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Chan CK, Azah HN, Yeow CH, Goh SK, Ting HN, Salmah K. Effects of Squatting Speed and Depth on Lower Extremity Kinematics, Kinetics and Energetics. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Squatting has received considerable attention in sports and is commonly utilized in daily activities. Knowledge of the squatting biomechanics in terms of its speed and depth may enhance exercise selection when targeting for sport-specific performance improvement and injury avoidance. Nonetheless, these perspectives have not been consistently reported. Hence, this preliminary study intends to quantify the kinematics, kinetics, and energetics in squat with different depths and speeds among healthy young adults with different physical activity levels; i.e., between active and sedentary groups. Twenty participants were administered to squat at varying depths (deep, normal, and half) and speeds (fast, normal, and slow). Motion-capture system and force plates were employed to acquire motion trajectories and ground reaction force. Joint moment was obtained via inverse dynamics, while power was derived as a product of moment and angular velocity. Higher speeds and deeper squats greatly influence higher joint moments and powers at the hip ([Formula: see text]) and knee ([Formula: see text]) than ankle, signifying these joints as the prime movers with knee as the predominant contributor. These preliminary findings show that the knee-strategy and hip-strategy were employed in compensating speed and depth manipulations during squatting. In certain contexts, appreciating these findings may provide clinically relevant implications, from the performance and injury avoidance viewpoint, which will ameliorate the physical activity level of practitioners.
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Affiliation(s)
- Chow-Khuen Chan
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Hamzaid Nur Azah
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chen-Hua Yeow
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Sim-Kuan Goh
- Department of Mechanical Engineering, Nanyang Technological University, Singapore
| | - Hua-Nong Ting
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Karman Salmah
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
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Body-Worn IMU-Based Human Hip and Knee Kinematics Estimation during Treadmill Walking. SENSORS 2022; 22:s22072544. [PMID: 35408159 PMCID: PMC9003309 DOI: 10.3390/s22072544] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 12/22/2022]
Abstract
Traditionally, inertial measurement unit (IMU)-based human joint angle estimation techniques are evaluated for general human motion where human joints explore all of their degrees of freedom. Pure human walking, in contrast, limits the motion of human joints and may lead to unobservability conditions that confound magnetometer-free IMU-based methods. This work explores the unobservability conditions emergent during human walking and expands upon a previous IMU-based method for the human knee to also estimate human hip angles relative to an assumed vertical datum. The proposed method is evaluated (N=12) in a human subject study and compared against an optical motion capture system. Accuracy of human knee flexion/extension angle (7.87∘ absolute root mean square error (RMSE)), hip flexion/extension angle (3.70∘ relative RMSE), and hip abduction/adduction angle (4.56∘ relative RMSE) during walking are similar to current state-of-the-art self-calibrating IMU methods that use magnetometers. Larger errors of hip internal/external rotation angle (6.27∘ relative RMSE) are driven by IMU heading drift characteristic of magnetometer-free approaches and non-hinge kinematics of the hip during gait, amongst other error sources. One of these sources of error, soft tissue perturbations during gait, is explored further in the context of knee angle estimation and it was observed that the IMU method may overestimate the angle during stance and underestimate the angle during swing. The presented method and results provide a novel combination of observability considerations, heuristic correction methods, and validation techniques to magnetic-blind, kinematic-only IMU-based skeletal pose estimation during human tasks with degenerate kinematics (e.g., straight line walking).
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McGrath T, Stirling L. Body-Worn IMU Human Skeletal Pose Estimation Using a Factor Graph-Based Optimization Framework. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6887. [PMID: 33276492 PMCID: PMC7729748 DOI: 10.3390/s20236887] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/17/2020] [Accepted: 11/28/2020] [Indexed: 11/17/2022]
Abstract
Traditionally, inertial measurement units- (IMU) based human joint angle estimation requires a priori knowledge about sensor alignment or specific calibration motions. Furthermore, magnetometer measurements can become unreliable indoors. Without magnetometers, however, IMUs lack a heading reference, which leads to unobservability issues. This paper proposes a magnetometer-free estimation method, which provides desirable observability qualities under joint kinematics that sufficiently excite the lower body degrees of freedom. The proposed lower body model expands on the current self-calibrating human-IMU estimation literature and demonstrates a novel knee hinge model, the inclusion of segment length anthropometry, segment cross-leg length discrepancy, and the relationship between the knee axis and femur/tibia segment. The maximum a posteriori problem is formulated as a factor graph and inference is performed via post-hoc, on-manifold global optimization. The method is evaluated (N = 12) for a prescribed human motion profile task. Accuracy of derived knee flexion/extension angle (4.34∘ root mean square error (RMSE)) without magnetometers is similar to current state-of-the-art with magnetometer use. The developed framework can be expanded for modeling additional joints and constraints.
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Affiliation(s)
- Timothy McGrath
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Leia Stirling
- Industrial and Operations Engineering, Robotics Institute, University of Michigan, 1205 Beal Avenue, Ann Arbor, MI 48109, USA;
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Kawakami S, Fujisawa H. Kinetic analysis of tandem gait on a sine-wave-shaped walkway. J Phys Ther Sci 2019; 31:649-655. [PMID: 31528003 PMCID: PMC6698478 DOI: 10.1589/jpts.31.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/27/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to ascertain the kinetic characteristics on a horizontal plane, including knee joint rotation, when performing tandem gait on a sine-wave walkway. [Participants and Methods] The participants were 10 healthy adults. The movement task included tandem gait on a sine-wave walkway. The instruments used were an electromyograph and a three-dimensional motion analysis system. Regarding data analysis, we determined the knee joint rotation angle and muscle activity of the biceps femoris and semitendinosus muscle. [Results] The knee joint rotation angle range was 48.1 ± 6.7°. Two strategies were confirmed with regard to the direction of knee joint rotation: a case in which the agonist muscle acts actively and a case in which the antagonist muscle acts passively. [Conclusion] It has been suggested that the knee joint rotational angle and muscular activity of the rotator muscle group are important for tandem gait on a sine-wave-shaped walking path.
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Affiliation(s)
- Shingo Kawakami
- Department of Rehabilitation, Sendai Rehabilitation
Hospital: 1-3-1 Narita, Tomiya-shi, Miyagi 981-3341, Japan,Corresponding author. Shingo Kawakami (E-mail: )
| | - Hiroyuki Fujisawa
- Department of Rehabilitation, Faculty of Medical Science
& Welfare, Tohoku Bunka Gakuen University, Japan
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Exploring the Development Requirements for Virtual Reality Gait Analysis. MULTIMODAL TECHNOLOGIES AND INTERACTION 2019. [DOI: 10.3390/mti3020024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The hip joint is highly prone to traumatic and degenerative pathologies resulting in irregular locomotion. Monitoring and treatment depend on high-end technology facilities requiring physician and patient co-location, thus limiting access to specialist monitoring and treatment for populations living in rural and remote locations. Telemedicine offers an alternative means of monitoring, negating the need for patient physical presence. In addition, emerging technologies, such as virtual reality (VR) and immersive technologies, offer potential future solutions through virtual presence, where the patient and health professional can meet in a virtual environment (a virtual clinic). To this end, a prototype asynchronous telemedicine VR gait analysis system was designed, aiming to transfer a full clinical facility within the patients’ local proximity. The proposed system employs cost-effective alternative motion capture combined with the system’s immersive 3D virtual gait analysis clinic. The user interface and the tools in the application offer health professionals asynchronous, objective, and subjective analyses. This paper investigates the requirements for the design of such a system and discusses preliminary comparative data of its performance evaluation against a high-fidelity gait analysis clinical application.
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van der Straaten R, De Baets L, Jonkers I, Timmermans A. Mobile assessment of the lower limb kinematics in healthy persons and in persons with degenerative knee disorders: A systematic review. Gait Posture 2018; 59:229-241. [PMID: 29096266 DOI: 10.1016/j.gaitpost.2017.10.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 09/29/2017] [Accepted: 10/03/2017] [Indexed: 02/02/2023]
Abstract
Inertial sensor systems are increasingly used in the assessment of persons with knee osteoarthritis (KOA) and total knee replacement (TKR). This systematic review aims to (1) investigate the application of inertial sensor systems and kinematics derived from these systems, and (2) assess if current assessment protocols consist of tasks which are, according to the International Classification of Functioning, Disability and Health (ICF) for KOA, relevant for persons with KOA and TKR. A search was conducted in six electronic databases (ACM, CINAHL, EMBASE, IEEE, PubMed, Web of Science) to include papers assessing the knee and one or more adjacent joints by means of inertial sensors in healthy persons or persons with KOA or TKR. Two reviewers checked the methodological quality. Twenty-three papers were included: 18 in healthy persons and five in persons with KOA or TKR. In healthy persons, 11 tasks were related to metrics of the ICF-function and ICF-activity level. In persons with KOA, only walking was assessed. Apart from walking, four additional tasks were related to the ICF-function and ICF-activity level in persons with TKR. In healthy persons, joints located proximally and distally to the knee were assessed, while in persons with KOA and TKR, only the knee and ankle were assessed. This is a shortcoming since hip and trunk motion potentially contain clinically relevant information, in terms of identifying (mal)adaptive compensatory movement strategies. Additionally, physically more demanding tasks should be evaluated as these might be superior in detecting compensatory movement strategies. Former considerations warrant attention in future research.
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Affiliation(s)
- R van der Straaten
- REVAL Rehabilitation Research Center, Hasselt University,Agoralaan building A, 3560 Diepenbeek, Belgium.
| | - L De Baets
- REVAL Rehabilitation Research Center, Hasselt University,Agoralaan building A, 3560 Diepenbeek, Belgium.
| | - I Jonkers
- Department of Kinesiology, Human Movement Biomechanics, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium.
| | - A Timmermans
- REVAL Rehabilitation Research Center, Hasselt University,Agoralaan building A, 3560 Diepenbeek, Belgium.
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Mok KM, Bahr R, Krosshaug T. Reliability of lower limb biomechanics in two sport-specific sidestep cutting tasks. Sports Biomech 2017; 17:157-167. [DOI: 10.1080/14763141.2016.1260766] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Kam-Ming Mok
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Tron Krosshaug
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
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Meireles S, De Groote F, Van Rossom S, Verschueren S, Jonkers I. Differences in knee adduction moment between healthy subjects and patients with osteoarthritis depend on the knee axis definition. Gait Posture 2017; 53:104-109. [PMID: 28126693 DOI: 10.1016/j.gaitpost.2017.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 12/14/2016] [Accepted: 01/16/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study, firstly, investigates the effect of using an anatomical versus a functional axis of rotation (FAR) on knee adduction moment (KAM) in healthy subjects and patients with knee osteoarthritis (KOA). Secondly, this study reports KAM for models with FAR calculated using weight-bearing and non-weight-bearing motion. DESIGN Three musculoskeletal models were created using OpenSim with different knee axis of rotation (AR): transepicondylar axis (TEA); FAR calculated based on SARA algorithm using a weight-bearing motion (wFAR) and a non-weight-bearing motion (nwFAR). KAM were calculated during gait in fifty-nine subjects (n=20 healthy, n=16 early OA, n=23 established OA) for all models and groups. RESULTS Significant differences between the three groups in the first peak KAM were found when TEA was used (p=0.038). However, these differences were no longer present when using FAR. In subjects with established OA, KAMs were significantly reduced when using nwFAR compared to TEA models but also compared to wFAR models. CONCLUSION The presence of excessive KAM in subjects with established KOA showed to be dependent on the definition of the AR: anatomical versus functional. Therefore, caution should be accounted when comparing KAM in different studies on KOA patients. In patients with end-stage knee OA where increased passive knee laxity is likely to exist, the use of weight-bearing motions should be considered to avoid increased variability in the location and orientation of a FAR obtained from activities with only limited joint loading.
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Affiliation(s)
- S Meireles
- Department of Kinesiology, KU Leuven, Belgium.
| | - F De Groote
- Department of Kinesiology, KU Leuven, Belgium.
| | | | - S Verschueren
- Department of Rehabilitation Sciences, KU Leuven, Belgium.
| | - I Jonkers
- Department of Kinesiology, KU Leuven, Belgium.
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Severijns P, Vanslembrouck M, Vermulst J, Callewaert B, Innocenti B, Desloovere K, Vandenneucker H, Scheys L. High-demand motor tasks are more sensitive to detect persisting alterations in muscle activation following total knee replacement. Gait Posture 2016; 50:151-158. [PMID: 27621084 DOI: 10.1016/j.gaitpost.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 08/05/2016] [Accepted: 09/05/2016] [Indexed: 02/02/2023]
Abstract
Knee osteoarthritis is one of the most frequent indications for total knee replacement (TKR). Unfortunately, many patients still have difficulties during daily life activities after TKR. As the underlying causes of these difficulties are still not fully understood, especially with regard to the role of aberrant muscle activation profiles, the purpose of this study was to examine to what extent muscle activation patterns return to normal after TKR. Furthermore, we aimed to further discuss remaining differences by linking them to pre- and post-operative measurements of the knee and hip kinetics and kinematics during multiple functional motor tasks. Therefore, muscle activity, kinetics and kinematics of knee and hip were measured and analyzed in seven patients during a number of functional tasks by using electromyography and three-dimensional motion analysis. Measurements were performed one week before and one year after surgery. Results were compared to seven matched healthy controls. The analyzed functional tasks included walking at self-selected speed, walking followed by a crossover and a sidestep turn, step descent and ascent. This study suggested that, while muscle activation profiles in patients one year after TKR did return to normal during walking, this was not the case during more demanding motor tasks. These findings may have direct implications for the design of future rehabilitation programs in order to result in faster recovery and ultimately more functional patients after TKR.
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Affiliation(s)
- Pieter Severijns
- Institute for Orthopaedic Research and Training (IORT), University Hospitals Leuven, Belgium; Department of Regeneration and Development - Organ Systems Cluster, KU Leuven/Division of Orthopaedics, University Hospitals Leuven, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
| | | | - John Vermulst
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Barbara Callewaert
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, Belgium
| | - Bernardo Innocenti
- BEAMS Department (Bio Electro and Mechanical Systems), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Belgium
| | - Hilde Vandenneucker
- Institute for Orthopaedic Research and Training (IORT), University Hospitals Leuven, Belgium; Department of Regeneration and Development - Organ Systems Cluster, KU Leuven/Division of Orthopaedics, University Hospitals Leuven, Belgium
| | - Lennart Scheys
- Institute for Orthopaedic Research and Training (IORT), University Hospitals Leuven, Belgium; Department of Regeneration and Development - Organ Systems Cluster, KU Leuven/Division of Orthopaedics, University Hospitals Leuven, Belgium
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Stastny P, Lehnert M, Zaatar AMZ, Svoboda Z, Xaverova Z. Does the Dumbbell-Carrying Position Change the Muscle Activity in Split Squats and Walking Lunges? J Strength Cond Res 2016; 29:3177-87. [PMID: 25968228 PMCID: PMC4640053 DOI: 10.1519/jsc.0000000000000976] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Stastny, P, Lehnert, M, Zaatar, AMZ, Svoboda, Z, and Xaverova, Z. Does the dumbbell-carrying position change the muscle activity in split squats and walking lunges? J Strength Cond Res 29(11): 3177–3187, 2015—The forward walking lunge (WL) and split squat (SSq) are similar exercises that have differences in the eccentric phase, and both can be performed in the ipsilateral or contralateral carrying conditions. This study aimed to determine the effects of dumbbell-carrying position on the kinematics and electromyographic (EMG) amplitudes of the gluteus medius (Gmed), vastus medialis (VM), vastus lateralis (VL), and biceps femoris during WLs and SSqs. The resistance-trained (RT) and the non–resistance-trained (NT) groups (both n = 14) performed ipsilateral WLs, contralateral WLs, ipsilateral SSqs, and contralateral SSqs in a randomized order in a simulated training session. The EMG amplitude, expressed as a percentage of the maximal voluntary isometric contraction (%MVIC), and the kinematics, expressed as the range of motion (ROM) of the hip and knee, were measured during 5 repetition maximum for both legs. The repeated measure analyses of variance showed significant differences between the RT and NT groups. The NT group showed a smaller knee flexion ROM (p < 0.001, η2 = 0.36) during both types of WLs, whereas the RT group showed a higher eccentric Gmed amplitude (p < 0.001, η2 = 0.46) during all exercises and a higher eccentric VL amplitude (p < 0.001, η2 = 0.63) during contralateral WLs. Further differences were found between contralateral and ipsilateral WLs in both the RT (p < 0.001, η2 = 0.69) and NT groups (p < 0.001, η2 = 0.80), and contralateral WLs resulted in higher eccentric Gmed amplitudes. Contralateral WLs highly activated the Gmed (90% MVIC); therefore, this exercise can increase the Gmed maximal strength. The ipsilateral loading condition did not increase the Gmed or VM activity in the RT or NT group.
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Affiliation(s)
- Petr Stastny
- Faculty of Physical Culture, Palacky University in Olomouc, Olomouc, Czech Republic
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Shi D, Li N, Wang Y, Jiang S, Lin J, Zhu W. Gait modification strategies in trunk over right stance phase in patients with right anterior cruciate ligament deficiency. Gait Posture 2016; 46:63-8. [PMID: 27131179 DOI: 10.1016/j.gaitpost.2016.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 02/02/2023]
Abstract
This study aimed to investigate the gait modification strategies of trunk over right stance phase in patients with right anterior cruciate ligament deficiency (ACL-D). Thirty-six patients with right chronic ACL-D were recruited, as well as 36 controls. A 3D optical video motion capture system was used during gait and stair ambulation. Kinematic variables of the trunk and kinematic and kinetic variables of the knee were calculated. Patients with chronic right ACL-D exhibited many significant abnormalities compared with controls. Trunk rotation with right shoulder trailing over the right stance phase was lower in all five motion patterns (P<0.05). Compared with controls, trunk posterior lean was higher from descending stairs to walking when the knee sagittal plane moment ended (P<0.01). Trunk lateral flexion to the left was higher when ascending stairs at the start of right knee coronal plane moment (P=0.01), when descending stairs at the maximal knee coronal plane moment (P<0.01), and when descending stairs at the end of the knee coronal plane moment (P=0.03). Trunk rotation with right shoulder forward was higher at the minimal knee transverse plane moment (P<0.01) and when the knee transverse plane moment ended (P<0.01); during walking, trunk rotation with right shoulder trailing was lower at other knee moments during other walking patterns (all P<0.01). In conclusion, gait modification strategies of the trunk were apparent in patients with ACL-D. These results provide new insights about diagnosis and rehabilitation of chronic ACL-D (better use of walking and stair tasks as part of a rehabilitation program).
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Affiliation(s)
- Dongliang Shi
- Department of Pediatric Orthopedic, Xinhua Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200092, China
| | - Nannan Li
- Department of Sports Medicine, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Yubin Wang
- Department of Pediatric Orthopedic, Xinhua Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200092, China
| | - Shuyun Jiang
- Gait Analysis Laboratory, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai 200437, China
| | - Jianping Lin
- Department of Orthopedic, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
| | - Wenhui Zhu
- Department of Sports Medicine, Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China.
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Three-Year Outcome After a 1-Month Physiotherapy Program of Local and Individualized Global Treatment for Patellofemoral Pain Followed by Self-Management. Clin J Sport Med 2016; 26:190-8. [PMID: 26327289 DOI: 10.1097/jsm.0000000000000226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The main aim of this study was to assess whether improvements after a 1-month patellofemoral pain (PFP) program addressing local and global deficits were maintained for 3 years. DESIGN This prospective cohort study comprised 4 treatment phases including a randomized trial during week 1. SETTING The study was conducted in a private physiotherapy practice. PATIENTS Thirty-seven patients (55 knees) from an original cohort of 41 patients (60 knees) with PFP were followed for 3 years after referral by doctors to participate in this study. INTERVENTIONS Patients received 4 treatments: local treatment focusing on quadriceps strengthening, quadriceps stretching, and taping for fortnight 1, supplemented with individualized global treatment focusing on lower limb posture and movement patterns for fortnight 2, followed by ongoing self-management. MAIN OUTCOME MEASURES Seven outcome measures, assessed at 4 time points, were quadriceps strength, quadriceps length, eccentric knee control, and 4 pain measures. Long-term measures included return to sporting activity, pain recurrence, exercise compliance, and Kujala score. RESULTS Improvements after fortnight 1 (P < 0.001) and fortnight 2 (P < 0.05) were maintained over 3 years for 6 of 7 measures. On testing, 73% were pain free and the remaining 27% had less pain than pretreatment. Kujala scores improved 27%. Eighty-two percent resumed any sport stopped and 54% of patients started new sports/activities. Patellofemoral pain recurred in 7% and 89% of patients was still exercising 3 years posttreatment. CONCLUSIONS Significant improvements after physiotherapy, incorporating local and individually targeted treatment, were maintained for 3 years in a compliant cohort.
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The use of turning tasks in clinical gait analysis for children with cerebral palsy. Clin Biomech (Bristol, Avon) 2016; 32:286-94. [PMID: 26549659 DOI: 10.1016/j.clinbiomech.2015.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Turning while walking is a crucial component of locomotion that is performed using an outside (step) or inside (spin) limb strategy. The aims of this paper were to determine how children with cerebral palsy perform turning maneuvers and if specific kinematic and kinetic adaptations occur compared to their typically developing peers. METHODS Motion capture data from twenty-two children with cerebral palsy and fifty-four typically developing children were collected during straight and 90° turning gait trials. Experimental data were used to compute spatio-temporal parameters, margin of stability, ground reaction force impulse, as well as joint kinematics and kinetics. FINDINGS Both child groups preferred turning using the spin strategy. The group of children with cerebral palsy exhibited the following adaptations during turning gait compared to the typically developing group: stride length was decreased across all phases of the turn with largest effect size for the depart phase (2.02), stride width was reduced during the turn phase, but with a smaller effect size (0.71), and the average margin of stability during the approach phase of turning was reduced (effect size of 0.98). Few overall group differences were found for joint kinematic and kinetic measures; however, in many cases, the intra-subject differences between straight walking and turning gait were larger for the majority of children with cerebral palsy than for the typically developing children. INTERPRETATION In children with cerebral palsy, turning gait may be a better discriminant of pathology than straight walking and could be used to improve the management of gait abnormalities.
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Dixon PC, Jansen K, Jonkers I, Stebbins J, Theologis T, Zavatsky AB. Muscle contributions to centre of mass acceleration during turning gait in typically developing children: A simulation study. J Biomech 2015; 48:4238-45. [DOI: 10.1016/j.jbiomech.2015.10.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 10/19/2015] [Accepted: 10/21/2015] [Indexed: 11/17/2022]
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Pianigiani S, Scheys L, Labey L, Pascale W, Innocenti B. Biomechanical analysis of the post-cam mechanism in a TKA: comparison between conventional and semi-constrained insert designs. Int Biomech 2015. [DOI: 10.1080/23335432.2015.1014849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Chen L, Gordon K, Hurtig M. Design and validation of a cadaveric knee joint loading device compatible with magnetic resonance imaging and computed tomography. Med Eng Phys 2014; 36:1346-51. [DOI: 10.1016/j.medengphy.2014.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/13/2014] [Accepted: 06/28/2014] [Indexed: 11/27/2022]
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Three-Dimensional Knee Kinematics by Conventional Gait Analysis for Eleven Motor Tasks of Daily Living: Typical Patterns and Repeatability. J Appl Biomech 2013; 29:214-28. [DOI: 10.1123/jab.29.2.214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The availability of detailed knee kinematic data during various activities can facilitate clinical studies of this joint. To describe in detail normal knee joint rotations in all three anatomical planes, 25 healthy subjects (aged 22–49 years) performed eleven motor tasks, including walking, step ascent and descent, each with and without sidestep or crossover turns, chair rise, mild and deep squats, and forward lunge. Kinematic data were obtained with a conventional lower-body gait analysis protocol over three trials per task. To assess the repeatability with standard indices, a representative subset of 10 subjects underwent three repetitions of the entire motion capture session. Extracted parameters with good repeatability included maximum and minimum axial rotation during turning, local extremes of the flexion curves during gait tasks, and stride times. These specific repeatable parameters can be used for task selection or power analysis when planning future clinical studies.
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d'Entremont AG, Nordmeyer-Massner JA, Bos C, Wilson DR, Pruessmann KP. Do dynamic-based MR knee kinematics methods produce the same results as static methods? Magn Reson Med 2012; 69:1634-44. [DOI: 10.1002/mrm.24425] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 06/14/2012] [Accepted: 06/27/2012] [Indexed: 12/24/2022]
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Leffler J, Scheys L, Planté-Bordeneuve T, Callewaert B, Labey L, Bellemans J, Franz A. Joint kinematics following bi-compartmental knee replacement during daily life motor tasks. Gait Posture 2012; 36:454-60. [PMID: 22748470 DOI: 10.1016/j.gaitpost.2012.04.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 04/08/2012] [Accepted: 04/17/2012] [Indexed: 02/02/2023]
Abstract
In many cases knee osteoarthritis leads to total knee replacement surgery (TKR) even if the lateral compartment is not involved. More recently, a bicompartmental knee replacement system (BKR) (Journey Deuce, Smith & Nephew Inc., Memphis, TN, USA) has been developed that only replaces the medial tibiofemoral and the patellofemoral compartments, thus preserving both cruciate ligaments with its associated benefits. However information on the effect of BKR on in vivo knee joint kinematics is not widely available in the literature. Therefore, this study analyzed full three-dimensional knee joint kinematics in 10 postoperative BKR-subjects for a broad spectrum of relevant daily life activities: walking, walking followed by a cross-over or sidestep turn, step ascent and descent, mild squatting and chair rise. We analyzed to what extent normal knee motion is regained through comparison with their non-involved limb as well as a group of matched controls. Furthermore, coefficients of multiple correlation were calculated to assess the consistency of knee joint kinematics both within and between subject groups. This analysis demonstrated that, despite the presence of differences indicative for retention of pre-operative motion patterns and/or remaining compensations, knee joint kinematics in BKR limbs replicate, for a large range of daily-life motor tasks, the kinematics of the contra-lateral non-affected limbs and healthy controls to a similar extent as they are replicated within both these control groups.
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Affiliation(s)
- J Leffler
- Klinik für Orthopädie und Sporttraumatologie, St. Marien-Krankenhaus, Kampenstraße 51, 57072 Siegen, Germany
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Age-related changes in kinematics of the knee joint during deep squat. Knee 2012; 19:208-12. [PMID: 21511482 DOI: 10.1016/j.knee.2011.02.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 01/28/2011] [Accepted: 02/16/2011] [Indexed: 02/02/2023]
Abstract
Researchers frequently use the deep knee squat as a motor task in order to evaluate the kinematic performance after total knee arthroplasty. Many authors reported about the kinematics of a normal squatting motion, however, little is known on what the influence of aging is. Twenty-two healthy volunteers in various age groups (range 21-75 years) performed a deep knee squat activity while undergoing motion analysis using an optical tracking system. The influence of aging was evaluated with respect to kinematics of the trunk, hip, knee and ankle joints. Older subjects required significantly more time to perform a deep squat, especially during the descending phase. They also had more knee abduction and delayed peak knee flexion. Older subjects were slower in descend than ascend during the squat. Although older subjects had a trend towards less maximal flexion and less internal rotation of the knee compared to younger subjects, this difference was not significant. Older subjects also showed a trend towards more forward leaning of the trunk, resulting in increased hip flexion and anterior thoracic tilt. This study confirmed that some aspects of squat kinematics vary significantly with age, and that the basic methodology employed here can successfully detect these age-related trends. Older subjects had more abduction of the knee joint, and this may indicate the load distribution of the medial and lateral condyles could be different amongst ages. Age-matched control data are therefore required whenever the performance of an implant is evaluated during a deep knee squat.
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Tibial rotation in single- and double-bundle ACL reconstruction: a kinematic 3-D in vivo analysis. Knee Surg Sports Traumatol Arthrosc 2011; 19 Suppl 1:S115-21. [PMID: 21667089 DOI: 10.1007/s00167-011-1568-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 05/26/2011] [Indexed: 12/27/2022]
Abstract
PURPOSE The effect of double-bundle ACL reconstruction on knee kinematics has recently been studied by several authors under controlled laboratory conditions however little evidence has been derived from dynamic in vivo evaluations. This study hypothesized that tibial rotation during pivoting motor tasks would be better restored after double-bundle ACL reconstructions when compared with single-bundle procedures. METHODS Twenty patients with a chronic ACL rupture were randomly assigned to receive a single- or double-bundle ACL reconstruction. Both knees were evaluated pre-operatively by kinematic 3-D gait analysis while performing low- and high-demand motor tasks, including pivoting. At 6 months post-operatively, measurements were repeated in 16 patients. Ten healthy, sex- and age-matched subjects with no history of lower limb pathology formed the control group. The tibial rotational excursion was set as the dependent variable. RESULTS The results indicate that at 6 months after surgery both "anatomic" single- and double-bundle ACL reconstruction are able to restore tibial rotational excursion when compared with the contralateral knees and with control knees from uninjured subjects. Chronic ACL-deficient patients show an increase in tibial rotation in both knees during high-demand pivoting tasks. CONCLUSIONS Both "anatomic" single- and double-bundle ACL reconstruction adequately restore tibial rotational excursion in a human, "in vivo" kinematic model. As knee stability measurements by in vivo kinematic 3-D analysis more accurately represent actual knee loading during activities, the results of this study might better correlate with functional outcome after ACL reconstructions compared with static knee stability tests or ex vivo laboratory experiments. In such, the results of this dynamic study do not support the theoretical advantage of a double-bundle ACL reconstruction over an "anatomic" single-bundle ACL reconstruction.
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