adults, including kinetics, for which reliability data from markerless systems is difficult to find reported.
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Affiliation(s)
- Andreia Carvalho
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal; Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, Leuven KU, Belgium; Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal.
| | - Jos Vanrenterghem
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, Leuven KU, Belgium.
| | - Sílvia Cabral
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | - Ana Assunção
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | - Rita Fernandes
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal; Instituto Politécnico de Setúbal, Escola Superior de Saúde, Campus do Instituto Politécnico de Setúbal, ESCE, Estefanilha, Edifício 2914-503 Setúbal, Portugal; Comprehensive Health Research Centre, Nova Medical School, 1150-190 Lisboa, Portugal.
| | - António P Veloso
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | - Vera Moniz-Pereira
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
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De Bleecker C, Vermeulen S, Willems T, Segers V, Spanhove V, Pataky T, Roosen P, Vanrenterghem J, De Ridder R. How reliable are lower limb biomechanical evaluations during volleyball-specific jump-landing tasks? Gait Posture 2024; 113:287-294. [PMID: 38972170 DOI: 10.1016/j.gaitpost.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Biomechanical evaluations of sport-specific jump-landing tasks may provide a more ecologically valid interpretation compared to generic jump-landing tasks. For accurate interpretation of longitudinal research, it is essential to understand the reliability of biomechanical parameters of sport-specific jump-landing tasks. RESEARCH QUESTION How reliable are hip, knee and ankle joint angles and moment curves during two volleyball-specific jump-landing tasks and is this comparable with the reliability of a generic jump-landing task? METHODS Three-dimensional (3D) biomechanical analyses of 27 male volleyball players were performed in two sessions separated by one week. Test-retest reliability was analyzed by calculating integrated as well as 1D intraclass correlation coefficient (ICC) and integrated standard error of measurement (SEM) for hip, knee and ankle angles and moments during a spike and block jump (volleyball-specific tasks), and during a drop vertical jump (generic task). RESULTS Reliability of joint angles of volleyball-specific and generic jump-landing tasks are similar with excellent-to-good integrated ICC for hip, knee and ankle flexion/extension (ICC= 0.61-0.89) and hip and knee abduction/adduction (ICC=0.61-0.78) but fair-to-poor ICC for ankle abduction/adduction (ICC=0.28-0.52) and hip, knee and ankle internal/external rotation (ICC=0.29-0.53). Reliability of hip, knee and ankle joint moments was good-to excellent (ICC= 0.62-0.86) except for hip flexion moment during spike jump and drop vertical jump (ICC=0.43-0.47) and knee flexion moment during both volleyball-specific tasks (ICC=0.56-0.57). For all tasks, curve analysis revealed poorer reliability at start and end of the landing phase than during the midpart. SIGNIFICANCE Our data suggests that kinematic evaluations of volleyball-specific jump-landing tasks are reliable to use in screening programs, especially in the sagittal plane. Notably, reliability is poorer at the beginning and end of the landing phase, requiring careful interpretation. In conclusion, the results of this study indicate the potential for integration of sport-specific jump-landing tasks in screening programs, which will be more ecologically valid.
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Affiliation(s)
- Camilla De Bleecker
- Department of Rehabilitation Sciences, Ghent University, East Flanders, Ghent, Belgium; Department of Rehabilitation Sciences, KU Leuven, Flemish Brabant, Leuven, Belgium.
| | - Stefan Vermeulen
- Department of Rehabilitation Sciences, Ghent University, East Flanders, Ghent, Belgium; Department of Rehabilitation Sciences, KU Leuven, Flemish Brabant, Leuven, Belgium.
| | - Tine Willems
- Department of Rehabilitation Sciences, Ghent University, East Flanders, Ghent, Belgium.
| | - Veerle Segers
- Department of Movement and Sports Sciences, Ghent University, Belgium.
| | - Valentien Spanhove
- Department of Rehabilitation Sciences, Ghent University, East Flanders, Ghent, Belgium.
| | - Todd Pataky
- Department of Human Health Sciences, Kyoto University, Japan.
| | - Philip Roosen
- Department of Rehabilitation Sciences, Ghent University, East Flanders, Ghent, Belgium.
| | - Jos Vanrenterghem
- Department of Rehabilitation Sciences, KU Leuven, Flemish Brabant, Leuven, Belgium.
| | - Roel De Ridder
- Department of Rehabilitation Sciences, Ghent University, East Flanders, Ghent, Belgium.
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Okada K, Haruyama K, Okuyama K, Tsuzuki K, Nakamura T, Kawakami M. Categorizing knee hyperextension patterns in hemiparetic gait and examining associated impairments in patients with chronic stroke. Gait Posture 2024; 113:18-25. [PMID: 38820765 DOI: 10.1016/j.gaitpost.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/08/2024] [Accepted: 05/22/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Post-stroke hemiparetic gait exhibits considerable variations in motion patterns and abnormal muscle activities, notably knee hyperextension during the stance phase. Existing studies have primarily concentrated on its joint angle or moment. However, the underlying causes remain unclear. Thus, the causes of knee hyperextension were explored from a new perspective based on temporal-durational factors. RESEARCH QUESTION Does the temporal-durational difference of knee hyperextension presence result from specific decreased motor functions? METHODS Barefoot gait at a comfortable speed was captured using a three-dimensional camera system. Scores of knee hyperextension used a metric with the temporal-durational factor of knee hyperextension presence in each of four stance phases (1st double support, DS1; early single-leg stance, ESS; late single-leg stance, LSS; 2nd double support, DS2). These scores were used in cluster analysis. The classification and regression tree analysis characterizing each knee hyperextension cluster used the clinical measures of the lower limb and trunk motor function, muscle strength, and spasticity as explanatory variables. RESULTS Thirty patients with hemiparetic chronic stroke who exhibited knee hyperextension during gait were included. Four knee hyperextension clusters were shown: Momentary (almost no hyperextension), Continuous (DS1-DS2), ESS-LSS, and ESS-DS2. Knee flexor strength was lower in the groups with long hyperextension durations (Continuous and ESS-DS2) compared with short durations (ESS-LSS and Momentary). ESS-DS2 exhibited higher trunk motor function than Continuous, whereas more severe spasticity was observed in ESS-LSS than in Momentary. SIGNIFICANCE This study successfully classified four hemiparetic gait patterns with knee hyperextension based on the temporal-durational factor, providing valuable perspectives for understanding and addressing specific functional physical impairments. These findings offer guidance for focusing on related physical functions when striving for gait improvement with knee hyperextension and are expected to serve as a reference for treatment decision-making.
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Affiliation(s)
- Kohsuke Okada
- Saiseikai Higashi-kanagawa Rehabilitation Hospital, Kanagawa 221-0822, Japan.
| | - Koshiro Haruyama
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo 113-8421, Japan
| | - Kohei Okuyama
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Keita Tsuzuki
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takuya Nakamura
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
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Oder K, Unglaube F, Farr S, Kranzl A, Stauffer A, Ganger R, Raimann A, Mindler GT. Clinical, Radiographic, and Biomechanical Evaluation of the Upper Extremity in Patients with Osteogenesis Imperfecta. J Clin Med 2024; 13:5174. [PMID: 39274387 PMCID: PMC11396301 DOI: 10.3390/jcm13175174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/23/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024] Open
Abstract
Introduction: Osteogenesis imperfecta (OI) is a hereditary disorder primarily caused by mutations in type I collagen genes, resulting in bone fragility, deformities, and functional limitations. Studies on upper extremity deformities and associated functional impairments in OI are limited. This cross-sectional study aimed to evaluate upper extremity deformities and functional outcomes in OI. Methods: We included patients regardless of their OI subtypes with a minimum age of 7 years. Radiographic analysis of radial head dislocation, ossification of the interosseous membrane, and/or radioulnar synostosis of the forearm were performed, and deformity was categorized as mild, moderate, or severe. Clinical evaluation was performed using the Quick Disabilities of Arm, Shoulder, and Hand (qDASH) questionnaire and shoulder-elbow-wrist range of motion (ROM). Three-dimensional motion analysis of the upper limb was conducted using the Southampton Hand Assessment Procedure (SHAP). The SHAP quantifies execution time through the Linear Index of Function (LIF) and assesses the underlying joint kinematics using the Arm Profile Score (APS). Additionally, the maximum active Range of Motion (aRoM) was measured. Results: Fourteen patients aged 8 to 73 were included. Radiographic findings revealed diverse deformities, including radial head dislocation, interosseous membrane ossification, and radioulnar synostosis. Six patients had mild, six moderate, and two severe deformities of the upper extremity. Severe deformities and radial head dislocation correlated with compromised ROM and worse qDASH scores. The qDASH score ranged from 0 to 37.5 (mean 11.7). APS was increased, and LIF was reduced in OI-affected persons compared with non-affected peers. APS and LIF also varied depending on the severity of bony deformities. aRoM was remarkably reduced for pro-supination. Conclusion: Patients with OI showed variable functional impairment from almost none to severe during daily life activities, mainly depending on the magnitude of deformity in the upper extremity. Larger multicenter studies are needed to confirm the results of this heterogeneous cohort. Level of evidence: Retrospective clinical study; Level IV.
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Affiliation(s)
- Katharina Oder
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
| | - Fabian Unglaube
- Laboratory for Gait and Movement Analysis, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
| | - Sebastian Farr
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
| | - Andreas Kranzl
- Laboratory for Gait and Movement Analysis, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Alexandra Stauffer
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Rudolf Ganger
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Adalbert Raimann
- Vienna Bone and Growth Center, Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gabriel T Mindler
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130 Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Blanco-Coloma L, García-González L, Sinovas-Alonso I, Torio-Álvarez S, Martos-Hernández P, González-Expósito S, Gil-Agudo Á, Herrera-Valenzuela D. Validation of inertial measurement units based on waveform similarity assessment against a photogrammetry system for gait kinematic analysis. Front Bioeng Biotechnol 2024; 12:1449698. [PMID: 39193230 PMCID: PMC11348432 DOI: 10.3389/fbioe.2024.1449698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
When assessing gait analysis outcomes for clinical use, it is indispensable to use an accurate system ensuring a minimal measurement error. Inertial Measurement Units (IMUs) are a versatile motion capture system to evaluate gait kinematics during out-of-lab activities and technology-assisted rehabilitation therapies. However, IMUs are susceptible to distortions, offset and drifting. Therefore, it is important to have a validated instrumentation and recording protocol to ensure the reliability of the measurements, to differentiate therapy effects from system-induced errors. A protocol was carried out to validate the accuracy of gait kinematic assessment with IMUs based on the similarity of the waveform of concurrent signals captured by this system and by a photogrammetry reference system. A gait database of 32 healthy subjects was registered synchronously with both devices. The validation process involved two steps: 1) a preliminary similarity assessment using the Pearson correlation coefficient, and 2) a similarity assessment in terms of correlation, displacement and gain by estimating the offset between signals, the difference between the registered range of motion (∆ROM), the root mean square error (RMSE) and the interprotocol coefficient of multiple correlation (CMCP). Besides, the CMCP was recomputed after removing the offset between signals (CMCPoff). The correlation was strong (r > 0.75) for both limbs for hip flexion/extension, hip adduction/abduction, knee flexion/extension and ankle dorsal/plantar flexion. These joint movements were studied in the second part of the analysis. The ∆ROM values obtained were smaller than 6°, being negligible relative to the minimally clinically important difference (MCID) estimated for unaffected limbs, and the RMSE values were under 10°. The offset for hips and ankles in the sagittal plane reached -9° and -8°, respectively, whereas hips adduction/abduction and knees flexion/extension were around 1°. According to the CMCP, the kinematic pattern of hip flexion/extension (CMCP > 0.90) and adduction/abduction (CMCP > 0.75), knee flexion/extension (CMCP > 0.95) and ankle dorsi/plantar flexion (CMCP > 0.90) were equivalent when captured by each system synchronously. However, after offset correction, only hip flexion/extension (CMCPoff = 1), hip adduction/abduction (CMCPoff > 0.85) and knee flexion/extension (CMCPoff > 0.95) satisfied the conditions to be considered similar.
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Affiliation(s)
- Laura Blanco-Coloma
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, Toledo, Spain
| | - Lucía García-González
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, Toledo, Spain
| | - Isabel Sinovas-Alonso
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, Toledo, Spain
| | - Silvia Torio-Álvarez
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, Toledo, Spain
| | | | - Sara González-Expósito
- Biorobotics Group, CAR-Centre of Automation and Robotics, CSIC-Spanish National Research Council, Madrid, Spain
| | - Ángel Gil-Agudo
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, Toledo, Spain
| | - Diana Herrera-Valenzuela
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, Toledo, Spain
- International Doctoral School, Rey Juan Carlos University, Madrid, Spain
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Di Paolo S, Ito N, Seymore KD, Sigurðsson HB, Bragonzoni L, Zaffagnini S, Snyder-Mackler L, Gravare Silbernagel K. Hop Distance Symmetry Moderately Reflects Knee Biomechanics Symmetry During Landing But Not For Controlled Propulsions. Int J Sports Phys Ther 2024; 19:956-964. [PMID: 39268226 PMCID: PMC11392465 DOI: 10.26603/001c.121599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/21/2024] [Indexed: 09/15/2024] Open
Abstract
Background Landing with poor knee sagittal plane biomechanics has been identified as a risk factor for Anterior Cruciate Ligament (ACL) injury. However, it is unclear if the horizontal hop test battery reflects knee function and biomechanics. Hypothesis/Purpose To investigate the correlation between clinical limb symmetry index (LSI) and landing and propulsion knee biomechanics during the hop test battery using markerless motion capture. Study Design Cross-sectional biomechanics laboratory study. Methods Forty-two participants with and without knee surgery (age 28.0 ± 8.0 years) performed the hop test battery which consisted of a single hop for distance, crossover hop, triple hop, and 6-m timed hop in the order listed. Eight high speed cameras were used to collect simultaneous 3D motion data and Theia 3D (Theia Markerless Inc.) was used to generate 3D body model files. Lower limb joint kinematics were calculated in Visual3D. Correlation (Spearman's ρ) was computed between clinical LSI and symmetry in peak and initial contact (IC) knee flexion angle during propulsion and landing phases of each movement. Results In the single hop, clinical LSI showed positive correlation with kinematic LSI at peak landing (ρ= 0.39, p=0.011), but no correlation at peak propulsion (ρ= -0.03, p=0.851). In the crossover hop, non-significant correlations were found in both propulsion and landing. In the triple hop, positive correlation was found at peak propulsion (ρ= 0.38, p=0.027), peak landing (ρ= 0.48 - 0.66, p<0.001), and last landing IC (ρ= 0.45, p=0.009). In the timed hop, peak propulsion showed positive correlation (ρ= 0.51, p=0.003). Conclusions Single hop and triple hop distance symmetry reflected landing biomechanical symmetry better than propulsion symmetry. Poor scores on the hop test battery reflect asymmetrical knee landing biomechanics, emphasizing the importance of continuing to use the hop test battery as part of clinical decision making. Level of Evidence 3b.
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Affiliation(s)
- Stefano Di Paolo
- Clinica Ortopedica e Traumatologica II IRCCS Istituto Ortopedico Rizzoli
| | - Naoaki Ito
- Department of Physical Therapy University of Delaware
| | | | | | | | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica II IRCCS Istituto Ortopedico Rizzoli
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Nijmeijer EM, Kempe M, Elferink-Gemser MT, Benjaminse A. Observe, Practice, and Improve? Enhancing Sidestep Cutting Execution in Talented Female Soccer Players: A Four-Week Intervention Program With Video Instruction. J Strength Cond Res 2024; 38:e430-e439. [PMID: 38662706 PMCID: PMC11286158 DOI: 10.1519/jsc.0000000000004796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
ABSTRACT Nijmeijer, EM, Kempe, M, Elferink-Gemser, MT, and Benjaminse A. Observe, practice and improve? Enhancing sidestep cutting (SSC) execution in talented female soccer players: A four-week intervention program with video instruction. J Strength Cond Res 38(8): e430-e439, 2024-Implicit learning has the potential to improve movement execution and reduce injury risk. Previous research showed beneficial effects of short-term interventions with implicit learning in male athletes. However, research on long-term interventions in female athletes is lacking. The aim of this study was to examine the effects of a 4-week intervention with video instruction on movement execution of SSC, a task that is highly related with anterior cruciate ligament (ACL) injury risk, in female athletes. Twenty talented adolescent female soccer players were part of the control (CTRL, n = 10) or video instruction (VIDEO, n = 10) group. All subjects practiced 4 weeks and received general task instructions. In addition, the VIDEO group received expert video instruction during practice. Lower extremity kinematics and kinetics and vertical ground reaction force of SSC were examined during baseline, immediate post, and 1-week retention tests. After nonlinear registration, differences between each subject and the expert she had seen were determined. These differences were analyzed with SPM1D 2-way ANOVA. No interaction effects between time and group were found ( p > 0.05). Main effects of time were found in the frontal plane. In particular, smaller deviations of subjects compared with the seen expert of the knee adduction ( p = 0.005, 97.9-100% stance phase [SP]) and hip abduction ( p = 0.005, 11.5-13.8% SP) and adduction ( p < 0.001, 33.4-87.7% SP) moments were found in immediate post compared with baseline. These frontal plane short-term improvements, replicating earlier findings in both sexes, may lower ACL injury risk. The large observed interindividual differences over time may have concealed the long-term effects of video instruction at the group level.
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Affiliation(s)
- Eline M Nijmeijer
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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LeCursi NA, Janka BM, Gao F, Orendurff MS, He Y, Kobayashi T. A proposed evidence-guided algorithm for the adjustment and optimization of multi-function articulated ankle-foot orthoses in the clinical setting. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1353303. [PMID: 39119264 PMCID: PMC11307126 DOI: 10.3389/fresc.2024.1353303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 07/05/2024] [Indexed: 08/10/2024]
Abstract
Individuals with neuromuscular pathologies are often prescribed an ankle-foot orthosis (AFO) to improve their gait mechanics by decreasing pathological movements of the ankle and lower limb. AFOs can resist or assist excessive or absent muscular forces that lead to tripping, instability, and slow inefficient gait. However, selecting the appropriate AFO with mechanical characteristics, which limit pathological ankle motion in certain phases of the gait cycle while facilitating effective ankle movement during other phases, requires careful clinical decision-making. The aim of this study is to propose an explicit methodology for the adjustment of multi-function articulated AFOs in clinical settings. A secondary aim is to outline the evidence supporting this methodology and to identify gaps in the literature as potential areas for future research. An emerging class of AFO, the multi-function articulated AFO, offers features that permit more comprehensive, iterative, and reversible adjustments of AFO ankle alignment and resistance to ankle motion. However, no standard method exists for the application and optimization of these therapeutic devices in the clinical setting. Here we propose an evidence-guided methodology applicable to the adjustment of multi-function articulated AFOs in the clinical setting. Characteristic load-deflection curves are given to illustrate the idealized yet complex resistance-angle behavior of multi-function articulated AFOs. Research is cited to demonstrate how these mechanical characteristics can help mitigate specific pathologic ankle and knee kinematics and kinetics. Evidence is presented to support the effects of systematic adjustment of high resistance, alignable, articulated AFOs to address many typical pathomechanical patterns observed in individuals with neuromuscular disorders. The published evidence supporting most decision points of the algorithm is presented with identified gaps in the evidence. In addition, two hypothetical case examples are given to illustrate the application of the method in optimizing multi-function articulated AFOs for treating specific gait pathomechanics. This method is proposed as an evidence-guided systematic approach for the adjustment of multi-function articulated AFOs. It utilizes observed gait deviations mapped to specific changes in AFO alignment and resistance settings as a clinical tool in orthotic treatment for individuals with complex neuromuscular gait disorders.
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Affiliation(s)
| | | | - Fan Gao
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, United States
| | | | - Yufan He
- Deparment of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Toshiki Kobayashi
- Deparment of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Morikawa T, Mura N, Sato T, Katoh H. Validity of the estimated angular information obtained using an inertial motion capture system during standing trunk forward and backward bending. BMC Sports Sci Med Rehabil 2024; 16:154. [PMID: 39020423 PMCID: PMC11253345 DOI: 10.1186/s13102-024-00942-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Bending the trunk forward and backward while standing are common daily activities and can have various patterns. However, any dysfunction in these movements can considerably affect daily living activities. Consequently, a comprehensive evaluation of spinal motion during these activities and precise identification of any movement abnormalities are important to facilitate an effective rehabilitation. In recent years, with the development of measurement technology, the evaluation of movement patterns using an inertial motion capture system (motion sensor) has become easy. However, the accuracy of estimated angular information obtained via motion sensor measurements can be affected by angular velocity. This study aimed to compare the validity of estimated angular information obtained by assessing standing trunk forward and backward bending at different movement speeds using a motion sensor with a three-dimensional motion analysis system. METHODS The current study included 12 healthy older men. A three-dimensional motion analysis system and a motion sensor were used for measurement. The participants performed standing trunk forward and backward bending at comfortable and maximum speeds, and five sensors were attached to their spine. Statistical analysis was performed using the paired t-test, intraclass correlation coefficient, mean absolute error, and multiple correlation coefficient. RESULTS Results showed that the estimated angular information obtained using each motion sensor was not affected by angular velocity and had a high validity. CONCLUSIONS Therefore, the angular velocity in this study can be applied clinically for an objective evaluation in rehabilitation.
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Affiliation(s)
- Taiki Morikawa
- Department of Rehabilitation, Eniwa Hospital, Eniwa, Hokkaido, 061-1449, Japan.
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan.
| | - Nariyuki Mura
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan
| | - Toshiaki Sato
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan
| | - Hiroshi Katoh
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata, Yamagata, 990-2212, Japan
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Le Roy A, Dubois F, Roche N, Brunel H, Bonnyaud C. Cautious Gait during Navigational Tasks in People with Hemiparesis: An Observational Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4241. [PMID: 39001018 PMCID: PMC11244485 DOI: 10.3390/s24134241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024]
Abstract
Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.
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Affiliation(s)
- Albane Le Roy
- APHP, GHU Paris-Saclay, Raymond Poincaré Hospital, Physical Medicine and Rehabilitation Department, 92380 Garches, France
- IFMK Saint-Michel, 75015 Paris, France
| | - Fabien Dubois
- APHP, GHU Paris-Saclay, Raymond Poincaré Hospital, Motion Analysis Laboratory, Functional Explorations Department, 92380 Garches, France
- Université Paris-Saclay, UVSQ, Research Unit ERPHAN, 78000 Versailles, France
| | - Nicolas Roche
- APHP, GHU Paris-Saclay, Raymond Poincaré Hospital, Motion Analysis Laboratory, Functional Explorations Department, 92380 Garches, France
- Université Paris-Saclay, UVSQ, Inserm Unit 1179, END-ICAP Laboratory, 78000 Versailles, France
| | | | - Céline Bonnyaud
- IFMK Saint-Michel, 75015 Paris, France
- APHP, GHU Paris-Saclay, Raymond Poincaré Hospital, Motion Analysis Laboratory, Functional Explorations Department, 92380 Garches, France
- Université Paris-Saclay, UVSQ, Research Unit ERPHAN, 78000 Versailles, France
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11
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Bonanno M, De Pasquale P, De Marchis C, Lombardo Facciale A, Paladina G, Fonti B, Quartarone A, Calabrò RS. Might patients with cerebellar ataxia benefit from the Computer Assisted Rehabilitation ENvironment (CAREN)? A pilot study focusing on gait and balance. Front Bioeng Biotechnol 2024; 12:1385280. [PMID: 39011156 PMCID: PMC11247328 DOI: 10.3389/fbioe.2024.1385280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/03/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction: Ataxia is a neurological symptom that causes decreased balance, loss of coordination, and gait alterations. Innovative rehabilitation devices like virtual reality (VR) systems can provide task-oriented, repetitive and intensive training with multisensorial feedback, thus promoting neuroplastic processes. Among these VR technologies, the Computer Assisted Rehabilitation ENvironment (CAREN) associates a split belt treadmill on a 6-degrees of freedom platform with a 180° VR screen and a Vicon motion capture system to monitor patients' movements during training sessions. Methods: Eight patients affected by cerebellar ataxia were enrolled and received 20 sessions of CAREN training in addition to standard rehabilitation treatment. Each patient was evaluated at the beginning and at the end of the study with 3D gait analysis and clinical scales to assess balance, gait function and risk of falls. Results: We found improvements in kinematic, kinetic, and electromyographic parameters (as per pre-post- CAREN training), as well as in clinical outcomes, such as balance and risk of falls in ataxic patients. In addition, we found that trunk rotation improved, after CAREN intervention, approximating to the normative values. Discussion: Our results suggested that CAREN might be useful to improve specific biomechanical parameters of gait in ataxic patients.
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Affiliation(s)
| | | | | | | | | | - Bartolo Fonti
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
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12
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Ye B, Liu G, He Z, Xu J, Pan H, Zhu H. Biomechanical mechanisms of anterior cruciate ligament injury in the jerk dip phase of clean and jerk: A case study of an injury event captured on-site. Heliyon 2024; 10:e31390. [PMID: 38832262 PMCID: PMC11145241 DOI: 10.1016/j.heliyon.2024.e31390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
Background Weightlifting exposes athletes to significant loads, potentially placing the knee joint in an abnormal mechanical environment and leading to anterior cruciate ligament (ACL) injuries. Once an ACL injury occurs, it can affect athletes' competitive ability to varying degrees and even prematurely end their career. Understanding the biomechanical mechanisms of ACL injuries in weightlifters helps in comprehensively understanding the stress patterns and degrees on ACL during human movement, and identifying potential injury-causing factors, thereby enabling the implementation of appropriate preventive measures to reduce the occurrence of injuries. This study aimed to explore the biomechanical mechanisms of ACL injuries during the jerk dip phase of clean and jerk in weightlifters, providing a theoretical basis for the prevention of ACL injuries in weightlifting sports. Methods This study utilized the German SIMI Motion 10.2 movement analysis system and the AnyBody simulation system to analyze the kinematic and dynamic parameters of a 109 kg + class weightlifter (height: 191 cm, age: 22 years, weight: 148 kg, athletic level: elite) performing a 205 kg clean and jerk (non-injured) and a 210 kg clean and jerk (ACL injury occurred). The differences in kinematic and dynamic indicators of lower limb joints under injured and non-injured jerk dip conditions were investigated. Results Knee joint torque during non-injured clean and jerk was consistently positive (i.e., external rotation) but turned from positive to negative (i.e., from external rotation to internal rotation) during injured clean and jerk and reached a maximum internal rotation torque of 21.34 Nm at the moment of injury. At every moment, the muscle activation and simulated muscle force of the quadriceps and gastrocnemius during the injured clean and jerk were higher than those during the non-injured clean and jerk. By contrast, the muscle activation and simulated muscle force of the semitendinosus, semimembranosus, biceps femoris, and soleus during non-injured clean and jerk were higher than those during injured clean and jerk. The knee joint internal rotation angle during injured clean and jerk first increased and then declined, reaching a peak at 46.93° at the moment of injury, whereas it gradually increased during non-injured clean and jerk. The proximal tibia on the left side during the injured clean and jerk moved forward faster by 0.76 m/s compared with that during the non-injured clean and jerk. Conclusions The small muscle activation and simulated muscle force of the hamstring and soleus could not resist timely and effectively the large muscle activation and simulated muscle force of the quadriceps (especially the medial quad) and gastrocnemius. As such, the force applied to the ACL could exceed its ultimate load-bearing capacity. Kinematic indicators in the athlete's injured lift demonstrated certain disparities from those in their non-injured lift. Knee internal rotation and tibial anterior translation during the jerk dip phase of weightlifting might be the kinematic characteristics of ACL injuries.
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Affiliation(s)
- Binyong Ye
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321000, China
| | - Gongju Liu
- Scientific Research Center & Laboratory of Aquatic Sports Science of General Administration of Sports China, Zhejiang College of Sports, Hangzhou, 311200, China
| | - Zhanyang He
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321000, China
| | - Jun Xu
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321000, China
| | - Huiju Pan
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321000, China
| | - Houwei Zhu
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321000, China
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Dabirrahmani D, Farshidfar S, Cadman J, Shahidian H, Kark L, Sullivan J, Appleyard R. Biomechanical improvements in gait following medial pivot knee implant surgery. Clin Biomech (Bristol, Avon) 2024; 116:106267. [PMID: 38838419 DOI: 10.1016/j.clinbiomech.2024.106267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 03/11/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Total knee replacements are used to improve function and reduce pain in patients with advanced osteoarthritis. The medially stabilising implant is designed to mimic a healthy knee. This study aims to provide a comprehensive analysis of the kinematics and kinetics of a medially stabilising knee implant, comparing it to a healthy control group, as well as to its pre-operative state and the contralateral limb. METHODS Sixteen total knee replacement patients and ten healthy participants were recruited. Patients underwent testing 4-6 weeks before surgery and repeated the same tests 12 months after surgery. Healthy participants completed the same tests at a single time point. All participants completed three walking trials: kinematics was captured with eight cameras; kinetics with in-ground force plates. Subject-specific musculoskeletal models were developed in OpenSim. Inverse kinematics and inverse dynamics were used to determine gait parameters. Joint angles and joint moments were evaluated using Statistical Parametric Mapping. Patient-reported outcome measures were also collected at both time points. FINDINGS Spatiotemporal results indicate significant differences in velocity and step length between pre-operative patients and control participants. Differences are observed in the adduction angles between the contralateral and ipsilateral limbs pre-operatively. Postoperatively, there was an increase in the 1st peak flexion moment, reduced adduction moment and reduced internal rotation moment. In PROMs, patients all report improvements in pain levels and high satisfaction levels following surgery. INTERPRETATIONS Following medial stabilising total knee arthroplasty, patients displayed improved clinical parameters and joint moments reflecting a shift towards more normal, healthy gait.
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Affiliation(s)
- D Dabirrahmani
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - S Farshidfar
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - J Cadman
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - H Shahidian
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - L Kark
- Graduate School of Biomedical Engineering, University of New South Wales, Australia
| | - J Sullivan
- Department of Orthopaedics, Macquarie University Hospital, Australia
| | - R Appleyard
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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Smit IH, Parmentier JIM, Rovel T, van Dieen J, Serra Bragança FM. Towards standardisation of surface electromyography measurements in the horse: Bipolar electrode location. J Electromyogr Kinesiol 2024; 76:102884. [PMID: 38593582 DOI: 10.1016/j.jelekin.2024.102884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/15/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024] Open
Abstract
The use of surface electromyography in the field of animal locomotion has increased considerably over the past decade. However, no consensus exists on the methodology for data collection in horses. This study aimed to start the development of recommendations for bipolar electrode locations to collect surface electromyographic data from horses during dynamic tasks. Data were collected from 21 superficial muscles of three horses during trot on a treadmill using linear electrode arrays. The data were assessed both quantitatively (signal-to-noise ratio (SNR) and coefficient of variation (CoV)) and qualitatively (presence of crosstalk and activation patterns) to compare and select electrode locations for each muscle. For most muscles and horses, the highest SNR values were detected near or cranial/proximal to the central region of the muscle. Concerning the CoV, there were larger differences between muscles and horses than within muscles. Qualitatively, crosstalk was suspected to be present in the signals of twelve muscles but not in all locations in the arrays. With this study, a first attempt is made to develop recommendations for bipolar electrode locations for muscle activity measurements during dynamic contractions in horses. The results may help to improve the reliability and reproducibility of study results in equine biomechanics.
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Affiliation(s)
- I H Smit
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, the Netherlands.
| | - J I M Parmentier
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, the Netherlands; Pervasive Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, 7522NB Enschede, the Netherlands
| | - T Rovel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, the Netherlands
| | - J van Dieen
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - F M Serra Bragança
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584CM Utrecht, the Netherlands; Sleip AI, Birger Jarlsgatan 58, 11426 Stockholm, Sweden
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15
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Hulburt T, Santos L, Moos K, Popoli D, Nicholson K. Cueing Dancers to "Externally Rotate From the Hips" Improves Potentially Injurious Ankle Joint Angles and Contact Forces During a Demipointe Ballet Position. J Dance Med Sci 2024:1089313X241246601. [PMID: 38616540 DOI: 10.1177/1089313x241246601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Introduction: The demipointe dance position puts the ankle at high risk of overuse injury and posteromedial ankle pain due to increased ankle valgus forces. Previous work has shown that creating lower limb external rotation intrinsic to demipointe with hip external rotation reduces foot pronation that causes ankle valgus stress. Therefore, the purpose of this work was to examine long axis rotation kinematics of the hip, knee, and ankle as well as the ankle joint contact forces in demipointe to better understand the biomechanical impact(s) of the specific cue to increase hip external rotation in this position. Methods: Three-dimensional motion capture and force plate data were collected from 23 contemporary or ballet pre-professional dancers (age: 19.94 ± 1.34 years) who each performed 3 dancer-selected (DS) demipointe positions and 3 demipointes with the cue to "externally rotate from the hips." Results: The cue to increase hip external rotation resulted in significantly increased hip external rotation angle [DS: 37.5; 9.42° (median; interquartile range), Cued: 39.9; 10.8°, P < .0001)] and significantly reduced ankle eversion angle (DS: 8.13; 11.4°, Cued: 7.77; 10.3°, P = .023). However, total turnout angle was also significantly decreased (DS: 75.8; 7.91°, Cued: 75.4; 7.73°, P < .0001), which is undesirable for proper esthetic performance of demipointe. Total ankle joint force remained unchanged, but ankle eversion force was significantly reduced (DS: 15.3; 4.18 %bodyweight (BW), Cued: 14.7; 4.99 %BW, P < .0001) with use of the cue. Discussion/Conclusion: Utilization of a cue to increase hip external rotation was successful in increasing hip contribution to turnout angle and reducing injurious ankle eversion force. Further coaching using this cue may allow dancers to produce these advantageous mechanics while maintaining turnout angle.
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Affiliation(s)
- Tessa Hulburt
- Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Blacksburg, VA, USA
| | - Laura Santos
- University of North Carolina School of the Arts, Health Services, Winston-Salem, NC, USA
| | - Katherine Moos
- University of North Carolina School of the Arts, Health Services, Winston-Salem, NC, USA
| | - David Popoli
- Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Kristen Nicholson
- Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Blacksburg, VA, USA
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Mantese B, Pirozzi Chiusa CG, Basilotta Marquez Y, Gotter Campo MP, Nazar R, Crespo M, Toledo A, Ravera E. Selective dorsal rhizotomy: Analysis of two rootlet sectioning techniques. Childs Nerv Syst 2024; 40:1147-1157. [PMID: 38092980 DOI: 10.1007/s00381-023-06247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/29/2023] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To analyze and compare the efficacy of two selective dorsal rhizotomy (SDR) techniques with intraoperative neurophysiological monitoring, using instrumented three-dimensional gait analysis. INTRODUCTION SDR is a common, irreversible surgical treatment increasingly used to address gait disturbances in children with chronic non-progressive encephalopathy by reducing spasticity. Various techniques have been used, which mainly differ in the percentage of rootlets selected for sectioning. A greater proportion of rootlets sectioned leads to a more effective reduction of spasticity; however, there is a potential risk of unwanted neurological effects resulting from excessive deafferentation. While there is evidence of the short- and long-term benefits and complications of SDR, no studies have compared the effectiveness of each technique regarding gait function and preservation of the force-generating capacity of the muscles. MATERIALS AND METHODS Instrumented three-dimensional gait analysis was used to evaluate two groups of patients with spastic cerebral palsy treated by the same neurosurgeon in different time periods, initially using a classic technique (cutting 50% of the nerve rootlets) and subsequently a conservative technique (cutting no more than 33% the nerve rootlets). RESULTS In addition to an increase in knee joint range of motion (ROM), in children who underwent SDR with the conservative technique, a statistically significant increase (p = 0.04) in the net joint power developed by the ankle was observed. Patients who underwent SDR with the conservative technique developed a maximum net ankle joint power of 1.37 ± 0.61 (unit: W/BW), whereas those who were operated with the classic technique developed a maximum net ankle joint power of 0.98 ± 0.18 (unit: W/BW). The conservative group not only showed greater improvement in net ankle joint power but also demonstrated more significant enhancements in minimum knee flexion during the stance phase and knee extension at initial contact. CONCLUSION Our results show that both techniques led to a reduction in spasticity with a positive impact on the gait pattern. In addition, patients treated with the conservative technique were able to develop greater net ankle joint power, leading to a better scenario for rehabilitation and subsequent gait.
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Affiliation(s)
- Beatriz Mantese
- Department of Neurosurgery, Pediatric Hospital J.P. Garrahan, ZC 1407, Buenos Aires, Argentina
- Department of Neurosurgery, Fleni, Buenos Aires, Argentina
| | | | | | | | - Ricardo Nazar
- Department of Neurosurgery, Fleni, Buenos Aires, Argentina
| | - Marcos Crespo
- Gait and Movement Laboratory, Fleni, Buenos Aires, Argentina
| | - Alfredo Toledo
- Gait and Movement Laboratory, Maimonides University, Buenos Aires, Argentina
| | - Emiliano Ravera
- Institute for Research and Development in Bioengineering and Bioinformatics (IBB), CONICET-UNER, Oro Verde, Argentina
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Martinez L, Lalevée M, Poirier T, Brunel H, Matsoukis J, Van Driessche S, Billuart F. Influence of Skin Marker Positioning and Their Combinations on Hip Joint Center Estimation Using the Functional Method. Bioengineering (Basel) 2024; 11:297. [PMID: 38534571 DOI: 10.3390/bioengineering11030297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024] Open
Abstract
Accurate estimation of hip joint center (HJC) position is crucial during gait analysis. HJC is obtained with predictive or functional methods. But in the functional method, there is no consensus on where to place the skin markers and which combination to use. The objective of this study was to analyze how different combinations of skin markers affect the estimation of HJC position relative to predictive methods. Forty-one healthy volunteers were included in this study; thirteen markers were placed on the pelvis and hip of each subject's lower limbs. Various marker combinations were used to determine the HJC position based on ten calibration movement trials, captured by a motion capture system. The estimated HJC position for each combination was evaluated by focusing on the range and standard deviation of the mean norm values of HJC and the mean X, Y, Z coordinates of HJC for each limb. The combinations that produced the best estimates incorporated the markers on the pelvis and on proximal and easily identifiable muscles, with results close to predictive methods. The combination that excluded the markers on the pelvis was not robust in estimating the HJC position.
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Affiliation(s)
- Lucas Martinez
- Unité de Recherche ERPHAN, UR 20201, UVSQ, 92380 Garches, France
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-Kinésithérapie Saint Michel, 68 rue du Commerce, 75015 Paris, France
| | - Matthieu Lalevée
- CETAPS UR3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, 76821 Mont-Saint-Aignan, France
- Department of Orthopedic Surgery, Rouen University Hospital, 37 Bd Gambetta, 76000 Rouen, France
| | - Thomas Poirier
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-Kinésithérapie Saint Michel, 68 rue du Commerce, 75015 Paris, France
| | - Helena Brunel
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-Kinésithérapie Saint Michel, 68 rue du Commerce, 75015 Paris, France
| | - Jean Matsoukis
- Département de Chirurgie Orthopédique, Groupe Hospitalier du Havre, BP24, 76083 Le Havre CEDEX, France
| | - Stéphane Van Driessche
- Polyclinique Sainte Marguerite, 5 Avenue de la Font Sainte-Marguerite, 89000 Auxerre, France
| | - Fabien Billuart
- Unité de Recherche ERPHAN, UR 20201, UVSQ, 92380 Garches, France
- Université de Versailles-Saint-Quentin-en-Yvelines, UFR Simone Veil-Santé, 20 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France
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Fiori L, Castiglia SF, Chini G, Draicchio F, Sacco F, Serrao M, Tatarelli A, Varrecchia T, Ranavolo A. The Lower Limb Muscle Co-Activation Map during Human Locomotion: From Slow Walking to Running. Bioengineering (Basel) 2024; 11:288. [PMID: 38534562 DOI: 10.3390/bioengineering11030288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
The central nervous system (CNS) controls movements and regulates joint stiffness with muscle co-activation, but until now, few studies have examined muscle pairs during running. This study aims to investigate differences in lower limb muscle coactivation during gait at different speeds, from walking to running. Nineteen healthy runners walked and ran at speeds ranging from 0.8 km/h to 9.3 km/h. Twelve lower limb muscles' co-activation was calculated using the time-varying multi-muscle co-activation function (TMCf) with global, flexor-extension, and rostro-caudal approaches. Spatiotemporal and kinematic parameters were also measured. We found that TMCf, spatiotemporal, and kinematic parameters were significantly affected by gait speed for all approaches. Significant differences were observed in the main parameters of each co-activation approach and in the spatiotemporal and kinematic parameters at the transition between walking and running. In particular, significant differences were observed in the global co-activation (CIglob, main effect F(1,17) = 641.04, p < 0.001; at the transition p < 0.001), the stride length (main effect F(1,17) = 253.03, p < 0.001; at the transition p < 0.001), the stride frequency (main effect F(1,17) = 714.22, p < 0.001; at the transition p < 0.001) and the Center of Mass displacement in the vertical (CoMy, main effect F(1,17) = 426.2, p < 0.001; at the transition p < 0.001) and medial-lateral (CoMz, main effect F(1,17) = 120.29 p < 0.001; at the transition p < 0.001) directions. Regarding the correlation analysis, the CoMy was positively correlated with a higher CIglob (r = 0.88, p < 0.001) and negatively correlated with Full Width at Half Maximum (FWHMglob, r = -0.83, p < 0.001), whereas the CoMz was positively correlated with the global Center of Activity (CoAglob, r = 0.97, p < 0.001). Positive and negative strong correlations were found between global co-activation parameters and center of mass displacements, as well as some spatiotemporal parameters, regardless of gait speed. Our findings suggest that walking and running have different co-activation patterns and kinematic characteristics, with the whole-limb stiffness exerted more synchronously and stably during running. The co-activation indexes and kinematic parameters could be the result of global co-activation, which is a sensory-control integration process used by the CNS to deal with more demanding and potentially unstable tasks like running.
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Affiliation(s)
- Lorenzo Fiori
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
- Behavioral Neuroscience PhD Program, Department of Physiology and Pharmacology, Sapienza University, Viale dell'Università 30, 00185 Rome, Italy
| | - Stefano Filippo Castiglia
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100 Latina, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy
| | - Giorgia Chini
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Floriana Sacco
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100 Latina, Italy
| | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
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Huang T, Ruan M, Huang S, Fan L, Wu X. Comparison of kinematics and joint moments calculations for lower limbs during gait using markerless and marker-based motion capture. Front Bioeng Biotechnol 2024; 12:1280363. [PMID: 38532880 PMCID: PMC10963629 DOI: 10.3389/fbioe.2024.1280363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objective: This study aimed at quantifying the difference in kinematic and joint moments calculation for lower limbs during gait utilizing a markerless motion system (TsingVA Technology, Beijing, China) in comparison to values estimated using a marker-based motion capture system (Nokov Motion Capture System, Beijing, China). Methods: Sixteen healthy participants were recruited for the study. The kinematic data of the lower limb during walking were acquired simultaneously based on the markerless motion capture system (120 Hz) and the marker-based motion capture system (120 Hz). The ground reaction force was recorded synchronously using a force platform (1,200 Hz). The kinematic and force data were input into Visual3D for inverse dynamics calculations. Results: The difference in the lower limb joint center position between the two systems was the least at the ankle joint in the posterior/anterior direction, with the mean absolute deviation (MAD) of 0.74 cm. The least difference in measuring lower limb angles between the two systems was found in flexion/extension movement, and the greatest difference was found in internal/external rotation movement. The coefficient of multiple correlations (CMC) of the lower limb three joint moments for both systems exceeded or equaled 0.75, except for the ad/abduction of the knee and ankle. All the Root Mean Squared Deviation (RMSD) of the lower limb joint moment are below 18 N·m. Conclusion: The markerless motion capture system and marker-based motion capture system showed a high similarity in kinematics and inverse dynamic calculation for lower limbs during gait in the sagittal plane. However, it should be noted that there is a notable deviation in ad/abduction moments at the knee and ankle.
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Affiliation(s)
- Tianchen Huang
- Sports Biomechanics Laboratory, College of Physical Education and Health, Wenzhou University, Wenzhou, China
| | - Mianfang Ruan
- Sports Biomechanics Laboratory, College of Physical Education and Health, Wenzhou University, Wenzhou, China
| | - Shangjun Huang
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Linlin Fan
- TsingVA (Beijing) Technology Co., Ltd., Beijing, China
| | - Xie Wu
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai, China
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Peiffer M, Duquesne K, Delanghe M, Van Oevelen A, De Mits S, Audenaert E, Burssens A. Quantifying walking speeds in relation to ankle biomechanics on a real-time interactive gait platform: a musculoskeletal modeling approach in healthy adults. Front Bioeng Biotechnol 2024; 12:1348977. [PMID: 38515625 PMCID: PMC10956131 DOI: 10.3389/fbioe.2024.1348977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background: Given the inherent variability in walking speeds encountered in day-to-day activities, understanding the corresponding alterations in ankle biomechanics would provide valuable clinical insights. Therefore, the objective of this study was to examine the influence of different walking speeds on biomechanical parameters, utilizing gait analysis and musculoskeletal modelling. Methods: Twenty healthy volunteers without any lower limb medical history were included in this study. Treadmill-assisted gait-analysis with walking speeds of 0.8 m/s and 1.1 m/s was performed using the Gait Real-time Analysis Interactive Lab (GRAIL®). Collected kinematic data and ground reaction forces were processed via the AnyBody® modeling system to determine ankle kinetics and muscle forces of the lower leg. Data were statistically analyzed using statistical parametric mapping to reveal both spatiotemporal and magnitude significant differences. Results: Significant differences were found for both magnitude and spatiotemporal curves between 0.8 m/s and 1.1 m/s for the ankle flexion (p < 0.001), subtalar force (p < 0.001), ankle joint reaction force and muscles forces of the M. gastrocnemius, M. soleus and M. peroneus longus (α = 0.05). No significant spatiotemporal differences were found between 0.8 m/s and 1.1 m/s for the M. tibialis anterior and posterior. Discussion: A significant impact on ankle joint kinematics and kinetics was observed when comparing walking speeds of 0.8 m/s and 1.1 m/s. The findings of this study underscore the influence of walking speed on the biomechanics of the ankle. Such insights may provide a biomechanical rationale for several therapeutic and preventative strategies for ankle conditions.
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Affiliation(s)
- M. Peiffer
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - K. Duquesne
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - M. Delanghe
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - A. Van Oevelen
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - S. De Mits
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
- Smart Space, Ghent University Hospital, Ghent, Belgium
| | - E. Audenaert
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Electromechanics, Op3Mech Research Group, University of Antwerp, Antwerp, Belgium
| | - A. Burssens
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
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Ma M, Zhao S, Long T, Song Q, Holmberg HC, Liu H. Comparative Analysis of the Diagonal Stride Technique during Roller Skiing and On-Snow Skiing in Youth Cross-Country Skiers. SENSORS (BASEL, SWITZERLAND) 2024; 24:1412. [PMID: 38474946 DOI: 10.3390/s24051412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/11/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
Roller skiing is one primary form of training method as it is an off-snow equivalent to cross-country (XC) skiing during the dry land preseason training, but the results could only be applied to on-snow skiing with appropriate caution. The aim of this present study was to investigate the similarities and differences in roller skiing and on-snow skiing with the diagonal stride (DS) technique. Six youth (age: 14.3 ± 2.9 years) skiers participated in this study. Two high-definition video camcorders and FastMove 3D Motion 2.23.3.3101 were used to obtain the three-dimensional kinematic data. The cycle characteristics and joint angle ROM of the DS technique while skiing on different surfaces were similar. Almost all joint angle-time curves that were obtained from roller skiing showed a moderate-to-high degree of similarity to the angle-time curves obtained from on-snow skiing, except the hip adduction-abduction angle. The differences between roller skiing and on-snow skiing were mainly found in the body and calf anteversion angles, and the joint angles at critical instants. DS roller skiing can simulate DS on-snow skiing to a large extent in youth athletes. The hip movement, knee flexion, and calf anteversion at ski/roller ski touchdown and take-off, pole inclination at pole touchdown, body anteversion angle, and trunk anteversion angle at pole touchdown were the points that required caution when transferring preseason practice roller skiing to on-snow skiing.
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Affiliation(s)
- Mujia Ma
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Shuang Zhao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
- Dalian Fast Move Technology Co., Ltd., Dalian 116033, China
| | - Ting Long
- Auckland Bioengineering Institute, University of Auckland, Auckland 1010, New Zealand
| | - Qingquan Song
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China
| | | | - Hui Liu
- School of Sport Science, Beijing Sport University, Beijing 100084, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
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22
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Zhu X, Pang Y, Li L, Sun W, Ding L, Song Q, Shen P. Standard isometric contraction has higher reliability than maximum voluntary isometric contraction for normalizing electromyography during level walking among older adults with knee osteoarthritis. Front Bioeng Biotechnol 2024; 12:1276793. [PMID: 38433819 PMCID: PMC10904509 DOI: 10.3389/fbioe.2024.1276793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction: Electromyography (EMG) normalization often relies on maximum voluntary isometric contraction (MVIC), which may not be suitable for knee osteoarthritis (KOA) patients due to difficulties in generating maximum joint torques caused by pain. This study aims to assess the reliability of standard isometric contraction (SIC) for EMG normalization in older adults with KOA, comparing it with MVIC. Methods: We recruited thirty-five older adults with KOA and collected root mean square EMG amplitudes from seven muscles in the affected limb during level walking, SIC, and MVIC tests. EMG data during level walking were normalized using both SIC and MVIC methods. This process was repeated after at least 1 week. We calculated intra-class correlation coefficients (ICCs) with 95% confidence intervals to evaluate between- and within-day reliabilities. Results: SIC tests showed higher between- (ICC: 0.75-0.86) and within-day (ICC: 0.84-0.95) ICCs across all seven muscles compared to MVIC tests. When normalized with SIC, all seven muscles exhibited higher between- (ICC: 0.67-0.85) and within-day (ICC: 0.88-0.99) ICCs compared to MVIC normalization. Conclusion: This study suggests that SIC may offer superior movement consistency and reliability compared to MVIC for EMG normalization during level walking in older adults with KOA.
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Affiliation(s)
- Xiaoxue Zhu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Yaya Pang
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Li Li
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, United States
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Lijie Ding
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Peixin Shen
- College of Sports and Health, Shandong Sport University, Jinan, China
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Kim KM, Lee TK, Lee SM, Chang WS, Lee SJ, Hwang J, Cho SR. Case report: Intrathecal baclofen therapy improved gait pattern in a stroke patient with spastic dystonia. Front Neurol 2024; 15:1330811. [PMID: 38419706 PMCID: PMC10899344 DOI: 10.3389/fneur.2024.1330811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Background Intrathecal baclofen (ITB) therapy, a viable alternative for unsuitable candidates of conventional spasticity medications, is a preferred method of administration over the oral route. Owing to its enhanced bioavailability, ITB ensures a more effective delivery at the target site. Objective There is a lack of conclusive evidence regarding the use of ITB treatment in managing ambulatory patients with spastic dystonia. Before ITB pump implantation, patients commonly undergo an ITB bolus injection trial to rule out potential adverse reactions and verify the therapeutic effects on hypertonic issues. In this report, we highlight a case of spastic dystonia, particularly focusing on an ambulatory patient who demonstrated significant improvement in both the modified Ashworth scale (MAS) score and gait pattern following the ITB injection trial. Case report This case report outlines the medical history of a 67-year-old male diagnosed with left-side hemiplegia and spastic dystonia, resulting from his second episode of intracranial hemorrhage in the right thalamus. An ITB injection trial was initiated because the patient was not suitable for continued botulinum toxin injections and oral medications. This was due to the persistent occurrence of spastic dystonia in both the upper and lower extremities. The patient underwent a four-day ITB injection trial with progressively increasing doses, resulting in improved MAS scores and gait parameters, including cadence, step length, step time, stride length, and stride time were increased. Particularly, kinematic gait analysis demonstrates a substantial improvement of increased knee flexion in the swing phase in stiff knee gait pattern. These findings indicated a gradual reduction in spasticity-related symptoms, signifying the positive effect of the ITB injection trial. The patient eventually received an ITB pump implantation. Conclusion In this post-stroke patient with spastic dystonia, ITB therapy has demonstrated effective and substantial management of spasticity, along with improvement in gait patterns.
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Affiliation(s)
- Kyung Min Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Kwon Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Min Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won Seok Chang
- Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Ji Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jihye Hwang
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-Rae Cho
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 FOUR Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
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Thammachat K, Songkhla SN, Aniwattanapong D, Suriyaamarit D. Reliability and minimal detectable change of nonlinear analysis measure of postural control in older adults with mild cognitive impairment. Gait Posture 2024; 107:152-154. [PMID: 37321920 DOI: 10.1016/j.gaitpost.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/30/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Evaluating quiet stance under various conditions using nonlinear analysis may be an effective method of measuring postural control in older adults with mild cognitive impairment (MCI). However, no studies have examined the reliability of using sample entropy (SampEn) in older adults with MCI. RESEARCH QUESTION What are the within- and between-session reliability and minimal detectable change (MDC) of a nonlinear analysis measure of postural control during quiet stance in older adults with MCI? METHODS Fourteen older adults with MCI performed static standing under four conditions, and the center of pressure signal was calculated and applied to SampEn nonlinear analysis. The within- and between-session reliability and MDC were explored. RESULTS Within-session reliability was found to be fair to good and excellent (ICC = 0.527-0.960), and between-session reliability was excellent (ICC = 0.795-0.979). MDC values were less than 0.15. SIGNIFICANCE The between-session reliability of SampEn in all conditions demonstrates SampEn's stable performance. This method may be useful in assessing postural control in older adults with MCI, and MDC values may be helpful in detecting subtle changes in patient performance.
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Affiliation(s)
- Khantamat Thammachat
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| | - Sawit Na Songkhla
- Department of Electrical Engineering, Faculty of Engineering, Chulalongkorn University, Thailand
| | - Daruj Aniwattanapong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Thailand; Chulalongkorn Cognitive, Clinical & Computational Neuroscience Lab, Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Thailand
| | - Duangporn Suriyaamarit
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand.
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Lin J, Wang Y, Sha J, Li Y, Fan Z, Lei W, Yan Y. Clinical reliability and validity of a video-based markerless gait evaluation method. Front Pediatr 2023; 11:1331176. [PMID: 38188911 PMCID: PMC10771829 DOI: 10.3389/fped.2023.1331176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Objective To explore the reliability and validity of gait parameters obtained from gait assessment system software employing a human posture estimation algorithm based on markerless videos of children walking in clinical practice. Methods Eighteen typical developmental (TD) children and ten children with developmental dysplasia of the hip (DDH) were recruited to walk along a designated sidewalk at a comfortable walking speed. A 3-dimensional gait analysis (3D GA) and a 2-dimensional markerless (2D ML) gait evaluation system were used to extract the gait kinematics parameters twice at an interval of 2 h. Results The two measurements of the children's kinematic gait parameters revealed no significant differences (P > 0.05). Intra-class correlation coefficients (ICC) were generally high (ICC >0.7), showing moderate to good relative reliability. The standard error of measurement (SEM) values of all gait parameters measured by the two walks were 1.26°-2.91°. The system software had good to excellent validity compared to the 3D GA, with ICC values between 0.835 and 0.957 and SEM values of 0.87°-1.71° for the gait parameters measured by both methods. The Bland-Altman plot analysis indicated no significant systematic errors. Conclusions The feasibility of the markerless gait assessment method using the human posture estimation-based algorithm may provide reliable and valid gait analysis results for practical clinical applications.
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Affiliation(s)
- Jincong Lin
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Yongtao Wang
- School of Telecommunications Engineering, Xidian University, Xi’an, China
- Guangzhou Institute, Xidian University, Xi’an, China
| | - Jia Sha
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yi Li
- School of Telecommunications Engineering, Xidian University, Xi’an, China
- Guangzhou Institute, Xidian University, Xi’an, China
| | - Zongzhi Fan
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Wei Lei
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Yabo Yan
- Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi’an, China
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Ji R, Lee WYW, Guan X, Yan B, Yang L, Yang J, Wang L, Tao C, Kuai S, Fan Y. Comparison of plugin and redundant marker sets to analyze gait kinematics between different populations. Biomed Eng Online 2023; 22:122. [PMID: 38087307 PMCID: PMC10717987 DOI: 10.1186/s12938-023-01177-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Gait model consists of a marker set and a segment pose estimation algorithm. Plugin marker set and inverse kinematic algorithm (IK.) are prevalent in gait analysis, especially musculoskeletal motion analysis. Adding extra markers for the plugin marker set could increase the robustness to marker misplacement, motion artifacts, and even markers occlusion. However, how the different marker sets affect the gait analysis's kinematic output is unclear. Therefore, this study aims to investigate the effect of marker sets on the kinematic output during level walking in different populations. RESULTS In all three planes, there are significant differences (P < 0.05) between marker sets in some kinematic variables at the hip, knee, and ankle. In different populations, the kinematic variables that show significant differences varied. When comparing the kinematic differences between populations using the two marker sets separately, the range of motion (ROM) of hip flexion was only found to be a significant difference using the redundant marker set, while the peak internal rotation at the knee was only found a significant difference using plugin marker set. In addition, the redundant marker set shows less intra-subject variation than the plugin marker set. CONCLUSION The findings in this study demonstrate the importance of marker set selection since it could change the result when comparing the kinematic differences between populations. Therefore, it is essential to increase the caution in explaining the result when using different marker sets. It is crucial to use the same marker set, and the redundant marker set might be a better choice for gait analysis.
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Affiliation(s)
- Run Ji
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China
- Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Wayne Yuk-Wai Lee
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xinyu Guan
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China
| | - Bin Yan
- Department of Spine Surgery, Shenzhen Second People's Hospital, Shenzhen, 518039, China
- Department of Spine Surgery, First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
- Shenzhen University School of Medicine, Shenzhen, 518060, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Lei Yang
- Department of Spine Surgery, Shenzhen Second People's Hospital, Shenzhen, 518039, China
- Department of Spine Surgery, First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
- Shenzhen University School of Medicine, Shenzhen, 518060, China
- Shenzhen Youth Spine Health Center, Shenzhen, China
| | - Jiemeng Yang
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China
- Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Ling Wang
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, 300384, China
- National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, Tianjin University of Technology, Tianjin, China
| | - Chunjing Tao
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China.
| | - Shengzheng Kuai
- Department of Spine Surgery, Shenzhen Second People's Hospital, Shenzhen, 518039, China.
- Department of Spine Surgery, First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China.
- Shenzhen University School of Medicine, Shenzhen, 518060, China.
- Shenzhen Youth Spine Health Center, Shenzhen, China.
| | - Yubo Fan
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China.
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Patathong T, Klaewkasikum K, Angsnuntsukh C, Woratanarat T, Kijkunasathian C, Sanguantrakul J, Woratanarat P. The knee kinematic patterns and associated factors in healthy Thai adults. BMC Musculoskelet Disord 2023; 24:940. [PMID: 38053059 PMCID: PMC10696785 DOI: 10.1186/s12891-023-07081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Reference values for normal knee kinematics were limited in Asian population and were influenced by race and other factors. This study was aimed to establish the reference values and identify the factors associated with knee kinematics in healthy Thai adults, aged 18-40 years. METHODS A retrospective cohort study was conducted between 2016 and 2020. Healthy Thai adults aged 18-40 years old with body mass index (BMI) between 18.5 and 24.9 kg/m2 were included. All eligible participants were attached with reflective markers. Their walking was captured by 8-digital cameras, and assessed by motion analysis software. The primary outcomes were average knee kinematic data (degrees) in three dimensional planes as valgus-varus, flexion-extension, and internal-external rotation. Paired t-test and multiple linear regression were applied to compare the outcomes and to determine their associated factors. RESULTS Ninety-eight participants (60 females and 38 males) were included with mean age 28.5 ± 5.4 years, and BMI 21.1 ± 2.0 kg/m2. Knee kinematics showed slight adduction during the swing phase, flexion during the stance phase, and obvious external rotation throughout the gait cycle, with a peak of 30-31 degrees during mid-swing. Right knee was significantly more adducted, flexed and externally rotated than the left side, particularly at mid-stance (P = 0.047, 0.017, and < 0.001, respectively). Females had more knee abduction, flexion and external rotation than males. Age, sex, and BMI were significantly correlated with knee abduction at terminal stance (correlation coefficient - 0.12, 95% confidence interval (CI) -0.23, -0.01; -1.37, 95%CI -2.54, -0.20; and - 0.32, 95%CI -0.61, -0.39, respectively), and rotation at mid-swing (correlation coefficient - 0.36, 95%CI -0.69, -0.02; -7.37, 95%CI -10.82, -3.92; and 0.89, 95%CI 0.01, 1.78, respectively). CONCLUSION Knee kinematics demonstrates external tibial rotation throughout the gait cycle, significant side differences, and are associated with age, sex, and BMI. Reference values from this study will be useful for functional gait assessment in healthy Thais. However, further comprehensive knee kinetic study including spatio-temporal parameter is recommended.
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Affiliation(s)
- Tanyaporn Patathong
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Krongkaew Klaewkasikum
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Chanika Angsnuntsukh
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Thira Woratanarat
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chusak Kijkunasathian
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Jongsook Sanguantrakul
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, 12120, Thailand
| | - Patarawan Woratanarat
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
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Wiles TM, Mangalam M, Sommerfeld JH, Kim SK, Brink KJ, Charles AE, Grunkemeyer A, Kalaitzi Manifrenti M, Mastorakis S, Stergiou N, Likens AD. NONAN GaitPrint: An IMU gait database of healthy young adults. Sci Data 2023; 10:867. [PMID: 38052819 PMCID: PMC10698035 DOI: 10.1038/s41597-023-02704-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
An ongoing thrust of research focused on human gait pertains to identifying individuals based on gait patterns. However, no existing gait database supports modeling efforts to assess gait patterns unique to individuals. Hence, we introduce the Nonlinear Analysis Core (NONAN) GaitPrint database containing whole body kinematics and foot placement during self-paced overground walking on a 200-meter looping indoor track. Noraxon Ultium MotionTM inertial measurement unit (IMU) sensors sampled the motion of 35 healthy young adults (19-35 years old; 18 men and 17 women; mean ± 1 s.d. age: 24.6 ± 2.7 years; height: 1.73 ± 0.78 m; body mass: 72.44 ± 15.04 kg) over 18 4-min trials across two days. Continuous variables include acceleration, velocity, position, and the acceleration, velocity, position, orientation, and rotational velocity of each corresponding body segment, and the angle of each respective joint. The discrete variables include an exhaustive set of gait parameters derived from the spatiotemporal dynamics of foot placement. We technically validate our data using continuous relative phase, Lyapunov exponent, and Hurst exponent-nonlinear metrics quantifying different aspects of healthy human gait.
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Affiliation(s)
- Tyler M Wiles
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Joel H Sommerfeld
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Seung Kyeom Kim
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Kolby J Brink
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Anaelle Emeline Charles
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Alli Grunkemeyer
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Marilena Kalaitzi Manifrenti
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Spyridon Mastorakis
- College of Information Science and Technology, University of Nebraska at Omaha, Omaha, NE, 68182, USA
| | - Nick Stergiou
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA
- Department of Physical Education and Sport Science, Aristotle University, Thessaloniki, Greece
| | - Aaron D Likens
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, 68182, USA.
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Van Criekinge T, Saeys W, Truijen S, Vereeck L, Sloot LH, Hallemans A. A full-body motion capture gait dataset of 138 able-bodied adults across the life span and 50 stroke survivors. Sci Data 2023; 10:852. [PMID: 38040770 PMCID: PMC10692332 DOI: 10.1038/s41597-023-02767-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023] Open
Abstract
This reference dataset contains biomechanical data of 138 able-bodied adults (21-86 years) and 50 stroke survivors walking bare-footed at their preferred speed. It is unique due to its size, and population, including adults across the life-span and over 70 years, as well as stroke survivors. Full-body kinematics (PiG-model), kinetics and muscle activity of 14 back and lower limbs muscles was collected with a Vicon motion capture system, ground-embedded force plates, and a synchronized surface EMG system. The data is reliable to compare within and between groups as the same methodology and infrastructure were used to gather all data. Both source files (C3D) and post-processed ready-to-use stride-normalized kinematics, kinetics and EMG data (MAT-file, Excel file) are available, allowing high flexibility and accessibility of analysis for both researchers and clinicians. These records are valuable to examine ageing, typical and hemiplegic gait, while also offering a wide range of reference data which can be utilized for age-matched controls during normal walking.
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Affiliation(s)
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Luc Vereeck
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Lizeth H Sloot
- Institut für Technische Informatik (ZITI), Heidelberg University, Heidelberg, Germany.
- Translational and Clinical Research Institute (TCRI), Newcastle University, Newcastle, UK.
| | - Ann Hallemans
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.
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30
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Werling K, Bianco NA, Raitor M, Stingel J, Hicks JL, Collins SH, Delp SL, Liu CK. AddBiomechanics: Automating model scaling, inverse kinematics, and inverse dynamics from human motion data through sequential optimization. PLoS One 2023; 18:e0295152. [PMID: 38033114 PMCID: PMC10688959 DOI: 10.1371/journal.pone.0295152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
Creating large-scale public datasets of human motion biomechanics could unlock data-driven breakthroughs in our understanding of human motion, neuromuscular diseases, and assistive devices. However, the manual effort currently required to process motion capture data and quantify the kinematics and dynamics of movement is costly and limits the collection and sharing of large-scale biomechanical datasets. We present a method, called AddBiomechanics, to automate and standardize the quantification of human movement dynamics from motion capture data. We use linear methods followed by a non-convex bilevel optimization to scale the body segments of a musculoskeletal model, register the locations of optical markers placed on an experimental subject to the markers on a musculoskeletal model, and compute body segment kinematics given trajectories of experimental markers during a motion. We then apply a linear method followed by another non-convex optimization to find body segment masses and fine tune kinematics to minimize residual forces given corresponding trajectories of ground reaction forces. The optimization approach requires approximately 3-5 minutes to determine a subject's skeleton dimensions and motion kinematics, and less than 30 minutes of computation to also determine dynamically consistent skeleton inertia properties and fine-tuned kinematics and kinetics, compared with about one day of manual work for a human expert. We used AddBiomechanics to automatically reconstruct joint angle and torque trajectories from previously published multi-activity datasets, achieving close correspondence to expert-calculated values, marker root-mean-square errors less than 2 cm, and residual force magnitudes smaller than 2% of peak external force. Finally, we confirmed that AddBiomechanics accurately reproduced joint kinematics and kinetics from synthetic walking data with low marker error and residual loads. We have published the algorithm as an open source cloud service at AddBiomechanics.org, which is available at no cost and asks that users agree to share processed and de-identified data with the community. As of this writing, hundreds of researchers have used the prototype tool to process and share about ten thousand motion files from about one thousand experimental subjects. Reducing the barriers to processing and sharing high-quality human motion biomechanics data will enable more people to use state-of-the-art biomechanical analysis, do so at lower cost, and share larger and more accurate datasets.
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Affiliation(s)
- Keenon Werling
- Department of Computer Science, Stanford University, Stanford, California, United States of America
| | - Nicholas A. Bianco
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Michael Raitor
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Jon Stingel
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Jennifer L. Hicks
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Scott L. Delp
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - C. Karen Liu
- Department of Computer Science, Stanford University, Stanford, California, United States of America
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31
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Kim S, Glaviano NR, Park J. Sex Differences in Knee Extensor Neuromuscular Function in Individuals With and Without Patellofemoral Pain. Sports Health 2023:19417381231209318. [PMID: 37978417 DOI: 10.1177/19417381231209318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Impaired knee extensor neuromuscular function has been frequently observed in individuals with patellofemoral pain (PFP); however, few researchers have aimed to understand the influence of sex on knee extensor neuromuscular function in this pathological population. The authors aimed to determine whether there are differences in knee extensor neuromuscular function between sexes in individuals with and without PFP. HYPOTHESIS Women with PFP would exhibit greater deficits in knee extensor neuromuscular function than men with PFP, compared with sex-matched individuals without PFP. STUDY DESIGN Cross-sectional, case-control study. LEVEL OF EVIDENCE Level 4. METHODS A total of 110 individuals were classified into 4 groups: women with PFP (n = 25); men with PFP (n = 30); women without PFP (n = 25); and men without PFP (n = 30). Knee extensor strength (isometric peak torque [PT]), activation (central activation ratio), early, late, and total phase rate of torque development (RTD0-100, RTD100-200, and RTD20-80%), and endurance (isokinetic average PT) were assessed using an isokinetic dynamometer. Group differences were assessed using a 2-way multivariate analysis of variance (sex by PFP). RESULTS Both women and men with PFP exhibited lower knee extensor strength, activation, early, late, and total phase RTD, and endurance versus sex-matched individuals without PFP (P < 0.05 for all comparisons). Women with PFP exhibited lower early phase (7.91 ± 2.02 versus 9.78 ± 2.43 N·m/s/kg; P < 0.01; Cohen d = 0.83), late phase (5.34 ± 1.02 versus 7.28±2.28 N·m/s/kg; P < 0.01; Cohen d = 1.37), and total phase (7.40 ± 2.57 versus 8.72 ± 2.57 N·m/s/kg; P = 0.03; Cohen d = 0.51) RTD than men with PFP. CONCLUSION Compared with sex-matched pain-free individuals, women with PFP displayed lower RTD than men with PFP. Clinicians should note that among individuals with PFP, women are more likely to experience a greater impairment in their knee extensor torque-generating capacity than men. CLINICAL RELEVANCE Additional treatment strategies that effectively improve the ability to rapidly generate torque should be developed and implemented, especially when treating women with PFP.
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Affiliation(s)
- Sungwan Kim
- Department of Sports Medicine, Kyung Hee University, Yongin, Republic of Korea
| | - Neal R Glaviano
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Jihong Park
- Department of Sports Medicine, Kyung Hee University, Yongin, Republic of Korea
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32
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Bakke D, Ortega-Auriol P, Besier T. Shape-model scaling is more robust than linear scaling to marker placement error. J Biomech 2023; 160:111805. [PMID: 37801863 DOI: 10.1016/j.jbiomech.2023.111805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 08/10/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
When reconstructing bone geometry to calculate joint kinematics, shape-model scaling can be more accurate and repeatable than linear scaling given the same anatomical landmarks. This study perturbed anatomical landmarks from optical motion capture and determined the robustness of shape-model scaling to misplaced markers compared to a traditional approach of linear scaling. We hypothesised that shape-model scaling would be less susceptible to variance in marker positions compared to linear scaling. The positions of hip joint centres and femoral/tibial segment lengths across perturbations were compared to determine each scaling method's range of geometric variation. The standard deviation (SD) of the hip joint centre location from the shape model had a maximum of 1.4 mm, compared to 4.2 mm for linear scaling. Femoral and tibial segments displayed SD's of 5.4 mm and 5.2 mm when shape-model scaled, compared to 9.2 mm and 9.5 mm with linear scaling, respectively, thus supporting our hypothesis. Geometric constraints within a shape model provide robustness to marker misplacement providing potential improvements in repeatability and data exchange.
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Affiliation(s)
- Duncan Bakke
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Pablo Ortega-Auriol
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Thor Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand; Department of Engineering Science, University of Auckland, Auckland, New Zealand.
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33
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Lu C, Ge R, Tang Z, Fu X, Zhang L, Yang K, Xu X. Multi-Channel FES Gait Rehabilitation Assistance System Based on Adaptive sEMG Modulation. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3652-3663. [PMID: 37695970 DOI: 10.1109/tnsre.2023.3313617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Functional electrical stimulation (FES) can be used to stimulate the lower-limb muscles to provide walking assistance to stroke patients. However, the existing surface electromyography (sEMG)-based FES control methods mostly only consider a single muscle with a fixed stimulation intensity and frequency. This study proposes a multi-channel FES gait rehabilitation assistance system based on adaptive myoelectric modulation. The proposed system collects sEMG of the vastus lateralis muscle on the non-affected side to predict the sEMG values of four targeted lower-limb muscles on the affected side using a bidirectional long short-term memory (BILSTM) model. Next, the proposed system modulates the real-time FES output frequency for four targeted muscles based on the predicted sEMG values to provide muscle force compensation. Fifteen healthy subjects were recruited to participate in an offline model-building experiment conducted to evaluate the feasibility of the proposed BILSTM model in predicting the sEMG values. The experimental results showed that the [Formula: see text] value of the best-obtained prediction result reached 0.85 using the BILSTM model, which was significantly higher than that using traditional prediction methods. Moreover, two patients after stroke were recruited in the online assisted-walking experiment to verify the effectiveness of the proposed walking-assistance system. The experimental results showed that the activation of the target muscles of the patients was higher after FES, and the gait movement data were significantly different before and after FES. The proposed system can be effectively applied to walking assistance for stroke patients, and the experimental results can provide new ideas and methods for sEMG-controlled FES rehabilitation applications.
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34
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Werling K, Bianco NA, Raitor M, Stingel J, Hicks JL, Collins SH, Delp SL, Liu CK. AddBiomechanics: Automating model scaling, inverse kinematics, and inverse dynamics from human motion data through sequential optimization. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.15.545116. [PMID: 37398034 PMCID: PMC10312696 DOI: 10.1101/2023.06.15.545116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Creating large-scale public datasets of human motion biomechanics could unlock data-driven breakthroughs in our understanding of human motion, neuromuscular diseases, and assistive devices. However, the manual effort currently required to process motion capture data and quantify the kinematics and dynamics of movement is costly and limits the collection and sharing of large-scale biomechanical datasets. We present a method, called AddBiomechanics, to automate and standardize the quantification of human movement dynamics from motion capture data. We use linear methods followed by a non-convex bilevel optimization to scale the body segments of a musculoskeletal model, register the locations of optical markers placed on an experimental subject to the markers on a musculoskeletal model, and compute body segment kinematics given trajectories of experimental markers during a motion. We then apply a linear method followed by another non-convex optimization to find body segment masses and fine tune kinematics to minimize residual forces given corresponding trajectories of ground reaction forces. The optimization approach requires approximately 3-5 minutes to determine a subjecťs skeleton dimensions and motion kinematics, and less than 30 minutes of computation to also determine dynamically consistent skeleton inertia properties and fine-tuned kinematics and kinetics, compared with about one day of manual work for a human expert. We used AddBiomechanics to automatically reconstruct joint angle and torque trajectories from previously published multi-activity datasets, achieving close correspondence to expert-calculated values, marker root-mean-square errors less than 2 c m , and residual force magnitudes smaller than 2 % of peak external force. Finally, we confirmed that AddBiomechanics accurately reproduced joint kinematics and kinetics from synthetic walking data with low marker error and residual loads. We have published the algorithm as an open source cloud service at AddBiomechanics.org, which is available at no cost and asks that users agree to share processed and de-identified data with the community. As of this writing, hundreds of researchers have used the prototype tool to process and share about ten thousand motion files from about one thousand experimental subjects. Reducing the barriers to processing and sharing high-quality human motion biomechanics data will enable more people to use state-of-the-art biomechanical analysis, do so at lower cost, and share larger and more accurate datasets.
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Affiliation(s)
- Keenon Werling
- Department of Computer Science, Stanford University, Stanford, California
| | - Nicholas A. Bianco
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Michael Raitor
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Jon Stingel
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Jennifer L. Hicks
- Department of Bioengineering, Stanford University, Stanford, California
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Scott L. Delp
- Department of Mechanical Engineering, Stanford University, Stanford, California
- Department of Bioengineering, Stanford University, Stanford, California
| | - C. Karen Liu
- Department of Computer Science, Stanford University, Stanford, California
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35
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Phillips T, Brierty A, Goodchild D, Patritti BL, Murphy A, Boocock M, Dwan L, Passmore E, McGrath M, Edwards J. Australia and New Zealand Clinical Motion Analysis Group (ANZ-CMAG) clinical practice recommendations. Gait Posture 2023; 106:1-10. [PMID: 37607445 DOI: 10.1016/j.gaitpost.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Clinical motion analysis involves quantitative measurement of gait patterns to identify gait anomalies that currently or have the potential to impact function, activities of daily living and participation. Clinical motion analysis services are equipped with motion capture technology and comprise specialised staff who deliver 3-dimensional motion analysis services to children and adults who present with varying levels of gait impairment. Data is then used to inform intervention recommendations to clinicians with a view to maintaining independent, functional and pain free walking (or appropriate mobility). The ANZ-CMAG (established in 2013) identified a need to establish recommendations to assist in standardising practice guidelines for both current and new clinical motion analysis services within the region. The group serves to promote collaboration between services in quality assurance processes, clinical practices, data sets and research activities. The clinical practice recommendations described in this paper cover: i) requirements for a motion analysis service (including staffing, facilities and equipment), ii) patient assessments (requirements, clinical information and data gathered, reporting and interpretation of patient data), iii) quality assurance processes (including motion capture system / biomechanical models & limitations, marker placement, data storage / record keeping, creation of normative dataset); iv) helpful resources. Better outcomes for children and adults with gait deviations is dependent upon accurate measurement and evaluation of walking and requires input from multidisciplinary clinical teams with specialist knowledge and skills. The ANZ-CMAG hopes these clinical practice recommendations are beneficial to motion analysis services with an aim to improve clinical practices, patient outcomes, and support research collaboration.
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Affiliation(s)
- Teresa Phillips
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia.
| | - Alexis Brierty
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
| | - Denni Goodchild
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
| | - Benjamin L Patritti
- South Australian Movement Analysis Centre, Division of Rehabilitation, Aged and Palliative Care, Flinders Medical Centre, Adelaide, 5042, Australia; College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia
| | - Anna Murphy
- Clinical Gait Analysis Service, Monash Health, Victoria, 3192, Australia; Faculty of Medicine, Nursing and Allied Health Sciences, Monash University, Victoria, 3800, Australia
| | - Mark Boocock
- Health and Rehabilitation Research Institute, Auckland University of Technology, Northcote, 0627, New Zealand
| | - Leanne Dwan
- The Children's Hospital at Westmead, Sydney, 2145, Australia; School of Health Sciences, The University of Sydney, Sydney, 2006, Australia
| | - Elyse Passmore
- Royal Children's Hospital, Gait Analysis Laboratory, Parkville, 3052, Australia; Murdoch Children's Research Institute, Developmental Imaging, Parkville, 3052, Australia; University of Melbourne, Engineering and Information Technology, Parkville, 3052, Australia; University of Melbourne, Medicine, Dentistry & Health Sciences, Parkville, 3052, Australia
| | - Michelle McGrath
- Queensland Motion Analysis Centre, Department of Physiotherapy, Royal Brisbane and Women's Hospital, Herston, 4006, Australia
| | - Julie Edwards
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
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36
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Matsumoto Y, Ogihara N, Kosuge S, Hanawa H, Kokubun T, Kanemura N. Sex differences in the kinematics and kinetics of the foot and plantar aponeurosis during drop-jump. Sci Rep 2023; 13:12957. [PMID: 37563188 PMCID: PMC10415335 DOI: 10.1038/s41598-023-39682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
Plantar fasciitis is one of the most common musculoskeletal injuries in runners and jumpers, with a higher incidence in females. However, mechanisms underlying sex-associated differences in its incidence remain unclear. This study investigated the possible differences in landing and jumping kinematics and kinetics of the foot between sexes during drop-jump activities. Twenty-six participants, including 13 males and 13 females, performed drop-jumps from a platform onto force plates. Nineteen trials including ten males and nine females were selected for inverse dynamics analysis. The patterns of stretch and tensile force generated by the plantar aponeurosis (PA) were estimated using a multi-segment foot model incorporating the PA. Our results demonstrated that dorsiflexion, angular velocity, and normalized plantarflexion moment of the midtarsal joint right after the heel landed on the floor were significantly larger in females than in males. Consequently, the PA strain rate and tensile stress tended to be larger in females than in males. Such differences in the kinematics and kinetics of the foot and the PA between sexes could potentially lead to a higher prevalence of foot injuries such as plantar fasciitis in females.
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Affiliation(s)
- Yuka Matsumoto
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, The University of Tokyo, Tokyo, Japan
| | - Sachiko Kosuge
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
- Maeda Seikeigeka, Saitama, Japan
| | - Hiroki Hanawa
- Department of Health Science, University of Human Arts and Sciences, Saitama, Japan
| | - Takanori Kokubun
- Department of Health and Social Services, Saitama Prefectural University, 820 Sannomiya, Koshigaya, Saitama, 343-8540, Japan
| | - Naohiko Kanemura
- Department of Health and Social Services, Saitama Prefectural University, 820 Sannomiya, Koshigaya, Saitama, 343-8540, Japan.
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37
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de Assis MA, Santos TRT, Fonseca ST, de Andrade AGP, Araújo PA, de Souza TR, Resende RA, Ocarino JM. Effects of Resistance Training of Upper Limb and Trunk Muscles on Soccer Instep Kick Kinematics. J Appl Biomech 2023:1-10. [PMID: 37487581 DOI: 10.1123/jab.2022-0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/15/2023] [Accepted: 06/16/2023] [Indexed: 07/26/2023]
Abstract
The upper body and trunk muscles are crucial to perform soccer kicks. Resistance training targeting these muscles may modify the pattern adopted during kicking. This study aimed to investigate the effect of resistance training of the arm and anterior trunk muscles on instep kicking kinematics. Twenty-six male participants were randomly allocated into a training group or control group. The training group underwent resistance training of arm and trunk muscles and practiced the instep kick for 8 weeks. The control group only practiced kicking during the same period. The trunk, hip, and knee kinematics were assessed during the instep kick before and after the intervention. Kinematics were analyzed according to their data distribution with statistical parametric or nonparametric mapping. The effect of the training on the 1-repetition maximum test was analyzed using a repeated-measures multivariate analysis of variance. The training group showed greater hip extension after the training during the backswing phase (Hedge g effect size of 0.316-0.321) and increased 1-repetition maximum for all exercises. There were no other differences. The present study documented the nonlocal effect of strengthening training in which arm and trunk muscle training resulted in changes in hip kinematics during the backswing phase of the instep kick.
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Affiliation(s)
- Miguel Arcanjo de Assis
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
| | - Thiago Ribeiro Teles Santos
- Faculty of Physical Education and Physical Therapy, Universidade Federal de Uberlândia, Uberlândia, MG,Brazil
| | - Sergio Teixeira Fonseca
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
| | - André Gustavo Pereira de Andrade
- Graduate Program in Sports Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
| | - Priscila Albuquerque Araújo
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
| | - Thales Rezende de Souza
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
| | - Renan Alves Resende
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
| | - Juliana Melo Ocarino
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG,Brazil
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38
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Heitzmann DWW, Block J, Trinler U, Wolf SI, Alimusaj M. [Motion analysis in lower limb exoprosthetics-possibilities and limitations]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04408-z. [PMID: 37458809 DOI: 10.1007/s00132-023-04408-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Gait analysis is of high relevance in prosthetics as it is an essential part of the fitting process. The documentation of movement by means of videos and instrumented methods is becoming increasingly important in prosthetics as benefits of a complex prosthesis can best be shown by structured observation. PROCEDURE A movement analysis should always be preceded by an anamnesis and clinical examination in order to detect functional limitations of the examined person and thus to establish correlations to gait deviations. Additionally, the orthopaedic aid should be evaluated as well. In addition to walking on level ground, walking on everyday obstacles such as stairs and ramps is also of interest when observing people using prosthetic limbs. Functional tests can be used to determine the functional status more comprehensively. An instrumental-3D gait analysis is indicated for specific questions, especially regarding kinetic parameters.
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Affiliation(s)
- Daniel Walter Werner Heitzmann
- Abteilungen Technische Orthopädie und Bewegungsanalytik, Klinik für Orthopädie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland.
| | - Julia Block
- Abteilungen Technische Orthopädie und Bewegungsanalytik, Klinik für Orthopädie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland
| | - Ursula Trinler
- Andreas Wentzensen Forschungsinstitut, BG Klinik Ludwigshafen, Ludwigshafen, Deutschland
| | - Sebastian I Wolf
- Abteilungen Technische Orthopädie und Bewegungsanalytik, Klinik für Orthopädie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland
| | - Merkur Alimusaj
- Abteilungen Technische Orthopädie und Bewegungsanalytik, Klinik für Orthopädie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland
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St. George L, Spoormakers TJP, Roy SH, Hobbs SJ, Clayton HM, Richards J, Serra Bragança FM. Reliability of surface electromyographic (sEMG) measures of equine axial and appendicular muscles during overground trot. PLoS One 2023; 18:e0288664. [PMID: 37450555 PMCID: PMC10348569 DOI: 10.1371/journal.pone.0288664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
The reliability of surface electromyography (sEMG) has not been adequately demonstrated in the equine literature and is an essential consideration as a methodology for application in clinical gait analysis. This observational study investigated within-session, intra-subject (stride-to-stride) and inter-subject reliability, and between-session reliability of normalised sEMG activity profiles, from triceps brachii (triceps), latissimus dorsi (latissimus), longissimus dorsi (longissimus), biceps femoris (biceps), superficial gluteal (gluteal) and semitendinosus muscles in n = 8 clinically non-lame horses during in-hand trot. sEMG sensors were bilaterally located on muscles to collect data during two test sessions (session 1 and 2) with a minimum 24-hour interval. Raw sEMG signals from ten trot strides per horse and session were DC-offset removed, high-pass filtered (40 Hz), full-wave rectified, and low-pass filtered (25 Hz). Signals were normalised to peak amplitude and percent stride before calculating intra- and inter-subject ensemble average sEMG profiles across strides for each muscle and session. sEMG profiles were assessed using waveform similarity statistics: the coefficient of variation (CV) to assess intra- and inter-subject reliability and the adjusted coefficient of multiple correlation (CMC) to evaluate between-session reliability. Across muscles, CV data revealed that intra-horse sEMG profiles within- and between-sessions were comparatively more reliable than inter-horse profiles. Bilateral gluteal, semitendinosus, triceps and longissimus (at T14 and L1) and right biceps showed excellent between-session reliability with group-averaged CMCs > 0.90 (range 0.90-0.97). Bilateral latissimus and left biceps showed good between-session reliability with group-averaged CMCs > 0.75 (range 0.78-0.88). sEMG profiles can reliably describe fundamental muscle activity patterns for selected equine muscles within a test session for individual horses (intra-subject). However, these profiles are more variable across horses (inter-subject) and between sessions (between-session reliability), suggesting that it is reasonable to use sEMG to objectively monitor the intra-individual activity of these muscles across multiple gait evaluation sessions at in-hand trot.
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Affiliation(s)
- L. St. George
- Centre for Applied Sport and Exercise Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - T. J. P. Spoormakers
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - S. H. Roy
- Delsys/Altec Inc., Natick, Massachusetts, United States of America
| | - S. J. Hobbs
- Centre for Applied Sport and Exercise Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - H. M. Clayton
- Sport Horse Science, Mason, Michigan, United States of America
| | - J. Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - F. M. Serra Bragança
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Fonseca M, Gasparutto X, Lena C, Grouvel G, Bonnefoy-Mazure A, Dumas R, Armand S. Can the evaluation of marker placement confidence be used as an indicator of gait kinematic variability? FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1122303. [PMID: 37496701 PMCID: PMC10368473 DOI: 10.3389/fresc.2023.1122303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/22/2023] [Indexed: 07/28/2023]
Abstract
Introduction Three-dimensional gait analysis is widely used for the clinical assessment of movement disorders. However, measurement error reduces the reliability of kinematic data and consequently assessment of gait deviations. The identification of high variability is associated with low reliability and those parameters should be ignored or excluded from gait data interpretation. Moreover, marker placement error has been demonstrated to be the biggest source of variability in gait analysis and may be affected by factors intrinsic to the evaluators such as the evaluator's expertise which could be appraised through his/her experience and confidence in marker placement. Objectives In the present study, we hypothesized that confidence in marker placement is correlated with kinematic variability and could potentially be used as part of a score of reliability. Therefore, we have proposed a questionnaire to evaluate qualitatively the confidence of evaluators in lower-limb marker placement. The primary aim of this study was to evaluate the reliability and validity of the presented questionnaire. The secondary objective was to test a possible relationship between marker placement confidence and kinematics variability. Methods To do so, test-retest gait data were acquired from two different experimental protocols. One protocol included data from a cohort of 32 pathological and 24 asymptomatic subjects where gait analysis was repeated three times, involving two evaluators. A second protocol included data from a cohort of 8 asymptomatic adults with gait analysis repeated 12 times, per participant, and involving four evaluators with a wider range of experience. Results Results demonstrated that the questionnaire proposed is valid and reliable to evaluate qualitatively the confidence of evaluators in placing markers. Indeed, confidence scores were correlated with the actual variability of marker placement and revealed the evaluator's experience and the subjects' characteristics. However, no correlation was observed between confidence scores and kinematic variability and the formulated hypothesis was not supported.
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Affiliation(s)
- Mickael Fonseca
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR_T9406, LBMC, Lyon, France
| | - Xavier Gasparutto
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Carcreff Lena
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Gautier Grouvel
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Alice Bonnefoy-Mazure
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Raphaël Dumas
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR_T9406, LBMC, Lyon, France
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Mattiussi AM, Shaw JW, Price P, Brown DD, Cohen DD, Lineham J, Pedlar CR, Tallent J, Atack AC. Reliability of ankle mechanics during jump landings in turned-out and parallel foot positions in professional ballet dancers. J Biomech 2023; 156:111662. [PMID: 37300978 DOI: 10.1016/j.jbiomech.2023.111662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
This study aimed to determine the within- and between-session reliability of ankle mechanics and vertical ground reaction forces (vGRF) during jump landings in turned-out and parallel foot positions in professional ballet dancers. Twenty-four professional ballet dancers (men = 13, women = 11) attended two data collection sessions where they completed five maximal countermovement jumps in each foot position. The ankle joint mechanics and vGRF of the right limb were recorded via a seven-camera motion capture system and one force platform. Within- and between-session intraclass correlation coefficients (ICC), coefficients of variation (CV), standard error of measurement, and minimal detectable change were calculated for three-dimensional ankle excursion, peak ankle angle, ankle joint velocity, moment, and power, as well as peak landing vGRF, time to peak landing vGRF, loading rate, and jump height. Across both foot positions, within- (ICC: 0.17-0.96; CV: 1.4-82.3%) and between-session (ICC: 0.02-0.98; CV:1.3-57.1%) reliability ranged from poor to excellent, with ankle excursion, peak ankle angle, and jump height demonstrating the greatest ICC values (ICC: 0.65-0.96; CV: 1.4-57%). Jump landings in a turned-out foot position demonstrated better within-session reliability compared to a parallel position, however, no difference in between-session reliability across the foot positions was observed. Most ankle mechanics provide adequate between-session, but not within-session, reliability during jump landings in professional ballet dancers.
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Affiliation(s)
- Adam M Mattiussi
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK; Ballet Healthcare, The Royal Ballet, Royal Opera House, London, UK.
| | - Joseph W Shaw
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK; Ballet Healthcare, The Royal Ballet, Royal Opera House, London, UK. https://twitter.com/@josephshaw
| | - Phil Price
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK. https://twitter.com/@thepricep
| | - Derrick D Brown
- Institute of Sport Science, Dance Science, University of Bern, Bern, Switzerland. https://twitter.com/@ddbrown__
| | - Daniel D Cohen
- Faculty of Health Sciences, University of Santander, Bucaramanga, Colombia. https://twitter.com/@danielcohen1971
| | - Jack Lineham
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
| | - Charles R Pedlar
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK; Division of Surgery and Interventional Science, University College London, UK. https://twitter.com/@pedlarcr
| | - Jamie Tallent
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK; Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia. https://twitter.com/@jamietallent
| | - Alexandra C Atack
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK. https://twitter.com/@a_atack2
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Linder SM, Learman K, Miller Koop M, Espy D, Haupt M, Streicher M, Davidson S, Bethoux F, Nadler N, Alberts JL. Increased Comfortable Gait Speed Is Associated With Improved Gait Biomechanics in Persons With Chronic Stroke Completing an 8-Week Forced-Rate Aerobic Cycling Intervention: A Preliminary Study. Am J Phys Med Rehabil 2023; 102:619-624. [PMID: 37026847 PMCID: PMC10272085 DOI: 10.1097/phm.0000000000002248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
ABSTRACT Task-specific gait training is recommended to improve locomotor function after stroke. Our objective was to determine the effects of a forced-rate aerobic exercise intervention on gait velocity and biomechanics in the absence of task-specific gait training. Individuals with chronic stroke ( N = 14) underwent 24 sessions of forced-rate aerobic exercise, at a targeted aerobic intensity of 60%-80% of their heart rate reserve. Change in comfortable walking speed in addition to spatiotemporal, kinematic, and kinetic variables were measured using three-dimensional motion capture. Overground walking capacity was measured by the 6-min walk test. To determine gait biomechanics associated with increased walking speed, spatiotemporal, kinematic, and kinetic variables were analyzed separately for those who met the minimal clinically important difference for change in gait velocity compared with those who did not. Participants demonstrated a significant increase in gait velocity from 0.61 to 0.70 m/sec ( P = 0.004) and 6-min walk test distance from 272.1 to 325.1 meters ( P < 0.001). Those who met the minimal clinically important difference for change in gait velocity demonstrated significantly greater improvements in spatiotemporal parameters ( P = 0.041), ground reaction forces ( P = 0.047), and power generation ( P = 0.007) compared with those who did not. Improvements in gait velocity were accompanied by normalization of gait biomechanics.
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Affiliation(s)
- Susan M Linder
- From the Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Cleveland, Ohio (SML, MH, FB, NN); Cleveland Clinic, Department of Biomedical Engineering, Cleveland, Ohio (SML, MMK, JLA); Youngstown State University, Youngstown, Ohio (SML, KL); Cleveland State University, Cleveland, Ohio (DE); Cleveland Clinic, Concussion Center, Cleveland, Ohio (MS, SD, JLA); and Cleveland Clinic, Center for Neurologic Restoration, Cleveland, Ohio (JLA)
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Fonseca M, Gasparutto X, Grouvel G, Bonnefoy-Mazure A, Dumas R, Armand S. Evaluation of lower limb and pelvic marker placement precision among different evaluators and its impact on gait kinematics computed with the Conventional Gait Model. Gait Posture 2023; 104:22-30. [PMID: 37307761 DOI: 10.1016/j.gaitpost.2023.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/03/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Gait analysis relies on the accurate and precise identification of anatomical landmarks to provide reliable and reproducible data. More specifically, the precision of marker placement among repeated measurements is responsible for increased variability in the output gait data. RESEARCH QUESTION The objective of this study was to quantify the precision of marker placement on the lower limbs by a test-retest procedure and to investigate its propagation to kinematic data. METHODS The protocol was tested on a cohort of eight asymptomatic adults involving four evaluators, with different levels of experience. Each evaluator performed, three repeated marker placements for each participant. The standard deviation was used to calculate the precision of the marker placement, the precision of the orientation of the anatomical (segment) coordinate systems, and the precision of the lower limb kinematics. In addition, one-way ANOVA was used to compare the intra-evaluator marker placement precision and kinematic precisions among the different levels of the evaluator's experience. Finally, a Pearson correlation between marker placement precision and kinematic precision was analyzed. RESULTS Results have shown a precision of skin markers within 10 mm and 12 mm for intra-evaluator and inter-evaluator, respectively. Analysis of kinematic data showed good to moderate reliability for all parameters apart from hip and knee rotation that demonstrated poor intra- and inter-evaluator precision. Inter-trial variability was observed reduced than intra- and inter-evaluator variability. Moreover, experience had a positive impact on kinematic reliability since evaluators with higher experience showed a statistically significant increase in precision for most kinematic parameters. However, no correlation was observed between marker placement precision and kinematic precision which indicates that an error in the placement of one specific marker can be compensated or enhanced, in a non-linear way, by an error in the placement of other markers.
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Affiliation(s)
- Mickael Fonseca
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Switzerland; Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMRT_9406, F-69622 Lyon, France.
| | - Xavier Gasparutto
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Switzerland
| | - Gautier Grouvel
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Switzerland
| | - Alice Bonnefoy-Mazure
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Switzerland
| | - Raphaël Dumas
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMRT_9406, F-69622 Lyon, France
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Switzerland
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Wren TAL, Isakov P, Rethlefsen SA. Comparison of kinematics between Theia markerless and conventional marker-based gait analysis in clinical patients. Gait Posture 2023; 104:9-14. [PMID: 37285635 DOI: 10.1016/j.gaitpost.2023.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Markerless motion capture systems have the potential to make clinical gait analysis more efficient and convenient. Theia3D is a commercially available markerless system that may serve as an alternative to traditional gait analysis for clinical gait laboratories. RESEARCH QUESTION What is the concurrent validity of markerless gait analysis using Theia3D compared to traditional marker-based gait analysis in pediatric clinical gait patients? METHODS Thirty-six patients (20 male, age 2-25 years) with a range of diagnoses underwent clinical gait analysis with data being captured concurrently by a traditional marker-based motion capture system (Vicon Nexus) and a commercial markerless system (Theia3D). Multiple left strides were averaged for each subject, and the difference in kinematics (Theia - Vicon) was calculated over the gait cycle and evaluated using root mean square difference (RMSD), mean difference, and RMSD after subtracting the mean value across the gait cycle (RMSDoffset). Sub-analysis was performed for 25 patients with foot deformities, 9 wearing ankle-foot orthoses, and 6 walking with assistance (cane, crutches, walker, or handheld). RESULTS Kinematics showed similar patterns between the marker-based and markerless systems. RMSD was < 6° except for pelvic tilt, hip flexion, ankle inversion, foot progression, and transverse plane rotation of the hip, knee, and ankle. These measures mainly differed due to an offset between the curves. After adjusting for offsets, all RMSDoffset were < 6°. RMSD was larger for patients with foot deformities, wearing orthoses, or using assistive devices, but all RMSDoffset were still < 8°. In some cases, however, the markerless system had greater trial-to-trial variability, showed a larger knee varus "bump" in swing, or failed to track the subject. SIGNIFICANCE This study provides preliminary evidence of concurrent validity of Theia3D for pediatric patients with abnormal gait. However, some questions remain regarding identification of the knee axis and for patients with foot deformity or assistive devices.
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Affiliation(s)
- Tishya A L Wren
- Jackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, USA; Departments of Orthopaedic Surgery, Radiology, and Biomedical Engineering, University of Southern California, Los Angeles, USA.
| | - Pavel Isakov
- Jackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, USA
| | - Susan A Rethlefsen
- Jackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, USA
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Nijmeijer EM, Heuvelmans P, Bolt R, Gokeler A, Otten E, Benjaminse A. Concurrent validation of the Xsens IMU system of lower-body kinematics in jump-landing and change-of-direction tasks. J Biomech 2023; 154:111637. [PMID: 37210922 DOI: 10.1016/j.jbiomech.2023.111637] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/07/2023] [Accepted: 05/10/2023] [Indexed: 05/23/2023]
Abstract
Inertial measurement units (IMUs) allow for measurements of kinematic movements outside the laboratory, persevering the athlete-environment relationship. To use IMUs in a sport-specific setting, it is necessary to validate sport-specific movements. The aim of this study was to assess the concurrent validity of the Xsens IMU system by comparing it to the Vicon optoelectronic motion system for lower-limb joint angle measurements during jump-landing and change-of-direction tasks. Ten recreational athletes performed four tasks; single-leg hop and landing, running double-leg vertical jump landing, single-leg deceleration and push off, and sidestep cut, while kinematics were recorded by 17 IMUs (Xsens Technologies B.V.) and eight motion capture cameras (Vicon Motion Systems, Ltd). Validity of lower-body joint kinematics was assessed using measures of agreement (cross-correlation: XCORR) and error (root mean square deviation and amplitude difference). Excellent agreement was found in the sagittal plane for all joints and tasks (XCORR > 0.92). Highly variable agreement was found for knee and ankle in transverse and frontal plane. Relatively high error rates were found in all joints. In conclusion, this study shows that the Xsens IMU system provides highly comparable waveforms of sagittal lower-body joint kinematics in sport-specific movements. Caution is advised interpreting frontal and transverse plane kinematics as between-system agreement highly varied.
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Affiliation(s)
- Eline M Nijmeijer
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Pieter Heuvelmans
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Paderborn University, Germany
| | - Ruben Bolt
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Alli Gokeler
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Paderborn University, Germany; Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center Amsterdam, the Netherlands; Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Egbert Otten
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Anne Benjaminse
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands; School of Sport Studies, Hanze University Groningen, The Netherlands.
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Welke B, Hurschler C, Schwarze M, Jakubowitz E, Aschoff HH, Örgel M. Comparison of conventional socket attachment and bone-anchored prosthesis for persons living with transfemoral amputation - mobility and quality of life. Clin Biomech (Bristol, Avon) 2023; 105:105954. [PMID: 37075546 DOI: 10.1016/j.clinbiomech.2023.105954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND For patients with transfemoral amputation experiencing issues with their sockets, bone-anchored prosthesis systems are an alternative and sometimes the only way to be mobile and independent. The present cross-sectional study aimed to investigate the gait performance and quality of life of a group of patients treated with bone-anchored systems compared to those of participants treated with a conventional socket-suspended prosthesis. METHODS A total of 17 participants with a socket-suspended and 20 with a bone-anchored prosthesis were included. Gait patterns were examined for symmetry, and performance was assessed using the six-minute walk test and the timed "Up & Go" test. Magnetic resonance imaging was performed to detect signs of osteoarthritis in both hips. Mobility in everyday life and quality of life were assessed using questionnaires. FINDINGS There were no differences between the groups regarding the quality of life, daily mobility, and gait performance. The step width was significantly higher for the patients using socket-suspended prosthesis. The socket-suspended group showed a significant asymmetry regarding the step length. In the socket-suspended group, the prosthetic leg showed significantly higher cartilage abrasion than the contralateral leg did. INTERPRETATION Large differences in the measured outcomes in both groups illustrate the very different capabilities of the individual participants, which is apparently not primarily determined by the type of treatment. For patients who are satisfied with the socket treatment and perform well, bone-anchored prosthesis systems may not necessarily improve their functional capabilities and perceived quality of life.
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Affiliation(s)
- Bastian Welke
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedics, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
| | - Christof Hurschler
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedics, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
| | - Michael Schwarze
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedics, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
| | - Eike Jakubowitz
- Laboratory for Biomechanics and Biomaterials, Department of Orthopaedics, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
| | - Horst-Heinrich Aschoff
- Department of Trauma, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
| | - Marcus Örgel
- Department of Trauma, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
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Couto AGB, Vaz MAP, Pinho L, Félix J, Moreira J, Pinho F, Mesquita IA, Montes AM, Crasto C, Sousa ASP. Repeatability and Temporal Consistency of Lower Limb Biomechanical Variables Expressing Interlimb Coordination during the Double-Support Phase in People with and without Stroke Sequelae. SENSORS (BASEL, SWITZERLAND) 2023; 23:2526. [PMID: 36904730 PMCID: PMC10007500 DOI: 10.3390/s23052526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/08/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Reliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.
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Affiliation(s)
- Ana G. B. Couto
- Department of Physiotherapy, Santa Maria Health School, 4049-024 Porto, Portugal
- Centre for Rehabilitation Research (CIR), School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Research Centre and Projects (NIP), Santa Maria Health School, 4049-024 Porto, Portugal
| | - Mário A. P. Vaz
- Institute of Mechanical Engineering and Industrial Management, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal
| | - Liliana Pinho
- Centre for Rehabilitation Research (CIR), School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- College of Health Sciences—Escola Superior de Saúde do Vale do Ave, Cooperative for Higher, Polytechnic and University Education, 4760-409 Vila Nova de Famalicão, Portugal
- Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - José Félix
- Centre for Rehabilitation Research (CIR), School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Department of Physics, School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Juliana Moreira
- Centre for Rehabilitation Research (CIR), School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Department of Physiotherapy, School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Francisco Pinho
- College of Health Sciences—Escola Superior de Saúde do Vale do Ave, Cooperative for Higher, Polytechnic and University Education, 4760-409 Vila Nova de Famalicão, Portugal
- Human Movement Unit (H2M), Cooperative for Higher, Polytechnic and University Education, 4760-409 Vila Nova de Famalicão, Portugal
| | - Inês Albuquerque Mesquita
- Centre for Rehabilitation Research (CIR), School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Research Centre and Projects (NIP), Santa Maria Health School, 4049-024 Porto, Portugal
- Department of Functional Sciences, School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - António Mesquita Montes
- Department of Physiotherapy, Santa Maria Health School, 4049-024 Porto, Portugal
- Research Centre and Projects (NIP), Santa Maria Health School, 4049-024 Porto, Portugal
- Department of Physiotherapy, School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Carlos Crasto
- Department of Physiotherapy, Santa Maria Health School, 4049-024 Porto, Portugal
- Research Centre and Projects (NIP), Santa Maria Health School, 4049-024 Porto, Portugal
- Department of Physiotherapy, School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
| | - Andreia S. P. Sousa
- Department of Physiotherapy, School of Health of Polytechnic Institute of Porto, 4200-072 Porto, Portugal
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Kerver N, Schuurmans V, van der Sluis CK, Bongers RM. The multi-grip and standard myoelectric hand prosthesis compared: does the multi-grip hand live up to its promise? J Neuroeng Rehabil 2023; 20:22. [PMID: 36793049 PMCID: PMC9930076 DOI: 10.1186/s12984-023-01131-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/07/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Multi-grip myoelectric hand prostheses (MHPs), with five movable and jointed fingers, have been developed to increase functionality. However, literature comparing MHPs with standard myoelectric hand prostheses (SHPs) is limited and inconclusive. To establish whether MHPs increase functionality, we compared MHPs with SHPs on all categories of the International Classification of Functioning, Disability, and Health-model (ICF-model). METHODS MHP users (N = 14, 64.3% male, mean age = 48.6 years) performed physical measurements (i.e., Refined Clothespin Relocation Test (RCRT), Tray-test, Box and Blocks Test, Southampton Hand Assessment Procedure) with their MHP and an SHP to compare the joint angle coordination and functionality related to the ICF-categories 'Body Function' and 'Activities' (within-group comparisons). SHP users (N = 19, 68.4% male, mean age = 58.1 years) and MHP users completed questionnaires/scales (i.e., Orthotics and Prosthetics Users' Survey-The Upper Extremity Functional Status Survey /OPUS-UEFS, Trinity Amputation and Prosthesis Experience Scales for upper extremity/TAPES-Upper, Research and Development-36/RAND-36, EQ-5D-5L, visual analogue scale/VAS, the Dutch version of the Quebec User Evaluation of Satisfaction with assistive technology/D-Quest, patient-reported outcome measure to assess the preferred usage features of upper limb prostheses/PUF-ULP) to compare user experiences and quality of life in the ICF-categories 'Activities', 'Participation', and 'Environmental Factors' (between-group comparisons). RESULTS 'Body Function' and 'Activities': nearly all users of MHPs had similar joint angle coordination patterns with an MHP as when they used an SHP. The RCRT in the upward direction was performed slower in the MHP condition compared to the SHP condition. No other differences in functionality were found. 'Participation': MHP users had a lower EQ-5D-5L utility score; experienced more pain or limitations due to pain (i.e., measured with the RAND-36). 'Environmental Factors': MHPs scored better than SHPs on the VAS-item holding/shaking hands. The SHP scored better than the MHP on five VAS-items (i.e., noise, grip force, vulnerability, putting clothes on, physical effort to control) and the PUF-ULP. CONCLUSION MHPs did not show relevant differences in outcomes compared to SHPs on any of the ICF-categories. This underlines the importance of carefully considering whether the MHP is the most suitable option for an individual taking into account the additional costs of MHPs.
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Affiliation(s)
- Nienke Kerver
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Verena Schuurmans
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Corry K. van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Raoul M. Bongers
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Di Paolo S, Nijmeijer EM, Bragonzoni L, Gokeler A, Benjaminse A. Definition of High-Risk Motion Patterns for Female ACL Injury Based on Football-Specific Field Data: A Wearable Sensors Plus Data Mining Approach. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23042176. [PMID: 36850776 PMCID: PMC9961558 DOI: 10.3390/s23042176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 05/30/2023]
Abstract
The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.
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Affiliation(s)
- Stefano Di Paolo
- Department for Life Quality Studies, University of Bologna, 40136 Bologna, Italy
| | - Eline M. Nijmeijer
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Laura Bragonzoni
- Department for Life Quality Studies, University of Bologna, 40136 Bologna, Italy
| | - Alli Gokeler
- Exercise and Neuroscience Unit, Department Exercise & Health, Faculty of Science, University of Paderborn, 33098 Paderborn, Germany
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center, 1081 HZ Amsterdam, The Netherlands
- Faculty of Health, Amsterdam University of Applied Sciences, 1091 GC Amsterdam, The Netherlands
| | - Anne Benjaminse
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
- School of Sport Studies, Hanze University Groningen, 9747 AS Groningen, The Netherlands
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50
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Okahisa T, Matsuura T, Tomonari K, Komatsu K, Yokoyama K, Iwase J, Yamada M, Sairyo K. Between-day reliability and minimum detectable change of the Conventional Gait Model 2 and Plug-in Gait Model during running. Gait Posture 2023; 100:171-178. [PMID: 36563589 DOI: 10.1016/j.gaitpost.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The Plug-in Gait model (PiG) is commonly used in 3D motion analysis but has limited reliability. Although an improved version of PiG has been developed, called the Conventional Gait Model 2 (CGM2), there is limited evidence on its between-day reliability for running. RESEARCH QUESTION What is the between-day intraclass correlation coefficient (ICC3,k) and minimum detectable change (MDC) of lower limb kinematics and kinetics for CGM2 during running and does reliability differ between CGM2 and PiG. METHODS Twenty-three healthy participants performed running at a comfortable speed in two identical test sessions at least 5 days apart. Lower limb kinematic and kinetic data in the three planes of motion were calculated using CGM2 and PiG. The ICC and MDC were calculated for the kinematic and kinetic parameters at initial contact and peak during the stance phase of running. RESULTS CGM2 kinematics showed good-to-excellent reliability (ICC: 0.75-0.93), except for hip extension and ankle internal rotation, and less than 5° MDC (1.8°-4.9°) of the coronal and sagittal planes, except for hip extension. PiG showed poor-to-moderate reliability (ICC: -0.15 to 0.72) in the coronal and transverse planes and greater than 5° MDC (5.0°-21.8°), except for knee extension, adduction, and ankle dorsiflexion. CGM2 showed good-to-excellent reliability for peak kinetics (ICC: 0.75-0.97), except for hip internal rotation and knee extension. The ICC and MDC were higher for CGM2 than PiG, with significant differences in the coronal plane of the hip and knee joints and transverse plane of the hip joint in kinematics and in the sagittal and coronal plane of the hip and knee joints in kinetics. SIGNIFICANCE The between-day reliability of CGM2 was mostly good to excellent for lower limb kinematics and kinetics during running. We believe that CGM2 can more accurately assess kinematic differences between the coronal and transverse planes than the PiG.
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Affiliation(s)
- Tetsuya Okahisa
- Division of Rehabilitation, Tokushima University Hospital, Tokushima, Japan
| | - Tetsuya Matsuura
- Department of Rehabilitation, Tokushima University Hospital, Tokushima, Japan.
| | - Ken Tomonari
- Division of Rehabilitation, Tokushima University Hospital, Tokushima, Japan
| | - Kouji Komatsu
- Division of Rehabilitation, Tokushima University Hospital, Tokushima, Japan
| | - Kenji Yokoyama
- Department of Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Joji Iwase
- Department of Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Megumi Yamada
- Division of Rehabilitation, Tokushima University Hospital, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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