[Lombosacral radiculopathy (L3-S1) and specificity of multifidus EMG]

AIMS OF THE STUDY

This prospective study tried to establish, in a group of patients with lombosacral radiculopathy, whether the electromyography of the multifidus muscles following the "Paraspinal Mapping" described by Haig and colleagues (1991, 1993, 1995, 1997) allows to specify the exact level of the radiculopathy.

MATERIAL AND METHODS

Twenty-three patients with symptoms of mono or pluriradiculopathy were submitted to an EMG of the lower limbs and multifidus muscles at different levels in accordance to the "Paraspinal Mapping" cartography.

RESULTS AND CONCLUSION

No patient had signs of acute denervation in the multifidus muscles that corresponded exclusively to the suspected levels as determined by clinical and radiological examinations. No patient had signs of acute denervation in the multifidus muscles without associated signs in the lower limb muscles. Conversely, four patients had signs of acute denervation in the lower limb muscles without any signs in the multifidus muscles. In our small series, the EMG of the multifidus muscles was neither sensitive nor specific and did not allow by itself topographical diagnosis.

An Optimization Algorithm for Human Joint Angle Time-History Generation Using External Force Data

A mathematical model is presented that estimates joint kinematics and kinetics using measured external resultant loads and readily available parameters. The musculo-skeletal system was represented by a planar three degrees of freedom open kinematic chain. Information extraction was limited to the flexion-extension function of ankle, knee, and hip during quasi-planar motor tasks. Starting from plausible first approximation kinematics, other kinematic functions are iteratively generated by an optimization algorithm and corresponding ground reaction loads are calculated through inverse dynamics. Kinematic coordinates are represented using B-splines and modified by manipulating the control points. The iterative procedure stops and provides the final kinematic and kinetic estimates when a similarity criterion between estimated and measured ground reaction components is satisfied. The model structure was elaborated upon and the algorithm parameters optimized for robustness and accuracy using a benchmark motion in a simulation exercise. The maximal root mean square difference over time between estimated and benchmark quantities was approximately 1% of the peak to peak value for ground reaction components and intersegmental couples, and 6% for joint angles.

Effect of inverted orthoses on lower-extremity mechanics in runners

INTRODUCTION

Foot orthoses are recommended for individuals with injuries associated with abnormal lower-extremity mechanics. However, the biomechanical effect of these devices is not completely understood. Most clinicians and researchers believe that foot orthoses are effective in reducing some aspect of rearfoot motion. This is important as many injuries are suggested to be the result of increased pronation. Inverted orthoses are a more aggressive treatment in those whose symptoms do not respond to standard orthotics. They are likely to alter motion in all planes. However, no three-dimensional studies have assessed lower-extremity mechanics in individuals wearing inverted orthotics.

PURPOSE

The purpose of this study was to compare the three-dimensional kinematics and kinetics of the rearfoot and knee during running while varying orthotic intervention.

METHODS

Eleven subjects were initially fitted with standard foot orthoses and then with inverted orthoses. Three-dimensional kinematic and kinetic data were collected for conditions of no orthoses, standard orthoses, and inverted orthoses.

RESULTS

There were no differences between conditions in peak rearfoot eversion or rearfoot eversion excursion. Peak rearfoot inversion moment and work were significantly reduced (P = 0.045 and P < 0.001, respectively) in the inverted orthotic condition suggesting a decreased demand on the soft tissue structures that control eversion. Significant differences were seen in tibial rotation (P = 0.043), knee adduction (P = 0.035), and knee abduction moment (P < 0.001) in the inverted orthotic condition, suggesting alterations were made further up the kinetic chain.

CONCLUSIONS

The differences in kinetic parameters at the rearfoot may result in fewer injuries of the rearfoot soft tissue structures when using inverted orthotics. These alterations in lower-extremity mechanics associated with inverted orthoses provide clinicians some evidence for prescribing this device.

Heterogeneity of muscle recruitment pattern during pedaling in professional road cyclists: a magnetic resonance imaging and electromyography study

Although a number of studies have been devoted to the analysis of the activity pattern of the muscles involved in pedaling in sedentary subjects and/or amateur cyclists, data on professional cyclists are scarce and the issue of inter-individual differences has never been addressed in detail. In the present series of experiments, we performed a non-invasive investigation using functional magnetic resonance imaging and surface electromyography to determine the pattern of activity of lower limb muscles during two different exhausting pedaling exercises in eight French professional cyclists. Each subject performed an incremental exercise during which electromyographic activity of eight lower limb muscles and respiratory variables were recorded. After a 3-h recovery period, transverse relaxation times (T2) were measured before and just after a standardized constant-load maximal exercise in order to quantify exercise-related T2 changes. The global EMG activity illustrated by the root mean square clearly showed a large inter-individual difference during the incremental exercise regardless of the investigated muscle (variation coefficient up to 81%). In addition, for most of the muscles investigated, the constant-load exercise induced T2 increases, which varied noticeably among the subjects. This high level of variation in the recruitment of lower limb muscles in professional cyclists during both incremental and constant-load exercises is surprising given the homogeneity related to maximal oxygen consumption and training volume. The high degree of expertise of these professional cyclists was not linked to the production of a common pattern of pedaling and our results provide an additional evidence that the nervous system has multiple ways of accomplishing a given motor task, as has been suggested previously by neural control theorists and experimentalists.

Joint acceleration during gait in relation to age

Forty-four male and female subjects with no history of falling and whose ages ranged from 10 to 68 years participated in a series of experiments to assess movement at the joints during gait while walking in a straight line, in pivot turns and in turns of 0.33 and 0.66 m diameter. Acceleration at the joints in the forward and side-to-side direction was measured by dual-axis accelerometers placed at the ankles, knees, hips, shoulders, and on the head. Eye movement was assessed from electrodes placed on the sides of the eyes. The results of the experiments showed that for people whose age was above 40 years, significant increases in the forward-back and side-to-side movements occurred at all joints and progressively increased with age. By age 60, adverse movement of the joints as much as quadrupled in many subjects when compared to people whose age was 20-30 years. The increase in joint acceleration occurred equally in the front-back and side-to-side planes. The mechanism of the increased joint movement may be due to tendon laxness, peripheral neuropathy or loss of central control of gait due to age. Accelerometry may be a much more sensitive technique to analyze abnormalities in gait than standard video or observational gait analysis. Results are given as mean (SD) unless otherwise stated.

Power output of the lower limb during variable inertial loading: a comparison between methods using single and repeated contractions

The power-inertial load relationship of the lower limb muscles was studied during a single leg thrust using the Modified Nottingham Power Rig (mNPR) and during cycling exercise in nine young male subjects. The relationship between peak power and inertial load showed a parabolic-like relationship for mNPR exertions, with a peak [937 (SD 246) W] at 0.158 kg m(2), this being significantly (P <0.05) different from the power generated at both the lowest [723 (162) W] and highest [756 (206) W] inertial loads. In contrast, for cycling exercise power output did not differ significantly between inertial loads, except at the lowest inertia where power output was significantly ( P<0.05) less compared with all other inertial loads. Maximum peak power output during cycling was 1,620 (336) W, which was significantly (P <0.05) greater than that recorded on the mNPR. However, a close association was observed between the mean power generated by each method (r=0.84, P<0.05). The results suggest that during a single contraction a range of inertial loads is required to allow peak power to be expressed. Above a certain critical value, this is unnecessary during cycling movements where the load can be repeatedly accelerated.

Coordination modes in the multisegmental dynamics of hula hooping

In hula hooping, organized motions of the body keep the hoop in stable oscillatory motion parallel to the ground. We examined the hypothesis that the multiple degrees of freedom (DF) of the lower limbs in producing the oscillations are resolved into a few control DF. The Karhunen-Loève decomposition was applied to the kinematics of the lower limbs in three experiments in which oscillation amplitude and frequency were manipulated. Kinematic variance was accommodated by two modes whose relative contributions varied with task parameters. Complementary analyses of interjoint Hilbert relative phase suggested a lower-limb organization into a vertical suspension mode and an oscillatory fore-aft mode. These modes might stabilize the hoop's angular momentum by controlling, respectively, its vertical and horizontal components.

Postexercise increase of free fatty acids. A qualitative indicator for free fatty acid utilisation during exercise?

AIM

The purpose of this study was to verify the hypothesis that the postexercise increase (PEI) of plasma free fatty acid (FFA) concentrations after cessation of exercise is a suitable qualitative indicator for the FFA utilisation during the foregoing exercise.

METHODS

Fourteen, 17 and 23 healthy subjects participated in 3 test series performing several prolonged exercise protocols (PEP) on a bicycle ergometer. During and after cessation of the PEP heart frequency, lactate and FFA were measured.

RESULTS

Fasting resulted in an increase of PEI (90%, p<0.05) and the synergistic use of upper body muscles during cycling caused a significant rise of PEI compared to "regular" cycling (39%, p<0.01). Increasing workload step by step produced continuously rising PEI (p<0.05), only from 42% to 50% of maximal workload PEI decreased by 17% (p=n.s.).

CONCLUSION

The results support the hypothesis that PEI is a suitable qualitative indicator for FFA utilisation during a foregoing exercise. Furthermore the results indicate that there is a maximum of FFA utilisation in the legs at 40% of maximum workload during cycling and that the upper body muscles contribute substantially to total body FFA turnover at high inten-sities, an aspect to which possibly too little attention has been paid to when quantifying FFA turnover during cycling.

Electrical stimulation of human lower extremities enhances energy consumption, carbohydrate oxidation, and whole body glucose uptake

Our laboratory has recently demonstrated that low-frequency electrical stimulation (ES) of quadriceps muscles alone significantly enhanced glucose disposal rate (GDR) during euglycemic clamp (Hamada T, Sasaki H, Hayashi T, Moritani T, and Nakao K. J Appl Physiol 94: 2107–2112, 2003). The present study is further follow-up to examine the acute metabolic effects of ES to lower extremities compared with voluntary cycle exercise (VE) at identical intensity. In eight male subjects lying in the supine position, both lower leg (tibialis anterior and triceps surae) and thigh (quadriceps and hamstrings) muscles were sequentially stimulated to cocontract in an isometric manner at 20 Hz with a 1-s on-off duty cycle for 20 min. Despite small elevation of oxygen uptake by 7.3 ± 0.3 ml·kg-1·min-1 during ES, the blood lactate concentration was significantly increased by 3.2 ± 0.3 mmol/l in initial period (5 min) after the onset of the ES ( P < 0.01), whereas VE showed no such changes at identical oxygen uptake (7.5 ± 0.3 ml·kg-1·min-1). ES also induced enhanced whole body carbohydrate oxidation as shown by the significantly higher respiratory gas exchange ratio than with VE ( P < 0.01). These data indicated increased anaerobic glycolysis by ES. Furthermore, whole body glucose uptake determined by GDR during euglycemic clamp demonstrated a significant increase during and after the cessation of ES for at least 90 min ( P < 0.01). This post-ES effect was significantly greater than that of the post-VE period ( P < 0.01). These results suggest that ES can substantially enhance energy consumption, carbohydrate oxidation, and whole body glucose uptake at low intensity of exercise. Percutaneous ES may become a therapeutic utility to enhance glucose metabolism in humans.

Effects of bilateral vestibular loss on podokinetic after-rotation

We asked what the role of the vestibular system is in adaptive control of locomotor trajectory in response to walking on a rotating disc. Subjects with bilateral vestibular loss (BVL) were compared to age- and gender-matched controls (CTRL). Subjects walked in place on the surface of a rotating disc for 15 min and then attempted to step in place without vision on a stationary surface for 30 min. CTRL subjects demonstrated podokinetic after-rotation (PKAR), involuntarily and unknowingly turning themselves in circles while attempting to step in place. PKAR in CTRLs was characterized by a rapid rise in turning velocity over the first 1-2 min, followed by a gradual decay over the remaining 28 min. Subjects with BVL also demonstrated PKAR and had no knowledge of their turning. However, PKAR in BVLs was characterized by an extremely rapid, essentially instantaneous rise. Subjects with BVL immediately turned at maximum velocity and exhibited a gradual decay throughout the entire 30 min period. Despite this difference in the initial portion of PKAR in BVLs, their responses were not significantly different from CTRLs during minutes 2 to 30 of the response. These results suggest that vestibular inputs normally suppress PKAR velocity over the first 1-2 min of the response, but do not greatly influence PKAR decay. PKAR is therefore a process mediated primarily by somatosensory information and vestibular inputs are not required for its expression. Additionally, the absence of vestibular inputs does not result in increased somatosensory sensitivity that alters podokinetic intensity or decay time constants.

A step and a hop on the M�ller-Lyer: illusion effects on lower-limb movements

Past studies have shown that the effects of visual illusions on upper-limb movements can be modulated by the availability of current or recent visual information. The generality of this finding across body movements was examined by measuring the impact of the Müller-Lyer illusion on two types of lower limb actions. Subjects stood at one end of a Müller-Lyer figure, then either stepped or hopped to the other end. Visual feedback was manipulated through the use of visual closed-loop, open-loop, and open-loop three second delay conditions. For both stepping and hopping, effects of the illusion on movement accuracy were small in the closed-loop, moderate in the open-loop, and large in the three-second open-loop delay condition. These results were similar to those found in studies involving the Müller-Lyer illusion and upper-limb movements. The similar effects across different body movements suggests that a common visuomotor system subserves both upper and lower-limb movements, and that egocentric and allocentric reference frames make similar contributions for the two types of movements.

Not letting the left leg know what the right leg is doing: limb-specific locomotor adaptation to sensory-cue conflict

We investigated the phenomenon of limb-specific locomotor adaptation in order to adjudicate between sensory-cue-conflict theory and motor-adaptation theory. The results were consistent with cue-conflict theory in demonstrating that two different leg-specific hopping aftereffects are modulated by the presence of conflicting estimates of self-motion from visual and nonvisual sources. Experiment 1 shows that leg-specific increases in forward drift during attempts to hop in place on one leg while blindfolded vary according to the relationship between visual information and motor activity during an adaptation to outdoor forward hopping. Experiment 2 shows that leg-specific changes in performance on a blindfolded hopping-to-target task are similarly modulated by the presence of cue conflict during adaptation to hopping on a treadmill. Experiment 3 shows that leg-specific aftereffects from hopping additionally produce inadvertent turning during running in place while blindfolded. The results of these experiments suggest that these leg-specific locomotor aftereffects are produced by sensory-cue conflict rather than simple motor adaptation.

Optimal loading during two different leg-press movements in female rowers

PURPOSE

The purpose of this study was to determine the optimal load for power during concentric only (CO) and stretch-shortening cycle (SSC) leg-press movements during the initial portion of the concentric phase as well as throughout the entire concentric phase in trained female rowers.

METHODS

Thirty female rowers (age = 19.6 +/- 1.2 yr) were tested for strength (1RM), mean power (MP), peak power (PP), as well as power output at 50, 100, 150, and 200 ms (P50-P200) during both CO and SSC leg-press movements and across six different loads (30-80% 1RM) on the Omnikinetic dynamometer.

RESULTS

Split-split plot analysis indicated that MP and PP were maximized at approximately 60% 1RM in both CO and SSC movements. There were no significant differences in P50 and P100 across all loads for both CO and SSC. P150 was greatest at 30, 40, 50, and 60% 1RM for CO and SSC movements. P200 was maximized at 30, 40, and 50% 1RM during CO. P200 was maximized at 50, 60, and 70% 1RM during SSC.

CONCLUSIONS

There was no difference in the optimal loads for MP (40, 50, and 60% 1RM) and PP (50, 60, and 70% 1RM) between CO and SSC movements. An enhancement of power during the initial 200 ms of the concentric phase of SSC movements was observed. Greater time to reach PP was the reason for the enhancement in PP output observed in CO movements. The CO training regimen associated with the sport of rowing also may have lessened the effect of the SSC.

A Three-Dimensional Kinematic and Dynamic Study of the Lower Limb During the Stance Phase of Gait Using an Homogeneous Matrix Approach

This paper presents a method to analyze three dimensional kinematics and dynamics of lower limb during walking. The proposed method is based on a homogeneous matrix concept, derived from robotics and using compact, expressive notation convenient for computer applications. The major advantage of this method is that no hypothesis is required on the joint model, which makes it applicable to complex and pathologic joints. Kinematic data are computed from 3-D trajectories of markers collected by a motion analysis system. External forces applied on the leg are measured synchronously during the stance phase of gait. Angular velocity components obtained using the homogeneous matrix method are displayed for three subjects and compared with those obtained from the same experimental data using a helical axis method. Then, intersegmental moments calculated from the inverse dynamic part of the homogeneous matrix method are shown on the same subjects. Kinematic results indicate that there are no significant differences between the methods, thus demonstrating the reproducibility of the stance phase of gait in the sagittal plane. Use of this synthetic homogeneous method developed for both kinematics and dynamics of rigid bodies demonstrates good promise for applications in biomechanics.

Coupling Between "Hand" Primary Sensorimotor Cortex and Lower Limb Muscles After Ulnar Nerve Surgical Transfer in Paraplegia

Previous neuroimaging evidence revealed an "invasion" of "hand" over "lower limb" primary sensorimotor cortex in paraplegic subjects, with the exception of a rare patient who received a surgical motor reinnervation of hip-thigh muscles by the ulnar nerve. Here, the authors show that a functional reorganization of cortico-muscular and cortico-cortical oscillatory coupling was related to the recovery of the rare patient, as a paradigmatic case of long-term plasticity in human sensorimotor cortex after motor reinnervation of paraplegic muscles. This conclusion was based on electroencephalographic and electromyographic data collected while the patient and normal control subjects performed isometric muscle contraction of the left hand or lower limb. Cortico-muscular and cortico-cortical coupling was estimated by electroencephalographic-electromyographic coherence and directed transfer function of a multivariate autoregressive model.

Motion measurements in the jumping of a mountain bike

Mountain biking is generally a much more extreme sport than road cycling. It exhibits large motions and loadings, and involves complicated interactions between the rider and the bike. A dynamic model of a mountain bike and rider is being developed that requires validation by comparing predicted and actual dynamic performance. This paper reports the first step by acquiring experimental data of a moderately extreme maneuver; a mid speed jump and landing and was undertaken as part of a senior level instrumentation class. Both biomechanics and mechanical engineering studies can benefit from this data. A mountain bike and rider are instrumented for video marker tracking during the jumping maneuver. Positions are numerically differentiated to obtain velocities and accelerations. This motion data is examined for continuity and reasonableness. Future manipulation of this data will provide joint reaction data and center of mass motion for a bicycle/rider model validation.

Reliability of a measure of muscle extensibility in fullterm and preterm newborns

PURPOSE

The purpose of this study was to examine the test-retest and inter-rater reliability of a measure of muscle extensibility developed by Tardieu, de la Tour, Bret, and Tardieu (1982) in fullterm and preterm newborns.

METHOD

Twenty-one fullterm infants and twenty preterm infants were examined by two physical therapists. Each physical therapist measured AO (shortened position of the muscle belly and lengthened tendon) and AMax (maximum muscle belly and tendon length) of the gastrocnemius/ soleus muscle twice in succession. Reliability was assessed using intraclass correlation coefficients (2,2) and (3,2).

RESULTS

Inter-rater reliability between the two examiners ranged from .86 to .97 and test-retest reliability on the two measures ranged from .91 to .98.

CONCLUSIONS

The results suggest that this measure of muscle extensibility is reliable in the gastrocnemius/soleus muscle with fullterm and preterm newborns. Further research is needed to investigate if differences in muscle extensibility are present between fullterm and preterm infants and the relationship between muscle extensibility and active movement.

An Electrophysiological Study of the Deep Peroneal Sensory Nerve

The electrodiagnosis of peripheral neuropathy is often based on nerve conduction abnormalities in sensory nerves of the lower extremities. We performed nerve conduction studies of the deep peroneal sensory nerve prospectively in 63 limbs of 38 normal subjects. The sensory amplitudes showed a decreasing trend with increasing age. 21% of subjects had absent sensory potentials, especially those in the older age groups. This was seen in contrast with superficial peroneal and sural potentials, which were universally present. Although the deep peroneal sensory nerve is located in the distal lower limb, it should be used with caution in evaluating peripheral neuropathy, in view of the frequent occurrence of absent potentials even in asymptomatic normal subjects.

Identifying head-trunk and lower limb contributions to gaze stabilization during locomotion

The goal of the present study was to determine how the multiple, interdependent full-body sensorimotor subsystems respond to a change in gaze stabilization task constraints during locomotion. Nine subjects performed two gaze stabilization tasks while walking at 6.4 km/hr on a motorized treadmill: 1) focusing on a central point target; 2) reading numeral characters; both presented at 2 m in front at the level of their eyes. While subjects performed the tasks we measured: temporal parameters of gait, full body sagittal plane segmental kinematics of the head, trunk, thigh, tibia and foot, accelerations along the vertical axis at the head and the tibia, and the vertical forces acting on the support surface. We tested the hypothesis that with the increased demands placed on visual acuity during the number recognition task, subjects would modify full-body segmental kinematics in order to reduce perturbations to the head in order to successfully perform the task. We found that while reading numeral characters as compared to the central point target: 1) compensatory head pitch movement was on average 22% greater despite the fact that the trunk pitch and trunk vertical translation movement control were not significantly changed; 2) coordination patterns between head and trunk as reflected by the peak cross correlation between the head pitch and trunk pitch motion as well as the peak cross correlation between the head pitch and vertical trunk translation motion were not significantly changed; 3) knee joint total movement was on average 11% greater during the period from the heel strike event to the peak knee flexion event in stance phase of the gait cycle; 4) peak acceleration measured at the head was significantly reduced by an average of 13% in four of the six subjects. This was so even when the peak acceleration at the tibia and the transmission of the shock wave at heel strike (measured by the peak acceleration ratio of the head/tibia and the time lag between the tibial and head peak accelerations) remained unchanged. Taken together these results provide further evidence that the full body contributes to gaze stabilization during locomotion, and that its different functional elements can be modified online to contribute to gaze stabilization for different visual task constraints.

Finite element modelling of contracting skeletal muscle

To describe the mechanical behaviour of biological tissues and transport processes in biological tissues, conservation laws such as conservation of mass, momentum and energy play a central role. Mathematically these are cast into the form of partial differential equations. Because of nonlinear material behaviour, inhomogeneous properties and usually a complex geometry, it is impossible to find closed-form analytical solutions for these sets of equations. The objective of the finite element method is to find approximate solutions for these problems. The concepts of the finite element method are explained on a finite element continuum model of skeletal muscle. In this case, the momentum equations have to be solved with an extra constraint, because the material behaves as nearly incompressible. The material behaviour consists of a highly nonlinear passive part and an active part. The latter is described with a two-state Huxley model. This means that an extra nonlinear partial differential equation has to be solved. The problems and solutions involved with this procedure are explained. The model is used to describe the mechanical behaviour of a tibialis anterior of a rat. The results have been compared with experimentally determined strains at the surface of the muscle. Qualitatively there is good agreement between measured and calculated strains, but the measured strains were higher.

Venous occlusion to the lower limb attenuates vasoconstriction in the nonexercised limb during posthandgrip muscle ischemia

We investigated the effects of increases in calf volume on cardiovascular responses during handgrip (HG) exercise and post-HG exercise muscle ischemia (PEMI). Seven subjects completed two trials: one control (no occlusion) and one venous occlusion (VO) session. Both trials included a baseline measurement followed by 15 min of rest (REST), 2 min of HG, and 2 min of PEMI. VO was applied at 100 mmHg via cuffs placed around both distal thighs during REST, HG, and PEMI. Mean arterial pressure, heart rate, forearm blood flow (FBF) in the nonexercised arm, and forearm vascular resistance (FVR) in the nonexercised arm (FVR) were measured. During REST and HG, there were no significant differences between trials in all parameters. During PEMI in the control trial, mean arterial pressure and FVR were significantly greater and FBF was significantly lower than baseline values (P < 0.05 for each). In contrast, in the VO trial, FBF and FVR responses were different from control responses. In the VO trial, FBF was significantly greater than in the control trial (4.7 +/- 0.5 vs. 2.5 +/- 0.3 ml x 100 ml(-1) x min(-1), P < 0.05) and FVR was significantly lower (28.0 +/- 4.8 vs. 49.1 +/- 4.6 units, respectively, P < 0.05). These results indicate that increases in vascular resistance in the nonexercised limb induced by activation of the muscle chemoreflex can be attenuated by increases in calf volume.

Effect of the foot on the mechanical alignment of the lower limbs

The authors evaluated the effect of the foot on the loading axis of the lower limb measured from radiographs in 30 pediatric patients. Deviation at the knee was calculated for the hip-ankle (traditional) and the hip-foot lines (heel lined up with a metal wire). A trigonometric model of the limb loading axis was developed with predicted mechanical axis deviations at the knee. Statistics were based on the methods of Bland and Altman. Mechanical axis deviation at the knee in the frontal plane varies with foot height, foot-tibial angle, and genu valgum. The predicted trigonometric model was found to be in agreement with measured radiographic values. Including the foot in the radiographic measurement of limb alignment may increase validity of surgical planning for correction of malalignment and for evaluation of degenerative arthritis risk at the knee level.

Extramuscular myofascial force transmission: experiments and finite element modeling

The specific purpose of the present study was to show that extramuscular myofascial force transmission exclusively has substantial effects on muscular mechanics. Muscle forces exerted at proximal and distal tendons of the rat extensor digitorium longus (EDL) were measured simultaneously, in two conditions (1) with intact extramuscular connections (2) after dissecting the muscles' extramuscular connections to a maximum extent without endangering circulation and innervation (as in most in situ muscle experiments). A finite element model of EDL including the muscles' extramuscular connections was used to assess the effects of extramuscular myofascial force transmission on muscular mechanics, primarily to test if such effects lead to distribution of length of sarcomeres within muscle fibers. In condition (1), EDL isometric forces measured at the distal and proximal tendons were significantly different (F(dist) > F(prox), DeltaF approximates maximally 40% of the proximal force). The model results show that extramuscular myofascial force transmission causes distributions of strain in the fiber direction (shortening in the proximal, lengthening in the distal ends of fibers) at higher lengths. This indicates significant length distributions of sarcomeres arranged in series within muscle fibers. Stress distributions found are in agreement with the higher distal force measured, meaning that the muscle fiber is no longer the unit exerting equal forces at both ends. Experimental results obtained in condition (2) showed no significant changes in the length-force characteristics (i.e., proximo-distal force differences were maintained). This shows that a muscle in situ has to be distinguished from a muscle that is truly isolated in which case the force difference has to be zero. We conclude that extramuscular myofascial force transmission has major effects on muscle functioning.

Gait transitions are not dependent on changes in intralimb coordination variability

The HKB model (H. Haken, J. A. S. Kelso, & H. Bunz, 1985) of coordination has been predominantly applied to upper extremity stationary movements. It predicts increased variability of relative phase before a transition and a decrease after a transition. The authors of the present study extended the intralimb lower extremity locomotive research of F. J. Diedrich and W. H. Warren (1995) by conducting continuous treadmill walk-to-run and run-to-walk trials with 10 participants. Standard deviation of knee-ankle and hip-ankle relative phase did not increase before walk-to-run and run-to-walk transitions, and there was no decrease in knee-ankle relative phase variability after either transition. The results of this study did not provide strong support for application of the variability predictions of the HKB model of coordination to lower extremity intralimb coordination during gait transitions.