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Ozkan T, Ataoglu NEE, Soke F, Karakoc S, Bora HAT. Investigation of the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with Alzheimer's disease. Ir J Med Sci 2023; 192:2401-2408. [PMID: 36656422 DOI: 10.1007/s11845-023-03279-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Optimal trunk control relies on adequate musculoskeletal, motor, and somatosensory systems that are often affected in people with Alzheimer's disease (AD). Therefore, the aim of this study was to compare trunk control between people with AD and healthy older adults, and investigate the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with AD. METHODS The study was completed with 35 people with AD and 33 healthy older adults with matching age and gender. Trunk control was evaluated with Trunk Impairment Scale (TIS); balance with Berg Balance Scale (BBS), Functional Reach Test (FRT), One-Leg Standing Test (OLST) and Five-Repeat Sit-and-Stand Test (5STS); gait with Dynamic Gait Index (DGI); functional mobility with Timed Up and Go (TUG) Test; fear of falling with Falls Efficacy Scale-International (FES-I). RESULTS BBS, FRT, OLST, and DGI scores were lower and 5STS and TUG Test scores were higher in people with AD compared to healthy older adults (p < 0.05). There was no difference in FES-I score between people with AD and healthy older adults (p > 0.05). TIS was associated with BBS, FRT, OLST, 5STS, DGI, TUG Test, and FES-I (r between - 0.341 and 0.738; p < 0.05 for all). CONCLUSION Trunk control is affected and related with balance, gait, functional mobility, and fear of falling in people with AD. For this reason, we think that trunk control should be evaluated in the early period, and applications for trunk control should be included in rehabilitation approaches in order to improve balance, gait, functional mobility, and reduce fear of falling.
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Affiliation(s)
- Taskin Ozkan
- Giresun University, Vocational School of Health Services, Therapy and Rehabilitation, Giresun, 28200, Turkey.
| | | | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoc
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
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Ünlüer NÖ, Ozkan T, Sari YA, Karadağ YS. Investigation of the relationship between trunk position sense and balance, functional mobility, fear of falling, and disease stage in Parkinson's disease. Ir J Med Sci 2022:10.1007/s11845-022-03192-7. [PMID: 36251108 DOI: 10.1007/s11845-022-03192-7] [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: 08/24/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Parameters related to trunk control such as balance disorders, mobility problems, and falling are frequently observed in patients with Parkinson's disease (PD). However, to provide a stable foundation for movement, trunk stability requires appropriate adequate position sense. The aim of the study was to examine the relationship between trunk position sense, balance, functional mobility, fear of falling, and disease stage in patients with PD. METHODS The study was conducted in 41 patients with PD (16 female and 25 male). Trunk position sense was assessed with a digital inclinometer, balance with functional reach test, Berg balance scale and one-leg stand test, functional mobility with timed up and go test, fear of falling with activity-specific balance confidence scale, and disease stage with Modified Hoehn and Yahr Scale (MHYS). All patients were tested during the "on" phase following drug therapy. RESULTS Repositioning error degree was related with MHYS, Berg balance scale, right and left one-leg stand test, forward functional reach test, timed up and go test, timed up and go test-cognitive and activity-specific balance confidence scale results in patients with PD (r = - 0.363/ - 0.609, p < 0.05 for all). CONCLUSION It was shown in the study that trunk position sense was associated with disease stage, balance level, functional mobility, and fear of falling in patients with PD. These results suggest that trunk position sense is more important to plan effective rehabilitation program for development and protection of disease stage, balance level, functional mobility, and fear of falling in patients with PD.
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Affiliation(s)
- Nezehat Özgül Ünlüer
- Faculty of Health Science, Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, 06760, Ankara, Turkey.
| | - Taskin Ozkan
- Physiotherapy Program, Vocational School of Health Services, Giresun University, Giresun, Turkey
| | - Yasemin Ateş Sari
- Faculty of Health Science, Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, 06760, Ankara, Turkey
| | - Yesim Sücüllü Karadağ
- Department of Neurology, Health Science University, Ankara City Hospital, Ankara, Turkey
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Eizad A, Lee H, Pyo S, Oh MK, Lyu SK, Yoon J. Study on the Effects of Different Seat and Leg Support Conditions of a Trunk Rehabilitation Robot. IEEE Trans Neural Syst Rehabil Eng 2022; 30:812-822. [PMID: 35294353 DOI: 10.1109/tnsre.2022.3160188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Performance of trunk rehabilitation exercises while sitting on movable surfaces with feet on the ground can increase trunk and leg muscle activations, and constraining the feet to move with the seat isolates control of the trunk. However, there are no detailed studies on the effects of these different leg supports on the trunk and leg muscle activations under unstable and forcefully perturbed seating conditions. We have recently devised a trunk rehabilitation robot that can generate unstable and forcefully perturbed sitting surfaces, and can be used with ground-mounted or seat-connected footrests. In this study, we have evaluated the differences in balance performance, trunk movement and muscle activation (trunk and legs) of fourteen healthy adults caused by the use of these different footrest configurations under the different seating scenarios. The center of pressure and trunk movement results show that the seat-connected footrest may be a more suitable choice for use in a balance recovery focused rehabilitation protocol, while the ground-mounted footrest may be a more suitable choice for a trunk movement focused rehabilitation protocol. Although it is difficult to make a clear selection between footrests due to the mixed trends observed in the muscle activation results, it appears that the seat-connected footrest may be preferable for use with the unstable seat as it causes greater muscle activations. Furthermore, the results provide limited evidence that targeting of a particular muscle group may be possible through careful selection of the seat and footrest conditions. Therefore, it may be possible to utilize the trunk rehabilitation robot to maximize the training outcomes for a wide range of patients through careful selection of training protocols.
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Mills SJ, Mackintosh S, McDonnell MN, Thewlis D. Improvement in postural alignment is associated with recovery of mobility after complex acquired brain injury: An observational study. Physiother Theory Pract 2022; 39:1274-1286. [PMID: 35105252 DOI: 10.1080/09593985.2022.2034197] [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: 10/19/2022]
Abstract
PURPOSE Determine how mobility changes over 6 months in people unable to walk at 8-weeks post-Acquired Brain Injury (ABI); if there is an association over time between postural alignment and mobility post-ABI; and if alignment after ABI becomes closer to healthy alignment over time. METHODS Fourteen adults with ABI, evaluated over 6 months, and a reference sample of 30 healthy adults were studied. The primary measure for changes in mobility was the Clinical Outcome Variables Scale (COVS). Secondary measures were sit-to-stand, timed standing holding rails, independent walking speed and number of testing conditions achieved. The Functional Independence Measure (FIM) was scored at rehabilitation admission and discharge. To analyze postural alignment, participants were recorded in sitting and standing, each repeated holding rails, and walking if able. Three-dimensional kinematic data were used to quantify whole-body postural alignment, equal to mean segment displacements from the base of support in the transverse plane. Associations between three-dimensional kinematic alignment scores and COVS scores were calculated using Linear Mixed-Effects Models. RESULTS Participants made significant improvements in COVS scores, most secondary mobility scores, and FIM scores over time (p ≤ .001). Relationships between increasing COVS scores and decreasing sitting and standing mal-alignment scores were statistically significant. Visual analysis of graphed segment positions indicated that sitting and standing alignment became more similar to healthy alignment over time; this was not clear for walking. CONCLUSION Improvement in postural alignment may be a factor for improving mobility in people with severe impairments after ABI.
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Affiliation(s)
- Simon J Mills
- Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.,South Australian Brain Injury Rehabilitation Service, Hampstead Rehabilitation Centre, Adelaide, Australia.,UniSA: Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Shylie Mackintosh
- UniSA: Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | | | - Dominic Thewlis
- Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
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Friederich ARW, Audu ML, Triolo RJ. Characterization of the Force Production Capabilities of Paralyzed Trunk Muscles Activated With Functional Neuromuscular Stimulation in Individuals With Spinal Cord Injury. IEEE Trans Biomed Eng 2021; 68:2389-2399. [PMID: 33211651 PMCID: PMC8131402 DOI: 10.1109/tbme.2020.3039404] [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] [Indexed: 11/10/2022]
Abstract
Paralysis of the trunk results in seated instability leading to difficulties performing activities of daily living. Functional neuromuscular stimulation (FNS) combined with control systems have the potential to restore some dynamic functions of the trunk. However, design of multi-joint, multi-muscle control systems requires characterization of the stimulation-driven muscles responsible for movement. OBJECTIVE This study characterizes the input-output properties of paralyzed trunk muscles activated by FNS, and explores co-activation of muscles. METHODS Four participants with various spinal cord injuries (C7 AIS-B, T4 AIS-B, T5 AIS-A, C5 AIS-C) were constrained so lumbar forces were transmitted to a load cell while an implanted neuroprosthesis activated otherwise paralyzed hip and paraspinal muscles. Isometric force recruitment curves in the nominal seated position were generated by inputting the level of stimulation (pulse width modulation) while measuring the resulting muscle force. Two participants returned for a second experiment where muscles were co-activated to determine if their actions combined linearly. RESULTS Recruitment curves of most trunk and hip muscles fit sigmoid shaped curves with a regression coefficient above 0.75, and co-activation of the muscles combined linearly across the hip and lumbar joint. Subject specific perturbation plots showed one subject is capable of resisting up to a 300N perturbation anteriorly and 125N laterally; with some subjects falling considerably below these values. CONCLUSION Development of a trunk stability control system can use sigmoid recruitment dynamics and assume muscle forces combine linearly. SIGNIFICANCE This study informs future designs of multi-muscle, and multi-dimensional FNS systems to maintain seated posture and stability.
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Delayed and reduced intralimb muscular coupling during postural reactions in individuals with incomplete spinal cord injury. Gait Posture 2021; 88:84-93. [PMID: 34015546 DOI: 10.1016/j.gaitpost.2021.05.003] [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: 10/05/2020] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postural strategies are enabled by rapid muscle activation sequences to prevent a fall. Intralimb muscular couplings underlie these postural strategies are likely impaired after incomplete spinal cord injury (iSCI), leading to inappropriate postural reactions and increased fall risk; yet, the nature of these changes is unknown. RESEARCH QUESTION Identify changes occurring in intralimb coupling following a perturbation in individuals with iSCI. METHODS Ten men with iSCI and eight age-matched controls (CTRL) stood on a force-platform that was randomly tilted forward or backward. Electromyographic (EMG) activity of the lower limb muscles was recorded, and coactivation or simultaneous facilitation/suppression between pairs of muscles was analyzed. Onset and duration of coupling latency, intralimb coupling delay, and amplitude ratios were measured in the distal (soleus [SOL]/tibialis anterior [TA]), proximal (biceps femoris [BF]/vastus lateralis [VL]), anterior (TA-VL), and posterior (SOL-BF) muscle couplings. RESULTS In forward tilt, the main coupling was TA-SOL co-contraction for both groups, but the latency was longer and the duration shorter in SCI participants. In backward tilt, the TA-VL co-activation was the main coupling in CTRL (88 %), although it was also expressed by 60 % of SCI participant with a delayed latency. The facilitation/suppression of TA-SOL was the main coupling in SCI group (80 % vs 63 % in CTRL). Delayed coupling latencies were more pronounced in individuals with cervical iSCI and were correlated with the strength of lower limbs. SIGNIFICANCE Similar muscular couplings are present in both groups but are delayed, which might contribute to postural reaction deficits in individuals with iSCI.
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Duchene Y, Mornieux G, Petel A, Perrin PP, Gauchard GC. The trunk's contribution to postural control under challenging balance conditions. Gait Posture 2021; 84:102-107. [PMID: 33290903 DOI: 10.1016/j.gaitpost.2020.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/03/2020] [Accepted: 11/16/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The double inverted pendulum model is imprecise when applied to studies of postural control. Although multijoint analyses have improved our understanding of how balance is maintained, the exact role of the trunk remains unclear. RESEARCH QUESTIONS What is the trunk's contribution in postural control with respect to the other joints and how do trunk muscles control trunk kinematics? METHODS Thirty-six healthy athletes (handball, karate, long jump) performed a highly challenging balance task while the ground support was dynamically tilted in the sagittal plane. The center of force (CoF) as well as lower limb joint angles and the trunk-pelvis angle were respectively measured with a force platform and inertial measurement units. The amplitude, sway path and standard deviation of the CoF and the joint angles were then calculated. Electromyography was used to record the activity of the rectus abdominis, external obliquus, and erector spinae muscles. Multiple linear regressions were computed to determine the joints' and muscles' contributions (β-coefficients) in predicting CoF variables and trunk kinematics, respectively. RESULTS The linear combination of joint kinematic variables accounted for between 33 % and 75 % of the variance in the CoF. The ankle had the highestβ and was a significant predictor of all CoF variables. The trunk yielded the second highest β-coefficient and was a significant predictor of the CoF sway path. Electromyography variables accounted for no more than 35 % of the variance in the trunk kinematics, and erector spinae activity was the only significant predictor. SIGNIFICANCE The trunk appears to be the second most important element during this specific postural task, in the magnitude of body sway in particular. But neuromuscular control of these trunk processes is difficult to characterize with surface electromyography only. The trunk should be taken into account when seeking to improve overall postural control (e.g. during training, rehabilitation).
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Affiliation(s)
- Youri Duchene
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France.
| | - Guillaume Mornieux
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France
| | - Arthur Petel
- Université de Lorraine, DevAH, F-54000, Nancy, France
| | - Philippe P Perrin
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France; Université de Lorraine, CHRU-Nancy, Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), F-54000, Nancy, France
| | - Gérome C Gauchard
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France
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Evaluation of the effects of using a baby walker on trunk control and motor development. Turk Arch Pediatr 2021; 56:159-163. [PMID: 34286327 DOI: 10.14744/turkpediatriars.2020.48742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
Objective This study aimed to evaluate the effects of the use of baby walkers on trunk control and motor development in typically developing children. Material and methods Demonstrating standard developmental steps, 29 children (14 females, 15 males; mean age 10±1 month) who used a baby walker and 19 children (10 females, 9 males; mean age 10±1 month) who did not use a baby walker were included. Motor skills were assessed using the Alberta Infant Motor Scale and trunk control using Segmental Assessment of Trunk Control. Results The motor development scores and trunk balance scores were found significantly lower in infants who used a baby walker compared with those not using a baby walker. Conclusion It was concluded that the use of baby walkers might adversely affect the motor development of infants and this may be due to impaired trunk control.
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Campanini I, Disselhorst-Klug C, Rymer WZ, Merletti R. Surface EMG in Clinical Assessment and Neurorehabilitation: Barriers Limiting Its Use. Front Neurol 2020; 11:934. [PMID: 32982942 PMCID: PMC7492208 DOI: 10.3389/fneur.2020.00934] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/20/2020] [Indexed: 12/23/2022] Open
Abstract
This article addresses the potential clinical value of techniques based on surface electromyography (sEMG) in rehabilitation medicine with specific focus on neurorehabilitation. Applications in exercise and sport pathophysiology, in movement analysis, in ergonomics and occupational medicine, and in a number of related fields are also considered. The contrast between the extensive scientific literature in these fields and the limited clinical applications is discussed. The "barriers" between research findings and their application are very broad, and are longstanding, cultural, educational, and technical. Cultural barriers relate to the general acceptance and use of the concept of objective measurement in a clinical setting and its role in promoting Evidence Based Medicine. Wide differences between countries exist in appropriate training in the use of such quantitative measurements in general, and in electrical measurements in particular. These differences are manifest in training programs, in degrees granted, and in academic/research career opportunities. Educational barriers are related to the background in mathematics and physics for rehabilitation clinicians, leading to insufficient basic concepts of signal interpretation, as well as to the lack of a common language with rehabilitation engineers. Technical barriers are being overcome progressively, but progress is still impacted by the lack of user-friendly equipment, insufficient market demand, gadget-like devices, relatively high equipment price and a pervasive lack of interest by manufacturers. Despite the recommendations provided by the 20-year old EU project on "Surface EMG for Non-Invasive Assessment of Muscles (SENIAM)," real international standards are still missing and there is minimal international pressure for developing and applying such standards. The need for change in training and teaching is increasingly felt in the academic world, but is much less perceived in the health delivery system and clinical environments. The rapid technological progress in the fields of sensor and measurement technology (including sEMG), assistive devices, and robotic rehabilitation, has not been driven by clinical demands. Our assertion is that the most important and urgent interventions concern enhanced education, more effective technology transfer, and increased academic opportunities for physiotherapists, occupational therapists, and kinesiologists.
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Affiliation(s)
- Isabella Campanini
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Correggio, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Catherine Disselhorst-Klug
- Department of Rehabilitation & Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - William Z. Rymer
- Shirley Ryan Ability Lab, Single Motor Unit Laboratory, Chicago, IL, United States
| | - Roberto Merletti
- Laboratory for Engineering of the Neuromuscular System (LISiN), Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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Sung PS, Thomas TL, Hosmer EE. Internal consistencies of the delayed trunk muscle reaction times following a treadmill-induced slip perturbation while holding and not holding a tray. Gait Posture 2020; 80:260-267. [PMID: 32559645 DOI: 10.1016/j.gaitpost.2020.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Reaction time task performance using electromyography (EMG) has been widely studied in the evaluation of motor responses. However, specific testing conditions with tray usage and the reliability of the bilateral trunk muscle reactions have not been proven. RESEARCH QUESTIONS Are there internal consistencies of the reaction times for a particular condition, such as a handheld task, among the examiners? Is there a delayed reaction time on the dominant abdominal muscle in response to a treadmill-induced slip perturbation while holding or not holding a tray? METHODS One hundred and nineteen right upper and lower limb dominant individuals (71 female and 48 male subjects) were exposed to a treadmill-induced slip perturbation (0.24 m/s velocity for 1.2 cm) for 0.10 s in standing. The EMG electrodes were placed on both sides of the rectus abdominis (RA) and erector spinae (ES) muscles. The reliability of the test was established by using Cronbach's alpha, intra-class correlation coefficients (ICC2, k), and the standard error of measurements. RESULTS The results for holding a tray indicated a high degree of consistency based on Cronbach's alpha for the left RA (0.79), right RA (0.86), left ES (0.82), and right ES (0.73) muscles. However, there was a significant reaction time difference among trunk muscles (F = 10.58, p = 0.002) while not holding a tray. The post-hoc results indicated that the right RA muscle was delayed more than the bilateral ES muscles, although there was no significant difference with the left RA muscle. SIGNIFICANCE Overall, the EMG analyses for the reaction times were highly consistent with and without tray usage. The reaction times of the dominant abdominal muscles were delayed while not holding a tray. Given the high reliability, compensatory strategies by trunk dominance might be considered with a tray usage task.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, United States.
| | - Tyler L Thomas
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, United States
| | - Emily E Hosmer
- Department of Health Sciences, Central Michigan University,United States
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Spatial and temporal relation of kinematics and muscle activity during unstable sitting. J Electromyogr Kinesiol 2020; 52:102418. [DOI: 10.1016/j.jelekin.2020.102418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/12/2020] [Accepted: 03/20/2020] [Indexed: 12/30/2022] Open
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Li SSW, Zheng YP, Chow DHK. Changes of lumbosacral joint compression force profile when walking caused by backpack loads. Hum Mov Sci 2019; 66:164-172. [PMID: 31029838 DOI: 10.1016/j.humov.2019.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/27/2019] [Accepted: 04/10/2019] [Indexed: 11/30/2022]
Abstract
Walking with backpack loads induces additional mechanical stress on the spine and has been identified as a risk factor of lower-back pain. This study evaluated the effects of walking with backpack loads on the lumbosacral joint compression force profile in both the magnitude and time domains. Ten male adults geared with anatomical markers and trunk surface electromyographic sensors walked along a walkway embedded with three force plates with no load and various backpack loads (5%, 10%, 15%, and 20% body weight). Lower-body movements, ground reaction forces, and trunk muscle activations were measured using a synchronized motion analysis, force plate, and surface electromyography system. The force profiles of identified gait cycles were predicted using an integrated inverse dynamic and electromyography-assisted optimization model and evaluated statistically. The results showed that as backpack load increased, the 10th, 50th, and 90th percentiles of force profiles escalated disproportionately. However, no significant changes were observed in the timing of the two peak force incidences. Such changes in the compression force might be an indication of the combined effects of the increase in both gravitational and mass moment of inertia of the system (body plus pack loads) when walking with a backpack. Pearson correlation coefficients of the force profiles between the five loading conditions were greater than 0.94. Strong associations between the force profiles at different backpack loads were confirmed.
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Affiliation(s)
- Simon S W Li
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Daniel H K Chow
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong.
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Sperry MM, Phillips ATM, McGregor AH. Lower back pain and healthy subjects exhibit distinct lower limb perturbation response strategies: A preliminary study. J Back Musculoskelet Rehabil 2019; 32:27-35. [PMID: 30056411 DOI: 10.3233/bmr-170808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND It is hypothesized that inherent differences in movement strategies exist between control subjects and those with a history of lower back pain (LBP). Previous motion analysis studies focus primarily on tracking spinal movements, neglecting the connection between the lower limbs and spinal function. Lack of knowledge surrounding the functional implications of LBP may explain the diversity in success from general treatments currently offered to LBP patients. OBJECTIVE This pilot study evaluated the response of healthy controls and individuals with a history of LBP (hLBP) to a postural disturbance. METHODS Volunteers (n= 26) were asked to maintain standing balance in response to repeated balance disturbances delivered via a perturbation platform while both kinematic and electromyographic data were recorded from the trunk, pelvis, and lower limb. RESULTS The healthy cohort utilized an upper body-focused strategy for balance control, with substantial activation of the external oblique muscles. The hLBP cohort implemented a lower limb-focused strategy, relying on activation of the semitendinosus and soleus muscles. No significant differences in joint range of motion were identified. CONCLUSIONS These findings suggest that particular reactive movement patterns may indicate muscular deficits in subjects with hLBP. Identification of these deficits may aid in developing specific rehabilitation programs to prevent future LBP recurrence.
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Affiliation(s)
- Megan M Sperry
- Department of Civil and Environmental Engineering, Structural Biomechanics, Imperial College London, Charing Cross Hospital, London, UK
| | - Andrew T M Phillips
- Department of Civil and Environmental Engineering, Structural Biomechanics, Imperial College London, Charing Cross Hospital, London, UK
| | - Alison H McGregor
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Hospital, London, UK
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Haruyama K, Kasai K, Makino R, Hoshi F, Nishihara K. Quantification of trunk segmental coordination and head stability in laterally unstable sitting identifies aging and cerebellar ataxia. Clin Biomech (Bristol, Avon) 2019; 63:127-133. [PMID: 30889431 DOI: 10.1016/j.clinbiomech.2019.01.013] [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: 12/09/2017] [Revised: 11/05/2018] [Accepted: 01/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND We quantified trunk segmental coordination and head stability in unstable sitting and investigated whether it can discriminate postural control, age-related differences and presence of coordination disorder. METHODS Subjects were a healthy younger group (n = 7), a healthy elderly group (n = 7), and a cerebellar ataxia group (n = 8). The motion sensors and surface electrodes were located on the trunk and/or head segments to measure angle displacements, acceleration and electromyograms in unstable sitting during a lateral tilt task. Trunk lateral angle cross-correlation and electromyogram cross-correlation for the trunk segmental coordination, head root mean square (RMS) for the head stability, clinical performance scales, and gait parameters (velocity, coefficient of variation, and RMS ratio) were analyzed. FINDINGS Trunk lateral angle cross-correlation showed a significantly negative correlation in the healthy younger group compared with the two other groups (p < 0.01). Head RMS showed a significantly larger value in the cerebellar ataxia group compared with the two other groups (p < 0.01). Trunk lateral angle cross-correlation had moderate correlation with the clinical performance scale of ataxia and gait parameters; however, it was not correlated with head RMS. Classification using trunk lateral angle cross-correlation and head RMS was validated by discriminant analysis and hierarchical cluster analysis. INTERPRETATION We found that trunk lateral angle cross-correlation reflected age-related differences and head RMS characterized the pathology of cerebellar ataxia. Trunk segmental coordination and head stability, as two aspects of sitting postural control, can be used to discriminate the degree of aging and cerebellar ataxia.
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Affiliation(s)
- Koshiro Haruyama
- Department of Rehabilitation Medicine, Higashisaitama National Hospital, Saitama, Japan; Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan.
| | - Kenji Kasai
- Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan; Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Ryohei Makino
- Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan; Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Fumihiko Hoshi
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Ken Nishihara
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
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Reynard F, Christe D, Terrier P. Postural control in healthy adults: Determinants of trunk sway assessed with a chest-worn accelerometer in 12 quiet standing tasks. PLoS One 2019; 14:e0211051. [PMID: 30673753 PMCID: PMC6344019 DOI: 10.1371/journal.pone.0211051] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/07/2019] [Indexed: 11/19/2022] Open
Abstract
Many diseases and conditions decrease the ability to control balance. In clinical settings, there is therefore a major interest in the assessment of postural control. Trunk accelerometry is an easy, low-cost method used for balance testing and constitutes an alternative method to the posturography using force platforms. The objective was to assess the responsiveness of accelerometry in a battery of 12 quiet standing tasks. We evaluated the balance of 100 healthy adults with an accelerometer fixed onto the sternum. We used the average amplitude of acceleration as an indirect measure of postural sways. The tasks of increased difficulty were realized with or without vision. The battery of tasks was repeated four times on two different days to assess reliability. We analyzed the extent to which the task difficulty and the absence of vision affected the trunk sway. The influence of individual characteristics (age, height, mass, sex, and physical activity level) was also assessed. The reliability analysis revealed that four repetitions of the battery of tasks are needed to reach a high accuracy level (mean ICC = 0.85). The results showed that task difficulty had a very large effect on trunk sways and that the removal of vision further increased sways. Concerning the effects of individual characteristics, we observed that women tended to oscillate more than men did in tasks of low difficulty. Age and physical activity level also had significant effects, whereas height and mass did not. In conclusion, age, sex, and physical fitness are confounders that should be considered when assessing patients’ balance. A battery of simple postural tasks measured by upper-trunk accelerometry can be a useful method for simple balance evaluation in clinical settings.
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Affiliation(s)
| | - David Christe
- Swiss federal institute of technology, Lausanne, Switzerland
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16
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Goodworth AD, Barrett C, Rylander J, Garner B. Specificity and variability of trunk kinematics on a mechanical horse. Hum Mov Sci 2018; 63:82-95. [PMID: 30503985 DOI: 10.1016/j.humov.2018.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
Abstract
As perturbation training is gaining popularity, it is important to better understand postural control during complex three-dimensional stimuli. One clinically relevant and commonly used three-dimensional stimulus is found in hippotherapy and simulated hippotherapy on a mechanical horse. We tested nine healthy participants on a horse simulator, measured head and trunk kinematics, and characterized data in time (root-mean-square and variability) and frequency (amplitude spectra, gains, and phases) domains. We addressed three fundamental questions: 1) What is the specificity of postural responses to the simulator? 2) Which plane of motion is associated with the most and least variability (repeatable movements across repeated stimuli and across participants)? 3) To what extent are postural responses influenced by different degrees of stability (addition of pelvis straps and trunk support)? We found head and trunk responses were highly specific to the three-dimensional simulator perturbation direction and frequency. Frontal plane responses had the least variability across repetitions and participants whereas transverse motion was most variable. Head motion was more variable than the trunk at low frequencies and exhibited a marked decrease in tilt in the sagittal plane. Finally, the inclusion of pelvis straps had minimal effect on kinematics at low frequencies but altered higher frequencies; whereas added trunk support reduced head and trunk responses to perturbations and altered timing characteristics in all three planes. In conclusion, the present study suggests that frontal plane motion was under a high level of control, and results support the idea that specific head and trunk postural responses can be elicited from a complex three-dimensional stimuli, such as those found in hippotherapy. Researchers and clinicians can use results from this study to help interpret variability, implement mechanical adjustments to stability, and assess responses in pathological populations.
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Affiliation(s)
- Adam D Goodworth
- University of Hartford, 200 Bloomfield Avenue, West Hartford, CT 06117, United States.
| | - Cody Barrett
- Baylor University, One Bear Place #97356, Waco, TX 76798, United States
| | - Jonathan Rylander
- Baylor University, One Bear Place #97356, Waco, TX 76798, United States
| | - Brian Garner
- Baylor University, One Bear Place #97356, Waco, TX 76798, United States
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Bobet J, Masani K, Popovic MR, Vette AH. Kinematics-based prediction of trunk muscle activity in response to multi-directional perturbations during sitting. Med Eng Phys 2018; 58:S1350-4533(18)30089-4. [PMID: 29895449 DOI: 10.1016/j.medengphy.2018.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/07/2018] [Accepted: 05/28/2018] [Indexed: 11/23/2022]
Abstract
Recent work suggests that functional electrical stimulation can be used to enhance dynamic trunk stability following spinal cord injury. In this context, knowledge of the relation between trunk kinematics and muscle activation in non-disabled individuals may assist in developing kinematics-based neuroprostheses. Our objective was therefore to predict the activation profiles of the major trunk muscles from trunk kinematics following multi-directional perturbations during sitting. Trunk motion and electromyograms (EMG) from ten major trunk muscles were acquired in twelve non-disabled, seated individuals who experienced a force of approximately 200 N applied to the trunk in eight horizontal directions. A linear, time-invariant model with feedback gains on angular trunk displacement, velocity, and acceleration was optimized to predict the EMG from trunk kinematics. For each muscle, only the three directions that produced the largest EMG response were considered. Our results indicate that the time course of the processed EMG was similar across muscles and directions and that the model accounted for 68-92% of the EMG variance. A combination of neural and biomechanical mechanisms associated with trunk control can explain the obtained model parameters. Future work will apply the gained insights in the design of movement-controlled neuroprostheses for facilitating trunk stability following spinal cord injury.
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Affiliation(s)
- Jacques Bobet
- Department of Mechanical Engineering, University of Alberta, Donadeo Innovation Centre for Engineering, 9211 116 Street NW, Edmonton, Alberta T6G 1H9, Canada
| | - Kei Masani
- Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada; Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, Ontario M4G 3V9, Canada
| | - Milos R Popovic
- Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada; Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, Ontario M4G 3V9, Canada
| | - Albert H Vette
- Department of Mechanical Engineering, University of Alberta, Donadeo Innovation Centre for Engineering, 9211 116 Street NW, Edmonton, Alberta T6G 1H9, Canada; Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta T5G 0B7, Canada.
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18
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Double-Sided Mechanical Shocks Provoke Larger Seated Postural Reactions Compared With Single-Sided Mechanical Shocks. Spine (Phila Pa 1976) 2018; 43:E482-E487. [PMID: 28858181 DOI: 10.1097/brs.0000000000002396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Human volunteers were exposed experimentally to single-sided mechanical shocks (SSMS) and double-sided mechanical shocks (DSMS) while seated. OBJECTIVE The aim of this study was to describe and contrast seated postural reactions due to SSMS or DSMS in healthy male adults. SUMMARY OF BACKGROUND DATA Mechanical shocks to the body, caused when driving on irregular terrain, are suggested to be hazardous to the spine and may be associated with the reported musculoskeletal pain of the back and neck among professional drivers. However, very little is known about the characteristics of seated postural reactions and the biomechanical effects caused by mechanical shocks. METHODS Twenty healthy male subjects (18-43 years old) were exposed while seated to 5 SSMS and 15 DSMS in lateral directions. The second acceleration in the DSMS was in the opposite direction to the first acceleration and was fast, medium, or slow depending on the speed of direction change. Surface electromyography (EMG) was recorded in muscles of the upper neck, trapezius, erector spinae, and external oblique, while kinematics were recorded with inertial sensors placed at the neck, trunk, and pelvis. Muscle activity was normalized to maximum voluntary contractions (MVCs). RESULTS The EMG amplitudes were significantly higher (0.6-1%; P < 0.001) for the fast DSMS than all other shocks. Range of motion (ROM) of the neck and trunk was greater during the DSMS than the SSMS. Evoked muscle activity was less than 2% MVC in the trapezius, less than 10% MVC in the erector spinae and upper neck, while the activity exceeded 10% MVC in the external oblique muscles. CONCLUSION Fast DSMS in lateral directions appear more demanding than SSMS, demonstrating augmented seated postural reactions. However, the present mechanical shocks employed did not seem to induce postural reactions with regard to ROM or muscle activity of a magnitude likely to cause musculoskeletal overload. LEVEL OF EVIDENCE 4.
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Ólafsdóttir JM, Fice JB, Mang DWH, Brolin K, Davidsson J, Blouin JS, Siegmund GP. Trunk muscle recruitment patterns in simulated precrash events. TRAFFIC INJURY PREVENTION 2018; 19:S186-S188. [PMID: 29584507 DOI: 10.1080/15389588.2018.1426917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To quantify trunk muscle activation levels during whole body accelerations that simulate precrash events in multiple directions and to identify recruitment patterns for the development of active human body models. METHODS Four subjects (1 female, 3 males) were accelerated at 0.55 g (net Δv = 4.0 m/s) in 8 directions while seated on a sled-mounted car seat to simulate a precrash pulse. Electromyographic (EMG) activity in 4 trunk muscles was measured using wire electrodes inserted into the left rectus abdominis, internal oblique, iliocostalis, and multifidus muscles at the L2-L3 level. Muscle activity evoked by the perturbations was normalized by each muscle's isometric maximum voluntary contraction (MVC) activity. Spatial tuning curves were plotted at 150, 300, and 600 ms after acceleration onset. RESULTS EMG activity remained below 40% MVC for the three time points for most directions. At the 150- and 300 ms time points, the highest EMG amplitudes were observed during perturbations to the left (-90°) and left rearward (-135°). EMG activity diminished by 600 ms for the anterior muscles, but not for the posterior muscles. CONCLUSIONS These preliminary results suggest that trunk muscle activity may be directionally tuned at the acceleration level tested here. Although data from more subjects are needed, these preliminary data support the development of modeled trunk muscle recruitment strategies in active human body models that predict occupant responses in precrash scenarios.
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Affiliation(s)
- Jóna Marín Ólafsdóttir
- a Department of Mechanics and Maritime Sciences , Chalmers University of Technology , Gothenburg , Sweden
| | - Jason B Fice
- b School of Kinesiology, University of British Columbia , Vancouver , British Columbia , Canada
| | - Daniel W H Mang
- b School of Kinesiology, University of British Columbia , Vancouver , British Columbia , Canada
| | - Karin Brolin
- a Department of Mechanics and Maritime Sciences , Chalmers University of Technology , Gothenburg , Sweden
| | - Johan Davidsson
- a Department of Mechanics and Maritime Sciences , Chalmers University of Technology , Gothenburg , Sweden
| | - Jean-Sébastien Blouin
- b School of Kinesiology, University of British Columbia , Vancouver , British Columbia , Canada
| | - Gunter P Siegmund
- a Department of Mechanics and Maritime Sciences , Chalmers University of Technology , Gothenburg , Sweden
- c MEA Forensic Engineers & Scientists , Richmond , British Columbia , Canada
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Optimizing Function for the Older Adult With Degenerative Scoliosis Through Pilates Environment Intervention. TOPICS IN GERIATRIC REHABILITATION 2017. [DOI: 10.1097/tgr.0000000000000130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Pain catastrophizing and trunk muscle activation during walking in patients with chronic low back pain. Gait Posture 2016; 49:73-77. [PMID: 27388960 DOI: 10.1016/j.gaitpost.2016.06.025] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 06/09/2016] [Accepted: 06/20/2016] [Indexed: 02/02/2023]
Abstract
It has been hypothesized that individuals with low back pain (LBP) will have higher trunk muscle activity during gait, in an attempt to limit spine motion, and that this "guarding strategy" may be influenced by the person's psychological response to pain. This study investigated whether the amplitude of trunk muscle activation differs between persons with chronic LBP and healthy individuals during walking, and whether changes in muscle activation were related to pain catastrophizing. Thirty persons with chronic non-specific LBP, stratified into 2 groups of high (HLBP) and low (LLBP) pain catastrophizing, were contrasted with a control group of 15 healthy individuals during walking on a treadmill at a self-selected speed. Surface electromyographic (EMG) data were recorded from 10 trunk muscles. The effects of Group and gait Sub-phase on EMG activation amplitudes were assessed. The HLBP group exhibited higher activation of certain muscles throughout the gait cycle, and reduced variability of others at specific sub-phases of gait. A significant correlation was found between activation amplitude and pain catastrophizing in most muscles, when controlling for gait speed and pain intensity. These data indicate that altered trunk muscle activation is present in some patients with LBP during walking, but does not represent a universal increase in activation for all muscles. This altered neuromotor control is, however, more strongly associated with pain catastrophizing than with pain intensity, and appears to represent a non-functional, maladaptive behavior, as it alters the normal, phasic pattern of activation in certain trunk muscles.
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Mechanical and neuromuscular changes with lateral trunk lean gait modifications. Gait Posture 2016; 49:252-257. [PMID: 27472821 DOI: 10.1016/j.gaitpost.2016.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/13/2016] [Accepted: 07/16/2016] [Indexed: 02/02/2023]
Abstract
Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n=20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM). Surface electromyography, sampled at 2000Hz, measured activation of six trunk/hip muscles bilaterally. Peak LTL angle, peak KAM, gait speed, and mean values from electromyography waveforms were compared between normal and LTL conditions using paired t-tests or 2-way analysis of variance. There was a significant (p<0.05) increase in peak LTL angle, decrease in first but not second peak KAM, and decrease in gait speed during LTL gait. There were significant (p<0.01) increases in external oblique and iliocostalis muscle activation during LTL gait. There was no change in activation for internal oblique, rectus abdominis, longissimus, and gluteus medius. LTL gait decreased early/mid-stance KAM demonstrating its ability to decrease medial compartment knee loading. Increases in external oblique and iliocostalis activation were present but small to moderate in size and unlikely to lead to short term injury. Longitudinal studies should evaluate the effectiveness of increased LTL for knee osteoarthritis and if the increase in muscular demands leads to negative long term side effects.
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Mueller J, Engel T, Mueller S, Kopinski S, Baur H, Mayer F. Neuromuscular response of the trunk to sudden gait disturbances: Forward vs. backward perturbation. J Electromyogr Kinesiol 2016; 30:168-76. [PMID: 27469279 DOI: 10.1016/j.jelekin.2016.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/21/2016] [Accepted: 07/10/2016] [Indexed: 12/01/2022] Open
Abstract
The study aimed to analyse neuromuscular activity of the trunk comparing four different perturbations during gait. Thirteen subjects (28±3yrs) walked (1m/s) on a split-belt treadmill, while 4 (belt) perturbations (F1, F2, B1, B2) were randomly applied. Perturbations differed, related to treadmill belt translation, in direction (forward (F)/backward (B)) and amplitude (20m/s(2) (1)/40m/s(2) (2)). Trunk muscle activity was assessed with a 12-lead-EMG. EMG-RMS [%] (0-200ms after perturbation; normalized to RMS of normal gait) was analyzed for muscles and four trunk areas (ventral left/right; dorsal left/right). Ratio of ventral:dorsal muscles were calculated. Muscle onset [ms] was determined. Data analysis was conducted descriptively, followed by ANOVA (post hoc Tukey-Kramer (α=0.05)). All perturbations lead to an increase in EMG-RMS (428±289%). F1 showed the lowest and F2 the highest increase for the flexors. B2 showed the highest increase for the extensors. Significant differences between perturbations could be observed for 6 muscles, as well as the 4 trunk areas. Ratio analysis revealed no significant differences (range 1.25 (B1) to 1.71 (F2) between stimuli. Muscle response time (ventral: 87.0±21.7ms; dorsal: 88.4±17.0ms) between stimuli was only significant (p=0.005) for the dorsal muscles. Magnitude significantly influences neuromuscular trunk response patterns in healthy adults. Regardless of direction ventral muscles always revealed higher relative increase of activity while compensating the walking perturbations.
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Affiliation(s)
- Juliane Mueller
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Germany.
| | - Tilman Engel
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Germany
| | - Steffen Mueller
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Germany
| | - Stephan Kopinski
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Germany
| | - Heiner Baur
- Bern University of Applied Sciences, Health, Physiotherapy, Bern, Switzerland
| | - Frank Mayer
- University Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Germany
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Wu YH, Duncan K, Saavedra S, Goodworth A. Segmental trunk and head dynamics during frontal plane tilt stimuli in healthy sitting adults. J Biomech 2016; 49:2831-2837. [PMID: 27395757 DOI: 10.1016/j.jbiomech.2016.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/20/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
Abstract
A more detailed understanding of trunk behavior during upright sitting is needed to create a foundation to address functional posture impairments. Therefore, we characterized the dynamics of the trunk and head during perturbed sitting. A three-link inverted pendulum model of head and trunk segments was used to analyze kinematics of eight healthy sitting adults. Magnetic sensors were placed at the head and two locations of the trunk (C7 and T7). Six surface tilt stimuli (two spontaneous sway tests [no surface stimulus; eyes open, EO/eyes closed, EC] and four tests with continuous pseudorandom surface tilts [2 peak-to peak amplitudes of 2° or 8°; EO/EC]) were applied in the frontal plane. We used frequency-response functions (FRFs) to analyze sway across ~0.045-3Hz and found systematic differences in sway dynamics across segments. Superior segments exhibited larger fluctuations in gain and phase values across frequencies. FRF gains in superior segments were attenuated compared to other segments only at low frequencies but were larger at the higher frequencies. We also tested the influence of stimulus amplitude and visual availability on FRFs. Across all segments, increasing stimulus amplitude and visual availability (EO) resulted in lower gains, however, these effects were most prominent in superior segments. These changes in gain were likely influenced by changes in sensory reliance across test conditions. In conclusion, these results provide a benchmark for future comparisons to segmental responses from individuals with impaired trunk control. We suggest that a frequency-based approach provides detail needed to characterize multi-segment dynamics related to sensorimotor control.
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Affiliation(s)
- Yen-Hsun Wu
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA.
| | - Kerian Duncan
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Sandra Saavedra
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Adam Goodworth
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
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25
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Milosevic M, Shinya M, Masani K, Patel K, McConville KM, Nakazawa K, Popovic MR. Anticipation of direction and time of perturbation modulates the onset latency of trunk muscle responses during sitting perturbations. J Electromyogr Kinesiol 2016; 26:94-101. [DOI: 10.1016/j.jelekin.2015.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/15/2015] [Accepted: 12/07/2015] [Indexed: 11/30/2022] Open
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Maaswinkel E, Griffioen M, Perez R, van Dieën J. Methods for assessment of trunk stabilization, a systematic review. J Electromyogr Kinesiol 2016; 26:18-35. [DOI: 10.1016/j.jelekin.2015.12.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 12/03/2015] [Accepted: 12/20/2015] [Indexed: 11/27/2022] Open
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Rouhani H, Mahallati S, Preuss R, Masani K, Popovic MR. Sensitivity of intersegmental angles of the spinal column to errors due to marker misplacement. J Biomech Eng 2015; 137:2279320. [PMID: 25901652 DOI: 10.1115/1.4030406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Indexed: 11/08/2022]
Abstract
The ranges of angular motion measured using multisegmented spinal column models are typically small, meaning that minor experimental errors can potentially affect the reliability of these measures. This study aimed to investigate the sensitivity of the 3D intersegmental angles, measured using a multisegmented spinal column model, to errors due to marker misplacement. Eleven healthy subjects performed trunk bending in five directions. Six cameras recorded the trajectory of 22 markers, representing seven spinal column segments. Misplacement error for each marker was modeled as a Gaussian function with a standard deviation of 6 mm, and constrained to a maximum value of 12 mm in each coordinate across the skin. The sensitivity of 3D intersegmental angles to these marker misplacement errors, added to the measured data, was evaluated. The errors in sagittal plane motions resulting from marker misplacement were small (RMS error less than 3.2 deg and relative error in the angular range less than 15%) during the five trunk bending direction. The errors in the frontal and transverse plane motions, induced by marker misplacement, however, were large (RMS error up to 10.2 deg and relative error in the range up to 58%), especially during trunk bending in anterior, anterior-left, and anterior-right directions, and were often comparable in size to the intersubject variability for those motions. The induced errors in the frontal and transverse plane motions tended to be the greatest at the intersegmental levels in the lower lumbar region. These observations questioned reliability of angle measures in the frontal and transverse planes particularly in the lower lumbar region during trunk bending in anterior direction, and thus did not recommend interpreting these measures for clinical evaluation and decision-making.
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Vera-García F, Barbado D, Moreno-Pérez V, Hernández-Sánchez S, Juan-Recio C, Elvira J. Core stability. Concepto y aportaciones al entrenamiento y la prevención de lesiones. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.ramd.2014.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stenlund TC, Lundström R, Lindroos O, Häger CK, Burström L, Neely G, Rehn B. Seated postural neck and trunk reactions to sideways perturbations with or without a cognitive task. J Electromyogr Kinesiol 2015; 25:548-56. [PMID: 25843010 DOI: 10.1016/j.jelekin.2015.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 03/05/2015] [Accepted: 03/09/2015] [Indexed: 10/23/2022] Open
Abstract
Driving on irregular terrain will expose the driver to sideways mechanical shocks or perturbations that may cause musculoskeletal problems. How a cognitive task, imposed on the driver, affects seated postural reactions during perturbations is unknown. The aim of the present study was to investigate seated postural reactions in the neck and trunk among healthy adults exposed to sideways perturbations with or without a cognitive task. Twenty-three healthy male subjects aged 19-36 years, were seated on a chair mounted on a motion system and randomly exposed to 20 sideways perturbations (at two peak accelerations 5.1 or 13.2m/s(2)) in two conditions: counting backwards or not. Kinematics were recorded for upper body segments using inertial measurement units attached to the body and electromyography (EMG) was recorded for four muscles bilaterally in the neck and trunk. Angular displacements (head, neck, trunk and pelvis) in the frontal plane, and EMG amplitude (normalised to maximum voluntary contractions, MVC) were analysed. The cognitive task provoked significantly larger angular displacements of the head, neck and trunk and significantly increased EMG mean amplitudes in the upper neck during deceleration, although 10% of MVC was never exceeded. A cognitive task seems to affect musculoskeletal reactions when exposed to sideways perturbations in a seated position.
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Affiliation(s)
- T C Stenlund
- Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden.
| | - R Lundström
- Dept. of Public Health and Clinical Medicine, Occupational Medicine, Umeå University, Sweden; Dept. of Radiation Sciences, Biomedical Engineering, Umeå University, Sweden
| | - O Lindroos
- Dept. of Forest Biomaterials & Technology, Swedish University of Agricultural Sciences, Umeå, Sweden
| | - C K Häger
- Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden
| | - L Burström
- Dept. of Public Health and Clinical Medicine, Occupational Medicine, Umeå University, Sweden
| | - G Neely
- Dept. of Psychology, Umeå University, Sweden
| | - B Rehn
- Dept. of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden
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Anson E, Agada P, Kiemel T, Ivanenko Y, Lacquaniti F, Jeka J. Visual control of trunk translation and orientation during locomotion. Exp Brain Res 2015; 232:1941-51. [PMID: 24658632 DOI: 10.1007/s00221-014-3885-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
Abstract
Previous studies have suggested distinct control of gait characteristics in the anterior-posterior (AP) and medial-lateral (ML) directions in response to visual input. Responses were larger to a ML visual stimulus, suggesting that vision plays a larger role in stabilizing gait in the ML direction. Here, we investigated responses of the trunk during locomotion to determine whether a similar direction dependence is observed. We hypothesized that translation of the trunk would show a similar ML dependence on vision, but that angular deviations of the trunk would show equivalent responses in all directions. Subjects stood or walked on a treadmill at 5 km/h while viewing a virtual wall of white triangles that moved in either the AP or ML direction according to a broadband input stimulus. Frequency response functions between the visual scene motion and trunk kinematics revealed that trunk translation gain was larger across all frequencies during walking compared with standing. Trunk orientation responses were not different from standing at very low frequencies; however, at high frequencies, trunk orientation gain was much higher during walking. Larger gains in response to ML visual scene motion were found for all trunk movements. Higher gains in the ML direction while walking suggest that visual feedback may contribute more to the stability of trunk movements in the ML direction. Vision modified trunk movement behavior on both a slow (translation) and fast (orientation) time scale suggesting a priority for minimizing angular deviations of the trunk. Overall, trunk responses to visual input were consistent with the theme that control of locomotion requires higher-level sensory input to maintain stability in the ML direction.
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Buchecker M, Stöggl T, Müller E. Spine kinematics and trunk muscle activity during bipedal standing using unstable footwear. Scand J Med Sci Sports 2013; 23:e194-201. [DOI: 10.1111/sms.12053] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2012] [Indexed: 11/29/2022]
Affiliation(s)
- M. Buchecker
- Department of Sport Science and Kinesiology; University of Salzburg; Salzburg; Austria
| | - T. Stöggl
- Department of Sport Science and Kinesiology; University of Salzburg; Salzburg; Austria
| | - E. Müller
- Department of Sport Science and Kinesiology; University of Salzburg; Salzburg; Austria
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Lee NG, Lee JA, Kim JB. A Comparison of Three-dimensional Spine Kinematics during Multidirectional Trunk Movement between Elderly Subjects with Degenerative Spine Disease and Healthy Young Adults. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Nam-Gi Lee
- Department of Physical Therapy, Graduate School, Yonsei University
| | - Jung-Ah Lee
- Department of Motor and Cognitive Rehabilitation, Korea National Rehabilitation Research Institute
| | - Jong-Bae Kim
- Department of Rehabilitation and Assistive Technology, Korea National Rehabilitation Research Institute
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Gauthier C, Gagnon D, Jacquemin G, Duclos C, Masani K, Popovic MR. Which trunk inclination directions best predict multidirectional-seated limits of stability among individuals with spinal cord injury? J Spinal Cord Med 2012; 35:343-50. [PMID: 23031171 PMCID: PMC3459563 DOI: 10.1179/2045772312y.0000000039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To determine which trunk inclination directions most accurately predict multidirectional-seated limits of stability among individuals with spinal cord injury (SCI). DESIGN Predictive study using cross-sectional data. SETTING Pathokinesiology Laboratory. PARTICIPANTS Twenty-one individuals with complete or incomplete sensorimotor SCI affecting various vertebral levels participated in this study. INTERVENTIONS Participants were instructed to lean their trunk as far as possible in eight directions, separated by 45° intervals, while seated on an instrumented chair with their feet positioned on force plates. OUTCOMES MEASURES Eight direction-specific stability indices (DSIs) were used to define an overall stability index (OSI) (limits of stability). RESULTS All DSIs significantly correlated with the OSI (r = 0.816-0.925). A protocol that only tests the anterior, left postero-lateral, and right lateral trunk inclinations accurately predicts multidirectional-seated postural stability (r(2) = 0.98; P < 0.001). CONCLUSION Multidirectional-seated postural stability can be predicted almost perfectly by evaluating trunk inclinations performed toward the anterior, left postero-lateral, and right lateral directions.
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Affiliation(s)
- Cindy Gauthier
- Pathokinesiology Laboratory, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de Réadaptation Gingras-Lindsay-de-Montréal, Montreal, Canada; and School of Rehabilitation, Université de Montréal, Montreal, Canada
| | - Dany Gagnon
- Pathokinesiology Laboratory, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de Réadaptation Gingras-Lindsay-de-Montréal, Montreal, Canada; School of Rehabilitation, Université de Montréal, Montreal, Canada; and Rehabilitation Engineering Laboratory, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada,Correspondence to: Dany Gagnon, School of Rehabilitation, Université de Montréal, Pavillon 7077 Avenue du Parc, PO Box 6128, Station Centre-Ville, Montreal, Quebec, Canada H3C 3J7.
| | - Géraldine Jacquemin
- Pathokinesiology Laboratory, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de Réadaptation Gingras-Lindsay-de-Montréal, Montreal, Canada
| | - Cyril Duclos
- Pathokinesiology Laboratory, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de Réadaptation Gingras-Lindsay-de-Montréal, Montreal, Canada; and School of Rehabilitation, Université de Montréal, Montreal, Canada
| | - Kei Masani
- Rehabilitation Engineering Laboratory, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada; and Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Milos R. Popovic
- Rehabilitation Engineering Laboratory, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada; and Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Milosevic M, Valter McConville KM, Sejdic E, Masani K, Kyan MJ, Popovic MR. Visualization of trunk muscle synergies during sitting perturbations using self-organizing maps (SOM). IEEE Trans Biomed Eng 2012; 59:2516-23. [PMID: 22736687 DOI: 10.1109/tbme.2012.2205577] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this study was to demonstrate the use of the self-organizing map (SOM) method for visualization, modeling, and comparison of trunk neuromuscular synergies during perturbed sitting. Thirteen participants were perturbed at the level of the sternum, in eight directions during sitting. Electromyographic (EMG) responses of ten trunk muscles involved in postural control were recorded. The SOM was used to encode the EMG responses on a 2-D projection (i.e., visualization). The result contains similar patterns mapped close together on the plot therefore forming clusters of data. Such visualization of ten EMG responses, following eight directional perturbations, allows for comparisons of direction-dependent postural synergies. Direction-dependent neuromuscular response models for each muscle were then constructed from the SOM visualization. The results demonstrated that the SOM was able to encode neuromuscular responses, and the SOM visualization showed direction-dependent differences in the postural synergies. Moreover, each muscle was modeled using the SOM-based method, and derived models showed that all muscles, except for one, produced a Gaussian fit for direction-dependent responses. Overall, SOM analysis offers a reverse engineering method for exploration and comparison of complex neuromuscular systems, which can describe postural synergies at a glance.
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Affiliation(s)
- Matija Milosevic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
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A comprehensive three-dimensional dynamic model of the human head and trunk for estimating lumbar and cervical joint torques and forces from upper body kinematics. Med Eng Phys 2012; 34:640-9. [DOI: 10.1016/j.medengphy.2011.11.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 11/15/2011] [Accepted: 11/28/2011] [Indexed: 11/22/2022]
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Freeman J, Fox E, Gear M, Hough A. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial. BMC Neurol 2012; 12:19. [PMID: 22480437 PMCID: PMC3364845 DOI: 10.1186/1471-2377-12-19] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 04/05/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training; 2 Comparing core stability training with standardised physiotherapy exercise; 3 Exploring underlying mechanisms of change associated with this intervention METHODS This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before and after intervention to assess changes in abdominal musculature at one of the four centres (Plymouth). DISCUSSION This pragmatic trial will assess the effect of these exercise programmes on ambulatory people with MS. It may not be possible to extrapolate the conclusions to those who are non-ambulatory. TRIAL REGISTRATION ClinicalTrials.gov: NCT01414725.
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Affiliation(s)
- Jennifer Freeman
- Faculty of Health, Education and Society, School of Health Professions, Plymouth University, Peninsula Allied Health Centre, Derriford Road, Plymouth PL6 8BH, UK.
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Barron J, Guidon M. Grip strength and functional balance in community-dwelling older women. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2011. [DOI: 10.12968/ijtr.2011.18.11.622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Effective detection and treatment of balance impairment in older people is a matter of clinical urgency. 4 screening tool for impaired balance is required, as is clarity regarding the role of muscle strength in balance control. Methods: This observational study examined the relationship between grip strength and balance in 40 community-dwelling women aged 65-95 years. Measures included grip strength, Functional Reach test, Single Leg Stance Test, Timed Up and Go test and the Berg Balance Scale. Correlation analyses were used to investigate relationships between the variables. Findings: Significant correlations were found between grip strength and each of the balance measures. The strongest correlation (r=0.55, P<0.001) was found between right grip strength and the Berg Balance Scale. The weakest correlation (r=-0.36, P=0.012) was between left grip strength and the Timed Up and Go test. Grip strength accounted for only 14%-31% of the variance in balance test scores Conclusions: The association between grip strength and balance was not sufficiently robust for grip strength to be recommended as a screening tool for balance impairment in older people.
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Affiliation(s)
- Joan Barron
- Stroke and Medical Rehwabilitation Unit, Letterkenny General Hospital, County Donegal, Ireland
| | - Marie Guidon
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Vera-Garcia FJ, Moreside JM, McGill SM. Abdominal muscle activation changes if the purpose is to control pelvis motion or thorax motion. J Electromyogr Kinesiol 2011; 21:893-903. [PMID: 21925900 DOI: 10.1016/j.jelekin.2011.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 08/08/2011] [Accepted: 08/08/2011] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to compare trunk muscular recruitment and lumbar spine kinematics when motion was constrained to either the thorax or the pelvis. Nine healthy women performed four upright standing planar movements (rotations, anterior-posterior translations, medial-lateral translations, and horizontal circles) while constraining pelvis motion and moving the thorax or moving the pelvis while minimizing thorax motion, and four isometric trunk exercises (conventional curl-up, reverse curl-up, cross curl-up, and reverse cross curl-up). Surface EMG (upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, and latissimus dorsi) and 3D lumbar displacements were recorded. Pelvis movements produced higher EMG amplitudes of the oblique abdominals than thorax motions in most trials, and larger lumbar displacements in the medial-lateral translations and horizontal circles. Conversely, thorax movements produced larger rotational lumbar displacement than pelvis motions during rotations and higher EMG amplitudes for latissimus dorsi during rotations and anterior-posterior translations and for lower rectus abdominis during the crossed curl-ups. Thus, different neuromuscular compartments appear when the objective changes from pelvis to thorax motion. This would suggest that both movement patterns should be considered when planning spine stabilization programs, to optimize exercises for the movement and muscle activations desired.
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Affiliation(s)
- Francisco J Vera-Garcia
- Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n, C.P. 03202, Elche, Alicante, Spain
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St-Onge N, Côté JN, Preuss RA, Patenaude I, Fung J. Direction-dependent neck and trunk postural reactions during sitting. J Electromyogr Kinesiol 2011; 21:904-12. [PMID: 21917476 DOI: 10.1016/j.jelekin.2011.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 07/27/2011] [Accepted: 07/27/2011] [Indexed: 10/17/2022] Open
Abstract
Postural reactions in healthy individuals in the seated position have previously been described and have been shown to depend on the direction of the perturbation; however the neck response following forward and backward translations has not been compared. The overall objective of the present study was to compare neck and trunk kinematic, kinetic and electromyographic (EMG) stabilization patterns of seated healthy individuals to forward and backward translations. Ten healthy individuals, seated on a chair fixed onto a movable platform, were exposed to forward and backward translations (distance=0.15m, peak acceleration=1.2m/s(2)). The head and trunk kinematics as well as the EMG activity of 16 neck and trunk muscles were recorded. Neck and trunk angular displacements were computed in the sagittal plane. The centers of mass (COMs) of the head (HEAD), upper thorax (UPTX), lower thorax (LOWTX) and abdomen (ABDO) segments were also computed. Moments of force at the C7-T1 and L5-S1 levels were calculated using a top-down, inverse dynamics approach. Forward translations provoked greater overall COM peak displacements. The first peak of moment of force was also reached earlier following forward translations which may have played a role in preventing the trunk from leaning backwards. These responses can be explained by the higher postural threat imposed by a forward translation.
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Affiliation(s)
- Nancy St-Onge
- Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, Montreal, QC, Canada.
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Wilder DG, Vining RD, Pohlman KA, Meeker WC, Xia T, Devocht JW, Gudavalli RM, Long CR, Owens EF, Goertz CM. Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial. Trials 2011; 12:161. [PMID: 21708042 PMCID: PMC3148990 DOI: 10.1186/1745-6215-12-161] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 06/28/2011] [Indexed: 02/01/2023] Open
Abstract
Background Low back pain (LBP) is a recognized public health problem, impacting up to 80% of US adults at some point in their lives. Patients with LBP are utilizing integrative health care such as spinal manipulation (SM). SM is the therapeutic application of a load to specific body tissues or structures and can be divided into two broad categories: SM with a high-velocity low-amplitude load, or an impulse "thrust", (HVLA-SM) and SM with a low-velocity variable-amplitude load (LVVA-SM). There is evidence that sensorimotor function in people with LBP is altered. This study evaluates the sensorimotor function in the lumbopelvic region, as measured by postural sway, response to sudden load and repositioning accuracy, following SM to the lumbar and pelvic region when compared to a sham treatment. Methods/Design A total of 219 participants with acute, subacute or chronic low back pain are being recruited from the Quad Cities area located in Iowa and Illinois. They are allocated through a minimization algorithm in a 1:1:1 ratio to receive either 13 HVLA-SM treatments over 6 weeks, 13 LVVA-SM treatments over 6 weeks or 2 weeks of a sham treatment followed by 4 weeks of full spine "doctor's choice" SM. Sensorimotor function tests are performed before and immediately after treatment at baseline, week 2 and week 6. Self-report outcome assessments are also collected. The primary aims of this study are to 1) determine immediate pre to post changes in sensorimotor function as measured by postural sway following delivery of a single HVLA-SM or LVVA-SM treatment when compared to a sham treatment and 2) to determine changes from baseline to 2 weeks (4 treatments) of HVLA-SM or LVVA-SM compared to a sham treatment. Secondary aims include changes in response to sudden loads and lumbar repositioning accuracy at these endpoints, estimating sensorimotor function in the SM groups after 6 weeks of treatment, and exploring if changes in sensorimotor function are associated with changes in self-report outcome assessments. Discussion This study may provide clues to the sensorimotor mechanisms that explain observed functional deficits associated with LBP, as well as the mechanism of action of SM. Trial registration This trial is registered in ClinicalTrials.gov, with the ID number of NCT00830596, registered on January 27, 2009. The first participant was allocated on 30 January 2009 and the final participant was allocated on 17 March 2011.
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Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, Mobberley C, Nock A, Sims R, Thain J. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler 2010; 16:1377-84. [PMID: 20699285 DOI: 10.1177/1352458510378126] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Core stability training is popular in the management of people with multiple sclerosis (MS); however, scientific evidence to support its effectiveness is scarce. OBJECTIVE To explore the effectiveness of core stability training on balance and mobility. METHOD A multi-centre series of eight single case studies was undertaken. Eight ambulant individuals with stable MS participated in 16 face-to-face core stability training sessions, delivered by a neurophysiotherapist, plus a daily home exercise programme. A range of outcomes were measured: 10-m timed walk, 12-item MS walking scale, timed get up and go, functional reach tests, timed single leg stance, visual analogue scales of two activities, and the Activities-specific Balance Confidence Scale. RESULTS Visual analysis of trend, level and slope demonstrated improvement in five subjects (62%) in seven measures. This was confirmed by the two standard deviation band method of analysis for six measures. Analysis of group data (repeated measures within subjects analysis of variance) indicated significant improvement between baseline and intervention phases for timed walk (p = 0.019), MSWS-12 Scale (p = 0.041), forward (p = 0.015) and lateral reach (p = 0.012). In general, no further improvements were made following withdrawal of the intervention. CONCLUSIONS This study provides preliminary evidence of the effectiveness of an 8-week core stability training programme in improving balance and mobility in ambulant people with MS. Variations in response to intervention are evident. Assessor-blinded randomized controlled studies are required to confirm these findings and determine patient characteristics which identify those who benefit most from this intervention.
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Responses of the Trunk to Multidirectional Perturbations during Unsupported Sitting in Normal Adults. J Appl Biomech 2010; 26:332-40. [DOI: 10.1123/jab.26.3.332] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Understanding how the human body responds to unexpected force perturbations during quiet sitting is important to the science of motor behavior and the design of neuroprostheses for sitting posture. In this study, the performance characteristics of the neck and trunk in healthy individuals were assessed by measuring the kinematic responses to sudden, unexpected force perturbations applied to the thorax. Perturbations were applied in eight horizontal directions. It was hypothesized that displacement of the trunk, settling time and steady-state error would increase when the perturbation direction was diagonal (i.e., anterior-lateral or posterior-lateral) due to the increased complexity of asymmetrical muscle responses. Perturbation forces were applied manually. The neck and trunk responded in a synchronized manner in which all joints achieved peak displacement simultaneously then returned directly to equilibrium. Displacement in the direction of perturbation and perpendicular to the direction of perturbation were both significantly greater in response to diagonal perturbations (p < .001). The center of mass returned to equilibrium in 3.64 ± 1.42 s after the onset of perturbation. Our results suggest that the trunk sometimes behaves like an underdamped oscillator and is not controlled by simple stiffness when subjected to loads of approximately 200 N. The results of this study are intended to be used to develop a neuroprosthesis for artificial control of trunk stability in individuals with spinal cord injury.
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Küng UM, Horlings CGC, Honegger F, Allum JHJ. The effect of voluntary lateral trunk bending on balance recovery following multi-directional stance perturbations. Exp Brain Res 2010; 202:851-65. [DOI: 10.1007/s00221-010-2201-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 02/05/2010] [Indexed: 11/30/2022]
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Santos MJ, Kanekar N, Aruin AS. The role of anticipatory postural adjustments in compensatory control of posture: 2. Biomechanical analysis. J Electromyogr Kinesiol 2010; 20:398-405. [PMID: 20156693 DOI: 10.1016/j.jelekin.2010.01.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2009] [Revised: 11/21/2009] [Accepted: 01/14/2010] [Indexed: 12/23/2022] Open
Abstract
The central nervous system (CNS) utilizes anticipatory (APAs) and compensatory (CPAs) postural adjustments to maintain equilibrium while standing. It is known that these postural adjustments involve displacements of the center of mass (COM) and center of pressure (COP). The purpose of the study was to investigate the relationship between APAs and CPAs from a kinetic and kinematic perspective. Eight subjects were exposed to external predictable and unpredictable perturbations induced at the shoulder level while standing. Kinematic and kinetic data were recorded and analyzed during the time duration typical for anticipatory and compensatory postural adjustments. When the perturbations were unpredictable, the COM and COP displacements were larger compared to predictable conditions with APAs. Thus, the peak of COM displacement, after the pendulum impact, in the posterior direction reached 28+/-9.6mm in the unpredictable conditions with no APAs whereas it was 1.6 times smaller, reaching 17+/-5.5mm during predictable perturbations. Similarly, after the impact, the peak of COP displacement in the posterior direction was 60+/-14 mm for unpredictable conditions and 28+/-3.6mm for predictable conditions. Finally, the times of the peak COM and COP displacements were similar in the predictable and unpredictable conditions. This outcome provides additional knowledge about how body balance is controlled in presence and in absence of information about the forthcoming perturbation. Moreover, it suggests that control of posture could be enhanced by better utilization of APAs and such an approach could be considered as a valuable modality in the rehabilitation of individuals with balance impairment.
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Affiliation(s)
- Marcio J Santos
- Department of Physical Therapy, University of Illinois at Chicago, IL 60612, USA
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Abstract
PURPOSE The Segmental Assessment of Trunk Control (SATCo) provides a systematic method of assessing discrete levels of trunk control in children with motor disabilities. This study refined the assessment method and examined reliability and validity of the SATCo. METHODS After refining guidelines, 102 video recordings of the SATCo were made of 8 infants with typical development followed longitudinally from 3 to 9 months of age and 24 children with neuromotor disability with a mean age of 10 years 4 months. Eight researchers independently scored recordings. RESULTS Intraclass correlation coefficient values for interrater reliability were more than 0.84 and 0.98 across all data sets and all aspects of control. Tests of concurrent validity with the Alberta Infant Motor Scales resulted in coefficients ranging from 0.86 to 0.88. CONCLUSION The SATCo is a reliable and valid measure allowing clinicians greater specificity in assessing trunk control.
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St-Onge N, Côté JN, Patenaude I, Fung J. A paradigm to assess postural responses triggered by anteroposterior translations in healthy seated individuals. Gait Posture 2009; 30:417-23. [PMID: 19726190 DOI: 10.1016/j.gaitpost.2009.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 06/02/2009] [Accepted: 06/10/2009] [Indexed: 02/02/2023]
Abstract
Postural adjustments following mechanical perturbations have been studied in healthy seated humans. However, little is known on the minimal intensity that should be used to provoke a reaction. This knowledge could be essential to assess seated postural deficits in some pathological populations. The goal of the present study was to identify a low-intensity perturbation that could elicit postural reactions in healthy seated individuals. Six healthy participants sat on an adapted ergonomic chair fixed on a moveable support surface that was submitted to forward and backward translations. The head and trunk kinematics as well as the activity of sixteen neck and trunk muscles were recorded. The head, arm and trunk center of mass was computed using kinematics and standard anthropometric tables. We found that ramp displacements with an acceleration profile reaching a maximal value of 1.17 m/s(2) elicited reliable kinematic and electromyographic reactions across participants. Head and trunk segments initially responded opposite to the direction of translation, then reversed direction. Median peak-to-peak angular displacements in the neck, head and trunk, respectively, reached 3.6 degrees, 7.0 degrees and 7.1 degrees for forward translations, and 4.0 degrees, 8.2 degrees and 7.0 degrees for backward translations. For forward translations, neck and trunk flexor muscles were activated first, followed by the extensor muscles, whereas for backward translations, extensor muscles were activated first, followed by flexors. Although this perturbation is of low-intensity compared to those typically used previously to evoke postural reactions, this stimulus is sufficient to elicit a reliable response. We suggest that such a perturbation could be used to assess the physical condition of individuals with neck injuries.
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Affiliation(s)
- Nancy St-Onge
- Department of Exercise Science, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, Canada H4B 1R6.
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Gagnon D, Verrier M, Masani K, Nadeau S, Aissaoui R, Popovic M. Effects of Trunk Impairments on Manual Wheelchair Propulsion Among Individuals with a Spinal Cord Injury: A Brief Overview and Future Challenges. Top Spinal Cord Inj Rehabil 2009. [DOI: 10.1310/sci1502-59] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Preuss RA, Popovic MR. Three-dimensional spine kinematics during multidirectional, target-directed trunk movement in sitting. J Electromyogr Kinesiol 2009; 20:823-32. [PMID: 19674918 DOI: 10.1016/j.jelekin.2009.07.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 07/14/2009] [Accepted: 07/17/2009] [Indexed: 11/16/2022] Open
Abstract
The current study provides a quantitative assessment of three-dimensional spine motion during target-directed trunk movements in sitting. Subjects sat on an elevated surface, without foot support, and targets were placed in five directions, at three subject-specific distances (based on trunk height). Subjects were asked to lean toward the target, touch it with their head, and return to upright sitting. A retro-reflective motion analysis system was used to measure spine motion, using three kinematic trunk models (1, 3 and 7 segments). Significant differences were noted in the total trunk motion measured between the models, as well as between target distances and directions. In the most segmented model, inter-segmental trunk motion was also found to differ between trunk levels, with complex interaction effects involving target distance and direction. These findings suggest that inter-segmental spine motion is complex, task dependent, and often unevenly distributed between spine levels, with motion patterns differing between subjects, even in the absence of pathology. Use of a multi-segmental model provides the most interpretable findings, allowing for differentiation of individual motion patterns of the spine. Such an approach may be beneficial to the understanding of movement-related spine pathologies.
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Affiliation(s)
- Richard A Preuss
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute, 520 Sutherland Drive, Toronto, Ontario, Canada.
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Whiplash-associated disorders affect postural reactions to antero-posterior support surface translations during sitting. Gait Posture 2009; 29:603-11. [PMID: 19201611 DOI: 10.1016/j.gaitpost.2008.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 12/04/2008] [Accepted: 12/22/2008] [Indexed: 02/02/2023]
Abstract
Previous studies have shown that individuals with WAD display decreased postural stability during standing and walking tasks. However, their ability to maintain seated upright posture has never been investigated. The objective of this study was to characterize kinematic and electromyographic postural stabilization patterns in individuals with chronic WAD and to compare these patterns with those in an able-bodied control group. Ten individuals with WAD and an age- and gender-matched group of healthy individuals were exposed to sudden forward and backward support surface translations while they were seated. Neck and trunk muscle activity and angular displacements as well as centers of mass (COMs) linear displacements at four levels of the head and trunk were computed. The displacement onset of the combined head, arms and trunk COM was significantly delayed in persons with WAD. However, their peak trunk angles were smaller and were reached sooner. In the WAD group, the activation onset of the lumbar erector spinae was less affected by perturbation direction and the sternocleidomastoid muscle, a neck flexor, showed a trend towards being activated later, compared to the healthy group. These results suggest that individuals with WAD may alter stretch reflex threshold and/or elicit a learned response for pain avoidance that may be direction-specific. Such findings highlight the importance of assessing both spatial and temporal characteristics across different levels of the spinal musculoskeletal system to evaluate multidirectional postural responses in WAD individuals.
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Goodworth AD, Peterka RJ. Contribution of sensorimotor integration to spinal stabilization in humans. J Neurophysiol 2009; 102:496-512. [PMID: 19403751 DOI: 10.1152/jn.00118.2009] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The control of upper body (UB) orientation relative to the pelvis in the frontal plane was characterized by analyzing responses to external perturbations consisting of continuous pelvis tilts (eyes open [EO] and eyes closed [EC]) and visual surround tilts (EO) at various amplitudes. Lateral sway of the lower body was prevented on all tests. UB sway was analyzed by calculating impulse-response functions (IRFs) and frequency-response functions (FRFs) from 0.023 to 10.3 Hz for pelvis tilt tests and FRFs from 0.041 to 1.5 Hz for visual tests. For pelvis tilt tests, differences between FRFs were limited to frequencies<3 Hz and were dependent on stimulus amplitude. IRFs were nearly identical across all pelvis tilt tests for the first 0.2 s, but showed amplitude-dependent changes in their time course at longer time lags. The availability of visual orientation cues (EO vs. EC) had only a small effect on the UB sway during pelvis tilt tests. This small effect of vision was consistent with the small UB sway evoked on visual tilt tests. Experimental results were interpreted using a feedback model of UB orientation control that included time-delayed sensory integration, short-latency reflexive mechanisms, and intrinsic biomechanical properties of the UB. Variation in model parameters indicated that subjects shifted toward reliance on vestibular information and away from proprioceptive information as pelvis tilt amplitudes increased. For visual tilt stimuli, model parameters indicated that subjects shifted toward reliance on vestibular and proprioceptive information and away from visual information as the stimulus amplitude increased.
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Affiliation(s)
- Adam D Goodworth
- Department of Science and Engineering, Oregon Health & Science University, Portland, OR, USA
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