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Wade FE, Kellaher GK, Pesquera S, Baudendistel ST, Roy A, Clark DJ, Seidler RD, Ferris DP, Manini TM, Hass CJ. Kinematic analysis of speed transitions within walking in younger and older adults. J Biomech 2022; 138:111130. [PMID: 35569430 PMCID: PMC9284670 DOI: 10.1016/j.jbiomech.2022.111130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/02/2023]
Abstract
The ability to adapt to environmental and task demands while walking is critical to independent mobility outside the home and this ability wanes with age. Such adaptability requires individuals to acutely change their walking speed. Regardless of age, changes between walking speeds are common in daily life, and are a frequent type of walking adaptability. Here, we report on older and younger adults when transitioning from preferred walking speed overground to either slower or faster walking. Specifically, we evaluated biomechanical parameters prior to, during, and post transition. Individuals approached the walking speed transition similarly, independent of whether the transition was to slower or faster walking. Regardless of age or walking speed, the step during which a walking speed transition occurred was distinct from those prior- and post- transition, with on average 0.15 m shorter step lengths, 3.6° more hip flexion, and 3.3° more dorsiflexion during stance. We also found that peak hip flexion occurred 22% later, and peak hip extension (39%), knee flexion (26%), and dorsiflexion (44%) occurred earlier in stance for both typical to slower and typical to faster walking. Older adults had altered timing of peak joint angles compared with younger adults across both acceleration and deceleration conditions, indicating age-dependent responses to changing walking speed. Our findings are an important first step in establishing values for kinematics during walking speed transitions in younger and typical older adults.
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Affiliation(s)
- Francesca E Wade
- Department of Applied Physiology & Kinesiology, University of Florida, United States.
| | - Grace K Kellaher
- Department of Applied Physiology & Kinesiology, University of Florida, United States; Department of Kinesiology & Applied Physiology, University of Delaware, United States
| | - Sarah Pesquera
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, United States; Center for the Intrepid, San Antonio, United States
| | - Sidney T Baudendistel
- Department of Applied Physiology & Kinesiology, University of Florida, United States; Department of Physical Therapy, Washington University St. Louis, School of Medicine, United States
| | - Arkaprava Roy
- Department of Biostatistics, University of Florida, United States
| | - David J Clark
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, United States; Department of Aging and Geriatric Research, University of Florida, United States
| | - Rachael D Seidler
- Department of Applied Physiology & Kinesiology, University of Florida, United States; Norman Fixel Institute for Neurological Diseases, University of Florida, United States
| | - Daniel P Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, United States
| | - Todd M Manini
- Institute on Aging, University of Florida, United States; Department of Health Outcomes and Biomedical Informatics, University of Florida, United States
| | - Chris J Hass
- Department of Applied Physiology & Kinesiology, University of Florida, United States; Norman Fixel Institute for Neurological Diseases, University of Florida, United States
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152
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Thielen M, Waible D, Krautwurst BK, Wolf SI, Dreher T. Effects of artificially induced bilateral internal rotation gait on gait kinematics and kinetics. Gait Posture 2022; 95:204-209. [PMID: 35533614 DOI: 10.1016/j.gaitpost.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 04/20/2022] [Accepted: 05/02/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Bilateral internal rotation gait is a common gait abnormality in children with bilateral cerebral palsy, but still not fully understood. RESEARCH QUESTION The aim of this clinical study was to analyze the effects of artificially induced bilateral internal rotation gait on kinematics and kinetics. Our hypothesis was, that the internal rotation gait defined as increased dynamic internal hip rotation itself causes significant alterations in gait kinematics and kinetics. METHODS 30 typically developing children with a mean age of 12 (SD 3) years (range 8 - 16) performed three-dimensional gait analysis in two different conditions: with unaffected gait and with artificially induced bilateral internal rotation gait with two rotation bandages worn in order to internally rotate the hips. Kinematic and kinetic changes between these two conditions were calculated and compared using a mixed linear model with "gait condition" as fixed effect and both "limb" and "patient" as random effects. RESULTS The rotation bandages induced a significant increase in internal hip rotation and foot progression angle towards internal without affecting pelvic rotation. The peak hip internal rotator moment during loading response and the peak hip external rotator moment during the first half of stance phase increased significantly and the peak hip internal rotator moment during the second half of stance phase decreased significantly. Anterior pelvic tilt, hip flexion, knee flexion and ankle dorsiflexion increased significantly. The first peak of the frontal hip moment decreased, and the second increased significantly. The second peak of the frontal knee moment decreased significantly, while the first didn't change significantly. SIGNIFICANCE The data suggest, that the bilaterally increased dynamic internal hip rotation itself has a relevant impact on frontal hip moments. The increased anterior pelvic tilt, hip and knee flexion may be either induced by the pull of the rotation bandage or a secondary gait deviation.
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Affiliation(s)
- Mirjam Thielen
- University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany; BG Klinik Ludwigshafen, Department of Hand, Plastic and Reconstructive Surgery, Burn Center, Plastic and Hand Surgery, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen am Rhein, Germany.
| | - Dorothea Waible
- University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany.
| | - Britta K Krautwurst
- University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany; University Children's Hospital Zurich, Department of Pediatric Orthopedics, Steinwiesstr. 75, 8032 Zürich, Switzerland.
| | - Sebastian I Wolf
- University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany.
| | - Thomas Dreher
- University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany; University Children's Hospital Zurich, Department of Pediatric Orthopedics, Steinwiesstr. 75, 8032 Zürich, Switzerland.
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153
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Hill CN, Reed W, Schmitt D, Arent SM, Sands LP, Queen RM. Factors contributing to racial differences in gait mechanics differ by sex. Gait Posture 2022; 95:277-283. [PMID: 33658154 DOI: 10.1016/j.gaitpost.2021.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/25/2021] [Accepted: 02/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Racial differences in gait mechanics have been recently reported, but we don't know what factors may drive differences in gait and whether these factors are innate or modifiable. The answers to those questions will inform both basic research and clinical interventions and outcomes. RESEARCH QUESTION Do anthropometric, strength, and health status measures explain racial differences in gait between African Americans (AA) and white Americans (WA)? METHODS Venous blood samples, anthropometric measures, lower extremity strength, and an assessment of health status were collected from 92 participants (18-30 years old) as part of an Institutional Review Board-approved study. 3D motion capture and force plate data were recorded during 7 walking trials at set regular (1.35 m/s) and fast (1.6 m/s) speeds. Racial differences in gait were identified at both speeds. Correlations between anthropometric, strength, and health status independent variables and outcome measures were computed after stratifying data by sex. Stepwise linear regression models evaluated whether the inclusion of anthropometric, strength, and health status independent variables explained racial effects. RESULTS In males, no racial differences in gait were explained by independent variables. Q-angle and ankle dorsiflexion strength accounted for racial differences in self-selected walking speed in females. Racial differences in ankle plantarflexion angle were explained by ankle plantarflexion strength differences. SIGNIFICANCE Factors that explain racial differences in gait in females were both innate and modifiable. These data make clear that it is important to include racially diverse normative gait databases in research studies. These results also identify potential intervention targets aimed at reducing racial health disparities.
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Affiliation(s)
- C N Hill
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 495 Old Turner Street Blacksburg, VA, 24060, 300 Norris Hall, USA.
| | - W Reed
- Department of Sociology, Virginia Tech, 225 Stanger Street, Blacksburg, VA, 24060, 562C McBryde Hall, USA.
| | - D Schmitt
- Department of Evolutionary Anthropology, Duke University, 130 Science Drive, Durham, NC, 27708, 203 Biological Sciences Building, USA.
| | - S M Arent
- Department of Exercise Science, University of South Carolina, 921 Assembly Street Columbia, SC, 29208, United States.
| | - L P Sands
- Center for Gerontology, Virginia Tech, 230 Grove Ln Blacksburg, VA, 24060, USA.
| | - R M Queen
- Department of Biomedical Engineering and Mechanics, Virginia Tech, 495 Old Turner Street Blacksburg, VA, 24060, 300 Norris Hall, USA.
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154
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Machine Learning Approach to Support the Detection of Parkinson's Disease in IMU-Based Gait Analysis. SENSORS 2022; 22:s22103700. [PMID: 35632109 PMCID: PMC9148133 DOI: 10.3390/s22103700] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023]
Abstract
The aim of this study was to determine which supervised machine learning (ML) algorithm can most accurately classify people with Parkinson’s disease (pwPD) from speed-matched healthy subjects (HS) based on a selected minimum set of IMU-derived gait features. Twenty-two gait features were extrapolated from the trunk acceleration patterns of 81 pwPD and 80 HS, including spatiotemporal, pelvic kinematics, and acceleration-derived gait stability indexes. After a three-level feature selection procedure, seven gait features were considered for implementing five ML algorithms: support vector machine (SVM), artificial neural network, decision trees (DT), random forest (RF), and K-nearest neighbors. Accuracy, precision, recall, and F1 score were calculated. SVM, DT, and RF showed the best classification performances, with prediction accuracy higher than 80% on the test set. The conceptual model of approaching ML that we proposed could reduce the risk of overrepresenting multicollinear gait features in the model, reducing the risk of overfitting in the test performances while fostering the explainability of the results.
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155
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Three-dimensional gait analysis of lower extremity gait parameters in Japanese children aged 6 to 12 years. Sci Rep 2022; 12:7822. [PMID: 35551257 PMCID: PMC9098504 DOI: 10.1038/s41598-022-11906-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/25/2022] [Indexed: 12/05/2022] Open
Abstract
We aimed to develop gait standards for gait parameters in school-aged Japanese children and assess age-related differences in gait patterns and parameters. Children aged 6–12 years (n = 424) were recruited from two elementary schools. An instrumented three-dimensional gait analysis system was used to record each child's gait kinematics, kinetics, and spatiotemporal parameters. Participants were subdivided into three age groups (Group A, 6–8 years; Group B, 9–10 years; and Group C, 11–12 years). LMS Chartmaker, version 2.54, was used to create a developmental chart for the gait pattern. The non-normalized step and stride lengths were significantly longer, and the cadence was lower in older children; however, the opposite outcome occurred when analyzing normalized data. Ankle moment differed significantly by age, and the maximum ankle moment was higher in older children than that in younger children. Furthermore, the hip and knee flexion angles during gait and the normalized spatiotemporal parameters of Japanese children aged 6–12 years differed by age and from those of children from other countries. The centile chart of the gait pattern is a useful tool for clinicians to assess developmental changes in the gait pattern and detect gait abnormalities in children.
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156
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Fuchs PX, Hsieh CH, Chen WH, Tang YS, Fiolo NJ, Shiang TY. Sensor number in simplified insole layouts and the validity of ground reaction forces during locomotion. Sports Biomech 2022:1-14. [PMID: 35499556 DOI: 10.1080/14763141.2022.2057354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/19/2022] [Indexed: 10/18/2022]
Abstract
Research attempted to validate simplified insoles with a reduced number of sensors to facilitate clinical application. However, the ideal sensor number is yet to be determined. The purpose was to investigate the validity of vertical ground reaction forces in various simplified pressure sensor insoles and to identify an optimal compromise between sensor number and measurement performance. A Kistler force plate (1000 Hz) and 99-sensor Pedar-X insole (100 Hz) obtained force data of 15 participants during walking and jogging. Eight simplified insole layouts (3-17 sensors) were simulated. Layout performances were expressed as Pearson's correlation coefficients (r) with force plate as reference and coefficient of variation. Differences were assessed via repeated-measures ANOVA as partial eta square (η p 2 ) at p < .05. All layouts correlated with the force plate (r = .70-.99, p < .01). All layout performances were higher in jogging than in walking by r = +.07 ± .04 (η p 2 =.28-.66, p < .05). The three- and five-sensor layouts yielded the lowest correlation (r = .70-.88) and the highest coefficient of variation (11-22%). Layout performances improved constantly from 7 to 11 sensors. The optimal compromise between simplification and measurement performance, quantified via change in correlation per sensor number, was found in the 11-sensor layout, recommendable for practical settings to improve monitoring and adjusting protocols.
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Affiliation(s)
- Philip X Fuchs
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
- Department of Sport and Exercise, University of Salzburg, Salzburg, Austria
| | - Chang-Hsin Hsieh
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
| | - Wei-Han Chen
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
- Graduate Institute of Sports Equipment Technology, University of Taipei, Taipei City, Taiwan
| | - Yen-Shan Tang
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
| | - Nicholas J Fiolo
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
| | - Tzyy-Yuang Shiang
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
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157
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Lisee C, Davis-Wilson H, Evans-Pickett A, Horton WZ, Blackburn T, Franz JR, Thoma L, Spang JT, Pietrosimone B. Linking Gait Biomechanics and Daily Steps After ACL Reconstruction. Med Sci Sports Exerc 2022; 54:709-716. [PMID: 35072659 PMCID: PMC9255696 DOI: 10.1249/mss.0000000000002860] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Aberrant biomechanics and altered loading frequency are associated with poor knee joint health in osteoarthritis development. After anterior cruciate ligament reconstruction (ACLR), individuals demonstrate underloading (lesser vertical ground reaction force (vGRF)) with stiffened knee gait biomechanics (lesser knee extension moment (KEM) and knee flexion angle) and take fewer daily steps as early as 6 months after surgery. The purpose of this cross-sectional laboratory study is to compare gait biomechanics throughout stance between individuals 6-12 months after ACLR who take the lowest, moderate, and highest daily steps. METHODS Individuals with primary, unilateral history of ACLR between the ages of 16 and 35 yr were included (n = 36, 47% females; age, 21 ± 5 yr; months since ACLR, 8 ± 2). Barefoot gait biomechanics of vGRF (body weight), KEM (body weight × height), and knee flexion angle during stance were collected and time normalized. Average daily steps were collected via a waist-mounted accelerometer in free-living settings over 7 d. Participants were separated into tertiles based on lowest daily steps (3326-6042 daily steps), moderate (6043-8198 daily steps), and highest (8199-12,680 daily steps). Biomechanical outcomes of the ACLR limb during stance were compared between daily step groups using functional waveform gait analyses. RESULTS There were no significant differences in sex, body mass index, age, or gait speed between daily step groups. Individuals with the lowest daily steps walk with lesser vGRF and lesser KEM during weight acceptance, and lesser knee flexion angle throughout stance in the ACLR limb compared with individuals with highest and moderate daily steps. CONCLUSIONS After ACLR, individuals who take the fewest daily steps also walk with lesser vGRF during weight acceptance and a stiffened knee strategy throughout stance. These results highlight complex interactions between joint loading parameters after ACLR.
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Affiliation(s)
- Caroline Lisee
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC
| | - Hope Davis-Wilson
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - Alyssa Evans-Pickett
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, NC
| | - W. Zachary Horton
- Department of Statistics, University of California Santa Cruz, Santa Cruz, California
| | - Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, NC
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason R. Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC
| | - Louise Thoma
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, NC
| | - Jeffrey T. Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, NC
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC
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158
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Is Kinesio Taping Effective for Sport Performance and Ankle Function of Athletes with Chronic Ankle Instability (CAI)? A Systematic Review and Meta-Analysis. Medicina (B Aires) 2022; 58:medicina58050620. [PMID: 35630037 PMCID: PMC9146435 DOI: 10.3390/medicina58050620] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.
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159
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Erhart-Hledik JC, Titchenal MR, Migliore E, Asay JL, Andriacchi TP, Chu CR. Cartilage oligomeric matrix protein responses to a mechanical stimulus associate with ambulatory loading in individuals with anterior cruciate ligament reconstruction. J Orthop Res 2022; 40:791-798. [PMID: 34185322 DOI: 10.1002/jor.25121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 01/07/2021] [Accepted: 06/09/2021] [Indexed: 02/04/2023]
Abstract
Mechanical factors have been implicated in the development of osteoarthritis after anterior cruciate ligament (ACL) reconstruction. This study tested for associations between ambulatory joint loading (total joint moment [TJM] and vertical ground reaction force [vGRF]) and changes in serum levels of cartilage oligomeric matrix protein (COMP) in response to a mechanical stimulus (30-min walk) in individuals with ACL reconstruction. Twenty-five subjects (mean age: 34.5 ± 9.8 years; 2.2 ± 0.2 years post-surgery) with primary unilateral ACL reconstruction underwent gait analysis for assessment of peak vGRF and TJM first (TJM1) and second (TJM2) peaks. Serum COMP concentrations were measured by enzyme-linked immunosorbent assay immediately before, 3.5 h, and 5.5 h after a 30-min walk. Pearson correlation coefficients and backward stepwise multiple linear regression analysis, with adjustments for age, sex, body mass index, and between-limb speed difference, assessed associations between changes in COMP and between-limb differences in joint loading parameters. Greater TJM1 (R = 0.542, p = 0.005), TJM2 (R = 0.460, p = 0.021), and vGRF (R = 0.577, p = 0.003) in the ACL-reconstructed limb as compared to the contralateral limb were associated with higher COMP values 3.5 h following the 30-min walk. Change in COMP at 5.5 h became a significant predictor of the between-limb difference in TJM1 and vGRF in multivariate analyses after accounting for the between-limb speed difference. These results demonstrate that higher TJM and vGRF in the ACLR limb as compared to the contralateral limb are associated with higher relative COMP levels 3.5 and 5.5 h after a 30-min walk. Future work should investigate the effect of therapies to alter joint loading on the biological response in individuals after ACL reconstruction.
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Affiliation(s)
- Jennifer C Erhart-Hledik
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.,Palo Alto Veterans Hospital, Palo Alto, California, USA
| | - Matthew R Titchenal
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.,Palo Alto Veterans Hospital, Palo Alto, California, USA.,Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Eleonora Migliore
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.,Palo Alto Veterans Hospital, Palo Alto, California, USA
| | - Jessica L Asay
- Palo Alto Veterans Hospital, Palo Alto, California, USA.,Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Thomas P Andriacchi
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Constance R Chu
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA.,Palo Alto Veterans Hospital, Palo Alto, California, USA
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160
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Biomechanical Gait Analysis of an Adult with Severe Hemophilia: A Case Report. Hematol Rep 2022; 14:112-118. [PMID: 35466181 PMCID: PMC9036226 DOI: 10.3390/hematolrep14020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Hemophilia is characterized by recurrent bleeding into the joints leading to irreversible chronic arthropathy with reduced joint range of motion (ROM), which may lead to changes in gait patterns. To analyze the gait pattern in a 35-year-old male with severe hemophilia A, three-dimensional biomechanical analysis was performed during overground walking. The control group data from a public gait dataset of 10 healthy male individuals were used for comparison. The clinical examination was assessed with the Functional Independence Score in Hemophilia (FISH), Haemophilia Activities List (HAL), and Hemophilia Joint Health Score (HJHS). The biomechanical analysis demonstrated a pattern for both left knee and ankle joints with greater similarity to the control group compared to the right knee and ankle joints. ROM based on the HJHS questionnaire also showed greater impairment of the right-side knee joint compared to the left-side knee joint. This unique pattern could be the result of a compensation mechanism due to limited movement during the walking task and the surgical treatment.
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161
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Mobbs RJ, Natarajan P, Fonseka RD, Betteridge C, Ho D, Mobbs R, Sy L, Maharaj M. Walking orientation randomness metric (WORM) score: pilot study of a novel gait parameter to assess walking stability and discriminate fallers from non-fallers using wearable sensors. BMC Musculoskelet Disord 2022; 23:304. [PMID: 35351090 PMCID: PMC8966274 DOI: 10.1186/s12891-022-05211-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 03/04/2022] [Indexed: 05/31/2023] Open
Abstract
Background Musculoskeletal disorders can contribute to injurious falls and incur significant societal and healthcare burdens. Identification of fallers from non-fallers through wearable-based gait analysis can facilitate timely intervention to assist mobility and prevent falls whilst improving care and attention for high fall-risk patients. In this study, we use wearable sensor-based gait analysis to introduce a novel variable to assess walking stability in fallers and non-fallers – the Walking Orientation Randomness Metric. The WORM score quantifies the stability, or ‘figure-of-eight’ motion of a subject’s trunk during walking as an indicator of a falls-predictive (pathological) gait. Methods WORM is calculated as the ‘figure-of-eight’ oscillation mapped out in the transverse-plane by the upper body’s centre-point during a walking bout. A sample of patients presenting to the Prince of Wales Hospital (Sydney, Australia) with a primary diagnosis of “falls for investigation” and age-matched healthy controls (non-fallers) from the community were recruited. Participants were fitted at the sternal angle with the wearable accelerometer, MetaMotionC (Mbientlab Inc., USA) and walked unobserved (at self-selected pace) for 5-50 m along an obstacle-free, carpeted hospital corridor. Results Participants comprised of 16 fallers (mean age: 70 + 17) and 16 non-fallers (mean age: 70 + 9) based on a recent fall(s) history. The (median) WORM score was 17-fold higher (p < 0.001) in fallers (3.64 cm) compared to non-fallers (0.21 cm). ROC curve analyses demonstrate WORM can discriminate fallers from non-fallers (AUC = 0.97). Diagnostic analyses (cut-off > 0.51 cm) show high sensitivity (88%) and specificity (94%). Conclusion In this pilot study we have introduced the WORM score, demonstrating its discriminative performance in a preliminary sample size of 16 fallers. WORM is a novel gait metric assessing walking stability as measured by truncal way during ambulation and shows promise for objective and clinical evaluation of fallers. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05211-1.
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Affiliation(s)
- Ralph Jasper Mobbs
- Faculty of Medicine, University of New South Wales, Sydney, Australia. .,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia. .,Wearables and Gait Analysis Research Group (WAGAR), Sydney, Australia. .,Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia. .,Neuro Spine Clinic, Prince of Wales Private Hospital, 320-346 Barker St, Randwick, NSW, 2031, Australia.
| | - Pragadesh Natarajan
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Wearables and Gait Analysis Research Group (WAGAR), Sydney, Australia
| | - R Dineth Fonseka
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Wearables and Gait Analysis Research Group (WAGAR), Sydney, Australia
| | - Callum Betteridge
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Wearables and Gait Analysis Research Group (WAGAR), Sydney, Australia
| | - Daniel Ho
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
| | - Redmond Mobbs
- School of Mathematics and Computer Science, University of New South Wales (UNSW), Sydney, Australia
| | - Luke Sy
- School of Mathematics and Computer Science, University of New South Wales (UNSW), Sydney, Australia
| | - Monish Maharaj
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Wearables and Gait Analysis Research Group (WAGAR), Sydney, Australia.,Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, 320-346 Barker St, Randwick, NSW, 2031, Australia
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162
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Nilsson S, Ertzgaard P, Lundgren M, Grip H. Test-Retest Reliability of Kinematic and Temporal Outcome Measures for Clinical Gait and Stair Walking Tests, Based on Wearable Inertial Sensors. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22031171. [PMID: 35161916 PMCID: PMC8838027 DOI: 10.3390/s22031171] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/17/2022] [Accepted: 01/30/2022] [Indexed: 05/16/2023]
Abstract
It is important to assess gait function in neurological disorders. A common outcome measure from clinical walking tests is average speed, which is reliable but does not capture important kinematical and temporal aspects of gait function. An extended gait analysis must be time efficient and reliable to be included in the clinical routine. The aim of this study was to add an inertial sensor system to a gait test battery and analyze the test-retest reliability of kinematic and temporal outcome measures. Measurements and analyses were performed in the hospital environment by physiotherapists using customized software. In total, 22 healthy persons performed comfortable gait, fast gait, and stair walking, with 12 inertial sensors attached to the feet, shank, thigh, pelvis, thorax, and arms. Each person participated in 2 test sessions, with about 3-6 days between the sessions. Kinematics were calculated based on a sensor fusion algorithm. Sagittal peak angles, sagittal range of motion, and stride frequency were derived. Intraclass-correlation coefficients were determined to analyze the test-retest reliability, which was good to excellent for comfortable and fast gait, with exceptions for hip, knee, and ankle peak angles during fast gait, which showed moderate reliability, and fast gait stride frequency, which showed poor reliability. In stair walking, all outcome measures except shoulder extension showed good to excellent reliability. Inertial sensors have the potential to improve the clinical evaluation of gait function in neurological patients, but this must be verified in patient groups.
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Affiliation(s)
- Sofie Nilsson
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linkoping University, 581 83 Linköping, Sweden; (S.N.); (P.E.)
| | - Per Ertzgaard
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linkoping University, 581 83 Linköping, Sweden; (S.N.); (P.E.)
| | - Mikael Lundgren
- Department of Rehabilitation, Västervik Hospital, 593 33 Västervik, Sweden;
| | - Helena Grip
- Department of Radiation Sciences, Biomedical Engineering, Umeå University, 901 87 Umeå, Sweden
- Correspondence: ; Tel.: +46-907854029
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163
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Donatoni da Silva L, Shiel A, McIntosh C. Effects of Pilates on the risk of falls, gait, balance and functional mobility in healthy older adults: A randomised controlled trial. J Bodyw Mov Ther 2022; 30:30-41. [DOI: 10.1016/j.jbmt.2022.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
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164
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Kim HY, An KO, Ko SS. Effects of Walking Type and Speed on Oxygen Uptake and Fat Oxidation in College Students. THE ASIAN JOURNAL OF KINESIOLOGY 2022. [DOI: 10.15758/ajk.2022.24.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the difference in oxygen uptake, fat oxidation rate, and fat oxidation during treadmill walking, depending on the type and speed of walking.METHODS Ten male college students randomly participated in the experiment under two conditions. Four types of exercise: normal walking, power walking, dumbbell walking, and sand walking, and three exercise intensity conditions: low-speed walking (40% VT), medium-speed walking (50% VT), and high-speed walking (60% VT).RESULTS Oxygen uptake was statistically significantly higher as walking speed increased (p<.001), and there was no statistically significant difference in walking type, but the interaction effect was statistically significant (p=.048). The fatty acid oxidation rate was statistically significantly lower as the walking speed increased (p<.001), and there was no significant difference in walking type, but the interaction effect was statistically significant (p=.008). There was a significant difference in the amount of fat burning according to the walking speed (p=.007), but there was no difference in the walking type, and there was no interaction effect.CONCLUSIONS Dumbbell walking and band walking increased oxygen intake under medium and high speed walking conditions, excluding low speed, compared to normal walking, and it is shown that normal walking and sand walking have an advantage in increasing the fat oxidation rate. In particular, considering the amount of fat oxidation, sand walking in all speed conditions is considered to be effective for weight loss, and it is suggested that it is necessary to investigate this later.
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165
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Photobiomodulation Therapy Combined with Static Magnetic Field (PBMT–SMF) on Spatiotemporal and Kinematics Gait Parameters in Post-Stroke: A Pilot Study. Life (Basel) 2022; 12:life12020186. [PMID: 35207474 PMCID: PMC8874719 DOI: 10.3390/life12020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Gait deficit is a major complaint in patients after stroke, restricting certain activities of daily living. Photobiomodulation therapy combined with a static magnetic field (PBMT-SMF) has been studied for several diseases, and the two therapies are beneficia. However, their combination has not yet been evaluated in stroke. Therefore, for PBMT–SMF to be used more often and become an adjunctive tool in the rehabilitation of stroke survivors at physical therapy rehabilitation centers and clinics, some important aspects need to be clarified. Purpose: This study aimed to test different doses of PBMT–SMF, to identify the ideal dose to cause immediate effects on the spatiotemporal and kinematic variables of gait in post-stroke patients. Methods: A randomized, triple-blinded, placebo-controlled crossover pilot study was performed. A total of 10 individuals with hemiparesis within 6 months to 5 years since the occurrence of stroke, aged 45–60 years, were included in the study. Participants were randomly assigned and treated with a single PBMT–SMF dose (sham, 10 J, 30 J, or 50 J) on a single application, with one dose per stage at 7-day intervals between stages. PBMT–SMF was applied with a cluster of 12 diodes (4 of 905 nm laser, 4 of 875 nm LEDs, and 4 of 640 nm LEDs, SMF of 35 mT) at 17 sites on both lower limbs after baseline evaluation: plantar flexors (2), knee extensors (9), and flexors (6). The primary outcome was self-selected walking speed, and the secondary outcomes were kinematic parameters. Gait analysis was performed using SMART-D 140® and SMART-D INTEGRATED WORKSTATION®. The outcomes were measured at the end of each stage after the single application of each PBMT–SMF dose tested. Results: No significant differences (p > 0.05) in spatiotemporal variables were observed between the different doses, compared with the baseline evaluation. However, differences (p < 0.05) were observed in the kinematic variable of the hip in the paretic and non-paretic limbs, specifically in the minimum flexion/extension angulation during the support phase (HMST–MIN) in doses 10 J, 30 J, and 50 J. Conclusions: A single application of PBMT–SMF at doses of 10 J, 30 J, and 50 J per site of the lower limbs did not demonstrate positive effects on the spatiotemporal variables, but it promoted immediate effects in the kinematic variables of the hip (maximum and minimum flexion/extension angulation during the support phase) in the paretic and non-paretic limbs in post-stroke people.
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166
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Breu MS, Schneider M, Klemt J, Cebi I, Gharabaghi A, Weiss D. People With Parkinson’s Disease and Freezing of Gait Show Abnormal Low Frequency Activity of Antagonistic Leg Muscles. Front Hum Neurosci 2022; 15:733067. [PMID: 35153698 PMCID: PMC8825470 DOI: 10.3389/fnhum.2021.733067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022] Open
Abstract
Objective Freezing of gait is detrimental to patients with idiopathic Parkinson’s disease (PD). Its pathophysiology represents a multilevel failure of motor processing in the cortical, subcortical, and brainstem circuits, ultimately resulting in ineffective motor output of the spinal pattern generator. Electrophysiological studies pointed to abnormalities of oscillatory activity in freezers that covered a broad frequency range including the theta, alpha, and beta bands. We explored muscular frequency domain activity with respect to freezing, and used deep brain stimulation to modulate these rhythms thereby evaluating the supraspinal contributions to spinal motor neuron activity. Methods We analyzed 9 PD freezers and 16 healthy controls (HC). We studied the patients after overnight withdrawal of dopaminergic medication with stimulation off, stimulation of the subthalamic nucleus (STN-DBSonly) or the substantia nigra pars reticulate (SNr-DBSonly), respectively. Patients performed a walking paradigm passing a narrow obstacle. We analyzed the frequency-domain spectra of the tibialis anterior (TA) and gastrocnemius (GA) muscles in ‘regular gait’ and during the ‘freezing’ episodes. Results In stimulation off, PD freezers showed increased muscle activity of the alpha and low-beta band compared to HC in both TA and GA. This activity increase was present during straight walking and during the freezes to similar extent. STN- but not SNr-DBS decreased this activity and paralleled the clinical improvement of freezing. Conclusion We found increased muscle activation of the alpha and lower beta band in PD freezers compared to HC, and this was attenuated with STN-DBS. Future studies may use combined recordings of local field potentials, electroencephalography (EEG), and electromyography (EMG) to interrogate the supraspinal circuit mechanisms of the pathological activation pattern of the spinal pattern generator.
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Affiliation(s)
- Maria-Sophie Breu
- Centre of Neurology, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Tübingen, Germany
- *Correspondence: Maria-Sophie Breu,
| | - Marlieke Schneider
- Centre of Neurology, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Johannes Klemt
- Centre of Neurology, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Idil Cebi
- Centre of Neurology, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Alireza Gharabaghi
- Centre for Neurosurgery, Institute for Neuromodulation and Neurotechnology, University of Tübingen, Tübingen, Germany
| | - Daniel Weiss
- Centre of Neurology, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Daniel Weiss,
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167
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Auer S, Kubowitsch S, Süß F, Renkawitz T, Krutsch W, Dendorfer S. Mental stress reduces performance and changes musculoskeletal loading in football-related movements. SCI MED FOOTBALL 2022; 5:323-329. [PMID: 35077309 DOI: 10.1080/24733938.2020.1860253] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Hence, this study investigated the musculoskeletal response of elite youth football players during highly dynamic movements under stress. The hypothesis is that mental stress reduces performance and changes the muscular forces exerted.Materials & methods: Twelve elite youth football players were subjected to mental stress while performing sports-specific change-of-direction movements. A modified version of the d2 attention test was used as stressor. The kinetics are computed using inverse dynamics. Running times and exerted forces of injury-prone muscles were analysed.Results: The stressor runs were rated more mentally demanding by the players (p = 0.006, rs = 0.37) with unchanged physical demand (p = 0.777, rs = 0.45). This resulted in 10% longer running times under stress (p < 0.001, d = -1.62). The musculoskeletal analysis revealed higher peak muscle forces under mental stress for some players but not for others.Discussion: The study shows that motion capture combined with musculoskeletal computation is suitable to analyse the effects of stress on athletes in highly dynamic movements. For the first time in football medicine, our data quantifies an association between mental stress with reduced football players' performance and changes in muscle force.
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Affiliation(s)
- Simon Auer
- Laboratory for Biomechanics, OTH Regensburg, Regensburg, Germany.,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
| | | | - Franz Süß
- Laboratory for Biomechanics, OTH Regensburg, Regensburg, Germany
| | - Tobias Renkawitz
- Department of Orthopaedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, Regensburg University Medical Center., Regensburg, Germany
| | - Sebastian Dendorfer
- Laboratory for Biomechanics, OTH Regensburg, Regensburg, Germany.,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
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168
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Böpple JC, Tanner M, Campos S, Fischer C, Müller S, Wolf SI, Doll J. Short-term results of gait analysis with the Heidelberg foot measurement method and functional outcome after operative treatment of ankle fractures. J Foot Ankle Res 2022; 15:2. [PMID: 34998420 PMCID: PMC8742407 DOI: 10.1186/s13047-021-00505-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/12/2021] [Indexed: 02/07/2023] Open
Abstract
Background Ankle fractures are common fractures in trauma surgery. Several studies have compared gait patterns between affected patients and control groups. However, no one used the Heidelberg Foot Measurement Method in combination with statistical parametric mapping of the entire gait cycle in this patient cohort. We sought to identify possible mobility deficits in the tibio-talar joint and medial arch in patients after ankle fractures as a sign of stiffness and pain that could result in a pathological gait pattern. We focused on the tibio-talar flexion as it is the main movement in the tibio-talar joint. Moreover, we examined the healing progress over time. Methods Fourteen patients with isolated ankle fractures were included prospectively. A gait analysis using the Heidelberg Foot Measurement Method was performed 9 and 26 weeks after surgery to analyse the tibio-talar dorsal flexion, the foot tibia dorsal flexion, the subtalar inversion and the medial arch as well as the cadence, the walking speed and the ground reaction force. The American Orthopedic Foot & Ankle Society ankle hindfoot score was used to obtain clinical data. Results were compared to those from 20 healthy participants. Furthermore, correlations between the American Orthopedic Foot & Ankle Society hindfoot score and the results of the gait analysis were evaluated. Results Statistical parametric mapping showed significant differences for the Foot Tibia Dorsal Flexion for patients after 9 weeks (53–75%: p = 0.001) and patients after 26 weeks (58–70%: p = 0.011) compared to healthy participants, respectively. Furthermore, significant differences regarding the tibio-talar dorsal flexion for patients 9 weeks after surgery (15–40%: p < 0.001; 56,5–70%: p = 0.007; 82–88%: p = 0.033; 97–98,5%: p = 0.048) as well as patients after 26 weeks (62,5–65%: p = 0.049) compared to healthy participants, respectively. There were no significant differences looking at the medial arch and the subtalar inversion. Moreover, significant differences regarding the ground reaction force were found for patients after 9 weeks (0–17%: p < 0.001; 21–37%: p < 0.001; 41–54%: p < 0.001; 60–64%: p = 0.013) as well as patients after 26 weeks (0–1,5%: p = 0.046; 5–15%: p < 0.001; 27–33%: p = 0.001; 45–49%: p = 0.005; 57–59%: p = 0.049) compared to healthy participants, respectively. In total, the range of motion in the tibio-talar joint and the medial arch was reduced in affected patients compared to healthy participants. Patients showed significant increase of the range of motion between 9 and 26 weeks. Conclusions This study shows, that patients affected by ankle fractures show limited mobility in the tibio-talar joint and the medial arch when compared to healthy participants. Even though the limitation of motion remains at least over a period of 26 weeks, a significant increase can be recognized over time. Furthermore, if we look at the absolute values, the patients’ values tend to get closer to those of the control group. Trial registration This study is registered at the German Clinical Trials Register (DRKS00023379).
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Affiliation(s)
- Jessica C Böpple
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Michael Tanner
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Sarah Campos
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Christian Fischer
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Sebastian Müller
- ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany
| | - Sebastian I Wolf
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Julian Doll
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
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169
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Distraction From Smartphones Changed Pedestrians’ Walking Behaviors in Open Areas. Motor Control 2022; 27:275-292. [PMID: 36395762 DOI: 10.1123/mc.2022-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/18/2022]
Abstract
The prevalence of phone use has become a major concern for pedestrian safety. Using smartphones while walking reduces pedestrians’ ability to perceive the environment by increasing their cognitive, manual, and visual demands. The purpose of this study was to investigate the effect of common phone tasks (i.e., reading, tapping, gaming) on walking behaviors during outdoor walking. Nineteen young adults were instructed to complete four walking conditions (walking only, walking–reading, walking–tapping, and walking–gaming) along an open corridor. Results showed that all three phone tasks increased participants’ neck flexion (i.e., neck kyphosis) during walking. Meanwhile, the reading task showed a greater influence on the temporal aspect during the early phases of a gait cycle. The tapping task lowered the flexion angles of the middle and lower back (i.e., torso lordosis) and induced a longer terminal double support. And the gaming task resulted in a decrease in middle back flexion, a shorter stride length, and a longer terminal double support while walking. Findings from the study confirmed our hypothesis that phone tasks changed pedestrians’ physical responses to smartphone distraction while walking. To avoid potential risks caused by the observed posture and gait adaptations, safety precautions (e.g., roadside/electronic warning signals) might be imposed depending on the workload expected by different phone tasks.
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170
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Lapanantasin S, Thongloy N, Samsee M, Wonghirunsombat N, Nuangpulsarp N, Ua-areejit C, Phattaraphanasakul P. Comparative Effect of Walking Meditation and Rubber-band Exercise on Ankle Proprioception and Balance Performance Among Persons With Chronic Ankle Instability: A Randomized Controlled Trial. Complement Ther Med 2022; 65:102807. [DOI: 10.1016/j.ctim.2022.102807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/03/2022] Open
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171
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Chan PPK, Chen CY, Ayache H, Louie L, Lok A, Cheung N, Cheung RTH. Gait difference between children aged 9 to 12 with and without potential depressive mood. Gait Posture 2022; 91:126-130. [PMID: 34688209 DOI: 10.1016/j.gaitpost.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND It has been reported that depression has an impact on both temporal spatial parameters and walking kinematics in adults. Given the difference in the walking biomechanics between adults and children, this study aimed to compare the gait difference in children aged 9-12 with and without potential depressive mood (PDM). METHODS 49 children were recruited from local primary schools. We measured participants' depression level using Depression Anxiety Stress Scale (DASS) and classified them into control (i.e., DASS depression subscale score = 0.6 ± 1.4; n = 23) or PDM group (i.e., DASS depression subscale score = 21.3 ± 5.3; n = 26). Video gait analysis was employed to assess temporal spatial parameters and sagittal plane kinematics during self-paced overground walking. Independent t tests or Mann-Whitney tests were used to compare the gait parameters between the two groups. RESULTS Participants exhibited similar gait speed, vertical oscillation of the centre of mass, stance time, swing time, step length, upper and lower limb kinematics between the two groups (p > 0.05). However, children with PDM displayed a greater head flexion than controls (p = 0.026; Cohen's d = 0.66; moderate effect). SIGNIFICANCE Children with PDM may present a more slumped posture during walking when compared with their counterparts. This kinematics difference can potentially be used as a biomechanical marker for detection of mood problems in this cohort.
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Affiliation(s)
- Peter P K Chan
- Department of Information Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Chao-Ying Chen
- School of Physical Therapy, Chang Gung University, Taiwan
| | - Hussein Ayache
- School of Health Sciences, Western Sydney University, NSW, Australia
| | - Lobo Louie
- Department of Health and Physical Education, Education University of Hong Kong, Hong Kong
| | - Alan Lok
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Nathan Cheung
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Roy T H Cheung
- School of Health Sciences, Western Sydney University, NSW, Australia.
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172
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Makino A, Yamaguchi K, Sumi D, Ichikawa M, Ohno M, Nagano A, Goto K. Ground reaction force and electromyograms of lower limb muscles during fast walking. Front Sports Act Living 2022; 4:1055302. [PMID: 36873909 PMCID: PMC9981938 DOI: 10.3389/fspor.2022.1055302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/12/2022] [Indexed: 02/19/2023] Open
Abstract
Background Physically active status is an important contributor to individual health. Walking is regarded as commonly accepted exercise for exercise promotion. Particularly, interval fast walking (FW), consisting of alternating between fast and slow walking speeds, has gained popularity from practical viewpoints. Although previous studies have determined the short- and long-term effects of FW programs on endurance capacity and cardiovascular variables, factors affecting these outcomes have not been clarified. In addition to physiological variables, understanding of mechanical variables and muscle activity during FW would be a help to understand characteristics of FW. In the present study, we compared the ground reaction force (GRF) and lower limb muscle activity between fast walking (FW) and running at equivalent speeds. Method Eight healthy men performed slow walking (45% of the maximum walking speed; SW, 3.9 ± 0.2 km/h), FW (85% of the maximum walking speed, 7.4 ± 0.4 km/h), and running at equivalent speeds (Run) for 4 min each. GRF and average muscle activity (aEMG) were evaluated during the contact, braking, and propulsive phases. Muscle activities were determined for seven lower limb muscles: gluteus maximus (GM), biceps femoris (BF), rectus femoris (RF), vastus lateralis (VL), gastrocnemius medialis (MG), soleus (SOL), and tibialis anterior (TA). Results The anteroposterior GRF was greater in FW than in Run during the propulsive phase (p < 0.001), whereas the impact load (peak and average vertical GRF) was lower in FW than in Run (p < 0.001). In the braking phase, lower leg muscle aEMGs were higher during Run than during SW and FW (p < 0.001). However, in the propulsive phase, soleus muscle activity was greater during FW than during Run (p < 0.001). aEMG of tibialis anterior was higher during FW than during SW and Run in the contact phase (p < 0.001). No significant difference between FW and Run was observed for HR and RPE. Conclusion These results suggest that the average muscle activities of lower limbs (e.g., gluteus maximus, rectus femoris, and soleus) during the contact phase were comparable between FW and running, however, the activity patterns of lower limb muscles differed between FW and running, even at equivalent speeds. During running, muscles were mainly activated in the braking phase related to impact. In contrast, during FW, soleus muscle activity during the propulsive phase was increased. Although cardiopulmonary response was not different between FW and running, exercise using FW might be useful for health promotion among individuals who cannot exercise at high-intensity.
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Affiliation(s)
- Akitoshi Makino
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Keiichi Yamaguchi
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Daichi Sumi
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.,Research Center for Urban Health and Sports, Osaka City University, Osaka, Japan
| | | | - Masumi Ohno
- Business Incubation Department, ASICS Corporation, Hyogo, Japan
| | - Akinori Nagano
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Kazushige Goto
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
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Fonseca P, Machado L, Sousa MV, Sebastião R, Sousa F, Figueiredo J, Santos CP, Vilas-Boas JP. Does Gait with an Ankle Foot Orthosis Improve or Compromise Minimum Foot Clearance? SENSORS 2021; 21:s21238089. [PMID: 34884093 PMCID: PMC8659824 DOI: 10.3390/s21238089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to investigate if the use of an ankle foot orthosis in passive mode (without actuation) could modify minimum foot clearance, and if there are any compensatory mechanisms to enable these changes during treadmill gait at a constant speed. Eight participants walked on an instrumented treadmill without and with an ankle foot orthosis on the dominant limb at speeds of 0.8, 1.2, and 1.6 km/h. For each gait cycle, the minimum foot clearance and some gait linear kinematic parameters were calculated by an inertial motion capture system. Additionally, maximum hip and knee flexion and maximum ankle plantar flexion were calculated. There were no significant differences in the minimum foot clearance between gait conditions and lower limbs. However, differences were found in the swing, stance and step times between gait conditions, as well as between limbs during gait with orthosis (p < 0.05). An increase in hip flexion during gait with orthosis was observed for all speeds, and different ankle ranges of motion were observed according to speed (p < 0.05). Thus, the use of an ankle foot orthosis in passive mode does not significantly hinder minimum foot clearance, but can change gait linear and angular parameters in non-pathological individuals.
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Affiliation(s)
- Pedro Fonseca
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal; (P.F.); (M.V.S.); (R.S.); (F.S.); (J.P.V.-B.)
| | - Leandro Machado
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal; (P.F.); (M.V.S.); (R.S.); (F.S.); (J.P.V.-B.)
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sports of the University of Porto, 4200-450 Porto, Portugal
- Correspondence:
| | - Manoela Vieira Sousa
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal; (P.F.); (M.V.S.); (R.S.); (F.S.); (J.P.V.-B.)
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sports of the University of Porto, 4200-450 Porto, Portugal
| | - Ricardo Sebastião
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal; (P.F.); (M.V.S.); (R.S.); (F.S.); (J.P.V.-B.)
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sports of the University of Porto, 4200-450 Porto, Portugal
| | - Filipa Sousa
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal; (P.F.); (M.V.S.); (R.S.); (F.S.); (J.P.V.-B.)
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sports of the University of Porto, 4200-450 Porto, Portugal
| | - Joana Figueiredo
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal; (J.F.); (C.P.S.)
| | - Cristina P. Santos
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal; (J.F.); (C.P.S.)
| | - João Paulo Vilas-Boas
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal; (P.F.); (M.V.S.); (R.S.); (F.S.); (J.P.V.-B.)
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sports of the University of Porto, 4200-450 Porto, Portugal
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174
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Rhyu HS, Rhi SY. THE EFFECTS OF TRAINING ON DIFFERENT SURFACES, ON BALANCE AND GAIT PERFORMANCE IN STROKE HEMIPLEGIA. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127062020_0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Although many studies have focused on balance exercises for elderly or stroke patients, no comprehensive studies have investigated the use of training on different surfaces (TDS) with analysis of gait performance in elderly male stroke patients. The active properties of balance and subjective reporting of functional gait ability were used to identify the effects of TDS. Static balance (SB), dynamic balance (DB) and gait analysis was measured in 30 elderly stroke patients. The patients were divided into the TDS group (n=15) and a control group (CG, n=15). Fifteen elderly stroke patients underwent TDS five times a week for 12 weeks. The data was analyzed using repeated measures analysis of variance. Significant differences were observed between the two groups (TDS and Control): SB (p < 0.0001), DB (OSI: p < 0.0001, APSI: p < 0.001, MLSI: p < 0.004) and gait analysis (right: temporal step time: p < 0.0001, temporal cycle time: p < 0.001, temporal double support time: p < 0.0001; left: temporal step time: p < 0.0001, temporal cycle time: p < 0.0001, temporal double support time: p < 0.0001). TDS in elderly male stroke patients suggests that the characteristics of gait performance in these patients may be improved by increasing static balance, dynamic balance and gait velocity. It is hoped that the results of this trial will provide new information on the effects of TDS on balance stability and gait ability in stroke patients, through changes in stability of the lower extremities. Level III, Case-control Study.
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175
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Miyashita T, Katayama S, Yamamoto A, Sakamoto K, Kitano M, Takasaki R, Kudo S. The Effect of Functional Biomechanics Garment for Walking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312415. [PMID: 34886141 PMCID: PMC8656879 DOI: 10.3390/ijerph182312415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to investigate the effects of a functional biomechanics garment (FBG) with a lower extremity assist function. 32 healthy male participants were included in this study. Participants were divided into an FBG with taping function group (FBG group) and a compression garment group (CG group). Cadence (steps/min), step length (m), and usual walking speed (m/s) were measured as spatio-temporal data. Kinetics, kinematics data, and dynamic joint stiffness (DJS) of the lower extremity were calculated using a three-dimensional gait analysis system. The FBG group showed significantly faster walking speed (FBG, 1.54 ± 0.12 m/s; CG, 1.42 ± 0.15 m/s, p < 0.05) and reduced hip DJS in terminal stance (FBG, 0.033 ± 0.014 Nm/kg/degree; CG: 0.049 ± 0.016 Nm/kg/degree, p < 0.05) compared to the CG group. The FBG decreased hip DJS in the terminal stance and affected walking speed. The passive elastic moment generated by the high elasticity part of the hip joint front in the FBG supported the internal hip flexion moment. Therefore, our FBG has a biomechanical effect. The FBG may be useful as a tool to promote health activities.
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Affiliation(s)
- Toshinori Miyashita
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Nankokita 1–26–16, Suminoe Ward, Osaka 559-8611, Japan; (T.M.); (K.S.)
| | - Sho Katayama
- Department of Rehabilitation, Meidaimae Orthopedic Clinic, 1–38–25, Matsubara Setagaya Ward, Tokyo 156-0043, Japan;
| | - Ayane Yamamoto
- Department of Rehabilitation, AR-Ex Oyamadai Orthopedic Clinic, Tokyo Arthroscopy Center, 4–13–1, Todoroki Setagaya Ward, Tokyo 158-0082, Japan;
| | - Kodai Sakamoto
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Nankokita 1–26–16, Suminoe Ward, Osaka 559-8611, Japan; (T.M.); (K.S.)
| | - Masashi Kitano
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Nankokita 1–26–16, Suminoe Ward, Osaka 559-8611, Japan;
| | - Raita Takasaki
- Department of Acupuncture, Morinomiya University of Medical Sciences, Nankokita 1–26–16, Suminoe Ward, Osaka 559-8611, Japan;
| | - Shintarou Kudo
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Nankokita 1–26–16, Suminoe Ward, Osaka 559-8611, Japan; (T.M.); (K.S.)
- Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Nankokita 1–26–16, Suminoe Ward, Osaka 559-8611, Japan;
- AR-Ex Medical Research Center, 4–13–1, Todoroki Setagaya Ward, Tokyo 158-0082, Japan
- Correspondence: ; Tel.: +81-6-6616-6911; Fax: +81-6-6616-6912
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176
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Liew BXW, Rugamer D, Duffy K, Taylor M, Jackson J. The mechanical energetics of walking across the adult lifespan. PLoS One 2021; 16:e0259817. [PMID: 34767611 PMCID: PMC8589218 DOI: 10.1371/journal.pone.0259817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Understanding what constitutes normal walking mechanics across the adult lifespan is crucial to the identification and intervention of early decline in walking function. Existing research has assumed a simple linear alteration in peak joint powers between young and older adults. The aim of the present study was to quantify the potential (non)linear relationship between age and the joint power waveforms of the lower limb during walking. METHODS This was a pooled secondary analysis of the authors' (MT, KD, JJ) and three publicly available datasets, resulting in a dataset of 278 adults between the ages of 19 to 86 years old. Three-dimensional motion capture with synchronised force plate assessment was performed during self-paced walking. Inverse dynamics were used to quantity joint power of the ankle, knee, and hip, which were time-normalized to 100 stride cycle points. Generalized Additive Models for location, scale and shape (GAMLSS) was used to model the effect of cycle points, age, walking speed, stride length, height, and their interaction on the outcome of each joint's power. RESULTS At both 1m/s and 1.5 m/s, A2 peaked at the age of 60 years old with a value of 3.09 (95% confidence interval [CI] 2.95 to 3.23) W/kg and 3.05 (95%CI 2.94 to 3.16), respectively. For H1, joint power peaked with a value of 0.40 (95%CI 0.31 to 0.49) W/kg at 1m/s, and with a value of 0.78 (95%CI 0.72 to 0.84) W/kg at 1.5m/s, at the age of 20 years old. For H3, joint power peaked with a value of 0.69 (95%CI 0.62 to 0.76) W/kg at 1m/s, and with a value of 1.38 (95%CI 1.32 to 1.44) W/kg at 1.5m/s, at the age of 70 years old. CONCLUSIONS Findings from this study do not support a simple linear relationship between joint power and ageing. A more in-depth understanding of walking mechanics across the lifespan may provide more opportunities to develop early clinical diagnostic and therapeutic strategies for impaired walking function. We anticipate that the present methodology of pooling data across multiple studies, is a novel and useful research method to understand motor development across the lifespan.
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Affiliation(s)
- Bernard X. W. Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - David Rugamer
- Department of Statistics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kim Duffy
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - Matthew Taylor
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - Jo Jackson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
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177
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Kokolevich ZM, Biros E, Tirosh O, Reznik JE. Distinct Ground Reaction Forces in Gait between the Paretic and Non-Paretic Leg of Stroke Patients: A Paradigm for Innovative Physiotherapy Intervention. Healthcare (Basel) 2021; 9:healthcare9111542. [PMID: 34828588 PMCID: PMC8620401 DOI: 10.3390/healthcare9111542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
This case report study aims to identify the differences in the ground reaction forces (GRF) placed on the forefoot, hindfoot, and entire foot between the paretic and non-paretic legs in two stroke patients to identify potential targets for improved physiotherapy treatment. A digital gait analysis foot pressure insole was fitted inside the participants’ shoes to measure the percentage of body weight taken during the stance phase, and the vertical GRF of the two subjects are reported in this paper. Both patients presented noteworthy differences in gait parameters individually and between their paretic and non-paretic legs. The trend shows a decreased percentage of body weight on the paretic forefoot and hindfoot, although the percentage bodyweight placed on the entire foot remained similar in both feet. The gait patterns shown were highly individual and indicated that both legs were affected to some degree. These findings identify key motion targets for an improved physiotherapy treatment following a stroke, suggesting that physiotherapy treatment should be targeted and individually tailored and should include both extremities.
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Affiliation(s)
- Zoe Mass Kokolevich
- “Eshel Avraham” Centre for Special Needs Adults, Ezer Mizion, Bnei Brak 51553, Israel;
| | - Erik Biros
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| | - Oren Tirosh
- Biomechanics School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Jacqueline Elise Reznik
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
- Correspondence:
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178
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Ávila de Oliveira J, Bazán PR, de Oliveira CEN, Treza RDC, Hondo SM, Los Angeles E, Bernardo C, de Oliveira LDS, Carvalho MDJ, de Lima-Pardini AC, Coelho DB. The effects of levodopa in the spatiotemporal gait parameters are mediated by self-selected gait speed in Parkinson's disease. Eur J Neurosci 2021; 54:8020-8028. [PMID: 34755397 DOI: 10.1111/ejn.15522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/27/2022]
Abstract
In individuals with Parkinson's disease (PD), the medication induces different and inconsistent results in the spatiotemporal parameters of gait, making it difficult to understand its effects on gait. As spatiotemporal gait parameters have been reported to be affected by gait speed, it is essential to consider the gait speed when studying walking biomechanics to interpret the results better when comparing the gait pattern of different conditions. Since the medication alters the self-selected gait speed of individuals with PD, this study analysed whether the change in gait speed can explain the selective effects of l-DOPA on the spatiotemporal parameters of gait in individuals with PD. We analysed the spatiotemporal gait parameters at the self-selected speed of 22 individuals with PD under ON and OFF states of l-DOPA medication. Bayesian mediation analysis evaluated which gait variables were affected by the medication state and checked if those effects were mediated by speed changes induced by medication. The gait speed was significantly higher among ON compared with OFF medication. All the spatiotemporal parameters of the gait were mediated by speed, with proportions of mediation close to 1 (effect entirely explained by speed changes). Our results show that a change in gait speed better explains the changes in the spatiotemporal gait parameters than the ON-OFF phenomenon. As an implication for rehabilitation, our results suggest that it is possible to assess the effect of l-DOPA on improving motor symptoms related to gait disorders by measuring gait speed.
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Affiliation(s)
- Júlia Ávila de Oliveira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | | | - Renata de Castro Treza
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Sandy Mikie Hondo
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Emanuele Los Angeles
- Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Claudionor Bernardo
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil
| | | | | | - Andrea C de Lima-Pardini
- Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.,Center for Mathematics, Computation, and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil.,Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, Brazil
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179
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Bennett HJ, Haegele JA. Running Biomechanics of Adolescents With Autism Spectrum Disorder. J Biomech Eng 2021; 143:111005. [PMID: 34076239 DOI: 10.1115/1.4051346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Indexed: 11/08/2022]
Abstract
Research examining gait biomechanics of persons with autism spectrum disorder (ASD) has grown significantly in recent years and has demonstrated that persons with ASD walk at slower self-selected speeds and with shorter strides, wider step widths, and reduced lower extremity range of motion and moments compared to neurotypical controls. In contrast to walking, running has yet to be examined in persons with ASD. The purpose of this study was to examine lower extremity running biomechanics in adolescents (13-18-year-olds) with ASD and matched (age, sex, and body mass index (BMI)) neurotypical controls. Three-dimensional kinematics and ground reaction forces (GRFs) were recorded while participants ran at two matched speeds: self-selected speed of adolescents with ASD and at 3.0 m/s. Sagittal and frontal plane lower extremity biomechanics and vertical GRF waveforms were compared using two-way analyses of variances (ANOVAs) via statistical parametric mapping (SPM). Adolescents with ASD ran with reduced stride length at self-selected speed (0.29 m) and reduced vertical displacement (2.1 cm), loading-propulsion GRFs (by 14.5%), propulsion plantarflexion moments (18.5%), loading-propulsion hip abduction moments (44.4%), and loading knee abduction moments (69.4%) at both speeds. Running at 3.0 m/s increased sagittal plane hip and knee moments surrounding initial contact (both 10.4%) and frontal plane knee angles during midstance (2.9 deg) and propulsion (2.8 deg) compared to self-selected speeds. Reduced contributions from primarily the ankle plantarflexion but also knee abduction and hip abduction moments likely reduced the vertical GRF and displacement. As differences favored reduced loading, youth with ASD can safely be encouraged to engage in running as a physical activity.
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Affiliation(s)
- Hunter J Bennett
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529
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180
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A Study of Biofeedback Gait Training in Cerebral Stroke Patients in the Early Recovery Phase with Stance Phase as Target Parameter. SENSORS 2021; 21:s21217217. [PMID: 34770524 PMCID: PMC8588439 DOI: 10.3390/s21217217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 01/15/2023]
Abstract
Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry—stance phase duration—in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.
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181
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Kobayashi T, Hu M, Amma R, Hisano G, Murata H, Ichimura D, Hobara H. Effects of walking speed on magnitude and symmetry of ground reaction forces in individuals with transfemoral prosthesis. J Biomech 2021; 130:110845. [PMID: 34749160 DOI: 10.1016/j.jbiomech.2021.110845] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/01/2022]
Abstract
Individuals with unilateral transfemoral amputation (uTFA) walk asymmetrically. Investigating gait symmetry in ground reaction force (GRF) is critical because asymmetric loading on the residual limb can result in injury. The aim of this study was to investigate the GRF of individuals with uTFA by systematically controlling their walking at eight speeds(2.0-5.5 km/h with increments of 0.5 km/h) on a treadmill. Forty-eight individuals participated in this study, which included 24 individuals with uTFA (K3 and K4) and 24 individuals without amputation. GRFs (anteroposterior, mediolateral, and vertical) of the prosthetic and intact limb steps were collected for the individuals with uTFA and those of the right limb were collected for the control group. Peak force values of the GRF components, temporal parameters, impulses, and their asymmetry ratios were investigated and statistically analyzed. With an increasing walking speed, the magnitude of GRF changed gradually; individuals with uTFA exhibited increased GRF asymmetry in the vertical and mediolateral components, while that of the anteroposterior component remained constant. uTFA individuals typically maintained a constant asymmetry ratio in the mediolateral and anteroposterior (braking and propulsive) GRF impulses across a wide range of walking speeds. This result suggests that individuals with uTFA may cope with various walking speeds by maintaining symmetric mediolateral and anteroposterior impulses. The data provided in this study can serve as normative data for the GRF and its symmetry across a range of walking speeds in individuals with uTFA.
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Affiliation(s)
- Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mingyu Hu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ryo Amma
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan; Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Genki Hisano
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan; Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan; Research Fellow of Japan Society for the Promotion of Science (JSPS), Japan
| | - Hiroto Murata
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan; Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Daisuke Ichimura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Hiroaki Hobara
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan.
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182
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Pinvanichkul C, Siriphorn A. Effect of Walking Training with Textured Insole Socks in Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1994097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chanon Pinvanichkul
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Akkradate Siriphorn
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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183
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Yu B, Kramer PA. Walking Speed Alters Barefoot Gait Coordination and Variability. J Mot Behav 2021; 54:410-421. [PMID: 34641775 DOI: 10.1080/00222895.2021.1990005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Using the dynamic system approach, we examined the pattern and variability of inter-joint coordination in barefoot and shod walking in 20 women at three speeds: SLOW, FAST, and comfortable walking speed (CWS). We found that barefoot and shod walking used different coordination strategies to cope with increasing walking speed. As walking speed increased, ankle-knee coordination patterns between shod and barefoot became less different (p < 0.00001), and ankle-hip coordination patterns became more different (p < 0.001). Compared to shod, barefoot walking had significantly lower coordination variability in mid stance of knee-hip at CWS and FAST and late swing of ankle-hip at SLOW and CWS with medium effect (effect size 0.61-0.74). Future research should investigate the connection between the decreased coordination variability and joint tissue stress to understand the impact of barefoot walking on the lower extremity joints.
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Affiliation(s)
- Binnan Yu
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Patricia Ann Kramer
- Department of Anthropology, University of Washington, Seattle, Washington, USA
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184
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Ebihara B, Mutsuzaki H, Fukaya T, Iwai K. Interpretation of causal relationship between quadriceps tendon Young's modulus and gait speed by structural equation modeling in patients with severe knee osteoarthritis. J Orthop Surg (Hong Kong) 2021; 29:23094990211034003. [PMID: 34355609 DOI: 10.1177/23094990211034003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To clarify the causal relationship between quadriceps tendon stiffness and gait speed in patients with severe knee osteoarthritis (OA) using structural equation modeling. METHODS Participants were 36 patients with knee OA (median age, 75.0 [interquartile range, 67.3-76.0] years; Kellgren-Lawrence grade 3 or 4). We measured quadriceps tendon stiffness using Young's modulus by ShearWave Elastography. Gait speed and kinematics parameters were measured using a motion analysis system. Additional data collected for each patient included age, sex, height, body weight, body mass index, femorotibial angle, knee range of motion, knee extension torque, and pain. We performed structural equation modeling for interpretation of the causal relationship. RESULTS The comparative fit index of the structural equation modeling was 0.990. Quadriceps tendon Young's modulus was a predictor of maximum knee flexion angle during the swing phase (standardized partial regression coefficients [β] = -0.67, P < 0.001). Maximum knee flexion angle during the swing phase was a predictor of cadence and step length (β values 0.35 and 0.55, P = 0.035 and <0.001, respectively). Cadence and step length were predictors of gait speed (β values 0.50 and 0.63, P < 0.001 and <0.001, respectively). CONCLUSION Our results showed a causal relationship between quadriceps tendon stiffness and gait speed in patients with severe knee OA. Quadriceps tendon Young's modulus can affect gait speed through the maximum knee flexion angle during the swing phase, cadence, and step length. Adding therapeutic intervention to decrease the quadriceps tendon Young's modulus may lead to increased gait speed.
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Affiliation(s)
- Bungo Ebihara
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan.,Department of Rehabilitation, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Hirotaka Mutsuzaki
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan
| | - Takashi Fukaya
- Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Tsuchiura, Ibaraki, Japan
| | - Koichi Iwai
- Center for Humanities and Sciences, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan
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185
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Ármannsdóttir AL, Lecomte C, Brynjólfsson S, Briem K. Task dependent changes in mechanical and biomechanical measures result from manipulating stiffness settings in a prosthetic foot. Clin Biomech (Bristol, Avon) 2021; 89:105476. [PMID: 34517194 DOI: 10.1016/j.clinbiomech.2021.105476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/28/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Adaptation of lower limb function to different gait tasks is inherently not as effective among individuals with lower limb amputation as compared to able-bodied individuals. Varying stiffness of a prosthetic foot may be a way of facilitating gait tasks that require larger ankle joint range of motion. METHODS Three stiffness settings of a novel prosthetic foot design were tested for level walking at three speeds as well as for 7,5° incline and decline walking. Outcome measures, describing ankle range of motion and ankle dynamic joint stiffness were contrasted across the three stiffness settings. Standardized mechanical tests were done for the hindfoot and forefoot. FINDINGS Dorsiflexion angle was incrementally increased with a softer foot and a faster walking speed / higher degree of slope. The concurrent dynamic joint stiffness exhibited a less systematic change, especially during INCLINE and DECLINE walking. The small difference seen between the stiffness settings for hindfoot loading limits analysis for the effects of stiffness during weight acceptance, however, a stiffer foot significantly restricted plantarflexion during DECLINE. INTERPRETATIONS Varying stiffness settings within a prosthetic foot does have an effect on prosthetic foot dynamics, and differences are task dependent, specifically in parameters involving kinetic attributes. When considering the need for increased ankle range of motion while performing more demanding gait tasks, a foot that allows the users themselves to adjust stiffness according to the task at hand may be of benefit for active individuals, possibly enhancing the user's satisfaction and comfort during various daily activities.
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Affiliation(s)
- Anna L Ármannsdóttir
- Research Centre of Movement Science, University of Iceland, Sæmundargata 2, 102 Reykjavík, Iceland.
| | - Christophe Lecomte
- Faculty of Industrial Engineering, Mechanical Engineering and Computer Science, School of Engineering and Natural Sciences, University of Iceland, Sæmundargata 2, 102 Reykjavík, Iceland; Össur hf., Grjótháls 5, 110 Reykjavik, Iceland
| | | | - Kristín Briem
- Research Centre of Movement Science, University of Iceland, Sæmundargata 2, 102 Reykjavík, Iceland
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186
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Barboza TV, Weizemann C, Carvalho ARD. Causal relationship between spatiotemporal parameters of walking and the locomotor rehabilitation index in healthy people. Gait Posture 2021; 90:320-325. [PMID: 34564005 DOI: 10.1016/j.gaitpost.2021.09.191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/07/2021] [Accepted: 09/19/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Walking speed is a functional vital sign affecting mechanical parameters individually. Further, there is a tendency for pathological gait to occur at slower speeds, which does not always allow for an adequate comparison with normal gait. Therefore, recognizing the influence of spatiotemporal adjustments on healthy gait can broaden our understanding of the applicability of gait quality markers. RESEARCH QUESTION This study aimed to identify the causal relationship between the stride length-frequency walking ratio index (R_SL/SF) at the self-selected walking speed (SSWS) and optimal walking speed (OWS) and the locomotor rehabilitation index (LRI) in healthy adults. MATERIALS AND METHODS Healthy adults (n = 68) of both sexes aged 20-59 years were included in this study. The SSWS was determined using a 30-m walkway. The OWS and LRI were predicted by equations proposed in the literature. The volunteers walked on the treadmill at speeds corresponding to the OWS and SSWS in two bouts of 60 s each, with a break in between. The spatiotemporal parameters were recorded using a high-speed digital video camera, digitalized, and mathematically processed. Multiple linear regression was applied using the forced regression method. RESULTS Significant correlations were found between the LRI and R_SL/SF at the SSWS (R = 0.397; p < 0.001) and OWS (R = 0.266; p = 0.014). The regression model showed that 16 % of the variability in the LRI was attributable to the R_SL/SF variability at the SSWS. The average and 95 % confidence interval LRI were 94.7 % (91.6 %-97.8 %). CONCLUSION The LRI average is around 95 % for healthy and young adults and the R_SL/SF explained just 16 % of the variance in LRI.
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Affiliation(s)
- Taise Vieira Barboza
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil
| | - Carolina Weizemann
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil
| | - Alberito Rodrigo de Carvalho
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil.
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187
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Hashimoto H, Kobayashi T, Kataoka M, Okuda K. Influence of coronal and sagittal prosthetic foot alignment on socket reaction moments in transtibial prostheses during walking. Gait Posture 2021; 90:252-260. [PMID: 34534864 DOI: 10.1016/j.gaitpost.2021.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The socket reaction moment (SRM) has been reported to change because of alignment changes in transtibial prosthetic sockets. However, the influence of prosthetic foot alignment on SRM remains unclear. RESEARCH QUESTION Are SRMs predictable from alignment changes of prosthetic feet? METHODS Ten users of transtibial prostheses participated in this study. Under five alignment conditions (3 ° plantarflexion and dorsiflexion, 6 ° inversion and eversion, and baseline alignment), temporal-spatial parameters and sagittal and coronal SRMs were measured during walking. Cadence, walking speed, step time, single support time, and step length were compared. The maximum/minimum SRM, % stance (timing) of the maximum/minimum SRM, Zero-cross, and SRMs at 5 %, 20 %, and 75 % stance were extracted and compared. Repeated measures analysis of variance or Friedman tests, and linear regression analyses were conducted for statistical analyses (i.e., alignment conditions as independent variables and SRM parameters as dependent variables). RESULTS The SRMs at 5%, 20 %, and 75 % stance showed significant differences under coronal angular changes. The minimum SRM, % stance of the minimum/maximum SRM, and Zero-cross showed significant differences under sagittal alignment changes. In linear regression analysis, the minimum SRM, % stance of the minimum/maximum SRM, SRM at 20 % stance, and Zero-cross were significant dependent variables in the sagittal plane. The maximum/minimum SRM, SRM at 20 % and 75 % stance, and % stance of the minimum SRM were significant dependent variables in the coronal plane. SIGNIFICANCE The results indicated that the changes in prosthetic feet angles may predict the magnitude of SRM (maximum/minimum SRM, SRM at 20 % and 75 % stance) in the coronal plane, and the timing of SRM (Zero-cross, % stance of the maximum/minimum SRM) in the sagittal plane. These findings suggest that the SRM may be useful for evaluating foot alignment in transtibial prostheses.
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Affiliation(s)
- Hiroshi Hashimoto
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino City, Osaka, Japan; Pacific Supply Co. Ltd., Daito City, Osaka, Japan.
| | - Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Masataka Kataoka
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino City, Osaka, Japan
| | - Kuniharu Okuda
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino City, Osaka, Japan
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188
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The influence of net ground reaction force orientation on mediolateral stability during walking. Gait Posture 2021; 90:73-79. [PMID: 34418868 DOI: 10.1016/j.gaitpost.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 08/02/2021] [Accepted: 08/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous work has linked the eccentricity of the net ground reaction force (GRFnet) to increased mediolateral instability during single-step voluntary and compensatory stepping responses. The present work sought to understand the extent to which such control mechanisms for mediolateral stability are present during gait. RESEARCH QUESTION How do gait velocity and step width constraints influence the kinetic control of mediolateral stability control among healthy participants? METHODS 25 participants performed three walking conditions - normal walking with self-selected speed and foot-placement, fast walking with self-selected foot-placement, and narrowbase walking - across a 10-meter walkway. Lateral instability was quantified by the mediolateral margin of stability (MoSML). The frontal-plane eccentricity of the GRFnet was calculated as the difference between GRFnet vector orientation and that of a line joining the coordinates of COPnet and COM. Two discrete time-points (P1 and P2) following foot-contact were examined, as they have been suggested to be indicative of proactive and reactive COM control, respectively. Task-related differences in the magnitude and timing of kinematic and kinetic outcome variables were analysed using one-way ANOVAs with repeated-measures. RESULTS With constraints on step-width in narrow-base walking, participants exhibited reduced stability as evidenced by reduced MoSML, alongside reductions in the peak GRFnet eccentricity (θd) at P1. Participants exhibited no reduction in stability during fast walking, as revealed by the MoSML in part because of a similar onset of P1 within the gait cycle. P2 magnitude was larger in narrow-base walking relative to fast-walking, and occurred at an earlier point in the gait cycle. SIGNIFICANCE Findings suggest proactive mechanisms (i.e. P1) may predominantly regulate mediolateral stability during walking. Reactive mechanisms (i.e. P2), however, may be capable of offsetting instability in situations where proactive mechanisms are insufficient.
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189
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Freire Júnior RC, Pieruccini-Faria F, Porto JM, Montero-Odasso M, de Abreu DCC. Long-term living in unfavorable socioeconomic conditions impairs late-life gait performance. Arch Gerontol Geriatr 2021; 97:104526. [PMID: 34537514 DOI: 10.1016/j.archger.2021.104526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/02/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Low socioeconomic status has been associated with individual health-related problems; however, no study has specifically investigated the impact of socioeconomic disparities on gait performance using an index that considers the population aggregation, as the Human Development Index (HDI). Thus, the aim of the present study was to assess gait parameters of older people living in cities with differences in socioeconomic conditions, identified by HDI. METHODS Cross-sectional design study conducted with a sample of 233 older people from two Brazilians regions: Coari, state of Amazonas, Brazil (n= 124, low-HDI-Bra) and Ribeirão Preto, state of São Paulo, Brazil (n= 109, very high-HDI-Bra). The gait performance was assessed by an electronic walkway, and the interest variables were gait speed, cadence, stride time, step length and stride width. RESULTS Low-HDI-Bra group presented worse gait performance as identified by slower gait speed (p = < .001), slower cadence (p = < .001), higher stride time (p = < .001), shorter step length (p = < .001), compared with the very high-HDI-Bra group. There was a positive association between HDI, and gait spend, cadence and step length, and there was a negative association between HDI and stride time and stride width. CONCLUSIONS Long-term exposure to socioeconomic inequalities found in low HDI cities may impair gait performance in late life. Such information may be relevant to create public politics that use the gait parameter based on the region where the people live.
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Affiliation(s)
- Renato C Freire Júnior
- Laboratory of Assessment and Rehabilitation of Equilibrium. Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, Brazil
| | - Frederico Pieruccini-Faria
- Department of Medicine, Division of Geriatric Medicine, Parkwood Institute, University of Western Ontario, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, London, ON, Canada
| | - Jaqueline M Porto
- Laboratory of Assessment and Rehabilitation of Equilibrium. Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Parkwood Institute, University of Western Ontario, London, ON, Canada; Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, London, ON, Canada
| | - Daniela C C de Abreu
- Laboratory of Assessment and Rehabilitation of Equilibrium. Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
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190
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Estimation of Knee Joint Angle Using Textile Capacitive Sensor and Artificial Neural Network Implementing with Three Shoe Types at Two Gait Speeds: A Preliminary Investigation. SENSORS 2021; 21:s21165484. [PMID: 34450926 PMCID: PMC8398621 DOI: 10.3390/s21165484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/25/2022]
Abstract
The lower limb joints might be affected by different shoe types and gait speeds. Monitoring joint angles might require skill and proper technique to obtain accurate data for analysis. We aimed to estimate the knee joint angle using a textile capacitive sensor and artificial neural network (ANN) implementing with three shoe types at two gait speeds. We developed a textile capacitive sensor with a simple structure design and less costly placing in insole shoes to measure the foot plantar pressure for building the deep learning models. The smartphone was used to video during walking at each condition, and Kinovea was applied to calibrate the knee joint angle. Six ANN models were created; three shoe-based ANN models, two speed-based ANN models, and one ANN model that used datasets from all experiment conditions to build a model. All ANN models at comfortable and fast gait provided a high correlation efficiency (0.75 to 0.97) with a mean relative error lower than 15% implement for three testing shoes. And compare the ANN with A convolution neural network contributes a similar result in predict the knee joint angle. A textile capacitive sensor is reliable for measuring foot plantar pressure, which could be used with the ANN algorithm to predict the knee joint angle even using high heel shoes.
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191
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Li S, Ng WH, Abujaber S, Shaharudin S. Effects of resistance training on gait velocity and knee adduction moment in knee osteoarthritis patients: a systematic review and meta-analysis. Sci Rep 2021; 11:16104. [PMID: 34373507 PMCID: PMC8352951 DOI: 10.1038/s41598-021-95426-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/23/2021] [Indexed: 01/08/2023] Open
Abstract
The systematic review aimed to analyze the effects of resistance training in knee osteoarthritis (OA) rehabilitation from a biomechanical perspective. A meta-analysis was performed to determine the potential benefits of resistance training on patients with knee OA. Relevant studies based on the inclusion and exclusion criteria were selected from CENTRAL, PubMed, Scopus, and Web of Science databases inception to August 2020. Outcome measures included gait velocity and knee adduction moment (KAM). The mean differences of the data with a 95% confidence interval were analyzed using STATA 15.1 software The search identified eight studies that satisfied all the inclusion criteria, in which 164 patients were involved in gait velocity studies and another 122 patients were part of KAM studies. Analysis of the pooled data showed that resistance training significantly improved the gait velocity in patients with knee OA (p < 0.01, z = 2.73), ES (95% CI) = 0.03 (0.01, 0.06) m/s. However, resistance training had no significant effect on improving KAM in patients with knee OA (p = 0.98, z = 0.03), ES (95% CI) = 0.00 (− 0.16, 0.16) percentage of body weight × height (%BW × Ht). Therefore, resistance training may enhance gait velocity but not KAM in knee OA patients. The protocol was registered at PROSPERO (registration number: CRD42020204897).
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Affiliation(s)
- Shuoqi Li
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Wei Hui Ng
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.,Klinik Kesihatan Putrajaya Presint 9, Kementerian Kesihatan Malaysia, 62300, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
| | - Sumayeh Abujaber
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Shazlin Shaharudin
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
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192
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Zaroug A, Garofolini A, Lai DTH, Mudie K, Begg R. Prediction of gait trajectories based on the Long Short Term Memory neural networks. PLoS One 2021; 16:e0255597. [PMID: 34351994 PMCID: PMC8341582 DOI: 10.1371/journal.pone.0255597] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/20/2021] [Indexed: 11/19/2022] Open
Abstract
The forecasting of lower limb trajectories can improve the operation of assistive devices and minimise the risk of tripping and balance loss. The aim of this work was to examine four Long Short Term Memory (LSTM) neural network architectures (Vanilla, Stacked, Bidirectional and Autoencoders) in predicting the future trajectories of lower limb kinematics, i.e. Angular Velocity (AV) and Linear Acceleration (LA). Kinematics data of foot, shank and thigh (LA and AV) were collected from 13 male and 3 female participants (28 ± 4 years old, 1.72 ± 0.07 m in height, 66 ± 10 kg in mass) who walked for 10 minutes at preferred walking speed (4.34 ± 0.43 km.h-1) and at an imposed speed (5km.h-1, 15.4% ± 7.6% faster) on a 0% gradient treadmill. The sliding window technique was adopted for training and testing the LSTM models with total kinematics time-series data of 10,500 strides. Results based on leave-one-out cross validation, suggested that the LSTM autoencoders is the top predictor of the lower limb kinematics trajectories (i.e. up to 0.1s). The normalised mean squared error was evaluated on trajectory predictions at each time-step and it obtained 2.82-5.31% for the LSTM autoencoders. The ability to predict future lower limb motions may have a wide range of applications including the design and control of bionics allowing improved human-machine interface and mitigating the risk of falls and balance loss.
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Affiliation(s)
- Abdelrahman Zaroug
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | | | - Daniel T. H. Lai
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
- College of Engineering and Science, Victoria University, Melbourne, Victoria, Australia
| | - Kurt Mudie
- Defence Science and Technology Group, Melbourne, Victoria, Australia
| | - Rezaul Begg
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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193
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Almonroeder TG, Harding L, Seubert B, Cowley H, Kernozek T. The effects of incremental changes in rucksack load on lower extremity joint Kinetic patterns during ruck marching. ERGONOMICS 2021; 64:971-982. [PMID: 33688792 DOI: 10.1080/00140139.2021.1893391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
Injuries are often attributed to ruck marching. Therefore, it is important to examine how load carriage influences gait mechanics. The purpose of this study was to examine how subtle changes in rucksack load influence joint torque patterns during marching. Fourteen Army ROTC cadets marched with light, moderate, and heavy rucksack loads. Kinetic and kinematic data were recorded via an instrumented treadmill and motion capture system and principal component analysis was used to analyse the joint torque waveforms. Cadets exhibited moderate-large increases in knee extension torques during early stance (effect sizes ≥0.45) and small-moderate increases in ankle plantarflexion torques during push off (effect sizes ≥0.23) with each incremental increase in rucksack load. The lighter load also resulted in lower hip extension torques during early stance and flexion torques during late stance, vs. the moderate and heavier loads (effect sizes ≥0.23). It appears that subtle changes in rucksack load influence marching mechanics. Practitioner Summary: The purpose of this study was to examine how relatively subtle changes in rucksack load influence marching mechanics. Army ROTC cadets marched with relatively light, moderate, and heavy rucksack loads. Our results indicate that even subtle changes in rucksack load influence joint torque patterns of the hip, knee, and ankle. Abbreviations: ROTC: reserve officer training corps; RoF: rating-of-fatigue; PC: principal component; ICC: intraclass correlation coefficient; ES: effect size.
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Affiliation(s)
- Thomas Gus Almonroeder
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, La Crosse, WI, USA
| | - Lauren Harding
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, La Crosse, WI, USA
| | - Brooke Seubert
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, La Crosse, WI, USA
| | - Hanni Cowley
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, La Crosse, WI, USA
| | - Thomas Kernozek
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, La Crosse, WI, USA
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194
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Brisson NM, Agres AN, Jung TM, Duda GN. Gait Adaptations at 8 Years After Reconstruction of Unilateral Isolated and Combined Posterior Cruciate Ligament Injuries. Am J Sports Med 2021; 49:2416-2425. [PMID: 34115543 PMCID: PMC8283187 DOI: 10.1177/03635465211017147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND It remains unclear how posterior cruciate ligament (PCL) reconstruction influences long-term lower extremity joint biomechanics. PURPOSE To determine whether patients who underwent PCL reconstruction exhibited long-term alterations in lower limb gait mechanics. STUDY DESIGN Controlled laboratory study. METHODS A total of 26 patients underwent gait analyses at 8.2 ± 2.6 years after primary unilateral PCL reconstruction. Sex- and age-matched healthy controls were analyzed for comparison. Gait data were collected using motion capture and force plates. Hip, knee, and ankle angles and moments were compared during initial contact, early stance, and late stance for the reconstructed and uninjured contralateral limbs of patients who underwent PCL reconstruction (PCL group) as well as the limbs of healthy control participants (CON group). RESULTS No side-to-side kinematic differences were noted between the reconstructed and contralateral limbs of the PCL group; some trivial differences were noted in knee and hip moments. However, major differences between the PCL and CON groups occurred at the knee. Reconstructed and contralateral limbs of the PCL group exhibited larger knee flexion angles during initial contact (Δ = 7.0° [P < .001] and Δ = 6.9° [P < .001], respectively), early stance (Δ = 5.8° [P = .003] and Δ = 6.7° [P < .001], respectively), and late stance (Δ = 7.9° [P < .001] and Δ = 8.0° [P < .001], respectively) compared with the CON group. During early stance, contralateral limbs of the PCL group displayed larger knee flexion moments (Δ = 0.20 N·m/kg; P = .014) compared with the CON group, and both reconstructed (Δ = 0.05 N·m/kg; P = .027) and contralateral (Δ = 0.07 N·m/kg; P = .001) limbs of the PCL group exhibited larger knee external rotation moments compared with the CON group. During late stance, reconstructed and contralateral limbs of the PCL group exhibited smaller knee extension moments (Δ = 0.24 N·m/kg [P < .001] and Δ = 0.26 N·m/kg [P < .001], respectively) and knee internal rotation moments (Δ = 0.06 N·m/kg [P < .001] and Δ = 0.06 N·m/kg [P < .001], respectively) compared with the CON group. No discrepancies were observed at the hip; minimal differences were noted in sagittal-plane ankle mechanics. CONCLUSION Patients who underwent PCL reconstruction generally exhibited bilateral gait symmetry at 8 years after surgery. However, they exhibited important biomechanical deviations in both knees compared with healthy controls. These modifications likely reflect adaptive gait strategies to protect the PCL after reconstruction. CLINICAL RELEVANCE Long-term follow-up analyses of patients who underwent PCL reconstruction should not use the uninjured contralateral limb as a "healthy" reference, as it also exhibits mechanical differences compared with controls. Results could inform the development of neuromuscular and strength training programs targeting the restoration of knee biomechanics similar to healthy controls to prevent early-onset degeneration that is frequently associated with altered biomechanics.
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Affiliation(s)
- Nicholas M. Brisson
- Julius Wolff Institute, Berlin Institute of Health and Charité–Universitätsmedizin Berlin, Berlin, Germany,Nicholas M. Brisson, PhD, Julius Wolff Institute, Berlin Institute of Health and Charité–Universitätsmedizin Berlin, Philippstrasse 13, Haus 11, Raum 2.18, Berlin, 10115, Germany ()
| | - Alison N. Agres
- Julius Wolff Institute, Berlin Institute of Health and Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias M. Jung
- Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N. Duda
- Julius Wolff Institute, Berlin Institute of Health and Charité–Universitätsmedizin Berlin, Berlin, Germany,Center for Musculoskeletal Surgery, Charité–Universitätsmedizin Berlin, Berlin, Germany,Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health and Charité–Universitätsmedizin Berlin, Berlin, Germany
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195
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Raghu SL, Conners RT, Kang CK, Landrum DB, Whitehead PN. Kinematic analysis of gait in an underwater treadmill using land-based Vicon T 40s motion capture cameras arranged externally. J Biomech 2021; 124:110553. [PMID: 34161842 DOI: 10.1016/j.jbiomech.2021.110553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
Aquatic therapy for rehabilitation can be performed in a variety of environments, which can vary from a traditional swimming pool to a self-contained underwater treadmill. While kinematic analysis has been performed in large volume swimming pools using specific underwater motion capture systems, researchers may only have access to a land-based motion-capture system, which is not waterproof. Additionally, underwater motion capture systems may not fit within the confines of a smaller underwater treadmill. Thus, the purpose of this study was to design and analyze methodology to quantify lower limb kinematics during an aquatic treadmill session, using a land-based motion capture system. Kinematics of lower limb motion at different speeds was studied while walking on an underwater treadmill in comparison to walking on the same treadmill without water (empty tank). The effects of the presence of water on walking kinematics was analyzed and interpreted using parametric and non-parametric testing procedures. The results suggest significant influences of speed on knee and ankle angles (p < 0.05) in both dryland and aquatic scenarios. Knee and ankle angle measures revealed no significant differences between the dryland and water treadmill scenarios (p > 0.05). The increased time requirement in water for the full gait cycle found in this study indicates influence of resistive effects. This finding can be especially suited for muscle strengthening and stabilizing treatments for lower limbs. Also, a framework was developed to realize a potential methodology to use land-based motion capture cameras to successfully analyze the kinematics of gait in constrained aquatic volumes.
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Affiliation(s)
- Shreyas Lakshmipuram Raghu
- Mechanical and Aerospace Engineering Department, The Univeristy of Alabama in Huntsville, Huntsville, AL 35899, United States
| | - Ryan T Conners
- Department of Kinesiology, The Univeristy of Alabama in Huntsville, Huntsville, AL 35899, United States.
| | - Chang-Kwon Kang
- Mechanical and Aerospace Engineering Department, The Univeristy of Alabama in Huntsville, Huntsville, AL 35899, United States
| | - David Brian Landrum
- Mechanical and Aerospace Engineering Department, The Univeristy of Alabama in Huntsville, Huntsville, AL 35899, United States
| | - Paul N Whitehead
- Department of Kinesiology, The Univeristy of Alabama in Huntsville, Huntsville, AL 35899, United States
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Ismailidis P, Kaufmann M, Clauss M, Pagenstert G, Eckardt A, Ilchmann T, Mündermann A, Nüesch C. Kinematic changes in severe hip osteoarthritis measured at matched gait speeds. J Orthop Res 2021; 39:1253-1261. [PMID: 32930435 DOI: 10.1002/jor.24858] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 02/04/2023]
Abstract
Kinematic differences between patients with osteoarthritis (OA) and control participants have been reported to be influenced by gait speed. The purpose of this study was to experimentally detect the effect of walking speed on differences in spatiotemporal parameters and kinematic trajectories between patients with hip OA and age-matched asymptomatic participants using wearable sensors and statistical parametric mapping (SPM). Twenty-four patients with severe unilateral hip OA and 48 control participants were included in this study. Patients walked at a self-selected normal speed and control participants at self-selected normal and slow speeds. Spatiotemporal parameters and kinematic trajectories were measured with the inertial sensor system Rehagait®. Gait parameters were compared between patients with hip OA and control participants for normal and matched speed using SPM with independent sample t-tests. At self-selected normal speed, the patient group walked slower (-0.20 m/s, p < .001) and at lower cadence (-5.0 steps/minute, p < .001) as well as with smaller hip flexion (-7.4°, p < .001) and extension (-4.1°, p = .001), higher knee flexion during terminal stance (+8.0°, p < .001) and higher ankle dorsiflexion and plantarflexion (+7.1°, p < .001). While differences in spatiotemporal parameters and the ankle trajectory disappeared at matched speed, some clinically relevant and statistically significant differences in hip and knee trajectories remained. Most differences in sagittal plane gait kinematics between patients with hip OA and control participants were present for matched speed, and therefore appear to be associated with a disease rather than gait speed. Nevertheless, studies investigating hip kinematics in patients with hip OA should involve trials at matched speeds.
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Affiliation(s)
- Petros Ismailidis
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Mara Kaufmann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Martin Clauss
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Geert Pagenstert
- Department of Clinical Research, University of Basel, Basel, Switzerland.,Clarahof Clinic of Orthopaedic Surgery, Basel, Switzerland
| | - Anke Eckardt
- ENDO-Team, Hirslanden Klinik Birshof, Münchenstein, Switzerland
| | - Thomas Ilchmann
- ENDO-Team, Hirslanden Klinik Birshof, Münchenstein, Switzerland
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
| | - Corina Nüesch
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
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197
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Ability of a Set of Trunk Inertial Indexes of Gait to Identify Gait Instability and Recurrent Fallers in Parkinson's Disease. SENSORS 2021; 21:s21103449. [PMID: 34063468 PMCID: PMC8156709 DOI: 10.3390/s21103449] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/08/2021] [Accepted: 05/13/2021] [Indexed: 12/24/2022]
Abstract
The aims of this study were to assess the ability of 16 gait indices to identify gait instability and recurrent fallers in persons with Parkinson’s disease (pwPD), regardless of age and gait speed, and to investigate their correlation with clinical and kinematic variables. The trunk acceleration patterns were acquired during the gait of 55 pwPD and 55 age-and-speed matched healthy subjects using an inertial measurement unit. We calculated the harmonic ratios (HR), percent recurrence, and percent determinism (RQAdet), coefficient of variation, normalized jerk score, and the largest Lyapunov exponent for each participant. A value of ≤1.50 for the HR in the antero-posterior direction discriminated between pwPD at Hoehn and Yahr (HY) stage 3 and healthy subjects with a 67% probability, between pwPD at HY 3 and pwPD at lower HY stages with a 73% probability, and it characterized recurrent fallers with a 77% probability. Additionally, HR in the antero-posterior direction was correlated with pelvic obliquity and rotation. RQAdet in the antero-posterior direction discriminated between pwPD and healthy subjects with 67% probability, regardless of the HY stage, and was correlated with stride duration and cadence. Therefore, HR and RQAdet in the antero-posterior direction can both be used as age- and-speed-independent markers of gait instability.
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198
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Longitudinal changes in tibial and femoral cartilage thickness are associated with baseline ambulatory kinetics and cartilage oligomeric matrix protein (COMP) measures in an asymptomatic aging population. Osteoarthritis Cartilage 2021; 29:687-696. [PMID: 33610822 DOI: 10.1016/j.joca.2021.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 01/07/2021] [Accepted: 02/02/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To address the need for early knee osteoarthritis (OA) markers by testing if longitudinal cartilage thickness changes are associated with specific biomechanical and biological measures acquired at a baseline test in asymptomatic aging subjects. DESIGN Thirty-eight asymptomatic subjects over age 45 years were studied at baseline and at an average of 7-9 year follow-up. Gait mechanics and knee MRI were measured at baseline and MRI was obtained at follow-up to assess cartilage thickness changes. A subset of the subjects (n = 12) also had serum cartilage oligomeric matrix protein measured at baseline in response to a mechanical stimulus (30-min walk) (mCOMP). Baseline measures, including the knee extension (KEM), flexion (KFM), adduction (KAM) moments and mCOMP, were tested for associations with cartilage thickness changes in specific regions of the knee. RESULTS Cartilage change in the full medial femoral condyle (p = 0.005) and external medial femoral region (p = 0.041) was negatively associated with larger early stance peak KEM. Similarly, cartilage change in the full medial femoral region (p = 0.009) and medial femoral external region (p = 0.043) was negatively associated with larger first peak KAM, while cartilage change in the anterior medial tibia was positively associated with larger first peak KAM (p = 0.003). Cartilage change in the anterior medial tibia was also significantly associated (p = 0.011) with mCOMP levels 5.5-h post-activity (percentage of pre-activity levels). CONCLUSIONS Interactions found between gait, mechanically-stimulated serum biomarkers, and cartilage thickness in an at-risk aging asymptomatic population suggest the opportunity for early detection of OA with new approaches that bridge across disciplines and scales.
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199
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Pacini Panebianco G, Bisi MC, Mangia AL, Fantozzi S, Stagni R. Quantitative characterization of walking on sand inecological conditions: Speed, temporal segmentation, and variability. Gait Posture 2021; 86:211-216. [PMID: 33756411 DOI: 10.1016/j.gaitpost.2021.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/17/2021] [Accepted: 03/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Walking on compliant surfaces, on sand in particular, is now recommended for training in both elderlies and injured subjects/individuals, allowing to perform high intensity exercises (i.e. augmented energy expenditure) in safe conditions (i.e. minimizing the impact on the joints and the risk of fall). Nevertheless, despite the assessment of energetics of walking on sand, the quantitative biomechanical characterization of walking on sand in ecological conditions is largely lacking. RESEARCH QUESTION Which is the effect of sand surface on gait speed, gait temporal segmentation and their variability as related to surface compliance in ecological condition? METHODS Eighteen healthy adults were assessed while walking on solid ground, dry-, and wet sand in ecological conditions by means of wearable inertial sensors (Miniwave, Cometa s.r.l., Italy). The best performing algorithm for the segmentation of walking on sand was selected among 17 algorithms designed for solid ground. Gait timing (i.e. speed, temporal segmentation, variability) was analysed, for the first time, with respect to sand compliance, and compared to walking on solid ground. RESULTS Self-selected speed on a 60 m distance increased when walking on sand with respect to solid ground (Median 1.02 m/s), with the highest speed on wet sand (Median 1.15 m/s). A stabilizing strategy on the uneven surface provided by sand was highlighted by i) increased stance and double support durations with respect to speed on wet sand, and ii) increased short-term variability of stride, corresponding to continual adjustments of the lower limbs due to shifting surface provided by sand. SIGNIFICANCE This study represents the first step in the objective characterization of walking on compliant surfaces as sand, necessary for the definition of training and rehabilitative programs.
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Affiliation(s)
- Giulia Pacini Panebianco
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi"-Viale del Risorgimento, 2, 40136, University of Bologna, Bologna, Italy; Health Sciences and Technologies - Interdepartmental Center for Industrial Research, Via Tolara di Sopra, 50, 40064, Ozzano dell'Emilia, Italy.
| | - Maria Cristina Bisi
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi"-Viale del Risorgimento, 2, 40136, University of Bologna, Bologna, Italy.
| | - Anna Lisa Mangia
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi"-Viale del Risorgimento, 2, 40136, University of Bologna, Bologna, Italy.
| | - Silvia Fantozzi
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi"-Viale del Risorgimento, 2, 40136, University of Bologna, Bologna, Italy; Health Sciences and Technologies - Interdepartmental Center for Industrial Research, Via Tolara di Sopra, 50, 40064, Ozzano dell'Emilia, Italy.
| | - Rita Stagni
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi"-Viale del Risorgimento, 2, 40136, University of Bologna, Bologna, Italy; Health Sciences and Technologies - Interdepartmental Center for Industrial Research, Via Tolara di Sopra, 50, 40064, Ozzano dell'Emilia, Italy.
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200
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Sikandar T, Rabbi MF, Ghazali KH, Altwijri O, Alqahtani M, Almijalli M, Altayyar S, Ahamed NU. Using a Deep Learning Method and Data from Two-Dimensional (2D) Marker-Less Video-Based Images for Walking Speed Classification. SENSORS 2021; 21:s21082836. [PMID: 33920617 PMCID: PMC8072769 DOI: 10.3390/s21082836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/10/2021] [Accepted: 04/13/2021] [Indexed: 01/09/2023]
Abstract
Human body measurement data related to walking can characterize functional movement and thereby become an important tool for health assessment. Single-camera-captured two-dimensional (2D) image sequences of marker-less walking individuals might be a simple approach for estimating human body measurement data which could be used in walking speed-related health assessment. Conventional body measurement data of 2D images are dependent on body-worn garments (used as segmental markers) and are susceptible to changes in the distance between the participant and camera in indoor and outdoor settings. In this study, we propose five ratio-based body measurement data that can be extracted from 2D images and can be used to classify three walking speeds (i.e., slow, normal, and fast) using a deep learning-based bidirectional long short-term memory classification model. The results showed that average classification accuracies of 88.08% and 79.18% could be achieved in indoor and outdoor environments, respectively. Additionally, the proposed ratio-based body measurement data are independent of body-worn garments and not susceptible to changes in the distance between the walking individual and camera. As a simple but efficient technique, the proposed walking speed classification has great potential to be employed in clinics and aged care homes.
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Affiliation(s)
- Tasriva Sikandar
- Faculty of Electrical and Electronics Engineering, Universiti Malaysia Pahang, Pekan 26600, Malaysia; (T.S.); (K.H.G.)
| | - Mohammad F. Rabbi
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia;
| | - Kamarul H. Ghazali
- Faculty of Electrical and Electronics Engineering, Universiti Malaysia Pahang, Pekan 26600, Malaysia; (T.S.); (K.H.G.)
| | - Omar Altwijri
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (O.A.); (M.A.); (M.A.); (S.A.)
| | - Mahdi Alqahtani
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (O.A.); (M.A.); (M.A.); (S.A.)
| | - Mohammed Almijalli
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (O.A.); (M.A.); (M.A.); (S.A.)
| | - Saleh Altayyar
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (O.A.); (M.A.); (M.A.); (S.A.)
| | - Nizam U. Ahamed
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA 15203, USA
- Correspondence:
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