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Dury J, Michel F, Ravier G. Electromyographic Activity of Lower Limb Muscles during Ankle Destabilizing Tests. Int J Sports Med 2024; 45:292-300. [PMID: 37871643 DOI: 10.1055/a-2197-1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Ankle destabilizing devices were developed to improve the recruitment of the evertor muscles. Nevertheless, the activity of lower-leg muscles has never been compared to each other during functional tests performed with destabilization. The objectives were i) to compare the electromyographic activity between the lower-leg muscles during four functional tests performed with ankle destabilization, and ii) to determine sex-related differences in neuromuscular activation. Twenty-six healthy volunteers (13 males, 13 females) performed the modified Star Excursion Balance Test (mSEBT), unipedal balance and weight-bearing inversion and eversion tests with a destabilizing device, while recording electromyographic activity of the peroneus longus and brevis, tibialis anterior, gastrocnemius lateralis and gluteus medius. The activity of peroneal muscles was significantly greater than other muscles during all functional tests. Furthermore, the anterior direction of the mSEBT was the one implying the greatest activity of the peroneus longus muscle compared to the posteromedial (p=0.003) or posterolateral (p<0.001) directions. Finally, no significant sex-related differences in neuromuscular activity were reported. This study highlights the effectiveness of the destabilizing device to involve specifically the peroneal muscles when performing various functional tests. This device should be used by clinicians to be more specific to the stabilizers of the ankle joint during functional exercises.
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Affiliation(s)
- Jeanne Dury
- Laboratoire C3S UFR STAPS, Université de Franche-Comté, Besancon, France
| | - Fabrice Michel
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique , Université de Franche-Comté, Besancon, France
| | - Gilles Ravier
- Laboratoire C3S UFR STAPS, Université de Franche-Comté, Besancon, France
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ALJawaee M, Williams JM, Jones MD. Informing wobble-board training and assessment through an investigation of the effect of biological-sex, anthropometrics, footwear and dual-tasking in young adults. J Back Musculoskelet Rehabil 2024; 37:305-315. [PMID: 37781790 DOI: 10.3233/bmr-230020] [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] [Indexed: 10/03/2023]
Abstract
BACKGROUND Despite wobble board use being common in physiotherapy the effect of certain factors, essential to clinical reasoning, have not been investigated. OBJECTIVE To determine the effect of biological sex, anthropometrics, footwear and dual tasking (DT) on wobble board balance performance. METHODS Eighty-six healthy participants (44 females) had their wobble board performance measured during double-leg-stance (DLS) with eyes open (DLSEO), closed (DLSEC) and single-leg-stance (SLS) tasks, with and without footwear and a DT added. Anthropometrics were also measured. RESULTS Females outperformed males during most tasks, with some large effect sizes (ES). Performance was moderately related to weight and shoulder, waist and hip circumference. Overall, there were no differences between footwear and no footwear, except for males during SLS. DT made little difference, except during DLSEO and SLS, where single task was better than DT, though only females had a large ES. CONCLUSION During wobble board tasks, biological sex differences were observed and a modest correlation between anthropometrics and performance noted. DT and footwear had minimal effect.
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Affiliation(s)
- Madawi ALJawaee
- Medical Engineering Research Group, Cardiff University, Cardiff, UK
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Michael D Jones
- Medical Engineering Research Group, Cardiff University, Cardiff, UK
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Steinberg N, Tenenbaum G, Witchalls J, Waddington G. The impact of unexpected platform perturbation on ankle proprioception ability in static and dynamic starting positions. Gait Posture 2022; 98:167-172. [PMID: 36137355 DOI: 10.1016/j.gaitpost.2022.09.003] [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: 04/19/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 02/02/2023]
Abstract
AIMS To examine the relationship between ankle proprioception and the ability to maintain balance with increased magnitudes of unexpected perturbations; and to compare the participants' ability to maintain balance following perturbations when starting from static and dynamic positions. METHODS Sixty physical education students (average 24.6 years) were tested for proprioception ability (AUC scores) and balance challenges presented on a perturbation treadmill. The degree at which participants lost postural balance was recorded in seven starting positions: standing-eyes-open (SO), standing-eyes-closed (SC), tandem-dominant (TD), tandem non-dominant, (TND) single-leg lateral side perturbation (SLP), single-leg medial side perturbation (SMP), and walking. Perturbation scores were analysed divided by tertiles. Multidimensional Unfolding SPSS Statistics 25 (PREFSCAL) was used to examine the relationships between data sets. RESULTS AUC scores of both dominant and non-dominant legs were significantly correlated with SO (r = 0.316; r = 0.445), SC (r = 0.364; r = 0.413), TD (r = 0.346; r = 0.308), and walking (r = 0.265; r = 0.439), respectively. In the dominant-leg, AUC scores of individuals with below-median SO scores were significantly worse compared to those with median SO scores (p = .046). In the non-dominant leg, individuals with above-median SC had significantly better AUC scores compared to those with lower-than-median SC (p = .008). Those with median and above-median SO and walking achieved better AUC scores than those with below-median (SO: p = .049, p = .004; walking: p = .016, p < .001, respectively). In dimension I, the SLP and SMP were located opposite one another; in dimension II, the TD and TND were located at the upper side, whereas SC, SO and walking were at the lowest side. CONCLUSIONS AUC scores were significantly correlated with the level at which postural balance was lost, whereby the better the proprioception ability, the better the ability to maintain balance. As such, the ability to maintain balance is harder in tandem positions than in standing and walking positions. This ability differed when perturbations were to the lateral or medial sides.
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Affiliation(s)
- Nili Steinberg
- Wingate College of Physical Education and Sports Sciences, Wingate Institute, Netanya, Israel.
| | - Galit Tenenbaum
- Wingate College of Physical Education and Sports Sciences, Wingate Institute, Netanya, Israel
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Australia
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Lin MIB, Yen YT, Chang CH. Use of an inflatable mat to reduce body discomfort development when performing computer work at a standing desk. ERGONOMICS 2022; 65:1015-1034. [PMID: 34797209 DOI: 10.1080/00140139.2021.2009042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to determine the effects of inflatable mat design on body discomfort, task performance, and musculoskeletal exposures during standing computer work. Twenty-seven healthy adults completed three 2-hour standing trials on different mediums (concrete floor, foam mat, and inflatable mat) on different days in an experimental laboratory. Both mats were associated with reduced discomfort in all lower-body regions and increased typing performance compared to the concrete floor. Perceived discomfort in lower extremities (except thighs) was further alleviated while standing on the inflatable mat than on the foam mat. Use of the inflatable mat led to increased lower-body muscle activity, a flexed lower back, and a wide range of sagittal knee movements. As standing time increased, body discomfort increased, typing accuracy decreased, and there were increased variations in muscle activity and postural movements in the lower body. The inflatable mat shows potential to improve the ergonomic experience during prolonged standing. Practitioner summary: Incorporating standing postures in office-based workplaces can reduce sitting time and may mitigate the health hazards associated with sedentary behaviour. With adequate weight-shifting movements, using an inflatable mat for standing could be an effective way to lessen discomfort and accumulated musculoskeletal strain due to constrained standing, without jeopardising task productivity. Abbreviations: APDF: amplitude probability distribution function. AVR: average rectified value. CI: confidence interval. CMRR: common mode rejection ratio. COP: center of pressure. CV: coefficient of variation. EA: electrical activity. EMG: electromyography. FL: fibularis longus. GM: gluteus medius. LBP: lower back pain. LES: lumbar erector spinae. MVC: maximum voluntary contraction. PD: pain developer. rANOVA: repeated-measures analysis of variance. SOL: soleus. VAS: visual analog scale. WPM: words per minute.
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Affiliation(s)
- Ming-I Brandon Lin
- Department of Industrial and Information Management, National Cheng-Kung University, Tainan, Taiwan
- Institute of Information Management, National Cheng-Kung University, Tainan, Taiwan
| | - Yi-Ting Yen
- Department of Industrial and Information Management, National Cheng-Kung University, Tainan, Taiwan
| | - Chun Han Chang
- Department of Industrial and Information Management, National Cheng-Kung University, Tainan, Taiwan
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Dury J, Michel F, Ravier G. Fatigue of hip abductor muscles implies neuromuscular and kinematic adaptations of the ankle during dynamic balance. Scand J Med Sci Sports 2022; 32:1324-1334. [PMID: 35612723 DOI: 10.1111/sms.14198] [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: 01/28/2022] [Revised: 04/27/2022] [Accepted: 05/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Determine whether hip abductor muscle fatigue influenced ankle kinematic and muscle activity during ankle-destabilized tasks. DESIGN Cross-sectional study. METHODS Twenty-six healthy, active participants performed two tests (Star Excursion Balance Test, SEBT; Weight Bearing Inversion Test, WBIT) for assessment of dynamic balance and ability to control inversion. Participants were equipped with an ankle-destabilizing sandal in inversion and eversion to perform both tests, which were completed before and after a fatiguing exercise of hip abductor muscles (up to 50% reduction in strength). Electromyographic activity of peroneus longus (PL) and brevis (PB), tibialis anterior, gastrocnemius lateralis (GastL) and gluteus medius (GlutM) muscles were recorded. In addition, ankle kinematics were recorded using an inertial measurement unit. RESULTS Hip abductor fatigue induced a significant decrease in SEBT scores in three directions (p < 0.01). During SEBT, ankle supination decreased by 3.2° in the anterior and posteromedial directions (p < 0.01). Muscle activity of GastL increased during achievement of three directions (p < 0.05) in response to hip abductor fatigue. In posteromedial direction, PL (p < 0.001) and GlutM (p < 0.01) activity increased with fatigue. During WBIT, inversion angular velocity was not impacted by fatigue while, PB and GastL activity increased after fatiguing exercise (p < 0.005). CONCLUSION A decrease in SEBT performance and EMG adaptations with proximal fatigue attest to the importance of the hip abductor muscle in dynamic postural control. This could have important implications in building injury prevention programs. Changes in ankle supination may reflect a protective strategy of the joint in response to hip fatigue.
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Affiliation(s)
- Jeanne Dury
- Laboratoire C3S (EA 4660), UFR STAPS, Université de Franche Comté, Besançon, France
| | - Fabrice Michel
- Laboratoire Nanomédecine (EA 4662), Université de Franche Comté, Besançon, France.,Service de Médecine Physique et de Réadaptation, CHRU Hôpital Jean Minjoz, Besançon, France
| | - Gilles Ravier
- Laboratoire C3S (EA 4660), UFR STAPS, Université de Franche Comté, Besançon, France.,Laboratoire Athlète Matériel Environnement, Besançon, France
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Rosenblum U, Melzer I, Zeilig G, Plotnik M. Muscle activation profile is modulated by unexpected balance loss in walking. Gait Posture 2022; 93:64-72. [PMID: 35091185 DOI: 10.1016/j.gaitpost.2022.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/30/2021] [Accepted: 01/16/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND During an unexpected loss of balance, avoiding a fall requires people to readjust their footing rapidly and effectively. A deeper understanding of muscle activation patterns in response to unexpected balance loss will provide insights into the mechanisms of balance recovery responses. This could have implications for treatment of people with balance deficits. RESEARCH QUESTION Explore the differences in balance recovery responses to perturbations in different phases of the gait cycle (single-support vs. double-support) in terms of biomechanical behavior (i.e., stepping and dynamic stability characteristics) and lower-limb muscle activation patterns. METHODS Muscle activation patterns of the ankle and knee muscles and muscle fiber type recruitment resulting from unannounced, mediolateral (i.e., right/left) horizontal-surface perturbations during walking was investigated in twenty healthy adults (27.00 ± 2.79 years, ten females). Surface electromyography (sEMG) total spectral power for specific frequency bands (40-60 Hz, 60-150 Hz, 150-250 Hz, 250-400 Hz and 400-1000 Hz), from tibialis anterior (TA) and vastus lateralis (VL) muscles were analyzed. Three mixed-effects models assessed behavioral and lower-limb muscle activation patterns resulting from perturbations in the gait cycle's single- and double-support phases. Statistical significance was set a priori at p < 0.05. RESULTS Compared to non-perturbed walking, we found a significant increase in the total spectral power of lower-extremity muscles during the first three seconds after perturbation. During the double-support phase of gait, we found a different muscle fiber type recruitment pattern between VL and TA muscles. However, there were no significant differences between VL and TA muscles for perturbations implemented in single-support phases. SIGNIFICANCE Our findings support the notion that muscle operating frequency is modulated in real-time to fit functional goal requirements, such as a rapid change of footing in response to unexpected loss of balance in single and double-support phases of gait.
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Affiliation(s)
- Uri Rosenblum
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel; Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel; Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Tel Aviv University, Israel; School of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Ugbolue UC, Yates EL, Ferguson K, Wearing SC, Gu Y, Lam WK, Baker JS, Dutheil F, Sculthorpe NF, Dias T. Electromyographic Assessment of the Lower Leg Muscles during Concentric and Eccentric Phases of Standing Heel Raise. Healthcare (Basel) 2021; 9:465. [PMID: 33919959 PMCID: PMC8070905 DOI: 10.3390/healthcare9040465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/10/2021] [Accepted: 04/11/2021] [Indexed: 11/17/2022] Open
Abstract
Only a small number of muscle activation patterns from lower limbs have been reported and simultaneous muscle activation from several lower limb muscles have not yet been investigated. The purpose of this study was to examine any gender differences in surface electromyography (EMG) activity from six recorded lower limb muscles of the dominant limb at baseline (i.e., with the foot placed flat on the floor and in the neutral position), and during concentric and eccentric phases when performing a heel raise task. In total, 10 females and 10 males performed a standing heel raise task comprising of three continuous phases: baseline, unloading (concentric muscle action), and loading (eccentric muscle action) phases. Muscle activation from six muscles (gastrocnemius medialis, gastrocnemius lateralis, soleus, tibialis anterior, peroneus longus, and peroneus brevis) were measured using the Myon 320 EMG System. Root mean squared values of each muscle were calculated for each phase. Descriptive and inferential statistics were incorporated into the study. Statistically significant p values were set at 0.05. The results showed no significant differences between baseline, concentric, and eccentric phases with respect to each of the muscles investigated. Except for the gastrocnemius medialis at baseline and concentric phases, no significant differences were observed between genders or contractions. The data suggests that gender does not significantly influence the eccentric phase during the standing heel raise task.
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Affiliation(s)
- Ukadike C. Ugbolue
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (J.S.B.)
- Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, UK; (E.L.Y.); (K.F.); (N.F.S.)
| | - Emma L. Yates
- Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, UK; (E.L.Y.); (K.F.); (N.F.S.)
| | - Kerensa Ferguson
- Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, UK; (E.L.Y.); (K.F.); (N.F.S.)
| | - Scott C. Wearing
- School of Clinical Sciences, Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove 4059, Australia;
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (J.S.B.)
| | - Wing-Kai Lam
- Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Co. Ltd., Beijing 101111, China;
- Department of Kinesiology, Shenyang Sports University, Shenyang 110102, China
| | - Julien S. Baker
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (J.S.B.)
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
- Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne 3000, Australia
| | - Nicholas F. Sculthorpe
- Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, UK; (E.L.Y.); (K.F.); (N.F.S.)
| | - Tilak Dias
- Advanced Textiles Research Group, School of Art and Design, Nottingham Trent University, Bonington Building, Dryden Street, Nottingham NG1 4GG, UK;
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Differences in Electromyographic Activities and Spatiotemporal Gait Parameters between General and Developed Insoles with a Toe-Grip Bar. BIOMED RESEARCH INTERNATIONAL 2021; 2020:6690343. [PMID: 33381574 PMCID: PMC7762632 DOI: 10.1155/2020/6690343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/18/2020] [Accepted: 11/27/2020] [Indexed: 11/21/2022]
Abstract
The present study was aimed at comparing the muscle activities and gait parameters between the toe-grip bar insoles and general insoles during walking using randomized crossover design. Twelve healthy men participated in this study. Temporal and spatial gait parameters and electromyography (EMG) results were concurrently collected while the subjects walked along an 8 m walkway with the developed and general insoles. Developed insoles provide a three-dimensional mesh structure at the toe portion and a convex bulging structure (toe-grip bar) near the center of the proximal phalanx of the first to fifth toe. The linear mixed model was used to estimate the toe-grip bar insole effect. The results showed that there were no sequence or period effects for any of the examined parameters. During the stance phase, those wearing the developed insoles had significantly higher %IEMG for the TA, GM, and GL than those wearing the general insoles (TA: 5.03%IEMG, p = 0.005; GM: 4.65%IEMG, p = 0.046; and GL: 6.50%IEMG, p = 0.008). During the swing phase, those wearing the developed insoles had significantly higher activity for only the TA compared to those wearing the general insoles (5.54%IEMG, p = 0.011). With respect to gait parameters, those wearing the developed insoles had greater step length (2.81 cm, p = 0.038), longer stance time (0.03 s, p = 0.001), and shorter swing time (−0.02 s, p = 0.003) compared to those wearing the general insoles. The results suggest that walking with toe-grip bar insoles contributes to increased crural muscle activity and step length.
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Khowailed IA, Lee H. Neuromuscular Control of Ankle-stabilizing Muscles-specific Effects of Sex and Menstrual Cycle. Int J Sports Med 2020; 42:270-276. [PMID: 32920801 DOI: 10.1055/a-1236-3654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to examine the differences in neuromuscular control and mechanical properties of the ankle-stabilizing muscles between men and women, and during different phases of menstrual cycle in women. Fifteen women with regular menstrual cycles and 17 male counterparts were included in this study. Electromyographic signals were recorded from the peroneus longus (PL) and tibialis anterior (TA) muscles while performing three balance tasks. Muscle tone, stiffness, and elasticity of muscles were measured using a MyotonPRO in the resting position. Outcomes were measured twice (ovulation and early follicular phases) for women, while measurements were acquired only once for men. Significantly higher tibialis anterior-peroneus longus co-contraction (TA/PL ratio) was observed in all balance tasks in women than in men (p< 0.05); however, significant differences between phases of the menstrual cycle were noted only in the 2 most difficult tasks (p< 0.05). A similar pattern was observed in the postural sway. These results highlight the importance of sex-specific hormonal effects on neuromuscular control and mechanical properties, and as well as the differences during phases of the menstrual cycle. These insights assume significance in the context of developing neuromuscular strategies for the purpose of preventing lower extremity injuries during sports activities.
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Affiliation(s)
- Iman Akef Khowailed
- University of St Augustine for Health Sciences, College of Rehabilitative Sciences San Marcos California Campus
| | - Haneul Lee
- Department of Physical Therapy, Gachon University - Medical Campus, Incheon, Korea (the Republic of)
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Sudden gait perturbations elicit sex-specific neuromuscular trunk responses in persons with low back pain. J Biomech 2020; 102:109646. [DOI: 10.1016/j.jbiomech.2020.109646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/01/2020] [Accepted: 01/15/2020] [Indexed: 12/26/2022]
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Wang S, Varas-Diaz G, Dusane S, Wang Y, Bhatt T. Slip-induced fall-risk assessment based on regular gait pattern in older adults. J Biomech 2019; 96:109334. [PMID: 31564458 PMCID: PMC8191506 DOI: 10.1016/j.jbiomech.2019.109334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/04/2019] [Accepted: 09/08/2019] [Indexed: 12/26/2022]
Abstract
Aging-associated fall-risk assessment is crucial for fall prevention. Thus, this study aimed to develop a prognostic model to predict fall-risk following an unexpected over-ground slip perturbation based on normal gait pattern in healthy older adults. 112 healthy older adults who experienced a novel slip in a safe laboratory environment were included. Their slip trial and natural walking trial immediately prior to it were analyzed. To identify the best fall-risk predictive model, gait related variables including step length, segment angles, center of mass state, and ground reaction force (GRF) were determined and inputted into a stepwise logistic regression. The optimal slip-induced fall prediction model was based on the right thigh angle at slipping foot touchdown (TD), the maximum GRF of the slipping limb after TD, and the momentum change from TD to recovery foot liftoff (LO), with an overall prediction accuracy of 75.9%, predicting 74.5% of falls (sensitivity) and 77.2% of recoveries (specificity). Conversely, a model based on clinical and demographic measures predicted 78.2% of falls and 47.4% of recoveries, resulting in a much lower overall accuracy of 62.5%. The fall-risk model based on normal gait pattern which was developed for slip-induced perturbations in healthy older adults was able to provide a high predictive accuracy. This information could provide insight about the ideal normal gait measures which could be used to contribute towards development of therapeutic strategies related to dynamic balance and fall prevention to enhance preventive interventions in populations with high-risk for slip-induced falls.
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Affiliation(s)
- Shuaijie Wang
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Gonzalo Varas-Diaz
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Shamali Dusane
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Yiru Wang
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, United States.
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Murillo C, Martinez-Valdes E, Heneghan NR, Liew B, Rushton A, Sanderson A, Falla D. High-Density Electromyography Provides New Insights into the Flexion Relaxation Phenomenon in Individuals with Low Back Pain. Sci Rep 2019; 9:15938. [PMID: 31685948 PMCID: PMC6828973 DOI: 10.1038/s41598-019-52434-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/11/2019] [Indexed: 11/26/2022] Open
Abstract
Recent research using high-density electromyography (HDEMG) has provided a more precise understanding of the behaviour of the paraspinal muscles in people with low back pain (LBP); but so far, HDEMG has not been used to investigate the flexion relaxation phenomenon (FRP). To evaluate this, HDEMG signals were detected with grids of electrodes (13 × 5) placed bilaterally over the lumbar paraspinal muscles in individuals with and without LBP as they performed repetitions of full trunk flexion. The root mean square of the HDEMG signals was computed to generate the average normalized amplitude; and the spatial FRP onset was determined and expressed as percentage of trunk flexion. Smoothing spline analysis of variance models and the contrast cycle difference approach using the Bayesian interpretation were used to determine statistical inference. All pain-free controls and 64.3% of the individuals with LBP exhibited the FRP. Individuals with LBP and the FRP exhibited a delay of its onset compared to pain-free controls (significant mean difference of 13.3% of trunk flexion). They also showed reduced normalized amplitude compared to those without the FRP, but still greater than pain-free controls (significant mean difference of 27.4% and 11.6% respectively). This study provides novel insights into changes in lumbar muscle behavior in individuals with LBP.
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Affiliation(s)
- Carlos Murillo
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Bernard Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Andy Sanderson
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.
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