Kinematics of lower limbs of healthy Chinese people sitting cross-legged

Database covering the prayer movements which were not available previously

Lower body implants are designed according to the boundary conditions of gait data and tested against. However, due to diversity in cultural backgrounds, religious rituals might cause different ranges of motion and different loading patterns. Especially in the Eastern part of the world, diverse Activities of Daily Living (ADL) consist of salat, yoga rituals, and different style sitting postures. A database covering these diverse activities of the Eastern world is non-existent. This study focuses on data collection protocol and the creation of an online database of previously excluded ADL activities, targeting 200 healthy subjects via Qualisys and IMU motion capture systems, and force plates, from West and Middle East Asian populations with a special focus on the lower body joints. The current version of the database covers 50 volunteers for 13 different activities. The tasks are defined and listed in a table to create a database to search based on age, gender, BMI, type of activity, and motion capture system. The collected data is to be used for designing implants to allow these sorts of activities to be performed.

Three-dimensional motion analysis of ten common Asian sitting positions in daily living and factors affect range of hip motions

BACKGROUND

Sitting involves many activities of daily life and requires most motion in the hip joint. Asians have more hip flexion and external rotation motions than Westerners owing to cultural and lifestyle differences. Being aware of the normal range of hip motion is essential in clinical practice. Limited research has focused on the hip motions of common sitting positions. The objective was to determine the hip motions of 10 common sitting positions, and to determine whether gender or being overweight affects the range of hip motions.

METHODS

An experimental cross-sectional study was conducted to determine hip motions by using a standard, three-dimensional, motion-analysis system. Healthy subjects performed 10 sitting positions during 3 trials. All hip-kinematic data were measured on the dominant leg of each participant, except for the right- and left-monk positions (both hips were analyzed). Density plots were constructed and statistical analyses were performed to detect the differences between groups (male and female; non-overweight and overweight).

RESULTS

The 48 participants comprised 24 males and 24 females. Most were right-leg dominant (45 participants, 93.8%). Of the 22 participants in the overweight group (body mass index ≥23 kg/m²), 18 (75%) were male. Squatting showed the highest flexion angle (99.7°, 47.3°-122°). Cross-legged sitting had the highest abduction angle (28.9°, 9.9°-45.7°) and the largest external rotation angle (62°, 37.6°-81.7°). In the female group, there were trends toward a greater flexion angle (4 out of 10 sitting positions) and a smaller abduction angle (6 out of 9 positions), with P values < 0.05. As to body weight, the overweight participants had a smaller flexion angle but a greater abduction angle, with 5 out of 9 positions having a P value < 0.05. Kinematic data of the transverse plane revealed that the heterogeneity of the rotational angles depended on the sitting position.

CONCLUSIONS

This study provided the functional hip motions of common Asian sitting positions. The kinematic data can be utilized in clinical practice as reference values to determine safe positions. Gender and being overweight affected the hip angles in the sagittal and frontal planes.

TRIAL REGISTRATION

Number TCTR20181021004 , retrospectively registered at the Thai Clinical Trials Registry (http//:www.clinicaltrials.in.th).

Gender-based age differences in hip and knee kinematics of Chinese adults during walking and running

BACKGROUND

Many studies have presented lower limb kinematics in Western countries, but few have concentrated on gender and age differences for Chinese populations.

OBJECTIVES

The purpose of this study was to investigate three-dimensional hip and knee kinematics especially for elderly Chinese during walking and running, as well as to analyze age differences.

MATERIALS AND METHODS

Sixty healthy volunteers, including 40 young and 20 elderly adults, were divided into two groups by gender and instructed to perform walking and running in a comfortable manner. The hip and knee kinematics were obtained with 3D Motion Capture System. Normalization was used to avoid the body size effect. Age differences were tested with independent t-test (p< 0.05).

RESULTS

In non-sagittal planes, the hip and knee ranges of motion of young males are larger during running, but smaller during walking than those of elderly males. Young females reveal smaller non-sagittal planes hip and knee ranges of motion than elderly females, regardless of whether they are walking or running. There are also significant age differences in the peak hip and knee angles especially in frontal plane during running. Young adults reveal greatly higher peak hip and knee adduction angles than elderly adults.

CONCLUSIONS

Walking speed and the hip and knee ROM for Chinese are different from Westerners. These kinematic differences can be used for reference to design better joint prostheses to meet various Chinese people's needs.

Prediction of Pelvic Inclination in the Sitting Position after Corrective Surgery for Adult Spinal Deformity

Introduction

Hip dislocation rates in patients with combined total hip arthroplasty (THA) and spinal deformity fixation are significantly higher than those of THA alone. Nevertheless, there are no treatment recommendations for patients who undergo THA and require a spine deformity correction later.

Methods

Twenty-eight patients underwent spinal fixation surgery for adult spinal deformity. Sagittal spinopelvic alignment was analyzed on lateral radiographs taken preoperatively and postoperatively in the sitting and standing positions. Univariate linear regression analysis was conducted to identify the factors affecting the pelvic inclination in the sitting position after spinal fixation. Multiple regression analysis was conducted to determine the most efficient combination of radiographic parameters for predicting postoperative pelvic inclination while sitting.

Results

There were significantly weak associations between postoperative sacral slope (SS) in the sitting position and the following factors: the number of vertebral levels fused (β = 0.30, p = 0.003); the presence of sacral fixation (β = 0.22, p = 0.01); the presence of sacroiliac joint fixation (β = 0.24, p = 0.008); and preoperative SS while standing and sitting (β = 0.21, p = 0.01 and β = 0.34, p = 0.001). Postoperative lumbar lordosis (LL) while standing was strongly associated with postoperative SS in the sitting position (β = 0.67, p <.0001). The combination of postoperative LL in the standing position and preoperative SS in the sitting position was the best fit, and the adjusted R-squared was 0.82.

Conclusions

We devised a prediction formula for pelvic inclination while sitting after spinal fixation that has high predictability: postoperative SS while sitting = 11.7+ (0.4 × postoperative planned LL while standing) + (0.16 × preoperative SS while sitting). This study could be the basis for treatment recommendations for patients who have undergone THA and require a spine deformity correction later.

Psychometric Assessment of Modified Harris Hip Score for Femoral Neck Fracture in Indian Population

BACKGROUND

Objective of the study was to evaluate and compare psychometric properties such as validity, reliability, floor ceiling effects and interpretability of the modified Harris Hip Score (mHHS) and the Forgotten Joint Score (FJS) in patients undergoing bipolar hemiarthroplasty for femoral neck fracture in Indian patients, because this has not been done before.

METHODS

This observational study consisted of 40 consecutively operated patients. Construct validity and reliability were evaluated using correlation coefficient and Intraclass correlation coefficient (ICC), respectively. Interpretability was evaluated by describing mean and standard deviation of mHHS and FJS in five subgroups of patients based on their response to the global rating questions and assessment.

RESULTS

The mean follow-up duration was 15.7 months ± 10.4. There was very high correlation between mHHS and FJS (r = 0.92, p < 0.0001) suggesting convergent construct validity. The results of correlation coefficient were 100% and 66.7% in accordance with the pre-formulated hypotheses for mHHS and FJS, respectively. mHHS and FJS demonstrated adequate construct validity and inadequate construct validity, respectively. The ICC value for mHHS and FJS was 0.80 (p = 0.005) {adequate reliability} and 0.34 (p = 0.06) {inadequate reliability}, respectively. Both mHHS and FJS-12 demonstrated acceptable level of floor (0% for mHHS and 14.3% for FJS) and ceiling effects (12.5% for both mHHS and FJS). There was significant difference in the mHHS and FJS in the five subgroups of patients suggesting adequate interpretability.

CONCLUSION

We recommend the use of the modified Harris Hip Score over the Forgotten Joint Score for functional outcome evaluation of Indian patients from rural setting undergoing bipolar hemiarthroplasty for femoral neck fracture.

The envelope of active hip motion in different sporting, recreational, and daily-living activities: A systematic review

BACKGROUND

In treating patients with limitations of hip motion, it is generally assumed that correction of bony morphology will provide the patient with the joint motion required to resume their activities. However, the positions of impingement and the specific excursions of joint motion required by each sport may vary. This systematic review aimed to define the envelope of active hip joint motion for participation in different sporting, recreational, and daily-living activities.

METHODS

The EMBASE, PubMed, Google Scholar, and Cochrane databases were searched to identify studies that reported kinematics of the hip in sporting, recreational, and daily-living activities. Inclusion criteria were (1) peer-reviewed articles reporting hip kinematics in a certain type of activity, and (2) presented in English. To synthesize the kinematic data, the peak values of kinematic components (i.e. flexion/extension, abduction/adduction, and internal/external rotation) during an activity, as well as the concurrent values in a certain phase of the activity were collected from each study.

RESULTS

A total of 67 studies met the inclusion criteria, involving 32 different types of activities. Seventeen activities required at least one component of supra-physiologic hip motion, however, there were eight different combinations of flexion/extension, abduction/adduction, and internal/external rotation observed. Specifically, three activities (sex, sitting cross-legged, and grand ecart lateral of ballet dancing) required simultaneous extreme degrees of all three components, five activities (arabesque, developpe devant right, and developpe a la seconde right of ballet dancing, picking up something, and taekwondo) required high degrees of two components, most commonly hip abduction combined with flexion or internal rotation.

SIGNIFICANCE

This review highlighted that many activities place supraphysiologic demands on hip joint motion, however, the kinematic components affected differ dramatically with the specific activity. This suggests that the demands of each patient's individual activities must be assessed before recommending or planning treatment rather than assuming that a fixed value of "normal" hip motion is applicable to all.

Cementless Total Hip Replacement for the Management of Severe Developmental Dysplasia of the Hip in the Middle Eastern Population: A Prospective Analysis

Introduction

In the Middle East, severe developmental dysplasia of the hip with subsequent high dislocation is often seen. We assessed the efficiency of total hip replacement (THR) with subtrochanteric shortening femoral osteotomy and trochanteric advancement in this population.

Methods

This prospective study assessed 25 female patients with symptomatic and severe (Crowe IV). Pre- and postoperative Harris hip score (HHS) and Oxford hip score (OHS) were performed alongside assessment of leg length discrepancy (LLD) and the ability to sit in a cross-legged position.

Results

The mean HHS and OHS improved pre-operatively at 1 and 10 years, respectively (p-value < 0.001). The mean postoperative LLD was 3 mm (0–8 mm). Functionally, 22/25 patients were able to sit cross-legged. None of the 25 hips underwent revision during this period.

Conclusion

Total hip replacement with subtrochanteric shortening osteotomy in combination with trochanteric advancement is sufficient for the management of Crowe type IV hips in this population.