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Chan CK, Azah HN, Yeow CH, Goh SK, Ting HN, Salmah K. Effects of Squatting Speed and Depth on Lower Extremity Kinematics, Kinetics and Energetics. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Squatting has received considerable attention in sports and is commonly utilized in daily activities. Knowledge of the squatting biomechanics in terms of its speed and depth may enhance exercise selection when targeting for sport-specific performance improvement and injury avoidance. Nonetheless, these perspectives have not been consistently reported. Hence, this preliminary study intends to quantify the kinematics, kinetics, and energetics in squat with different depths and speeds among healthy young adults with different physical activity levels; i.e., between active and sedentary groups. Twenty participants were administered to squat at varying depths (deep, normal, and half) and speeds (fast, normal, and slow). Motion-capture system and force plates were employed to acquire motion trajectories and ground reaction force. Joint moment was obtained via inverse dynamics, while power was derived as a product of moment and angular velocity. Higher speeds and deeper squats greatly influence higher joint moments and powers at the hip ([Formula: see text]) and knee ([Formula: see text]) than ankle, signifying these joints as the prime movers with knee as the predominant contributor. These preliminary findings show that the knee-strategy and hip-strategy were employed in compensating speed and depth manipulations during squatting. In certain contexts, appreciating these findings may provide clinically relevant implications, from the performance and injury avoidance viewpoint, which will ameliorate the physical activity level of practitioners.
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Affiliation(s)
- Chow-Khuen Chan
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Hamzaid Nur Azah
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chen-Hua Yeow
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Sim-Kuan Goh
- Department of Mechanical Engineering, Nanyang Technological University, Singapore
| | - Hua-Nong Ting
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Karman Salmah
- Department of Biomedical Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
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Kefala V, Ali AA, Hamilton LD, Mannen EM, Shelburne KB. Effects of Weight-Bearing on Tibiofemoral, Patellofemoral, and Patellar Tendon Kinematics in Older Adults. Front Bioeng Biotechnol 2022; 10:820196. [PMID: 35497367 PMCID: PMC9048742 DOI: 10.3389/fbioe.2022.820196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/08/2022] [Indexed: 11/26/2022] Open
Abstract
Quantification of natural knee kinematics is essential for the assessment of joint function in the diagnosis of pathologies. Combined measurements of tibiofemoral and patellofemoral joint kinematics are necessary because knee pathologies, such as progression of osteoarthritis and patellar instability, are a frequent concern in both articulations. Combined measurement of tibiofemoral and patellofemoral kinematics also enables calculation of important quantities, specifically patellar tendon angle, which partly determines the loading vector at the tibiofemoral joint and patellar tendon moment arm. The goals of this research were to measure the differences in tibiofemoral and patellofemoral kinematics, patellar tendon angle (PTA), and patellar tendon moment arm (PTMA) that occur during non-weight-bearing and weight-bearing activities in older adults. METHODS High-speed stereo radiography was used to measure the kinematics of the tibiofemoral and patellofemoral joints in subjects as they performed seated, non-weight-bearing knee extension and two weight-bearing activities: lunge and chair rise. PTA and PTMA were extracted from the subject's patellofemoral and tibiofemoral kinematics. Kinematics and the root mean square difference (RMSD) between non-weight-bearing and weight-bearing activities were compared across subjects and activities. RESULTS Internal rotation increased with weight-bearing (mean RMSD from knee extension was 4.2 ± 2.4° for lunge and 3.6 ± 1.8° for chair rise), and anterior translation was also greater (mean RMSD from knee extension was 2.2 ± 1.2 mm for lunge and 2.3 ± 1.4 mm for chair rise). Patellar tilt and medial-lateral translation changed from non-weight-bearing to weight-bearing. Changes of the patellar tendon from non-weight-bearing to weight-bearing were significant only for PTMA. CONCLUSIONS While weight-bearing elicited changes in knee kinematics, in most degrees of freedoms, these differences were exceeded by intersubject differences. These results provide comparative kinematics for the evaluation of knee pathology and treatment in older adults.
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Affiliation(s)
- Vasiliki Kefala
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
| | - Azhar A. Ali
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
- Stryker Orthopedics, Kalamazoo, MI, United States
| | - Landon D. Hamilton
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
| | - Erin M. Mannen
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
- Department of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, United States
| | - Kevin B. Shelburne
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
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Effects of aging on whole-body center of mass movement and lower limb joint kinematics and kinetics during deep-squat movement. J Biomech 2022; 134:110996. [DOI: 10.1016/j.jbiomech.2022.110996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 11/20/2022]
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Uysal I, Cetisli-Korkmaz N, Cavlak U. Assessment of the musculoskeletal performance with squat tests and performance-oriented measurements in older adults. J Back Musculoskelet Rehabil 2021; 33:735-741. [PMID: 31815685 DOI: 10.3233/bmr-181283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Balance and mobility impairments, declined musculoskeletal strength and performance, limited range of motion, and poor flexibility are fairly common among older adults. OBJECTIVES To determine the lower extremity muscle force and to verify the correlation with the gait characteristics and balance in community dwelling older adults. METHODS Seventy-five adults with a mean age of 75.07 ± 6.28 years were included in the study. All participants were evaluated with the following tests: half squat (HS), decline squat (DS), foot print analysis (step length, step wide, stride length, walking velocity and cadence) and Tinetti Performance Oriented Mobility Assessment (POMA). RESULTS HS and DS test scores were significantly correlated with Tinetti Balance and Gait Assessment scores and gait characteristics, except step wide (p< 0.01). The results of this study showed that the participants who have higher scores in the squat tests, showed higher scores in terms of POMA (p< 0.01). CONCLUSION Appropriate and direct assessment of lower limb power and performance in balance and gait tests should be done to identify functioning of the older adults. Half and eccentric decline squat tests used in this study were useful, cheap and easy. The squat tests can be used to determine the relationship between balance and gait characteristics, in addition to predicting the musculoskeletal performance in older adults.
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Affiliation(s)
- Irfan Uysal
- Gulenyuzler Special Education and Rehabilitation Center, Aydin, Turkey
| | | | - Ugur Cavlak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Avrasya University, Trabzon, Turkey
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Mengarelli A, Cardarelli S, Tigrini A, Strazza A, Di Nardo F, Marchesini L, Fioretti S, Verdini F. Fractal Analysis of Motor Control in Knee Arthroplasty Patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3159-3162. [PMID: 31946558 DOI: 10.1109/embc.2019.8856478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Knee osteoarthritis is commonly treated through total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) and therefore the assessment of postoperative differences in functional capabilities between TKA and UKA patients appears of primary importance. Throughout the years, fractal analysis has been applied to several biological time-series, revealing to be particularly useful for assessing human balance and motor control by quantifying complexity and repeatability of dynamic measures. In this study, fractal dimension (FD) has been computed on ground reaction force and momentum acquired during squatting movement in two groups of TKA and UKA patients and a control group of healthy subjects (CTRL). FD resulted able to discriminate between TKA and both CTRL and UKA group, showing significant differences in all the considered measures. Outcomes of this study could help to gain further information about functional recovery after different knee arthroplasty procedures, in order to improve the choice of rehabilitative treatment.
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Galvin CR, Perriman DM, Lynch JT, Pickering MR, Newman P, Smith PN, Scarvell JM. Age has a minimal effect on knee kinematics: A cross-sectional 3D/2D image-registration study of kneeling. Knee 2019; 26:988-1002. [PMID: 31427245 DOI: 10.1016/j.knee.2019.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Kneeling is an activity of daily living which becomes difficult with knee pathology and increasing age. This study aimed to capture kneeling kinematics in six-degrees-of-freedom in healthy adults as a function of age. METHODS 67 healthy knee participants aged from 20 to 90 years were categorised into four 20-year age-groups. 3D knee kinematics were captured using 3D/2D image-registration of CT scan and fluoroscopy during kneeling. Kinematic variables of position, displacement and rate-of-change in six-degrees-of-freedom were compared between age-groups while controlling for University of California Los Angeles activity scale and the Assessment of Quality of Life physical score. RESULTS Over the entire kneeling cycle there were few differences between the age-groups. Results are reported as pairwise contrasts. At 110° flexion, 80+ knees were more varus than 20-39 and 40-69 (4.9° (95%CI: 0.6°, 9.1°) and 6.4° (2.1°, 10.7°), respectively). At 120° flexion, the 80+ age-group femur was 5.5 (0.0, 11.0) mm more anterior than 20-39. Between 120° to maximum flexion, 80+ knees rotated into valgus more than 20-39, 40-59 and 60-79 (5.5° (1.2°, 9.8°); 5.5° (1.1°, 9.8°); and 4.5° (0.9°, 7.5°), respectively). CONCLUSION This is the first study to report kneeling knee kinematics of ageing using 3D/2D image registration. We found that ageing does not change knee kinematics under 80 years, and there are minimal changes between 120° and maximum flexion between the younger and 80+ age-groups. Thus, difficulty kneeling should not be considered to be an inevitable consequence of ageing.
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Affiliation(s)
- Catherine R Galvin
- Research School of Electrical, Energy and Materials Engineering, Australian National University, Ian Ross Building 31, North Road, Acton, ACT, 2601; Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia.
| | - Diana M Perriman
- The Australian National University, Acton, ACT, 2601, Australia; Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia.
| | - Joseph T Lynch
- The Australian National University, Acton, ACT, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia.
| | - Mark R Pickering
- University of New South Wales Canberra at ADFA, PO Box 7916, Canberra BC, ACT 2610, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia.
| | - Phillip Newman
- Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia.
| | - Paul N Smith
- The Australian National University, Acton, ACT, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia.
| | - Jennie M Scarvell
- Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia.
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Effects of Water Immersion on Squat and Split Squat Kinematics in Older Adults. J Aging Phys Act 2019; 27:398-405. [DOI: 10.1123/japa.2018-0166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Scarvell JM, Hribar N, Galvin CR, Pickering MR, Perriman DM, Lynch JT, Smith PN. Analysis of Kneeling by Medical Imaging Shows the Femur Moves Back to the Posterior Rim of the Tibial Plateau, Prompting Review of the Concave-Convex Rule. Phys Ther 2019; 99:311-318. [PMID: 30690574 DOI: 10.1093/ptj/pzy144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 08/08/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Physical therapists assess joint movement by observation and palpation. New imaging technologies that enable vision of bones and joints during functional activities can be used to analyze joint kinematics and review traditional assumptions. PURPOSE The purpose was to measure relations between flexion, rotation, and translation at the knee and to validate these visually. DESIGN This was a prospective, observational study. METHODS Twenty-five healthy participants aged >45 years (13 males) knelt from upright kneeling to full flexion with the foot free. Fluoroscopy recorded movement at 30 frames per second of x-ray. A computed tomography scan provided 3-dimensional data, which were registered to the fluoroscopy frames to provide a moving model. Motion in 6 degrees of freedom was analyzed for coupling of movements. RESULTS Mean (standard deviation) flexion reached by participants was 142 (6)° in kneeling. Posterior femoral translation was coupled to flexion (r = 0.96). From 90° to 150° flexion, the femur translated posteriorly by 36 (3) mm to finish 23 (3) mm posterior to the center of the tibia at 150° flexion. From 90° to 150° flexion, the femur externally rotated from 8 (6)° to 16 (5)°. Flexion was coupled to rotation (r = 0.47). Abduction was <3° and lateral translation was <3 mm. Visually, the femur appeared to translate posteriorly until the femoral condyles rested on the posterior rim of the tibial plateau with concurrent external rotation so that the popliteal fossa aligned with the posterior margin of the medial tibial plateau. LIMITATIONS A limitation of the study is that knee flexion can include squat and lunge as well as kneeling. CONCLUSION Deep flexion requires femoral posterior translation and external rotation. These findings invite review of the concave-convex rule as it might apply to manual therapy of the knee.
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Affiliation(s)
- Jennie M Scarvell
- Faculty of Health, University of Canberra, BRUCE, ACT 2617, Australia
| | | | | | - Mark R Pickering
- School of Engineering and Information Technology, University of New South Wales Canberra, ACT, Australia
| | - Diana M Perriman
- Medical School, Australian National University, Canberra, ACT, Australia
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Galvin CR, Perriman DM, Newman PM, Lynch JT, Smith PN, Scarvell JM. Squatting, lunging and kneeling provided similar kinematic profiles in healthy knees-A systematic review and meta-analysis of the literature on deep knee flexion kinematics. Knee 2018; 25:514-530. [PMID: 29802075 DOI: 10.1016/j.knee.2018.04.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/20/2018] [Accepted: 04/29/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Understanding healthy deep flexion kinematics will inform the design of conservative clinical rehabilitation strategies for knee osteoarthritis and contribute to improved knee prosthesis design. This study is a systematic review and meta-analysis of the kinematic outcomes measured at the healthy tibiofemoral joint during loaded deep knee flexion. METHODS A computerised literature search and bibliography review without date restriction identified twelve studies with 164 participants aged 25-61 years in-vivo, and 69-93 years in-vitro. Flexion higher than 120° was achieved by squatting, lunging or kneeling. Measurement technologies in-vivo included radiographs, open MRI and 2D-3D MRI or CT image registration on fluoroscopy. Microscribe was used in-vitro. RESULTS Outcomes were either six degrees-of-freedom based on femur movement or contact patterns on the tibial plateau. The meta-analysis demonstrated that in-vivo, between 120° and 135° of flexion, the tibia internally rotated (mean difference (MD) = 4.6°, 95% CI 3.55° to 5.64°). Both the medial-femoral-condyle and lateral-femoral-condyle translated posteriorly, (MD = 10.4 mm, 95% CI 6.9 to 13.9 mm) and (MD = 5.55 mm, 95% CI 4.64 to 6.46 mm) respectively. There was some evidence of femoral medial translation (3.8 mm) and adduction (1.9° to 3.3°), together with medial compression (1.7 mm) and lateral distraction (1.9) mm. CONCLUSIONS Across the in-vivo studies, consistent kinematic patterns emerged; despite the various measurement technologies and reference methods. In contrast, in-vivo and in-vitro results were contradictory. TRIAL REGISTRATION This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 25 February 2017 (registration number: 42017057614).
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Affiliation(s)
- Catherine R Galvin
- Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Garran, ACT, 2605, Australia.
| | - Diana M Perriman
- Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; The Australian National University, Acton, ACT 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Garran, ACT, 2605, Australia.
| | - Phillip M Newman
- Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; University of Canberra Research Institute for Sport and Exercise (UCRISE).
| | - Joseph T Lynch
- The Australian National University, Acton, ACT 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Garran, ACT, 2605, Australia.
| | - Paul N Smith
- The Australian National University, Acton, ACT 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Garran, ACT, 2605, Australia.
| | - Jennie M Scarvell
- Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Garran, ACT, 2605, Australia.
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Clément J, de Guise JA, Fuentes A, Hagemeister N. Comparison of soft tissue artifact and its effects on knee kinematics between non-obese and obese subjects performing a squatting activity recorded using an exoskeleton. Gait Posture 2018; 61:197-203. [PMID: 29353745 DOI: 10.1016/j.gaitpost.2018.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 01/09/2018] [Accepted: 01/11/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rigid attachment systems are one of the methods used to compensate for soft tissue artifact (STA) inherent in joint motion analyses. RESEARCH QUESTION The goal of this study was to quantify STA of an exoskeleton design to reduce STA at the knee, and to assess the accuracy of 3D knee kinematics recorded with the exoskeleton in non-obese and obese subjects during quasi-static weight-bearing squatting activity using biplane radiography. METHODS Nine non-obese and eight obese subjects were recruited. The exoskeleton was calibrated on each subject before they performed a quasistatic squatting activity in the EOS® imaging system. 3D models of exoskeleton markers and knee bones were reconstructed from EOS® radiographs; they served to quantify STA and to evaluate differences between the markers and bones knee kinematics during the squatting activity. RESULTS The results showed that STA observed at the femur was larger in non-obese subjects than in obese subjects in frontal rotation (p = 0.004), axial rotation (p = 0.000), medio-lateral displacement (p = 0.000) and antero-posterior displacement (p = 0.019), while STA observed at the tibia was lower in non-obese subjects than in obese subjects for the three rotations (p < 0.05) and medio-lateral displacement (p = 0.015). Differences between the markers and bones knee kinematics increased with knee flexion and were similar in both groups, except for abduction-adduction: 4.9° for non-obese subjects against 2.3° for obese subjects (p = 0.011). SIGNIFICANCE This study demonstrated that STA at the femur and its impact on knee abduction-adduction using a specific exoskeleton were greater among non-obese subjects than obese subjects, which is encouraging for future biomechanical studies on pathologies such as osteoarthritis.
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Affiliation(s)
- Julien Clément
- Laboratoire de recherche en imagerie et orthopédie, École de technologie supérieur, CRCHUM, 900 Rue Saint-Denis, Montréal, Que H2X 0A9, Canada.
| | - Jaques A de Guise
- Laboratoire de recherche en imagerie et orthopédie, École de technologie supérieur, CRCHUM, 900 Rue Saint-Denis, Montréal, Que H2X 0A9, Canada; École de Technologie Supérieure, Département du génie de la production automatisée, 1100 rue Notre-Dame Ouest, Montréal, Que H2L 2W5, Canada.
| | - Alexandre Fuentes
- Centre du genou EMOVI, 3095 Laval Autoroute West, Laval, Que H7P 4W5, Canada.
| | - Nicola Hagemeister
- Laboratoire de recherche en imagerie et orthopédie, École de technologie supérieur, CRCHUM, 900 Rue Saint-Denis, Montréal, Que H2X 0A9, Canada; École de Technologie Supérieure, Département du génie de la production automatisée, 1100 rue Notre-Dame Ouest, Montréal, Que H2L 2W5, Canada.
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Mengarelli A, Verdini F, Cardarelli S, Di Nardo F, Burattini L, Fioretti S. Balance assessment during squatting exercise: A comparison between laboratory grade force plate and a commercial, low-cost device. J Biomech 2018; 71:264-270. [PMID: 29449001 DOI: 10.1016/j.jbiomech.2018.01.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/10/2018] [Accepted: 01/24/2018] [Indexed: 11/26/2022]
Abstract
Testing balance through squatting exercise is a central part of many rehabilitation programs and sports and plays also an important role in clinical evaluation of residual motor ability. The assessment of center of pressure (CoP) displacement and its parametrization is commonly used to describe and analyze squat movement and the laboratory-grade force plates (FP) are the gold standard for measuring balance performances from a dynamic view-point. However, the Nintendo Wii Balance Board (NWBB) has been recently proposed as an inexpensive and easily available device for measuring ground reaction force and CoP displacement in standing balance tasks. Thus, this study aimed to compare the NWBB-CoP data with those obtained from a laboratory FP during a dynamic motor task, such as the squat task. CoP data of forty-eight subjects were acquired simultaneously from a NWBB and a FP and the analyses were performed over the descending squatting phase. Outcomes showed a very high correlation (r) and limited root-mean-square differences between CoP trajectories in anterior-posterior (r > 0.99, 1.63 ± 1.27 mm) and medial-lateral (r > 0.98, 1.01 ± 0.75 mm) direction. Spatial parameters computed from CoP displacement and ground reaction force peak presented fixed biases between NWBB and FP. Errors showed a high consistency (standard deviation < 2.4% of the FP outcomes) and a random spread distribution around the mean difference. Mean velocity is the only parameter which exhibited a tendency towards proportional values. Findings of this study suggested the NWBB as a valid device for the assessment and parametrization of CoP displacement during squatting movement.
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Affiliation(s)
- Alessandro Mengarelli
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy.
| | - Stefano Cardarelli
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Francesco Di Nardo
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Laura Burattini
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Sandro Fioretti
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
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Verdini F, Zara C, Leo T, Mengarelli A, Cardarelli S, Innocenti B. Assessment of patient functional performance in different knee arthroplasty designs during unconstrained squat. Muscles Ligaments Tendons J 2018; 7:514-523. [PMID: 29387646 DOI: 10.11138/mltj/2017.7.3.514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background In this paper, squat named by Authors unconstrained because performed without constrains related to feet position, speed, knee maximum angle to be reached, was tested as motor task revealing differences in functional performance after knee arthroplasty. It involves large joints ranges of motion, does not compromise joint safety and requires accurate control strategies to maintain balance. Methods Motion capture techniques were used to study squat on a healthy control group (CTR) and on three groups, each characterised by a specific knee arthroplasty design: a Total Knee Arthroplasty (TKA), a Mobile Bearing and a Fixed Bearing Unicompartmental Knee Arthroplasty (respectively MBUA and FBUA). Squat was analysed during descent, maintenance and ascent phase and described by speed, angular kinematics of lower and upper body, the Center of Pressure (CoP) trajectory and muscle activation timing of quadriceps and biceps femoris. Results Compared to CTR, for TKA and MBUA knee maximum flexion was lower, vertical speed during descent and ascent reduced and the duration of whole movement was longer. CoP mean distance was higher for all arthroplasty groups during descent as higher was, CoP mean velocity for MBUA and TKA during ascent and descent. Conclusions Unconstrained squat is able to reveal differences in the functional performance among control and arthroplasty groups and between different arthroplasty designs. Considering the similarity index calculated for the variables showing statistically significance, FBUA performance appears to be closest to that of the CTR group. Level of evidence III a.
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Affiliation(s)
- Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Claudio Zara
- Casa di Cura Stella Maris, San Benedetto del Tronto, Italy
| | - Tommaso Leo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Alessandro Mengarelli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Stefano Cardarelli
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Bernardo Innocenti
- BEAMS Department, École polytechnique de Bruxelles, ULB - Université Libre de Bruxelles, Bruxelles, Belgium
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Kefala V, Cyr AJ, Harris MD, Hume DR, Davidson BS, Kim RH, Shelburne KB. Assessment of Knee Kinematics in Older Adults Using High-Speed Stereo Radiography. Med Sci Sports Exerc 2018; 49:2260-2267. [PMID: 28614195 DOI: 10.1249/mss.0000000000001350] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Quantification of knee motion is essential for assessment of pathologic joint function, such as tracking osteoarthritis progression and evaluating outcomes after conservative or surgical treatment, including total knee arthroplasty. Our purpose was to establish a useful baseline for the kinematic envelope of knee motion in healthy older adults performing movements of daily living. METHODS A high-speed stereo radiography system was used to measure the three-dimensional tibiofemoral kinematics of eight healthy people over 55 yr of age (4 women/4 men; age, 61.7 ± 5.4 yr; body mass, 74.6 ± 7.7 kg; body mass index, 26.7 ± 4.4 kg·m; height, 168.2 ± 13.7 cm) during seated knee extension, level walking, pivoting, and step descent. RESULTS Internal-external and varus-valgus rotation and anterior-posterior range of motion through stance in normal walking averaged 3.6° ± 1.1°, 2.3° ± 0.6°, and 3.4 ± 1.57 mm, respectively. Average range of motion across subjects was greater during the step-down in both internal-external rotation (average, 6.5° ± 3.1°) and anterior-posterior translation (average, 4.5 ± 1.1). Average internal-external range of motion increased to 13.5° ± 3.6° during pivoting. Range of motion of the knee in varus-valgus rotation was nearly the same for each subject across activities, rarely exceeding 6°. CONCLUSIONS Pivoting and step descending during walking had greater internal-external rotation and anterior-posterior translation than normal gait. Internal-external rotation and anterior-posterior translation were shown to have greater activity dependence, whereas varus-valgus rotation was consistent across activities. These results were similar to prior measurements in younger cohorts, though a trend toward reduced range of motion in the older adults was observed.
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Affiliation(s)
- Vasiliki Kefala
- 1Center for Orthopaedic Biomechanics, The University of Denver, CO; and 2Colorado Joint Replacement, Denver, CO
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Severin AC, Burkett BJ, McKean MR, Wiegand AN, Sayers MGL. Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study. BMC Sports Sci Med Rehabil 2017; 9:20. [PMID: 29238596 PMCID: PMC5725812 DOI: 10.1186/s13102-017-0085-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022]
Abstract
Background The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. Methods Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. Results Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p = 0.032, single-leg squat: +9 cm, p = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. Conclusions Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected and unaffected limb in both environments.
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Affiliation(s)
- Anna C Severin
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs Drive 90, Sippy Downs, QLD 4556 Australia
| | - Brendan J Burkett
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs Drive 90, Sippy Downs, QLD 4556 Australia
| | - Mark R McKean
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs Drive 90, Sippy Downs, QLD 4556 Australia
| | - Aaron N Wiegand
- School of Science and Engineering, University of the Sunshine Coast, Sippy Downs Drive 90, Sippy Downs, QLD 4556 Australia
| | - Mark G L Sayers
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs Drive 90, Sippy Downs, QLD 4556 Australia
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Severin AC, Burkett BJ, McKean MR, Wiegand AN, Sayers MGL. Quantifying kinematic differences between land and water during squats, split squats, and single-leg squats in a healthy population. PLoS One 2017; 12:e0182320. [PMID: 28767683 PMCID: PMC5540590 DOI: 10.1371/journal.pone.0182320] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/16/2017] [Indexed: 11/18/2022] Open
Abstract
Aquatic exercises can be used in clinical and sporting disciplines for both rehabilitation and sports training. However, there is limited knowledge on the influence of water immersion on the kinematics of exercises commonly used in rehabilitation and fitness programs. The aim of this study was to use inertial sensors to quantify differences in kinematics and movement variability of bodyweight squats, split squats, and single-leg squats performed on dry land and whilst immersed to the level of the greater trochanter. During two separate testing sessions, 25 active healthy university students (22.3±2.9 yr.) performed ten repetitions of each exercise, whilst tri-axial inertial sensors (100 Hz) recorded their trunk and lower body kinematics. Repeated-measures statistics tested for differences in segment orientation and speed, movement variability, and waveform patterns between environments, while coefficient of variance was used to assess differences in movement variability. Between-environment differences in segment orientation and speed were portrayed by plotting the mean difference ±95% confidence intervals (CI) throughout the tasks. The results showed that the depth of the squat and split squat were unaffected by the changed environment while water immersion allowed for a deeper single leg squat. The different environments had significant effects on the sagittal plane orientations and speeds for all segments. Water immersion increased the degree of movement variability of the segments in all exercises, except for the shank in the frontal plane, which showed more variability on land. Without compromising movement depth, the aquatic environment induces more upright trunk and shank postures during squats and split squats. The aquatic environment allows for increased squat depth during the single-leg squat, and increased shank motions in the frontal plane. Our observations therefore support the use of water-based squat tasks for rehabilitation as they appear to improve the technique without compromising movement depth.
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Affiliation(s)
- Anna C. Severin
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- * E-mail:
| | - Brendan J. Burkett
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Mark R. McKean
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Aaron N. Wiegand
- School of Science and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Mark G. L. Sayers
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Clément J, Dumas R, Hagemeister N, de Guise JA. Can generic knee joint models improve the measurement of osteoarthritic knee kinematics during squatting activity? Comput Methods Biomech Biomed Engin 2016; 20:94-103. [DOI: 10.1080/10255842.2016.1202935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julien Clément
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
| | - Raphaël Dumas
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Laboratoire de Biomécanique et Mécanique des Chocs, IFSTTAR, UMR_T9406, Bron, France
| | - Nicola Hagemeister
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
| | - Jaques A. de Guise
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
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Clément J, Cresson T, Hagemeister N, Dumas R, de Guise JA. Estimating joint space of the knee during weight-bearing squatting activity using motion capture – preliminary results of a new method. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:1910-1. [DOI: 10.1080/10255842.2015.1069564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- J. Clément
- LIO, CRCHUM, École de technologie supérieure, Montréal, Canada
| | - T. Cresson
- LIO, CRCHUM, École de technologie supérieure, Montréal, Canada
| | - N. Hagemeister
- LIO, CRCHUM, École de technologie supérieure, Montréal, Canada
| | - R. Dumas
- IFSTTAR, LBMC, UMR_T9406, Université Lyon 1, Lyon, France
| | - J. A. de Guise
- LIO, CRCHUM, École de technologie supérieure, Montréal, Canada
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Bonnet V, Mazzà C, Fraisse P, Cappozzo A. A least-squares identification algorithm for estimating squat exercise mechanics using a single inertial measurement unit. J Biomech 2012; 45:1472-7. [DOI: 10.1016/j.jbiomech.2012.02.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 01/31/2012] [Accepted: 02/08/2012] [Indexed: 11/26/2022]
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