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Oliveira LKR, Marques AP, Andrade KFA, Assis JCSD, Brito AL, Souza GS, Callegari B. Virtual Reality in Improving Anticipatory Postural Adjustments to Step Initiation in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial. Games Health J 2024; 13:100-108. [PMID: 38436585 DOI: 10.1089/g4h.2023.0154] [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] [Indexed: 03/05/2024] Open
Abstract
Background: Virtual reality (VR) has been suggested as a new therapeutic approach in various sectors of rehabilitation, including the treatment of patients with knee osteoarthritis (OA), and one of its treatment goals is to improve the gait pattern and walking ability of patients. Objective: This study aimed to evaluate if VR, along with conventional physiotherapy treatment (CT), has superior effects to kinesiotherapy alone on pain, physical capacity, balance, and the parameters of anticipatory postural adjustments (APAs) in patients with knee OA. Design: This study is a single-blind randomized controlled trial. Setting: Secondary care at Hospital SARAH Network of Rehabilitation Hospitals, Brazil. Participants: Forty participants (31 women and 9 men) with knee OA in at least one knee and able to ambulate independently. Intervention: A rehabilitation program (8 consecutive weeks, 50-minute session, twice a week). Patients were randomized into the intervention groups CT or VR. Main Outcome Measures: Primary-latency of APA, amplitude of APA, and time to reach the maximum acceleration amplitude. Secondary-balance control by Mini-Balance Evaluation Systems Test, pain, and physical capacity by Western Ontario and McMaster Universities Arthritis Index. Results: The results of the study showed that conventional treatment significantly improved pain intensity, physical capacity, and balance in individuals with knee OA; however, only the group that used VR showed improvement in the APA parameters. Conclusion: This study demonstrated that VR associated with conventional treatment improved APAs in patients with knee OA.
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Affiliation(s)
- Luana Karine Resende Oliveira
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- SARAH Network of Rehabilitation Hospitals, Brasília, Distrito Federal, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Amélia Pasqual Marques
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Jéssica Cristina Santos de Assis
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Aymee Lobato Brito
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Givago Silva Souza
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Bianca Callegari
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
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Kong L, Zhang Z, Bao J, Zhu X, Tan Y, Xia X, Zhang Q, Hao Y. Influences of cognitive load on center of pressure trajectory of young male adults with excess weight during gait initiation. Front Bioeng Biotechnol 2024; 11:1297068. [PMID: 38249798 PMCID: PMC10796550 DOI: 10.3389/fbioe.2023.1297068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Falls and fall-related injuries in young male adults with excess weight are closely related to an increased cognitive load. Previous research mainly focuses on analyzing the postural control status of these populations performing cognitive tasks while stabilized walking progress but overlooked a specific period of walking known as gait initiation (GI). It is yet unknown the influences of cognitive load on this population's postural control status during GI. Objective: This study aimed to determine the influences of cognitive load on the center of pressure (CoP) trajectory of young male adults with excess weight during GI. Design: A controlled laboratory study. Methods: Thirty-six male undergraduate students were recruited and divided into normal-weight, overweight, and obese groups based on their body mass index (BMI). Participants' CoP parameters during GI under single and dual-task conditions were collected by two force platforms. A mixed ANOVA was utilized to detect significant differences. Results: Compared with the normal-weight group, the obese group showed significant changes in the duration and CoP parameters during sub-phases of GI, mainly reflecting prolonged duration, increased CoP path length, higher mediolateral CoP displacement amplitude, and decreased velocity of anteroposterior CoP displacement. During GI with 1-back task, significantly increased mediolateral CoP displacement amplitude occurred in the obese group. During GI with 2-back task, the obese group had increased CoP path length, higher mediolateral CoP displacement amplitude, as well as a decreased velocity of CoP displacement. Conclusion: Based on the changes in CoP parameters during GI with cognitive tasks, young male adults with excess weight, mainly obese ones, have compromised postural stability. During GI with a difficult cognitive task, obese young male adults are more susceptible to deterioration in their lateral postural balance. These findings indicate that the increased cognitive load could exacerbate obese young male adults' postural control difficulty during GI under dual-task conditions, putting them at a higher risk of experiencing incidents of falls. Based on these findings, we offer suggestions for therapists to intervene with these young male adults to ensure their safety of GI.
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Affiliation(s)
- Lingyu Kong
- School of Physical Education, Soochow University, Suzhou, China
| | - Zhiqi Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Jiawei Bao
- School of Mathematical Sciences, Soochow University, Suzhou, China
| | - Xinrui Zhu
- Rehabilitation Medicine Department, Xuzhou Rehabilitation Hospital, Xuzhou, China
| | - Yong Tan
- School of Physical Education, Soochow University, Suzhou, China
| | - Xihao Xia
- Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Qiuxia Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
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Moisan G, Robb K, Mainville C, Blanchette V. Effects of foot orthoses on the biomechanics of the lower extremities in adults with and without musculoskeletal disorders during functional tasks: A systematic review. Clin Biomech (Bristol, Avon) 2022; 95:105641. [PMID: 35429692 DOI: 10.1016/j.clinbiomech.2022.105641] [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: 12/14/2021] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Foot orthoses are among the most commonly used external supports to treat musculoskeletal disorders. It remains unclear how they change the biomechanics of the lower extremities during functional tasks. This systematic review aimed to determine the effects of foot orthoses on primary outcomes (i.e., kinematics, kinetics and electromyography of the lower extremities) in adults with and without musculoskeletal disorders during functional tasks. METHODS A literature search was conducted for articles published from inception to June 2021 in Medline, CINAHL, SPORTDiscus, Cochrane libraries and PEDro electronic databases. Two investigators independently assessed the titles and abstracts of retrieved articles based on the inclusion criteria. Of the 5578 citations, 24 studies were included in the qualitative synthesis as they reported the effects of foot orthoses on the primary outcomes. Risk of bias of included studies was determined using the modified Downs and Black Quality Index. FINDINGS During low impact tasks, foot orthoses decrease ankle inversion and increase midfoot plantar forces and pressure. During higher impact tasks, foot orthoses had little effects on electromyography and kinematics of the lower extremities but decreased ankle inversion moments. INTERPRETATION Even though the effects of foot orthoses on the biomechanics of the lower extremities seem task-dependent, foot orthoses mainly affected the biomechanics of the distal segments during most tasks. However, few studies determined their effects on the biomechanics of the foot. It remains unclear to what extent foot orthoses features induce different biomechanical effects and if foot orthoses effects change for different populations.
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Affiliation(s)
- Gabriel Moisan
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.
| | - Kelly Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Canada 75 University Ave., West Waterloo, ON N2L 3C5, Canada.
| | - Camille Mainville
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada.
| | - Virginie Blanchette
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Canada 3351 Boul des Forges, Trois-Rivières, PQ G9A 5H7, Canada; Groupe Interdisciplinaire de Recherche Appliquée en Santé (GIRAS), Université du Québec à Trois-Rivières, Trois-Rivières, PQ, Canada.
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Sabashi K, Ishida T, Matsumoto H, Mikami K, Chiba T, Yamanaka M, Aoki Y, Tohyama H. Dynamic postural control correlates with activities of daily living and quality of life in patients with knee osteoarthritis. BMC Musculoskelet Disord 2021; 22:287. [PMID: 33736640 PMCID: PMC7977169 DOI: 10.1186/s12891-021-04164-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/10/2021] [Indexed: 01/06/2023] Open
Abstract
Background Knee osteoarthritis (OA) negatively affects dynamic postural control, which is a basic function that individuals use to perform activities of daily living (ADL). The purpose of this study was to investigate the associations of center of pressure (COP) control during the transition from double-leg to single-leg standing with subjective assessments of ADL and quality of life (QOL) in patients with knee OA. Methods Thirty-six patients (29 females) with moderate-to-severe knee OA participated. Dynamic postural control was evaluated during the transition from double-leg to single-leg standing. Each patient stood on a force plate, lifted the less affected limb as fast as possible, and maintained single-leg standing with the more affected limb. The COP movements corresponding to anticipatory postural adjustment (APA) and transitional phases were assessed. The maximum displacement and peak velocity of the COP movements in the medial–lateral direction were calculated. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used for the subjective assessment of ADL and QOL. Pearson’s product correlation analysis was performed to investigate the associations of COP movements in the APA and transitional phases with KOOS-ADL and KOOS-QOL. Results In the APA phase, the maximum COP displacement was significantly correlated with KOOS-ADL (r = -0.353, P = 0.035) and KOOS-QOL (r = -0.379, P = 0.023). In the transitional phase, the maximum COP displacement and peak COP velocity were significantly correlated with KOOS-ADL (maximum displacement: r = 0.352, P = 0.035; peak velocity: r = 0.438, P = 0.008) and with KOOS-QOL (maximum displacement: r = 0.357, P = 0.032; peak velocity: r = 0.343, P = 0.040). Conclusions The present study showed that smaller COP movements in the APA phase and smaller and slower COP movements in the transitional phase correlated with poorer ADL and QOL conditions in patients with knee OA. These findings suggest that poor dynamic postural control is associated with poor ADL and QOL conditions in patients with moderate-to-severe medial knee OA. Conservative treatment for patients with knee OA may need to focus on dynamic postural control during the transition from double-leg to single-leg standing.
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Affiliation(s)
- Kento Sabashi
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, 060-0812, Sapporo, Japan.,Department of Rehabilitation, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, 060-8648, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, 060-0812, Sapporo, Japan.
| | - Hisashi Matsumoto
- Department of Rehabilitation, Hokushin Orthopaedic Hospital, 1-5, Kita 8, Higashi 4, Higashi- ku, 060-0908, Sapporo, Japan
| | - Kentaro Mikami
- Department of Rehabilitation, Hokushin Orthopaedic Hospital, 1-5, Kita 8, Higashi 4, Higashi- ku, 060-0908, Sapporo, Japan
| | - Takeshi Chiba
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, 060-0812, Sapporo, Japan.,Department of Rehabilitation, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, 060-8648, Sapporo, Japan
| | - Masanori Yamanaka
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Satomi 2-10, 066-0055, Chitose, Japan
| | - Yoshimitsu Aoki
- Department of Orthopaedic Surgery, Hokushin Orthopaedic Hospital, 1-5, Kita 8, Higashi 4, Higashi-ku, 060-0908, Sapporo, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, 060-0812, Sapporo, Japan
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