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Wearing SC, Jones B, Horstmann T, Robertson A. A Method-Comparison Study Highlighting the Disparity between Osseous- and Skin-Based Measures of Foot Mobility. Med Sci Sports Exerc 2024; 56:737-744. [PMID: 37908026 DOI: 10.1249/mss.0000000000003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE This study examined the validity of standard clinical measures of arch height mobility, midfoot width mobility (MWM), and foot mobility magnitude (FMM) relative to skin-based and osseous measures derived from radiographs. METHODS Skin-based clinical indices of foot mobility were calculated from standard, caliper-based measures of foot length, midfoot width, and dorsal arch height of the left limb of 20 healthy participants (8-71 yr) during non-weight-bearing and weight-bearing. Skin-based radiographic and osseous indices were derived from concurrent anteroposterior and lateral radiographs. Agreement between skin-based clinical and skin-based radiographic measures of foot mobility with those of osseous measures was investigated using the Bland and Altman approach. RESULTS Foot mobility indices derived from clinical measures were significantly higher (20%-50%) than skin-based radiographic measures ( P < 0.01), which were, in turn, significantly higher (200%-250%) than osseous measures ( P < 0.01). Clinical measures demonstrated significant levels of proportional bias compared with radiographic measures of foot mobility ( P < 0.01). The contribution of osseous movement to skin-based clinical measures of mobility was highly variable between individuals, ranging between 19% and 81% for arch height mobility, between 4% and 87% for MWM, and between 14% and 75% for FMM. The limits of tolerance for clinical measures of foot mobility ranged from ±3.2 mm for MWM to ±6.6 mm for measures of FMM. The limits of tolerance for skin-based clinical and skin-based radiographic measures were generally larger than osseous movement with weight-bearing. CONCLUSIONS Skin-based measures of foot mobility, whether clinical or radiographic methods, are not interchangeable and are poor indicators of osseous mobility. Although further research regarding the utility of osseous measures is warranted, these findings strongly caution against the use of skin-based clinical measures of foot mobility in clinical and research settings.
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Affiliation(s)
- Scott C Wearing
- Conservative and Rehabilitative Orthopaedics, Department of Sports and Health Sciences, Technical University of Munich, Munich, GERMANY
| | - Brendan Jones
- Brisbane Private Imaging and Royal Brisbane and Women's Hospital Radiology Department, Brisbane, AUSTRALIA
| | - Thomas Horstmann
- Conservative and Rehabilitative Orthopaedics, Department of Sports and Health Sciences, Technical University of Munich, Munich, GERMANY
| | - Aaron Robertson
- Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, AUSTRALIA
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Gabriel A, Konrad A, Herold N, Horstmann T, Schleip R, Paternoster FK. Testing the Posterior Chain: Diagnostic Accuracy of the Bunkie Test versus the Isokinetic Hamstrings/Quadriceps Measurement in Patients with Self-Reported Knee Pain and Healthy Controls. J Clin Med 2024; 13:1011. [PMID: 38398324 PMCID: PMC10889369 DOI: 10.3390/jcm13041011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/18/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: The isokinetic measurement (IM) of the leg muscles is well established but costly, whereas the Bunkie Test (BT) is a rarely investigated but easy-to-conduct functional test to evaluate the total posterior chain. Although the tests differ in aim and test structures, both have their justification in the assessment process. Therefore, this study evaluated the diagnostic accuracy of the BT and the IM. (2) Methods: 21 participants (9 female, 12 male; age, 26.2 ± 5.26 years; weight 73.8 ± 14.6 kg; height 176.0 ± 9.91 cm) and 21 patients (9 female, 12 male; age, 26.5 ± 5.56 years; weight, 72.6 ± 16.9 kg; height 177.0 ± 10.1 cm) with self-reported pain in the knee performed the IM and the BT. For IM, we calculated the ratio of the knee mean flexor/extensor peak torque (H/Q ratio) for 60°/s and 120°/s, and BT performance was measured in seconds. We classified the IM (<0.6 H/Q ratio) and the BT (leg difference ≥4 s) as binary results according to the literature. We calculated the sensitivity and specificity, which we compared with the Chi-Square test, and the 95% confidence intervals (CI). A p-value of ≤0.05 is considered significant. (3) Results: The sensitivity for the BT was 0.89, 95% CI [0.67, 0.99], and the specificity was 0.52 [0.30, 0.74]. For the IM, the sensitivity was 0.14 [0.03, 0.36] for 60°/s and 0.05 [0.00, 0.24] for 120°/s, and the specificity was 0.70 [0.46, 0.88] for 60°/s and 0.90 [0.68, 0.99] for 120°/s. The results of the Chi-Square tests were significant for the BT (χ2 (1) = 6.17, p = 0.01) but not for the IM (60°/s: χ2 (1) = 0.70, p = 0.40; 120°/s: χ2 (1) = 0.00, p = 0.97). (4) Conclusions: Patients were more likely to obtain a positive test result for the BT but not for the IM.
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Affiliation(s)
- Anna Gabriel
- Department of Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany; (A.G.); (R.S.)
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, 8010 Graz, Austria
| | - Nadine Herold
- Department Sport and Health Sciences, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany;
| | - Thomas Horstmann
- Department of Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany; (A.G.); (R.S.)
| | - Robert Schleip
- Department of Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany; (A.G.); (R.S.)
- Department of Medical Professions, Diploma University of Applied Sciences, 37242 Bad Sooden-Allendorf, Germany
| | - Florian K. Paternoster
- Department of Biomechanics in Sports, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany;
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Gras N, Brauner T, Wearing S, Horstmann T. Do increasingly unstable balance devices provide a graded challenge to bipedal stance in total hip arthroplasty patients? Gait Posture 2024; 108:9-14. [PMID: 37976606 DOI: 10.1016/j.gaitpost.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 09/06/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Progressive balance exercises are critical to early functional rehabilitation after total hip arthroplasty (THA) but little is known regarding the challenge imposed by common balance devices. RESEARCH QUESTION Do progressively unstable balance devices provide a graded challenge to bipedal stance during early functional rehabilitation in THA patients? METHODS Postural control was evaluated in 42 patients (age, 63.7 ± 9.6 years; height, 1.72 ± 0.08 m and body mass, 78.9 ± 14.6 kg) approximately 3 weeks (23 ± 6 days) following unilateral primary THA. Patients were divided into two groups, based on their ability to complete a 20-second unipedal stance test (UPST) on the operated limb. A lumbar mounted inertial sensor monitored center of mass (COM) displacement during bipedal balance conditions involving three balance pads of progressive stiffness and an oscillatory platform, used in isolation and in combination with the most stable balance pad. COM displacement was normalised to bipedal stance on a hard surface. Differences between conditions and patient groups were assessed using a mixed-model analysis of variance. RESULTS Twenty patients (48%) were able to complete the UPST on their operated limb. There was a significant effect of balance condition on COM displacement during bipedal stance (F4,160 = 82.6, p < .01). COM displacement was lowest for the oscillatory platform but increased non-linearly across the three balance pads (p < .05). There was no significant difference in COM displacement between THA patients able and unable to complete the UPST. SIGNIFICANCE Increasingly compliant balance pads provided a progressive, though nonlinear, challenge to bipedal balance control in THA patients that was greater than that of an oscillating platform and independent of the ability to stand independently on the operated limb. These findings serve as a guide for the design of progressive training programs that enhance balance in THA patients.
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Affiliation(s)
- Nina Gras
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.
| | - Torsten Brauner
- Department of Sport Science, Germany University of Health & Sport, Ismaning, Germany
| | - Scott Wearing
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany
| | - Thomas Horstmann
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany
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Byrnes SK, Holder J, Stief F, Wearing S, Böhm H, Dussa CU, Horstmann T. Frontal plane knee moment in clinical gait analysis: A systematic review on the effect of kinematic gait changes. Gait Posture 2022; 98:39-48. [PMID: 36049417 DOI: 10.1016/j.gaitpost.2022.07.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The frontal plane knee moment (KAM1 and KAM2) derived from non-invasive three-dimensional gait analysis is a surrogate measure for knee joint load and of great interest in clinical and research settings. Many aspects can influence this measure either unintentionally or purposely in order to reduce the knee joint load to relieve symptoms and pain. All these aspects must be known when conducting a study or interpreting gait data for clinical decision-making. METHODS This systematic review was registered with PROSPERO (CRD42020187038). Pubmed and Web of Science were searched for peer-reviewed, original research articles in which unshod three-dimensional gait analysis was undertaken and KAM1 and KAM2 were included as an outcome variable. Two reviewers independently screened articles for inclusion, extracted data and performed a methodological quality assessment using Downs and Black checklist. RESULTS In total, 42 studies were included. Based on the independent variable investigated, these studies were divided into three groups: 1) gait modifications, 2) individual characteristics and 3) idiopathic orthopedic deformities. Among others, fast walking speeds (1) were found to increase KAM1; There were no sex-related differences (2) and genu valgum (3) reduces KAM1 and KAM2. CONCLUSION While consistent use of terminology and reporting of KAM is required for meta-analysis, this review indicates that gait modifications (speed, trunk lean, step width), individual characteristics (body weight, age) and idiopathic orthopedic deformities (femoral or tibial torsion, genu valgum/varum) influence KAM magnitudes during walking. These factors should be considered by researchers when designing studies (especially of longitudinal design) or by clinicians when interpreting data for surgical and therapeutic decision-making.
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Affiliation(s)
- S Kimberly Byrnes
- Orthopedic Children's Hospital, Kind im Zentrum - Chiemgau, Aschau, Germany; Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany.
| | - Jana Holder
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Frankfurt am Main, Germany; Faculty of Medicine, Goethe University, Frankfurt am Main, Germany
| | - Felix Stief
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Frankfurt am Main, Germany; Faculty of Medicine, Goethe University, Frankfurt am Main, Germany
| | - Scott Wearing
- Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany
| | - Harald Böhm
- Orthopedic Children's Hospital, Kind im Zentrum - Chiemgau, Aschau, Germany
| | | | - Thomas Horstmann
- Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany; Medical Park St. Hubertus Klinik, Bad Wiessee, Germany
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Gabriel A, Paternoster FK, Konrad A, Horstmann T, Pohl T. Comparison between the Original- and a Standardized Version of a Physical Assessment Test for the Dorsal Chain - A Cohort-Based Cross Sectional Study. J Sports Sci Med 2022; 21:182-190. [PMID: 35719223 PMCID: PMC9157515 DOI: 10.52082/jssm.2022.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/17/2022] [Indexed: 11/24/2022]
Abstract
This cohort-based cross-sectional study compares the original (OV) and a newly developed standardized version (SV) of the Bunkie Test, a physical test used to assess the dorsal chain muscles. Twenty-three participants (13 females, 10 males; median age of 26 ± 3 years) performed the test, a reverse plank, with one foot on a stool and the contralateral leg lifted. In the SV, the position of the pelvis and the foot were predefined. The test performance time (s) and surface electromyography (sEMG) signals of the dorsal chain muscles were recorded. We performed a median power frequency (MPF) analysis, using short-time Fourier transformation, and calculated the MPF/time linear regression slope. We compared the slopes of the linear regression analysis (between legs) and the performance times (between the OV and SV) with the Wilcoxon test. Performance times did not differ between SV and OV for either the dominant (p = 0.28) or non-dominant leg (p = 0.08). Linear regression analysis revealed a negative slope for the muscles of the tested leg and contralateral erector spinae, with a significant difference between the biceps femoris of the tested (-0.91 ± 1.08) and contralateral leg (0.01 ± 1.62) in the SV (p = 0.004). The sEMG showed a clearer pattern in the SV than in the OV. Hence, we recommend using the SV to assess the structures of the dorsal chain of the tested leg and contralateral back.
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Affiliation(s)
- Anna Gabriel
- Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany, Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg Brauchle-Ring 60/62, 80992 Munich, Germany
| | | | - Andreas Konrad
- Biomechanics in Sports, Technical University of Munich, Munich, Germany, Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria
| | - Thomas Horstmann
- Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany
| | - Torsten Pohl
- Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany
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Gabriel A, Konrad A, Roidl A, Queisser J, Schleip R, Horstmann T, Pohl T. Myofascial Treatment Techniques on the Plantar Surface Influence Functional Performance in the Dorsal Kinetic Chain. J Sports Sci Med 2022; 21:13-22. [PMID: 35250329 PMCID: PMC8851122 DOI: 10.52082/jssm.2022.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/19/2021] [Indexed: 12/30/2022]
Abstract
Prior studies have shown that self- and manual massage (SMM) increases flexibility in non-adjacent body areas. It is unclear whether this also influences performance in terms of force generation. Therefore, this study investigated the effect of SMM on the plantar surface on performance in the dorsal kinetic chain. Seventeen young participants took part in this within-subject non-randomized controlled study. SMM was applied on the plantar surface of the dominant leg, but not on the non-dominant leg. A functional performance test of the dorsal kinetic chain, the Bunkie Test, was conducted before and after the intervention. We measured the performance in seconds for the so-called posterior power line (PPL) and the posterior stabilizing line (PSL). The performance of the dominant leg in the Bunkie Test decreased significantly by 17.2% from (mean ± SD) 33.1 ± 9.9 s to 27.4 ± 11.1 s for the PPL and by 16.3% from 27.6 ± 9.8 s to 23.1 ± 11.7 s for the PSL. This is in contrast to the non-dominant leg where performance increased significantly by 5.1% from 29.7 ± 9.6 s to 31.1 ± 8.9 s for the PPL and by 3.1% from 25.7 ± 1.5 s to 26.5 ± 1.7 s for the PSL. SMM interventions on the plantar surface might influence the performance in the dorsal kinetic chain.
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Affiliation(s)
- Anna Gabriel
- Technical University of Munich, Munich, Germany, Associate Professorship for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg Brauchle-Ring 60/62, 80992 Munich, Germany
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Austria
| | - Anna Roidl
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | | | - Robert Schleip
- Technical University of Munich, Munich, Germany,Diploma University of Applied Sciences, Germany, Department of Sports Medicine and Health Promotion, Friedrich Schiller University, Germany
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Byrnes SK, Wearing S, Böhm H, Dussa CU, Horstmann T. Effects of idiopathic flatfoot deformity on knee adduction moments during walking. Gait Posture 2021; 84:280-286. [PMID: 33418453 DOI: 10.1016/j.gaitpost.2020.12.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/15/2020] [Accepted: 12/19/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Flatfoot deformity is commonly characterized by a subtalar valgus, a low medial longitudinal arch, and abduction of the forefoot. Although flatfoot deformity has been associated with lower first (KAM1) and second (KAM2) peak knee adduction moments during walking, the biomechanical connection remains unknown. RESEARCH QUESTION We hypothesized that hindfoot eversion, lateral calcaneal shift correlate with KAM1 and forefoot abduction and arch height with KAM2, due to the lateralization of the ground reaction force vector resulting from shifted heel and forefoot in flatfoot deformity. METHODS Gait data from 103 children with flatfoot deformity who underwent three-dimensional gait analysis with the Oxford Foot Model were retrospectively included. Children with knee varus/valgus, in- and out-toeing were excluded. Fifteen healthy children with a rectus foot type were also collected from the database. Lateral calcaneal shift was defined as the distance between the projection of the ankle joint center onto the calcaneal axis and the midpoint of the calcaneal axis formed by the medial and lateral calcaneal markers. A subgroup of children with idiopathic flatfoot deformity that had received corrective surgery was also identified. Statistical analysis included Pearson's correlations and independent and paired t-tests (α < .05). RESULTS When compared to a norm cohort, flatfooted children had significant lower KAM1 and KAM2 (t-test, P < .001). Lateral calcaneal shift correlated with KAM1 and KAM2 (r = 0.42, p < .001 and r = 0.32, P < .001, respectively). Arch height correlated with KAM2 (r = 0.23, p = 0.017). KAM1 and KAM2 normalized after surgery and the change in KAM1 correlated with the change in lateral calcaneal shift for children who underwent corrective surgery. SIGNIFICANCE Lateral calcaneal shift explains the reduction of KAM1 by lateralization of the point of force application in flatfooted children. It is recommended to consider the lateral calcaneal shift when investigating KAM in gait analysis research.
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Affiliation(s)
- S Kimberly Byrnes
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Germany; Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany.
| | - Scott Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; Medical Park St. Hubertus Klinik, Bad Wiessee, Germany
| | - Harald Böhm
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Germany
| | | | - Thomas Horstmann
- Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany; Medical Park St. Hubertus Klinik, Bad Wiessee, Germany
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Wearing SC, Kuhn L, Pohl T, Horstmann T, Brauner T. Transmission-Mode Ultrasound for Monitoring the Instantaneous Elastic Modulus of the Achilles Tendon During Unilateral Submaximal Vertical Hopping. Front Physiol 2020; 11:567641. [PMID: 33343380 PMCID: PMC7744658 DOI: 10.3389/fphys.2020.567641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 11/11/2020] [Indexed: 11/30/2022] Open
Abstract
Submaximal vertical hopping capitalizes on the strain energy storage-recovery mechanism associated with the stretch-shortening cycle and is emerging as an important component of progressive rehabilitation protocols in Achilles tendon injury and a determinant of readiness to return to sport. This study explored the reliability of transmission mode ultrasound in quantifying the instantaneous modulus of elasticity of human Achilles tendon during repetitive submaximal hopping. A custom-built ultrasound transmission device, consisting of a 1 MHz broadband emitter and four regularly spaced receivers, was used to measure the axial velocity of ultrasound in the Achilles tendon of six healthy young adults (mean ± SD; age 26 ± 5 years; height 1.78 ± 0.11 m; weight 79.8 ± 13.6 kg) during steady-state unilateral hopping (2.5 Hz) on a piezoelectric force plate. Vertical ground reaction force and lower limb joint kinematics were simultaneously recorded. The potential sensitivity of the technique was further explored in subset of healthy participants (n = 3) that hopped at a slower rate (1.8 Hz) and a patient who had undergone Achilles tendon rupture-repair (2.5 Hz). Reliability was estimated using the mean-within subject coefficient of variation calculated at each point during the ground-contact phase of hopping, while cross-correlations were used to explore the coordination between lower limb kinematics ground reaction forces and ultrasound velocity in the Achilles tendon. Axial velocity of ultrasound in the Achilles tendon was highly reproducible during hopping, with the mean within-subject coefficient of variation ranging between 0.1 and 2.0% across participants. Ultrasound velocity decreased immediately following touch down (−19 ± 13 ms–1), before increasing by 197 ± 81 ms–1, on average, to peak at 2230 ± 87 ms–1 at 67 ± 3% of ground contact phase in healthy participants. Cross-correlation analysis revealed that ultrasound velocity in the Achilles tendon during hopping was strongly associated with knee (mean r = 0.98, range 0.95–1.00) rather than ankle (mean r = 0.67, range 0.35–0.79) joint motion. Ultrasound velocity was sensitive to changes in hopping frequency in healthy adults and in the surgically repaired Achilles tendon was characterized by a similar peak velocity (2283 ± 13 ms–1) but the change in ultrasound velocity (447 ± 21 ms–1) was approximately two fold that of healthy participants (197 ± 81 ms–1). Although further research is required, the technique can be used to reliably monitor ultrasound velocity in the Achilles tendon during hopping, can detect changes in the instantaneous elastic modulus of tendon with variation in hopping frequency and tendon pathology and ultimately may provide further insights into the stretch-shortening cycle and aid clinical decision concerning tendon rehabilitation protocols and readiness to return to sport.
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Affiliation(s)
- Scott C Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Faculty of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Larissa Kuhn
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Torsten Pohl
- Faculty of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Thomas Horstmann
- Faculty of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Torsten Brauner
- Department of Sport Science, German University of Health and Sport, Ismaning, Germany
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Pohl T, Brauner T, Wearing S, Horstmann T. Limb movement, coordination and muscle activity during a cross-coordination movement on a stable and unstable surface. Gait Posture 2020; 81:131-137. [PMID: 32888551 DOI: 10.1016/j.gaitpost.2020.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/02/2020] [Accepted: 07/20/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND At a clinical level, the intensity of dynamic balance tasks incorporating cross-coordination movements (CCM) is typically progressed by changing the stability of the support surface on which the movement is undertaken. However, biomechanical changes in CCMs performed on stable and unstable surfaces have not yet been quantified. RESEARCH QUESTION Do movement patterns, muscle activity, coordination strategies, knee joint loading and center of mass (CoM) movement differ during a CCM performed on stable and unstable surfaces? METHODS Motion analysis was used to monitor limb kinematics and surface electromyography to analyze supporting leg muscle activity in sixteen healthy athletes during a single-limb support task involving a cyclic CCM on a stable and unstable surface. Angle-angle plots were used to explore coordination strategies in sagittal movement of the hip and shoulder, while differences in kinematics and muscle activity between stable and unstable conditions were evaluated using dependent t-tests (α-level = 0.05). RESULTS CCMs on an unstable surface were performed at a slower speed (p < .05), with a more flexed posture of the support knee (p < .05) and ankle (p < .05) and resulted in reduced hip and shoulder movement of the swing limbs (p < .05). Instability increased activation of selected muscles of the ankle and knee (p < .05), resulted in a two-fold increase in the peak knee adduction moment (p < .05), and was accompanied by greater CoM movement (p < .05). Three coordination patterns of the swing limbs observed when performing CCM on a stable surface, which were mostly preserved on the unstable surface. SIGNIFICANCE Despite adopting several stabilization strategies, CCM undertaken on an unstable surface still evoked greater excursion of the center of mass and, as such, presented a greater challenge to sensorimotor control. Adding instability in form of a swinging platform provides progression of dynamic balance CCM difficulty in an athletic population.
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Affiliation(s)
- Torsten Pohl
- Department of Sports- and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University Munich, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany.
| | - Torsten Brauner
- Department of Sports- and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University Munich, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany; Department of Sport Science, Germany University of Health & Sport, Steinheilstr. 4, 85737 Ismaning, Germany
| | - Scott Wearing
- Department of Sports- and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University Munich, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany; Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Brisbane QLD 4001, Australia
| | - Thomas Horstmann
- Department of Sports- and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University Munich, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany; Medical Park Bad Wiessee St. Hubertus, Sonnenfeldweg 29, 83707 Bad Wiessee, Germany
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Byrnes SK, Kunic D, Rethwilm R, Böhm H, Horstmann T, Dussa CU. Compensatory mechanisms in children with idiopathic lower extremity internal rotational malalignment during walking and running. Gait Posture 2020; 79:46-52. [PMID: 32344359 DOI: 10.1016/j.gaitpost.2020.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/18/2020] [Accepted: 03/26/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Noticeable in-toeing gait is present in most children with internal rotational malalignment and often a reason to consult an orthopedic specialist. The risk of tripping may be higher for these patients. RESEARCH QUESTION The aim of this study was to determine compensatory mechanisms adopted by children with internal rotational deformities to avoid tripping and falling during walking and running. METHODS Sixty-nine patients between 5-18 years with idiopathic internal rotational malalignment were retrospectively included and subdivided into three groups: 18 patients with internal tibial torsion (ITT), 25 patients with internal femoral torsion (ITF) and 26 patients with both (ITB). Twenty-two typically developing age-matched children (TD) were analyzed for comparison. Three-dimensional gait data were evaluated. ANOVA's on two factors, group (ITT, ITF, ITB, TD) and movement (walking, running) with post-hoc t-tests were used to identify significant differences between groups. RESULTS All groups had significantly greater step width than TD during walking (P ≤ .002) and all torsional groups had significantly greater step width during running (P ≤ .001). Similarly, all torsional groups showed greater peak ankle dorsiflexion in swing during running than TD (P ≤ .006). Only the ITT group showed significantly greater external hip rotation than TD. When compared to TD, the ITF and ITB group had a significantly lower hip abduction moment in stance during running, but not for walking (P ≤ .032). SIGNIFICANCE Compensatory mechanisms in children with internal rotational deformities were mostly dependent on the location of rotational malalignment. All children with internal rotational malalignment had greater ankle dorsiflexion and greater step width during running. Especially in active patients, this greater ankle dorsiflexion during running may result in overuse of the ankle dorsiflexor muscles, while greater step width may have beneficial effects in normalizing knee adduction moments.
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Affiliation(s)
- S Kimberly Byrnes
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229, Aschau im Chiemgau, Germany; Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany.
| | - Demir Kunic
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229, Aschau im Chiemgau, Germany
| | - Roman Rethwilm
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229, Aschau im Chiemgau, Germany
| | - Harald Böhm
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229, Aschau im Chiemgau, Germany
| | - Thomas Horstmann
- Department of Sports and Health Sciences, Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Germany; Medical Park St. Hubertus Klinik, Bad Wiessee, Germany
| | - Chakravarthy U Dussa
- Orthopedic Children's Hospital, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229, Aschau im Chiemgau, Germany
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Müßig JA, Brauner T, Kröger I, Varady PA, Brand A, Klöpfer-Krämer I, Simmel S, Horstmann T, Augat P. Variability in trunk and pelvic movement of transfemoral amputees using a C-leg system compared to healthy controls. Hum Mov Sci 2019; 68:102539. [PMID: 31683085 DOI: 10.1016/j.humov.2019.102539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Gait variability is a measure of gait disturbance, and therefore constitutes a useful parameter for gait assessment as well as planning of therapeutic and medical interventions. To date, variability during walking has not been adequately analyzed in amputees. The aim of this examination was to evaluate trunk and pelvic movement variability in transfemoral amputees. The effect of different types of walking surfaces on variability in trunk and pelvic movement was also studied. METHOD This prospective clinical examination compares 20 transfemoral amputees (17 ♂, 42 ± 16 years; 3 ♀, 48 ± 3 years) with a group of 20 age and mass matched healthy controls regarding the extent of variability in trunk and pelvic movement. Kinematic data of trunk and pelvic movement during walking on level, uneven ground and slope was captured by eight infrared cameras (Vicon Nexus ™, Oxford, UK). Variability in trunk and pelvic movement was analyzed. Univariate ANCOVA and ANOVA with repeated measures and post hoc tests were used for statistical comparison. Fall history was retrospectively collected from medical history to assess the association between falls and variability in trunk and pelvic movement. RESULTS Trunk and pelvic movement variability in amputees was significantly higher during walking on uneven ground and slope compared to healthy controls (p ≤ 0.05). Variability in trunk and pelvic movement was increased during walking on uneven ground and slope compared to even ground for both groups (p ≤ 0.05). CONCLUSION Amputees showed increased trunk and pelvic movement variability during walking on uneven ground and slope, indicating an affected gait pattern in comparison to healthy controls. Therefore, trunk and pelvic movement variability could be a potential marker for gait quality with diagnostic implications.
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Affiliation(s)
- Janina A Müßig
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria; Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany.
| | - Torsten Brauner
- Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany
| | - Inga Kröger
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria
| | - Patrick A Varady
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria
| | - Andreas Brand
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria
| | - Isabella Klöpfer-Krämer
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria
| | - Stefan Simmel
- Abteilung für BG-Rehabilitation Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany
| | - Thomas Horstmann
- Institute for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany; Medical Park St. Hubertus Klinik, Sonnenfeldweg 29 Bad Wiessee, Germany
| | - Peter Augat
- Institute for Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Str. 8 Murnau, Germany; Institute for Biomechanics Paracelsus Medical University, Strubergasse 22, Salzburg, Austria
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Wearing SC, Davis IS, Brauner T, Hooper SL, Horstmann T. Do habitual foot-strike patterns in running influence functional Achilles tendon properties during gait? J Sports Sci 2019; 37:2735-2743. [PMID: 31506014 DOI: 10.1080/02640414.2019.1663656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The capacity of foot-strike running patterns to influence the functional properties of the Achilles tendon is controversial. This study used transmission-mode ultrasound to investigate the influence of habitual running foot-strike pattern on Achilles tendon properties during barefoot walking and running. Fifteen runners with rearfoot (RFS) and 10 with a forefoot (FFS) foot-strike running pattern had ultrasound transmission velocity measured in the right Achilles tendon during barefoot walking (≈1.1 ms-1) and running (≈2.0 ms-1). Temporospatial gait parameters, ankle kinematics and vertical ground reaction force were simultaneously recorded. Statistical comparisons between foot-strike patterns were made using repeated measure ANOVAs. FFS was characterised by a significantly shorter stance duration (-4%), greater ankle dorsiflexion (+2°), and higher peak vertical ground reaction force (+20% bodyweight) than RFS running (P < .05). Both groups adopted a RFS pattern during walking, with only the relative timing of peak dorsiflexion (3%), ground reaction force (1-2%) and peak vertical force loading rates (22-23%) differing between groups (P < .05). Peak ultrasound transmission velocity in the Achilles tendon was significantly higher in FFS during walking (≈100 ms-1) and running (≈130 ms-1) than RFS (P < .05). Functional Achilles tendon properties differ with habitual footfall patterns in recreational runners.
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Affiliation(s)
- Scott C Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane , Australia
| | - I S Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston , USA
| | - T Brauner
- Faculty of Sports and Health Sciences, Technische Universität München , Munich , Germany
| | - S L Hooper
- Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane , Australia
| | - T Horstmann
- Faculty of Sports and Health Sciences, Technische Universität München , Munich , Germany
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Kuhn L, Weberruß H, Horstmann T. Effects of core stability training on throwing velocity and core strength in female handball players. J Sports Med Phys Fitness 2018; 59:1479-1486. [PMID: 30543274 DOI: 10.23736/s0022-4707.18.09295-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study investigated the effect of a six-week in-season core stability training (CST) intervention on maximal throwing velocity and core strength parameters. METHODS Twenty female handball players (23.4±4.4 years, 168.4±3.5 cm, and 66.9±9.2 kg) were randomized into a CST intervention group (N.=10) and a control group (CON, N.=10). Throwing velocity, maximal isometric strength (MIS) and endurance strength of the ventral, dorsal and lateral core muscle chains were measured before and after progressive, six-week core stability training in the CST group. RESULTS Core endurance of both lateral core muscle chains (LR: F=7.03, P=0.017; LL: F=6.31, P=0.022;) and MIS of the left lateral core muscle chain (LL: F=7.08, P=0.019) was significantly improved in CST compared to CON group after 6 weeks. Additionally, CST group significantly increased MIS of the lateral right core muscles (21%, P=0.042) and the ventral core endurance (35%, P=0.016) compared to baseline. Although both groups significantly increased throwing velocity of the jump throw after the intervention (CST 12%, P=0.001; CON 8%, P=0.009), throwing velocity of the standing throw remained unchanged. CONCLUSIONS A six-week CST intervention effectively increased the isometric strength and endurance of selected core muscles but did not significantly enhance throwing velocity compared to standard training.
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Affiliation(s)
- Larissa Kuhn
- Department of Conservative and Rehabilitation Orthopedics, Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany -
| | - Heidi Weberruß
- Department of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Thomas Horstmann
- Department of Conservative and Rehabilitation Orthopedics, Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Medical Park Bad Wiessee, Klinik St. Hubertus, Bad Wiessee, Germany
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Brauner T, Pourcelot P, Crevier-Denoix N, Horstmann T, Wearing SC. Achilles Tendon Load is Progressively Increased with Reductions in Walking Speed. Med Sci Sports Exerc 2018; 49:2001-2008. [PMID: 28509763 DOI: 10.1249/mss.0000000000001322] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Achilles tendon rehabilitation protocols commonly recommend a gradual increase in walking speed to progressively intensify tendon loading. This study used transmission-mode ultrasound to evaluate the influence of walking speed on loading of the human Achilles tendon in vivo. METHODS Axial transmission speed of ultrasound was measured in the right Achilles tendon of 33 adults (mean ± SD: age, 29 ± 3 yr; height, 1.725 ± 0.069 m; weight, 71.4 ± 19.9 kg) during unshod, steady-state treadmill walking at three speeds (slow, 0.85 ± 0.12 ms; preferred, 1.10 ± 0.13 m·s; fast, 1.35 ± 0.20 m·s). Ankle kinematics, spatiotemporal gait parameters and vertical ground reaction force were simultaneously recorded. Statistical comparisons were made using repeated-measures ANOVA models. RESULTS Increasing walking speed was associated with higher cadence, longer step length, shorter stance duration, greater ankle plantarflexion, higher vertical ground reaction force peaks, and a greater loading rate (P < 0.05). Maximum (F1,38 = 7.38, P < 0.05) and minimum (F1,46 = 8.95, P < 0.05) ultrasound transmission velocities in the Achilles tendon were significantly lower (16-23 m·s) during the stance but not swing phase of gait, with each increase in walking speed. CONCLUSIONS Despite higher vertical ground reaction forces and greater ankle plantarflexion, increasing walking speed resulted in a reduction in the axial transmission velocity of ultrasound in the Achilles tendon; indicating a speed-dependent reduction in tensile load within the triceps surae muscle-tendon unit during walking. These findings question the rationale for current progressive loading protocols involving the Achilles tendon, in which reduced walking speeds are advocated early in the course of treatment to lower Achilles tendon loads.
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Affiliation(s)
- Torsten Brauner
- 1Faculty of Sports and Health Sciences, Technische Universität München, Munich, GERMANY; 2Unite 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort (National Veterinary School of Alfort), University Paris Est, Maisons-Alfort, FRANCE; and 3Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, AUSTRALIA
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Brauner T, Hooper S, Horstmann T, Wearing S. Effects of footwear and heel elevation on tensile load in the Achilles tendon during treadmill walking. Footwear Science 2018. [DOI: 10.1080/19424280.2017.1407965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Torsten Brauner
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany
| | - Sue Hooper
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Scott Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Bossmann T, Brauner T, Horstmann T. Differences in pain intensity in anti- and pro-nociceptive pain profile subgroups in patients with knee osteoarthritis. Pain Manag 2018; 8:27-36. [DOI: 10.2217/pmt-2017-0039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Aim: Facilitated temporal summation is one component of central sensitization. The aim of this exploratory study was to classify pro-, eu- and antinociceptive subgroups based on wind-up ratio cut-off scores in patients with knee osteoarthritis (OA). Patients & methods: A total of 56 patients with knee OA met the inclusion criteria. Temporal summation was measured and wind-up ratio was calculated. Reference values of 180 healthy subjects were used to define wind-up ratio cut-off scores. Results: Twenty-seven percent of patients showed a pro-nociceptive pain profile. Sixteen percent of patients showed an anti-nociceptive pain profile. A eu-nociceptive pain profile was present in 57% of patients. Conclusion: Central pain sensitization was present in approximately a third of knee OA patients. The results should be confirmed in larger studies.
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Affiliation(s)
- Tanja Bossmann
- Department of Conservative & Rehabilitative Orthopaedics, Faculty of Sports & Health Sciences, Technical University of Munich, Germany
| | - Torsten Brauner
- Department of Conservative & Rehabilitative Orthopaedics, Faculty of Sports & Health Sciences, Technical University of Munich, Germany
| | - Thomas Horstmann
- Department of Conservative & Rehabilitative Orthopaedics, Faculty of Sports & Health Sciences, Technical University of Munich, Germany
- Medical Park Bad Wiessee, Klinik St. Hubertus, Bad Wiessee, Germany
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Bossmann T, Brauner T, Wearing S, Horstmann T. Predictors of chronic pain following total knee replacement in females and males: an exploratory study. Pain Manag 2017; 7:391-403. [DOI: 10.2217/pmt-2017-0023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Tanja Bossmann
- Department of Conservative & Rehabilitative Orthopedics, Faculty of Sports & Health Sciences, Technical University Munich, Germany
| | - Torsten Brauner
- Department of Conservative & Rehabilitative Orthopedics, Faculty of Sports & Health Sciences, Technical University Munich, Germany
| | - Scott Wearing
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Kelvin Grove campus, Australia
| | - Thomas Horstmann
- Department of Conservative & Rehabilitative Orthopedics, Faculty of Sports & Health Sciences, Technical University Munich, Germany
- Medical Park Bad Wiessee, Klinik St. Hubertus, Bad Wiessee, Germany
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Brauner T, Horstmann T, Hooper S, Wearing S. Does heel offset alter tensile load in the Achilles tendon during treadmill walking? Footwear Science 2017. [DOI: 10.1080/19424280.2017.1314344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Torsten Brauner
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany
| | - Thomas Horstmann
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany
| | - Sue Hooper
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Scott Wearing
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Bossmann T, Brauner T, Lowak H, Anton F, Forster C, Horstmann T. Reliability of conditioned pain modulation for the assessment of endogenous pain control pathways. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.npbr.2016.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Wolburg T, Rapp W, Rieger J, Horstmann T. Muscle activity of leg muscles during unipedal stance on therapy devices with different stability properties. Phys Ther Sport 2015; 17:58-62. [PMID: 26521158 DOI: 10.1016/j.ptsp.2015.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 04/15/2015] [Accepted: 05/06/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To test the hypotheses that less stable therapy devices require greater muscle activity and that lower leg muscles will have greater increases in muscle activity with less stable therapy devices than upper leg muscles. DESIGN Cross-sectional laboratory study. SETTING Laboratory setting. PARTICIPANTS Twenty-five healthy subjects. MAIN OUTCOME MEASURES Electromyographic activity of four lower (gastrocnemius medialis, soleus, tibialis anterior, peroneus longus) and four upper leg muscles (vastus medialis and lateralis, biceps femoris, semitendinosus) during unipedal quiet barefoot stance on the dominant leg on a flat rigid surface and on five therapy devices with varying stability properties. RESULTS Muscle activity during unipedal stance differed significantly between therapy devices (P < 0.001). The order from lowest to highest relative muscle activity matched the order from most to least stable therapy device. There was no significant interaction between muscle location (lower versus upper leg) and therapy device (P = 0.985). Magnitudes of additional relative muscle activity for the respective therapy devices differed substantially among lower extremity muscles. CONCLUSIONS The therapy devices offer a progressive increase in training intensity, and thus may be useful for incremental training programs in physiotherapeutic practice and sports training programs.
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Affiliation(s)
| | - Walter Rapp
- Institute for Sport and Sport Sciences, Albert-Ludwigs University Freiburg, Germany; Department of Sports Medicine, University Hospital Tübingen, Germany.
| | - Jochen Rieger
- Department of Sports Medicine, University Hospital Tübingen, Germany
| | - Thomas Horstmann
- Medical Park Bad Wiessee St. Hubertus, Bad Wiessee, Germany; Faculty for Sport and Health Sciences, Technische Universität München, Munich, Germany
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Rapp W, Brauner T, Weber L, Grau S, Mündermann A, Horstmann T. Improvement of walking speed and gait symmetry in older patients after hip arthroplasty: a prospective cohort study. BMC Musculoskelet Disord 2015; 16:291. [PMID: 26459628 PMCID: PMC4603916 DOI: 10.1186/s12891-015-0755-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 10/05/2015] [Indexed: 11/10/2022] Open
Abstract
Background Retraining walking in patients after hip or knee arthroplasty is an important component of rehabilitation especially in older persons whose social interactions are influenced by their level of mobility. The objective of this study was to test the effect of an intensive inpatient rehabilitation program on walking speed and gait symmetry in patients after hip arthroplasty (THA) using inertial sensor technology. Methods Twenty-nine patients undergoing a 4-week inpatient rehabilitation program following THA and 30 age-matched healthy subjects participated in this study. Walking speed and gait symmetry parameters were measured using inertial sensor device for standardized walking trials (2*20.3 m in a gym) at their self-selected normal and fast walking speeds on postoperative days 15, 21, and 27 in patients and in a single session in control subjects. Walking speed was measured using timing lights. Gait symmetry was determined using autocorrelation calculation of the cranio-caudal (CC) acceleration signals from an inertial sensor placed at the lower spine. Results Walking speed and gait symmetry improved from postoperative days 15–27 (speed, female: 3.2 and 4.5 m/s; male: 4.2 and 5.2 m/s; autocorrelation, female: 0.77 and 0.81; male: 0.70 and 0.79; P <0.001 for all). After the 4-week rehabilitation program, walking speed and gait symmetry were still lower than those in control subjects (speed, female 4.5 m/s vs. 5.7 m/s; male: 5.2 m/s vs. 5.3 m/s; autocorrelation, female: 0.81 vs. 0.88; male: 0.79 vs. 0.90; P <0.001 for all). Conclusions While patients with THA improved their walking capacity during a 4-week inpatient rehabilitation program, subsequent intensive gait training is warranted for achieving normal gait symmetry. Inertial sensor technology may be a useful tool for evaluating the rehabilitation process during the post-inpatient period.
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Affiliation(s)
- Walter Rapp
- Institute of Sport and Sport Sciences, Albert-Ludwigs Universität Freiburg, Schwarzwaldstr 175, 79117, Freiburg, Germany.
| | - Torsten Brauner
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany.
| | - Linda Weber
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany.
| | - Stefan Grau
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.
| | | | - Thomas Horstmann
- Conservative & Rehabilitative Orthopedics, Technische Universität München, Munich, Germany. .,Medical Park St. Hubertus, Bad Wiessee, Germany.
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Pohl T, Brauner T, Wearing S, Stamer K, Horstmann T. Effects of sensorimotor training volume on recovery of sensorimotor function in patients following lower limb arthroplasty. BMC Musculoskelet Disord 2015; 16:195. [PMID: 26286593 PMCID: PMC4545701 DOI: 10.1186/s12891-015-0644-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 07/23/2015] [Indexed: 12/26/2022] Open
Abstract
Background Sensorimotor function is degraded in patients after lower limb arthroplasty. Sensorimotor training is thought to improve sensorimotor skills, however, the optimal training stimulus with regard to volume, frequency, duration, and intensity is still unknown. The aim of this study, therefore, was to firstly quantify the progression of sensorimotor function after total hip (THA) or knee (TKA) arthroplasty and, as second step, to evaluate effects of different sensorimotor training volumes. Methods 58 in-patients during their rehabilitation after THA or TKA participated in this prospective cohort study. Sensorimotor function was assessed using a test battery including measures of stabilization capacity, static balance, proprioception, and gait, along with a self-reported pain and function. All participants were randomly assigned to one of three intervention groups performing sensorimotor training two, four, or six times per week. Outcome measures were taken at three instances, at baseline (pre), after 1.5 weeks (mid) and at the conclusion of the 3 week program (post). Results All measurements showed significant improvements over time, with the exception of proprioception and static balance during quiet bipedal stance which showed no significant main effects for time or intervention. There was no significant effect of sensorimotor training volume on any of the outcome measures. Conclusion We were able to quantify improvements in measures of dynamic, but not static, sensorimotor function during the initial three weeks of rehabilitation following TKA/THA. Although sensorimotor improvements were independent of the training volume applied in the current study, long-term effects of sensorimotor training volume need to be investigated to optimize training stimulus recommendations. Trial registration Clinical trial registration number: DRKS00007894
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Affiliation(s)
- Torsten Pohl
- Conservative and Rehabilitative Orthopedics, Technische Universität München, Faculty for Sport and Health Science, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany.
| | - Torsten Brauner
- Conservative and Rehabilitative Orthopedics, Technische Universität München, Faculty for Sport and Health Science, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany.
| | - Scott Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
| | - Knut Stamer
- Medical Park Bad Wiessee St. Hubertus, Bad Wiessee, Germany.
| | - Thomas Horstmann
- Conservative and Rehabilitative Orthopedics, Technische Universität München, Faculty for Sport and Health Science, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany. .,Medical Park Bad Wiessee St. Hubertus, Bad Wiessee, Germany.
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Wulf M, Wearing SC, Hooper SL, Smeathers JE, Horstmann T, Brauner T. Achilles tendon loading patterns during barefoot walking and slow running on a treadmill: An ultrasonic propagation study. Scand J Med Sci Sports 2015; 25:868-75. [PMID: 25913324 DOI: 10.1111/sms.12455] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 01/13/2023]
Abstract
Measurement of tendon loading patterns during gait is important for understanding the pathogenesis of tendon "overuse" injury. Given that the speed of propagation of ultrasound in tendon is proportional to the applied load, this study used a noninvasive ultrasonic transmission technique to measure axial ultrasonic velocity in the right Achilles tendon of 27 healthy adults (11 females and 16 males; age, 26 ± 9 years; height, 1.73 ± 0.07 m; weight, 70.6 ± 21.2 kg), walking at self-selected speed (1.1 ± 0.1 m/s), and running at fixed slow speed (2 m/s) on a treadmill. Synchronous measures of ankle kinematics, spatiotemporal gait parameters, and vertical ground reaction forces were simultaneously measured. Slow running was associated with significantly higher cadence, shorter step length, but greater range of ankle movement, higher magnitude and rate of vertical ground reaction force, and higher ultrasonic velocity in the tendon than walking (P < 0.05). Ultrasonic velocity in the Achilles tendon was highly reproducible during walking and slow running (mean within-subject coefficient of variation < 2%). Ultrasonic maxima (P1, P2) and minima (M1, M2) were significantly higher and occurred earlier in the gait cycle (P1, M1, and M2) during running than walking (P < 0.05). Slow running was associated with higher and earlier peaks in loading of the Achilles tendon than walking.
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Affiliation(s)
- M Wulf
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany
| | - S C Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Centre of Excellence for Applied Sport Science Research, Queensland Academy of Sport, Brisbane, Australia
| | - S L Hooper
- Office of Health & Medical Research, Queensland Health, Brisbane, Australia
| | - J E Smeathers
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - T Horstmann
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.,MEDICAL PARK Bad Wiessee St. Hubertus, Bad Wiessee, Australia
| | - T Brauner
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany
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Brauner T, Wearing S, Rämisch E, Zillober M, Horstmann T. Can measures of limb loading and dynamic stability during the squat maneuver provide an index of early functional recovery after unilateral total hip arthroplasty? Arch Phys Med Rehabil 2014; 95:1946-53. [PMID: 24953251 DOI: 10.1016/j.apmr.2014.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 05/01/2014] [Accepted: 06/03/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate limb loading and dynamic stability during squatting in the early functional recovery of patients who had undergone total hip arthroplasty (THA). DESIGN Cohort study. SETTING Inpatient rehabilitation clinic. PARTICIPANTS Of the total participants (N=99), a random sample of patients who had undergone THA (n=61; 34 men and 27 women; mean age, 62±9y; weight, 77±14kg; height, 174±9 cm) was assessed twice, 13.2±3.8 days (t1) and 26.6±3.3 days postsurgery (t2), and compared with a healthy reference group (n=38; 22 men and 16 women; mean age, 47±12y; weight, 78±20kg; height, 175±10cm). INTERVENTIONS Patients who had undergone THA received 2 weeks of standard inpatient rehabilitation. MAIN OUTCOME MEASURES Interlimb vertical force distribution and dynamic stability during the squat maneuver, as defined by the root mean square of the center of pressure in anteroposterior and mediolateral directions, of operated and nonoperated limbs. Self-reported function was assessed via the Function Assessment Questionnaire Hannover for Osteoarthritis questionnaire. RESULTS At t1, unloading of the operated limb was 15.8% greater (P<.001; d=1.070) and anteroposterior and mediolateral center of pressure root mean square values were 30% to 34% higher in patients who had undergone THA than in the healthy reference group (P<.05). Unloading was reduced by 12.8% toward a more equal distribution from t1 to t2 (P<.001; d=.874). Although mediolateral stability improved between t1 and t2 (operated limb: 14.8%; P=.024; d=.397; nonoperated limb: 13.1%; P=.015; d=.321), anteroposterior stability was not significantly different. Self-reported physical function improved by 15.8% (P<.001; d=.965). CONCLUSIONS Patients who had undergone THA unload the operated limb and are dynamically more unstable during squatting in the early rehabilitation phase after THA than are healthy adults. Although loading symmetry and mediolateral stability improved to the level of healthy adults with rehabilitation, anteroposterior stability remained impaired. Measures of dynamic stability and load symmetry during squatting provide quantitative information that can be used to clinically monitor early functional recovery from THA.
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Affiliation(s)
- Torsten Brauner
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.
| | - Scott Wearing
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Center of Excellence for Applied Sport Science Research, Queensland Academy of Sport, Brisbane, Australia
| | | | - Marion Zillober
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany; Medical Park St. Hubertus, Bad Wiessee, Germany
| | - Thomas Horstmann
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany; Medical Park St. Hubertus, Bad Wiessee, Germany
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Brauner T, Sterzing T, Wulf M, Horstmann T. Leg stiffness: comparison between unilateral and bilateral hopping tasks. Hum Mov Sci 2013; 33:263-72. [PMID: 24290613 DOI: 10.1016/j.humov.2013.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 07/12/2013] [Accepted: 08/21/2013] [Indexed: 12/01/2022]
Abstract
Leg stiffness is a predictor of athletic performance and injury and typically evaluated during bilateral hopping. The contribution of each limb to bilateral leg stiffness, however, is not well understood. This study investigated leg stiffness during unilateral and bilateral hopping to address the following research questions: (1) does the magnitude and variability of leg stiffness differ between dominant and non-dominant legs? (2) Does unilateral leg stiffness differ from bilateral leg stiffness? and (3) Is bilateral leg stiffness determined by unilateral leg stiffness? Thirty-two physically active males performed repeated hopping tests on a force platform for each of the three conditions: bilateral hopping, unilateral hopping on the dominant leg, and unilateral hopping on the non-dominant leg. Leg stiffness was estimated as the ratio of the peak vertical force and the maximum displacement using a simple 1-D mass-spring model. Neither the magnitude nor variability of leg stiffness differed between dominant and non-dominant limbs. Unilateral leg stiffness was 24% lower than bilateral stiffness and showed less variability between consecutive hops and subjects. Unilateral leg stiffness explained 76% of the variance in bilateral leg stiffness. We conclude that leg stiffness estimates during unilateral hopping are preferable for intervention studies because of their low variability.
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Affiliation(s)
- Torsten Brauner
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.
| | | | - Mathias Wulf
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.
| | - Thomas Horstmann
- Faculty of Sports and Health Sciences, Technische Universität München, Munich, Germany; Medical Park St. Hubertus, Bad Wiessee, Germany.
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Perchthaler D, Horstmann T, Grau S. Variations in neuromuscular activity of thigh muscles during whole-body vibration in consideration of different biomechanical variables. J Sports Sci Med 2013; 12:439-446. [PMID: 24149149 PMCID: PMC3772586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/12/2013] [Indexed: 06/02/2023]
Abstract
The intention of this study was to systematically analyze the impact of biomechanical variables in terms of different vibration frequencies, amplitudes and knee angles on quadriceps femoris and hamstring activity during exposure to whole-body vibration (WBV). 51 healthy men and women (age 55 ± 8 years) voluntary participated in the study and were randomly allocated to five different vibration-frequency groups. Each subject performed 9 static squat positions (3 amplitudes x 3 knee angles) on a side alternating vibration platform. Surface electromyography (EMG) was used to record the neuromuscular activity of the quadriceps femoris and hamstring muscles. Maximal voluntary contractions (MVCs) were performed prior to the measurements to normalize the EMG signals. A three-way mixed ANOVA was performed to analyze the different effects of the biomechanical variables on muscle activity. Depending on the biomechanical variables, EMG muscle activity ranged between 18.2 and 74.1 % MVC in the quadriceps femoris and between 5.2 and 27. 3 % MVC in the hamstrings during WBV. The highest levels of muscle activation were found at high frequencies and large amplitudes. Especially in the quadriceps femoris muscle, a WBV frequency of 30 Hz led to a significant increase in muscle activity compared to the other tested frequencies. However, it seems that knee angle is only relevant for the quadriceps femoris muscle. The results of this study should give more information for developing individual training protocols for WBV treatment in different practical applications. Key PointsWBV leads to a higher muscle activity of the quadriceps femoris than of the hamstrings.The maximum levels of muscle activity were significantly reached at high amplitude and high frequency.The knee angle only significantly affects the quadriceps femoris.Certain combinations of the biomechanical variables have similar effects on the level of muscle activity.
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Affiliation(s)
- Dennis Perchthaler
- Department of Sports Medicine, Medical Clinic, University of Tuebingen , Germany
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Fang F, Austad B, Calkins T, Chase C, Horstmann T, Hu Y, Lewis B, Niu X, Noland T, Orr J, Schnaderbeck M, Zhang H, Asakawa N, Asai N, Chiba H, Hasebe T, Hoshino Y, Ishizuka H, Kajima T, Kayano A, Komatsu Y, Kubota M, Kuroda H, Miyazawa M, Tagami K, Watanabe T. Commercial Manufacture of Halaven®: Chemoselective Transformations En Route to Structurally Complex Macrocyclic Ketones. Synlett 2013. [DOI: 10.1055/s-0032-1317799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fang F, Austad B, Calkins T, Chase C, Horstmann T, Hu Y, Lewis B, Niu X, Noland T, Orr J, Schnaderbeck M, Zhang H, Asakawa N, Asai N, Chiba H, Hasebe T, Hoshino Y, Ishizuka H, Kajima T, Kayano A, Komatsu Y, Kubota M, Kuroda H, Miyazawa M, Tagami K, Watanabe T. Commercial Manufacture of Halaven®: Chemoselective Transformations En Route to Structurally Complex Macrocyclic Ketones. Synlett 2013. [DOI: 10.1055/s-0032-1318026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Francis Fang
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Brian Austad
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Trevor Calkins
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Charles Chase
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Thomas Horstmann
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Yongbo Hu
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Bryan Lewis
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Xiang Niu
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Thomas Noland
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - John Orr
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | | | - Huiming Zhang
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Inc
| | - Naoki Asakawa
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Naoki Asai
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Hiroyuki Chiba
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Takashi Hasebe
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Yorihisa Hoshino
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Hiroyuki Ishizuka
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Takashi Kajima
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Akio Kayano
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Yuki Komatsu
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Manabu Kubota
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Hirofumi Kuroda
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Mamoru Miyazawa
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Katsuya Tagami
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
| | - Tomohiro Watanabe
- Pharmaceutical Science & Technology, Eisai Product Creation Systems, Eisai Co., Ltd
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Horstmann T, Vornholt-Koch S, Brauner T, Grau S, Mündermann A. Impact of total hip arthroplasty on pain, walking ability, and cardiovascular fitness. J Orthop Res 2012; 30:2025-30. [PMID: 22653634 DOI: 10.1002/jor.22163] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 05/10/2012] [Indexed: 02/04/2023]
Abstract
We tested the hypothesis that total hip arthroplasty (THA) patients have less pain and are able to walk longer post-operatively than pre-operatively, and that THA patients before and after have higher heart rates and compromised gas exchange determinants at rest and following exercise compared to healthy subjects with a post-operative improvement. Fifty-two patients completed questionnaires and an incremental walking stress test pre-operatively and 6-months after THA. Twenty-four age-matched control subjects completed the same stress test. Fifty-one patients had less pain 6-months after THA compared to pre-operative levels. Forty-three patients showed an improvement of at least one walking duration category. Patients had compromised cardiovascular fitness compared to the control group with a tendency to improve after THA. Hence, 6-months following THA, deficits exist other than reduced strength as reported in the literature. Prior to THA, the ability to walk longer is compromised by pain and not by poor cardiovascular fitness. Studies on specific rehabilitation programs of varying intensities may demonstrate opportunities to improve the cardiovascular fitness of this population.
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Horstmann T, Böer J, Haupt G, Merk J, Brauner T. Sport bei (trotz) Arthrose. AKTUEL RHEUMATOL 2012. [DOI: 10.1055/s-0032-1304595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- T. Horstmann
- MEDICAL PARK Bad Wiessee GmbH u. Co., St. Hubertus, Bad Wiessee
- Technische Universität München, Fakultät für Sport und Gesundheitswissenschaften, Extraordinariat Konservative und rehabilitative Orthopädie, München
| | - J. Böer
- Medizinische Klinik und Polyklinik, Abteilung Sportmedizin, Tübingen
| | - G. Haupt
- Medizinische Klinik und Polyklinik, Abteilung Sportmedizin, Tübingen
| | - J. Merk
- Berufsgenossenschaftliche Unfallklink Tübingen, n/a, Tübingen
| | - T. Brauner
- Technische Universität München, Fakultät für Sport und Gesundheitswissenschaften, Extraordinariat Konservative und rehabilitative Orthopädie, München
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Hein T, Schmeltzpfenning T, Krauss I, Maiwald C, Horstmann T, Grau S. Using the variability of continuous relative phase as a measure to discriminate between healthy and injured runners. Hum Mov Sci 2012; 31:683-94. [DOI: 10.1016/j.humov.2011.07.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 03/16/2011] [Accepted: 07/06/2011] [Indexed: 10/17/2022]
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Abstract
The purpose of this study was to determine the long-term impact of surgical repair and subsequent 6-week immobilization of an Achilles tendon rupture on muscle strength, muscle strength endurance and muscle activity. 63 patients participated in this study on average 10.8 ± 3.4 years after surgically repaired Achilles tendon rupture and short-term immobilization. Clinical function was assessed and muscle strength, strength endurance and muscle activity were measured using a dynamometer and electromyography. Ankle ROM, heel height during heel-raise tests and calf circumference were smaller on the injured than on the contralateral side. Ankle torques during the concentric dorsiflexion tasks at 60 °/sec and 180 °/sec and ankle torques during the eccentric plantarflexion task and during the concentric plantarflexion task at 60 °/sec for the injured leg were significantly lower than those for the contralateral leg. The total work during a plantarflexion exercise at 180 °/sec was 14.9% lower in the injured compared to the contralateral leg (p < 0.001). Muscle activity for the gastrocnemius muscle during dorsiflexion tasks was significantly higher in the injured than in the contralateral limb. Limited ankle joint ROM and increased muscle activity in the injured leg suggest compensatory mechanisms to account for differences in muscle morphology and physiology caused by the injury.
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Affiliation(s)
- T Horstmann
- Faculty for Sport and Health Sciences, Technische Universität München, Germany.
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Krauss I, List R, Janssen P, Grau S, Horstmann T, Stacoff A. Comparison of distinctive gait variables using two different biomechanical models for knee joint kinematics in subjects with knee osteoarthritis and healthy controls. Clin Biomech (Bristol, Avon) 2012; 27:281-6. [PMID: 22019299 DOI: 10.1016/j.clinbiomech.2011.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/23/2011] [Accepted: 09/28/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gait analysis is an important instrument in clinical research and results should be objective. The purpose of this study was to quantify clinical outcomes of two biomechanical models with different anatomical coordinate systems and angle decomposition strategies for knee joint kinematics. METHODS The study was designed to compare a functional approach and a predictive approach with a single comprehensive marker set. 10 healthy subjects and 12 subjects with knee osteoarthritis were analysed. Distinctive gait variables were averaged across five trials. Agreement between methods was illustrated with the so-called levels of agreement. Differences between models were quantified using a paired t-test or Wilcoxon-Signed Rank test in case of non-normality (Shapiro-Wilk test). Unpaired t-tests/Wilcoxon tests were used to compare gait variables between healthy subjects and subjects with knee osteoarthritis, and to examine whether statistical analysis of this comparison would yield different data interpretations when using different models. FINDINGS Outcome variables differed between the functional and predictive approaches in the sagittal plane (0.1-3.1°), and transverse plane (1.0-3.7°). With respect to the range of motion in the given movement plane, variables in the sagittal plane of the knee were more consistent between methods. The functional approach was more sensitive for detecting differences between groups for sagittal plane kinematics. Statistical analysis for transverse plane kinematics differed substantially between models. INTERPRETATION Sensitivity to detect differences of kinematic data between population groups can vary between biomechanical models. Rotational gait variables are inconsistent between models and should not be used as clinical outcome variables in daily routine.
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Affiliation(s)
- Inga Krauss
- Medical Clinic, Department of Sports Medicine, University of Tuebingen, Silcherstrasse 5, Tuebingen, Germany.
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Fritz B, Rombach S, Godau J, Berg D, Horstmann T, Grau S. The influence of Nordic Walking training on sit-to-stand transfer in Parkinson patients. Gait Posture 2011; 34:234-8. [PMID: 21640591 DOI: 10.1016/j.gaitpost.2011.05.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 04/19/2011] [Accepted: 05/07/2011] [Indexed: 02/02/2023]
Abstract
Neurodegenerative processes in Parkinson's disease (PD) particularly affect activities of daily living (ADL). Problems of patients with PD in sit-to-stand (STS) performance have been verified before, but not the effects of training on biomechanical measures of STS function. This pilot study aimed to analyse effects of 12 weeks of Nordic Walking training and severity of PD: healthy controls (CO), least (UPDRS A) and more severe (UPDRS B) affected PA on selected functional outcome measures. We expected improvements in PD similar to CO, with better performance of the unstable second phase and faster execution of the entire movement with higher velocities of centre of gravity (COG). 3D kinematics of 22 PD and 18 CO subjects before and after training, were recorded using a motion analysis system (Vicon, Oxford). We compared five outcome measures for STS in 11 PD and 11 CO, matched according to age, gender, height, and weight. Effects of Nordic Walking training were not statistically significant but indicated different patterns which depended on the values of patient's UPDRS score (part III, motor functions). Time required for STS performance increased and horizontal and vertical velocity of COG decreased in UPDRS B, which could be due to progression of PD during the training period. In contrast, UPDRS A showed similar effects as CO. The effects of Nordic Walking as an easy, economic and low-risk intervention on STS in PD depend on the degree of PD. Our findings may help scientists, patients, and therapists to adjust sport-physiological interventions.
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Affiliation(s)
- B Fritz
- Medical Clinic, Department of Sports Medicine, University of Tuebingen, Silcherstrasse 5, 72076 Tuebingen, Germany.
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Betsch M, Wild M, Jungbluth P, Hakimi M, Windolf J, Haex B, Horstmann T, Rapp W. Reliability and validity of 4D rasterstereography under dynamic conditions. Comput Biol Med 2011; 41:308-12. [PMID: 21489425 DOI: 10.1016/j.compbiomed.2011.03.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Revised: 12/13/2010] [Accepted: 03/18/2011] [Indexed: 11/17/2022]
Abstract
Purpose of this study was to evaluate the reliability and validity of 4D rasterstereography under dynamic conditions. Therefore simulated anatomical fixed points on a wooden plate were measured during different movements. Seven different motion patterns in all three angles of space were evaluated. The simulated parameter trunk length was measured with an accuracy of 3.58 mm (SD±3.29 mm) and the dimple distance was detected with an accuracy of 0.88 mm (SD±1.04 mm). With this rasterstereographic prototype it is possible to examine dynamically the spinal posture with adequate accuracy.
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Affiliation(s)
- Marcel Betsch
- Heinrich Heine University Hospital, Department of Trauma and Hand Surgery, Moorenstrasse 5, D-40225 Düsseldorf, Germany
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Grau S, Krauss I, Maiwald C, Axmann D, Horstmann T, Best R. Kinematic classification of iliotibial band syndrome in runners. Scand J Med Sci Sports 2011; 21:184-9. [DOI: 10.1111/j.1600-0838.2009.01045.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Krauss I, Langbein C, Horstmann T, Grau S. Sex-related differences in foot shape of adult Caucasians--a follow-up study focusing on long and short feet. Ergonomics 2011; 54:294-300. [PMID: 21390959 DOI: 10.1080/00140139.2010.547605] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The study's purpose was to substantiate findings on sex-related differences in foot morphology focusing on fringe sizes. Altogether, 287 Caucasian adults with long or short feet were scanned. Data were analysed together with data from 847 subjects from a previous study with comparable inclusion criteria and anthropometric data by: (1)comparing absolute measures within 237-277 mm foot length (FL); (2) comparing averaged measures across sizes in % of foot length for 203-323 mm FL; (3) reclassifying the additional subjects into a previously defined foot type classification. Male feet were wider and higher for the same FL. Averaged across sizes, no relevant differences between sexes were found for widths and heights. Slender or flat-pointed foot types were more common in longer feet, shorter feet tended to be bigger. Definitions for 'long' and 'short' are sex-related with an offset of three shoe sizes (EU). Results of this follow-up study on long and short feet can substantiate previous findings mainly described for the most common sizes. STATEMENT OF RELEVANCE: Improper footwear can cause pain and injury and proper fit is a major criterion for shoe buyers. Knowledge about sex-related differences in foot shape is important for shoe design. This study supplements the field of knowledge for very small and large feet.
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Affiliation(s)
- I Krauss
- Medical Clinic, Department of Sports Medicine, University of Tuebingen, Germany.
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Siegele J, Horstmann T, Bunc V, Shifta P, Verle S, Niess A. [Relation between pelvis malposition and functional knee pain by long distance running]. Sportverletz Sportschaden 2010; 24:144-9. [PMID: 20845242 DOI: 10.1055/s-0029-1245638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE During endurance run knee problems often appear. This study wants to show the connection between a one- sided malposition of the pelvis and knee joint pain during endurance running. METHOD We tested endurance runners which had pelvis malposition and knee pain. Therefore 100 athletes were tested, 50 with knee pain and 50 without knee pain. Manual examination and clinical instruments were used for examination of sacroiliac joints for measurement of vertical distances between spinae iliacae anteriores superiores. Collected data were analyzed by appropriate statistical methods. RESULTS The results show that there is a connection between a one- sided pelvic malposition and knee pain during endurance running. These relations are probably realized by changes in lower extremity dysfunction as a result of pathological chains. The one sided pelvis malposition was in the control group significant higher (0.9 ± 0.4 cm) than in the control group (0.3 ± 0.2 cm). CONCLUSION There is a correlation between knee pain and os coxae malposition. (It is necessary in examine and treat the the cause- and effect chain to prevent injuries).
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Krauss I, List R, Janssen P, Maiwald C, Grau S, Horstmann T, Stacoff A. Comparison of distinctive gait variables using two different biomechanical models for ankle joint kinematics. Footwear Science 2010. [DOI: 10.1080/19424281003772971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Betsch M, Wild M, Jungbluth P, Thelen S, Hakimi M, Windolf J, Horstmann T, Rapp W. The rasterstereographic-dynamic analysis of posture in adolescents using a modified Matthiass test. Eur Spine J 2010; 19:1735-9. [PMID: 20490872 DOI: 10.1007/s00586-010-1450-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 02/01/2010] [Accepted: 05/09/2010] [Indexed: 11/29/2022]
Abstract
The Matthiass posture test is a clinical test to detect posture changes in children and adolescents. Aim of this study was to objectify this test using a dynamic rasterstereographic measuring device. We examined 31 healthy athletes during a modified Matthiass test with a dynamic rasterstereographic measuring system. Hereby the trunk inclination, kyphosis and lordosis angle were measured. The trunk inclination decreased by about 50% of the basic value just by raising the arms. Additional weight loads of only 5% body weight (bw) resulted in significant changes of the posture (lordosis and kyphosis angle) during this test. With this rasterstereographic measuring device it seems to be possible to determine spinal posture changes under dynamic conditions. The results suggest that additional weights of 5% bw during the Matthias-test are enough to create significant deviations in posture parameters, even in healthy subjects.
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Affiliation(s)
- Marcel Betsch
- Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Moorenstrasse 5, 40225 Düsseldorf, Germany
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Krauss I, Valiant G, Horstmann T, Grau S. Comparison of Female Foot Morphology and Last Design in Athletic Footwear—Are Men's Lasts Appropriate for Women? Res Sports Med 2010; 18:140-56. [PMID: 20397116 DOI: 10.1080/15438621003627216] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Inga Krauss
- a Medical Clinic, Department of Sports Medicine , University of Tuebingen , Tuebingen, Germany
| | - Gordon Valiant
- b Nike Sports Research Laboratory , Portland, Oregon, USA
| | - Thomas Horstmann
- a Medical Clinic, Department of Sports Medicine , University of Tuebingen , Tuebingen, Germany
- c Medical Park Bad Wiessee Gmb H & Co. , Bad Wiessee, Germany
| | - Stefan Grau
- a Medical Clinic, Department of Sports Medicine , University of Tuebingen , Tuebingen, Germany
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Boeer J, Mueller O, Krauss I, Haupt G, Horstmann T. Zuverlässigkeitsprüfung eines Messverfahrens zur Charakterisierung des Standverhaltens und Quantifizierung des Balancevermögens auf einer instabilen Plattform (Posturomed). Sportverletz Sportschaden 2010; 24:40-5. [DOI: 10.1055/s-0029-1245184] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Boeer J, Mueller O, Krauss I, Haupt G, Axmann D, Horstmann T. Effects of a sensory-motor exercise program for older adults with osteoarthritis or prosthesis of the hip using measurements made by the Posturomed oscillatory platform. J Geriatr Phys Ther 2010; 33:10-15. [PMID: 20503728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To assess changes in balance capacities after a 12-week sensory-motor training program for older adults with osteoarthritis or prosthesis of the hip. BACKGROUND Sensory-motor training is recommended to help aging adults with osteoarthritis maintain activity, avoid injurious falls, and improve functioning. Up to now, however, there has been no standard training protocol for sensory-motor training. METHODS AND MEASURES Thirty-five participants in a hip exercise group who had a mean age of 58 years (SD 12) were quasi-randomized into a training group (TG) and a control group (CG) by the month they applied for the Hip School program. The TG performed balance exercises using balance pads and received Hip School training once a week. The CG did not receive any training intervention. Balance was measured by recording center-of-pressure excursion while participants were in 1-legged stance on the oscillatory Posturomed platform. Outcome measures were the total path of center of pressure on the platform during balance recovery and the percentage of failed attempts. RESULTS The TG had a lower percentage of failed attempts (TG 5%, CG 18%, P = .001) and required fewer balance recovery movements to maintain balance (TG: mean [SD] measurement is 59 [36] mm; CG: 96 [68] mm, P = .036] after completing the 12-week training program. After the training period, participants in the TG compensated better for perturbations in the nondisplaced medial-lateral (ML) direction (pretest [SD] measurement was 48 [18] mm; posttest, 36 [14] mm; P= .001]. CONCLUSIONS Participants could successfully cope with more disturbances and improved their reactions to sudden displacements after training intervention. This exercise setting improves balance abilities and should be included in Hip School programs for patients with osteoarthritis.
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Affiliation(s)
- Johannes Boeer
- Medical Clinic, Department of Sports Medicine, University of Tübingen, Tübingen, Germany.
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Abstract
BACKGROUND Despite anecdotal evidence linking overpronation to the onset of Achilles tendinopathy (AT), there is little conclusive evidence of a particular movement pattern of the lower extremity associated with this injury. Therefore, the objective of the present study was to observe differences in the kinematic profiles of healthy runners (CON) and runners with mid-portion Achilles tendinopathy (ATG). MATERIALS AND METHODS In this cross-sectional analysis, 48 male height and weight matched subjects were invited to participate: 27 with mid-portion Achilles tendon pain and 21 asymptomatic controls. Subjects underwent lower extremity clinical examination, then ran barefoot for 10-trials at a self-selected pace. A 3D motion capture system analysed tri-plane kinematic data for the lower extremity. RESULTS The ATG displayed significantly greater sub-talar joint eversion displacement during mid-stance of the running gait (13 +/- 3 degrees vs. 11 +/- 3 degrees; p = 0.04). Trends were observed such that the ATG showed lower peak dorsiflexion velocity (300 +/- 39 degrees/s vs. 330 +/- 59 degrees/s; p = 0.08) and greater overall frontal plane ankle joint range of motion (45 degrees +/- 7 vs. 41 degrees +/- 7; p = 0.09). CONCLUSION We found an increase in eversion displacement of the sub-talar joint in runners with Achilles mid-portion tendinopathy. Based on the findings from this study, there is evidence that devices used to control sub-talar eversion may be warranted in patients with Achilles mid-portion tendinopathy who demonstrate over-pronation during mid-stance of the running gait.
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Affiliation(s)
- Michael Ryan
- University of British Columbia, Experimental Medicine Program, 602-1355 West 14th, Vancouver V6H1R2, Canada.
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Abstract
Current shoe designs do not allow for the comprehensive 3-D foot shape, which means they are unable to reproduce the wide variability in foot morphology. Therefore, the purpose of this study was to capture these variations of children's feet by classifying them into groups (types) and thereby provide a basis for their implementation in the design of children's shoes. The feet of 2867 German children were measured using a 3-D foot scanner. Cluster analysis was then applied to classify the feet into three different foot types. The characteristics of these foot types differ regarding their volume and forefoot shape both within and between shoe sizes. This new approach is in clear contrast to previous systems, since it captures the variability of foot morphology in a more comprehensive way by using a foot typing system and therefore paves the way for the unimpaired development of children's feet. Previous shoe systems do not allow for the wide variations in foot morphology. A new approach was developed regarding different morphological foot types based on 3-D measurements relevant in shoe construction. This can be directly applied to create specific designs for children's shoes.
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Affiliation(s)
- M Mauch
- crossklinik, Swiss Olympic Medical Center, Basel, Switzerland.
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Grau S, Maiwald C, Krauss I, Axmann D, Horstmann T. The influence of matching populations on kinematic and kinetic variables in runners with iliotibial band syndrome. Res Q Exerc Sport 2008; 79:450-457. [PMID: 19177946 DOI: 10.1080/02701367.2008.10599511] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this study was to assess how participant matching influences biomechanical variables when comparing healthy runners and runners with iliotibial band syndrome (ITBS). We examined 52 healthy runners (CO) and 18 with ITBS, using three-dimensional kinematics and pressure distribution. The study population was matched in three ways and compared with the biomechanical findings: ITBS versus CO I (unmatched), ITBS versus CO II (matched to gender) and ITBS versus CO III (matched to gender height, and weight). The final number of participants in each group was n = 18. The kinematic variables showed a dependency on the matching process. The largest statistically significant differences (after Bonferroni adjustment) in the frontal and transverse planes were between ITBS and CO III (p = .008). Pressure measurements were also dependent on the matching process, with decreasing and nonsignificant differences (p = .006) between ITBS and CO after refining the process (ITBS vs. CO III). The results of this study and the necessity of matching seem to be plausible (lever arms, different running styles). Data matching is important for understanding overuse injuries in running.
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Affiliation(s)
- Stefan Grau
- Department of Sports Medicine, University of Tübingen, Germany.
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Abstract
The purpose of the study was to investigate sex-related differences in foot morphology. In total, 847 subjects were scanned using a 3-D-footscanner. Three different analysis methods were used: (1) comparisons were made for absolute foot measures within 250-270 mm foot length (FL); (2) and for averaged measures (% FL) across all sizes; (3) the feet were then classified using a cluster analysis. Within 250-270 mm FL, male feet were wider and higher (mean differences (MD) 1.3-5.9 mm). No relevant sex-related differences could be found in the comparison of averaged measures (MD 0.3-0.6% FL). Foot types were categorised into voluminous, flat-pointed and slender. Shorter feet were more often voluminous, longer feet were more likely to be narrow and flat. However, the definition of 'short' and 'long' was sex-related; thus, allometry of foot measures was different. For shoe design, measures should be derived for each size and sex separately. Different foot types should be considered to account for the variety in foot shape. Improper footwear can cause foot pain and deformity. Therefore, knowledge of sex-related differences in foot measures is important to assist proper shoe fit in both men and women. The present study supplements the field of knowledge within this context with recommendations for the manufacturing of shoes.
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Affiliation(s)
- I Krauss
- Department of Sports Medicine, University of Tuebingen, Germany.
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Grau S, Krauss I, Maiwald C, Best R, Horstmann T. Hip Abductor Weakness is not the Cause for Iliotibial Band Syndrome. Int J Sports Med 2008; 29:579-83. [DOI: 10.1055/s-2007-989323] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE Due to the fact that there is a global increase in obesity, knowledge about the impact of obesity on the development of a child's foot is of great importance for orthopaedic and paediatric physicians with regard to prevention, clinical treatment and management. Therefore, the purpose of this study was to investigate the influence of body mass on the development of a child's foot based on a foot type classification. METHODS The feet of 1450 boys and 1437 girls aged 2-14 years were measured using a three-dimensional (3D) foot scanner (Pedus, Human Solutions Inc., Germany) in a bipedal upright position. Twelve relevant 3D foot measures were recorded, as well as the children's age, gender, height and mass. Factor analysis of principal components was used to obtain a smaller number of independent and standardized variables. The variables were used for cluster analysis to classify the children's feet. RESULTS Five foot types were identified: flat, robust, slender, short and long feet. There were significant differences among foot types with respect to the children's body mass index. Normal weight children displayed an almost equal distribution of all foot types throughout childhood. Flat and robust feet were more common in overweight children, whereas underweight children showed more slender and long feet. CONCLUSION The influence of excess, as well as deficient mass could be verified for the comprehensive foot morphology based on a foot type classification. Subsequently, foot discomfort as a result of various musculoskeletal disorders may develop. In turn, this might keep the children from being active and therefore reinforce the risk of developing obesity. However, there is still a lack of information regarding these relationships, which needs to be determined. This knowledge may help prevent orthopaedic foot problems and injuries.
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Affiliation(s)
- M Mauch
- Department of Sports Medicine, Medical Clinic, University of Tuebingen, Tuebingen, Germany.
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Martini F, Horstmann T, Knak J, Mayer F, Zacher J. Die Bedeutung der präoperativen Physiotherapie vor einer Hüfttotalendoprothesenversorgung bei Coxarthrose. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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