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Sagawa Y, Guilhendou C, Moulin T, Soares AV, Decavel P. Neuro-orthopaedic check-up and walking in people with multiple sclerosis: toward a more specific assessment to improve rehabilitation results. J Exerc Rehabil 2024; 20:65-75. [PMID: 38737468 PMCID: PMC11079549 DOI: 10.12965/jer.2448128.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/18/2024] [Accepted: 03/24/2024] [Indexed: 05/14/2024] Open
Abstract
The rehabilitation process of people with multiple sclerosis (PwMS) is a challenge, and decision-making requires a thorough assessment to increase the chances of success in rehabilitation planning. The aim of this study was to investigate the importance of the neuroorthopaedic check-Up (NOChU) for gait prognosis. Participated in the study 105 PwMS with different levels of impairment. The NOChU includes measurements of passive range of motion (ROM), muscle strength, and spasticity. Additionally, was carried out the spatial-temporal analysis of the walking, Timed Up and Go test, and 6-min walk test. ROM remained relatively preserved to perform daily life activities except for ankle dorsiflexion. Muscle strength was also relatively preserved. Spasticity affected especially the ankle muscles, clearly the sural triceps. Among the NOChU measurements the catch seemed to have the most impact on walking on its different phases and on other activities. Accurate NOChU measurements play a crucial role in clinical settings, guiding informed decisions in rehabilitation planning. Future research endeavours could focus on exploring the correlations between NOChU deficiencies and the decline in walking capabilities among PwMS, with the goal of proposing personalized treatment strategies that address their specific requirements.
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Affiliation(s)
- Yoshimasa Sagawa
- Integrative and Clinical Neurosciences, UMR 1322 INSERM, University of Franche-Comté, Besançon,
France
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon,
France
| | - Coline Guilhendou
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon,
France
| | - Thierry Moulin
- Integrative and Clinical Neurosciences, UMR 1322 INSERM, University of Franche-Comté, Besançon,
France
| | - Antonio Vinicius Soares
- Integrative and Clinical Neurosciences, UMR 1322 INSERM, University of Franche-Comté, Besançon,
France
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon,
France
- University of Joinville Region, Joinville,
Brazil
| | - Pierre Decavel
- Integrative and Clinical Neurosciences, UMR 1322 INSERM, University of Franche-Comté, Besançon,
France
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Cho SY, Myong Y, Park S, Cho M, Kim S. A portable articulated dynamometer for ankle dorsiflexion and plantar flexion strength measurement: a design, validation, and user experience study. Sci Rep 2023; 13:22221. [PMID: 38097727 PMCID: PMC10721896 DOI: 10.1038/s41598-023-49263-2] [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: 08/15/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
Monitoring ankle strength is crucial for assessing daily activities, functional ability, and preventing lower extremity injuries. However, the current methods for measuring ankle strength are often unreliable or not easily portable to be used in clinical settings. Therefore, this study proposes a portable dynamometer with high reliability capable of measuring ankle dorsiflexion and plantar flexion. The proposed portable dynamometer comprised plates made of aluminum alloy 6061 and a miniature tension-compression load cell. A total of 41 healthy adult participants applied maximal isometric dorsiflexor and plantar flexor forces on a Lafayette Handheld Dynamometer (HHD) and the portable dynamometer. The results were cross-validated, using change in mean, and two independent examiners evaluated the inter-rater and test-retest reliabilities in separate sessions using intraclass correlation coefficients, standard error of measurement, and minimal detectable change. Both dorsiflexion and plantar flexion measurements demonstrated a strong correlation with the HHD (r = 0.827; r = 0.973) and showed high inter-rater and test-retest reliabilities. Additionally, the participant responses to the user experience questionnaire survey indicated vastly superior positive experiences with the portable dynamometer. The study findings suggest that the designed portable dynamometer can provide accurate and reliable measurements of ankle strengths, making it a potential alternative to current methods in clinical settings.
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Affiliation(s)
- Seung Yeon Cho
- Interdisciplinary Program in Bioengineering, The Graduate School, Seoul National University, Seoul, South Korea
| | - Youho Myong
- Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Sungwoo Park
- Interdisciplinary Program in Bioengineering, The Graduate School, Seoul National University, Seoul, South Korea
- Institute of Innovative Medical Technology, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea
| | - Minwoo Cho
- Department of Transdisciplinary Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea.
| | - Sungwan Kim
- Interdisciplinary Program in Bioengineering, The Graduate School, Seoul National University, Seoul, South Korea.
- Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
- Institute of Bioengineering, Seoul National University, Seoul, South Korea.
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Myong Y, Park S, Cho M, Cho SY, Lee WH, Oh BM, Kim S. Development and validation of a portable articulated dynamometry system to assess knee extensor muscle strength. Sci Rep 2023; 13:11887. [PMID: 37482569 PMCID: PMC10363537 DOI: 10.1038/s41598-023-39062-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 07/19/2023] [Indexed: 07/25/2023] Open
Abstract
Muscle strength assessment is important in predicting clinical and functional outcomes in many disorders. Manual muscle testing, although commonly used, offers suboptimal accuracy and reliability. Isokinetic dynamometers (IKDs) have excellent accuracy and reliability; but are bulky and expensive, offering limited accessibility. This study aimed to design a portable dynamometer that is accessible, accurate and reliable, and to validate the device in a general population. The portable articulated dynamometry system (PADS) is a portable device with an embedded high-precision load cell, designed to measure muscle strength with optimal accuracy. Seventy-two participants underwent maximal isometric and isokinetic knee extensor torque measurement with the PADS and IKD, respectively. The PADS results were cross-validated against IKD results using change in mean (CIM). Interrater and intra-rater reliabilities were assessed using intraclass correlation coefficients, standard error of measurement, and minimal detectable change. The PADS maximal knee extensor strength results were not significantly different from those by IKD (CIM: - 2.13 Nm; 95% CI - 4.74, 0.49 Nm). The PADS showed interrater reliability (Pearson's r: 0.958; ICC: 0.979; SEM: 5.51%) and excellent intra-rater reliability (Pearson's r: 0.912; ICC: 0.954; SEM: 8.38%). The proposed PADS may be an effective alternative to IKD, offering good accuracy, reliability, and potentially better accessibility.
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Affiliation(s)
- Youho Myong
- Department of Biomedical Engineering, Seoul National University College of Medicine, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea
| | - Sungwoo Park
- Graduate School, Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Innovative Medical Technology, Seoul National University Hospital Biomedical Research Institute, Jongno gu, Seoul, 03122, Republic of Korea
| | - Minwoo Cho
- Department of Transdisciplinary Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea
- Department of Medicine, College of Medicine, Seoul National University, Seoul, 03080, Republic of Korea
| | - Seung Yeon Cho
- Graduate School, Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, 08826, Republic of Korea
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea.
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Gyeonggi, 12564, Republic of Korea.
| | - Sungwan Kim
- Department of Biomedical Engineering, Seoul National University College of Medicine, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea.
- Graduate School, Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, 08826, Republic of Korea.
- Institute of Bioengineering, Seoul National University, 101 Daehak-ro, Jongno gu, Seoul, 03080, Republic of Korea.
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Bravi M, Fossati C, Giombini A, Mannacio E, Borzuola R, Papalia R, Pigozzi F, Macaluso A. Do the Testing Posture and the Grip Modality Influence the Shoulder Maximal Voluntary Isometric Contraction? J Funct Morphol Kinesiol 2023; 8:jfmk8020045. [PMID: 37092377 PMCID: PMC10123673 DOI: 10.3390/jfmk8020045] [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: 02/14/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023] Open
Abstract
Assessing and monitoring shoulder strength is extremely important during rehabilitation. A fixed dynamometer represents a valid and inexpensive assessment method. However, it has not been studied whether posture and grip modality influence shoulder muscle strength. The aim of this study was to compare shoulder strength values between sitting and standing positions and between the handle and cuff grip modalities. A total of 40 volunteers were divided into a posture (PG) and a handle-cuff group (HCG). Participants in the PG were asked to perform a maximum voluntary isometric contraction (MVIC) for shoulder flexion, extension, ab-adduction, and intra-extra rotation in standing and sitting positions. The HCG participants were tested in a standing position while holding a handle or with a cuff around their wrist. PG showed higher forces in the standing position for shoulder flexion (p = 0.009); internal rotation showed higher values in the sitting position (p = 0.003). ER/IR ratio was significantly higher in the standing position (p < 0.001). HCG showed higher significant forces during cuff modality in all positions and grip modalities, including the ER/IR ratio (p < 0.05). Different body positions and grip modalities influenced the assessment of shoulder strength as recorded by a fixed dynamometer; therefore, these factors should be carefully considered when carrying out a shoulder strength assessment, and we encourage the development of assessment guidelines to make future clinical trial results comparable.
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Affiliation(s)
- Marco Bravi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
- Department of Physical and Rehabilitation Medicine, Università Campus Bio-Medico, 00128 Rome, Italy
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Arrigo Giombini
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Elena Mannacio
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Riccardo Borzuola
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico, 00128 Rome, Italy
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", 00135 Rome, Italy
- Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, 00135 Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy
- Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, 00135 Rome, Italy
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MontJohnson A, Cronce A, Qiu Q, Patel J, Eriksson M, Merians A, Adamovich S, Fluet G. Laboratory-Based Examination of the Reliability and Validity of Kinematic Measures of Wrist and Finger Function Collected by a Telerehabilitation System in Persons with Chronic Stroke. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23052656. [PMID: 36904860 PMCID: PMC10007090 DOI: 10.3390/s23052656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/09/2023]
Abstract
We have developed the New Jersey Institute of Technology-Home Virtual Rehabilitation System (NJIT-HoVRS) to facilitate intensive, hand-focused rehabilitation in the home. We developed testing simulations with the goal of providing richer information for clinicians performing remote assessments. This paper presents the results of reliability testing examining differences between in-person and remote testing as well as discriminatory and convergent validity testing of a battery of six kinematic measures collected with NJIT-HoVRS. Two different groups of persons with upper extremity impairments due to chronic stroke participated in two separate experiments. Data Collection: All data collection sessions included six kinematic tests collected with the Leap Motion Controller. Measurements collected include hand opening range, wrist extension range, pronation-supination range, hand opening accuracy, wrist extension accuracy, and pronation-supination accuracy. The system usability was evaluated by therapists performing the reliability study using the System Usability Scale. When comparing the in-laboratory collection and the first remote collection, the intra-class correlation coefficients (ICC) for three of the six measurements were above 0.900 and the other three were between 0.500 and 0.900. Two of the first remote collection/second remote collection ICCs were above 0.900, and the other four were between 0.600 and 0.900. The 95% confidence intervals for these ICC were broad, suggesting that these preliminary analyses need to be confirmed by studies with larger samples. The therapist's SUS scores ranged from 70 to 90. The mean was 83.1 (SD = 6.4), which is consistent with industry adoption. There were statistically significant differences in the kinematic scores when comparing unimpaired and impaired UE for all six measures. Five of six impaired hand kinematic scores and five of six impaired/unimpaired hand difference scores demonstrated correlations between 0.400 and 0.700 with UEFMA scores. Reliability for all measures was acceptable for clinical practice. Discriminant and convergent validity testing suggest that scores on these tests may be meaningful and valid. Further testing in a remote setting is necessary to validate this process.
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Affiliation(s)
- Ashley MontJohnson
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07105, USA
- NeurotechR3 Inc., Warren, NJ 07059, USA
| | - Amanda Cronce
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07105, USA
- NeurotechR3 Inc., Warren, NJ 07059, USA
| | - Qinyin Qiu
- NeurotechR3 Inc., Warren, NJ 07059, USA
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | - Jigna Patel
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | | | - Alma Merians
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | - Sergei Adamovich
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07105, USA
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
| | - Gerard Fluet
- School of Health Professions, Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
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Sobh KNM, Razak NAA, Osman NAA. A FSR Sensor Cuff to Measure Muscle Activation During Strength and Gait Cycle for Lower Limb. IEEE ACCESS 2022; 10:106135-106147. [DOI: 10.1109/access.2022.3207497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Khaled Nedal Mahmoud Sobh
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Noor Azuan Abu Osman
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
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Abstract
Management of the cavus foot is a difficult task for the foot and ankle surgeon. Tendon transfers have been a longstanding accepted treatment for the flexible cavus foot. Performing tendon transfers requires an in-depth understanding of the patient's medical history, factors leading to the development of deformity, as well as the deforming forces contributing to the deformity. Evaluation of the patient for rigid, progressive, and/or spastic deformities is critical to avoid postoperative complications. Educating the patient on postoperative rehabilitation, potential complications, and postoperative expectations is essential to ensure appropriate surgical outcomes.
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Multimodal Rehabilitation Following Gliosarcoma Resection: A Case Report. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kongwattanakul K, Hiengkaew V, Jalayondeja C, Sawangdee Y. A structural equation model of falls at home in individuals with chronic stroke, based on the international classification of function, disability, and health. PLoS One 2020; 15:e0231491. [PMID: 32275692 PMCID: PMC7147784 DOI: 10.1371/journal.pone.0231491] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/24/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To use structural equation model (SEM) to explain falls at home in individuals with chronic stroke, based on the International Classification of Functioning, Disability and Health (ICF). MATERIALS AND METHODS A cross sectional observation study was conducted in home-dwelling individuals with chronic stroke (N = 236; 148 non-fallers, 88 fallers). Participants were assessed; structural impairments using Modified Ashworth Scale, Fugl-Meyer Assessment upper (FMA-UE), lower (FMA-LE), and sensory function, ankle plantarflexor strength; activity limitations using Timed Up and Go Test, Step Test, Berg Balance Scale, Barthel Index (BI); participation restrictions using Stroke Impact Scale-participation (SIS-P); and contextual factors using home hazard environments, home safety surroundings, risk behaviors, and Fall-related Self Efficacy. The measurement model was analyzed by confirmatory factor analysis. The SEM was conducted to analyze a structural model of falls at home. RESULTS FMA-UE was significantly (p<0.01) associated with FMA-LE, combining as one variable in the structural impairments. In the measurement model, variables were fit to their domains, except variables of contextual factors, but the ICF domains did not correspond to disability. A structural model of falls at home demonstrated a significant (p<0.01) direct path of contextual factors and activity limitations with falls at home. The structural impairments showed a significant (p<0.01) direct path with activity limitations. All variables, except BI, SIS-P and risk behaviors, related to their domains in the structural model. CONCLUSIONS A structural model of falls at home proposes contextual factors being the strongest association with falls at home that home hazard environments seem the most influence in its domain. The activity limitations presented by balance ability are directed to falls at home. The structural impairments are associated with falls at home through activity limitations. Home assessment to decrease home hazard environments is suggested to prevent falls at home for individuals with chronic stroke.
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Affiliation(s)
| | - Vimonwan Hiengkaew
- Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand
- * E-mail:
| | - Chutima Jalayondeja
- Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Yothin Sawangdee
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
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Bohannon RW. Considerations and Practical Options for Measuring Muscle Strength: A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8194537. [PMID: 30792998 PMCID: PMC6354207 DOI: 10.1155/2019/8194537] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/15/2018] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Abstract
Muscle strength impairments are related to mobility limitations and other untoward outcomes. This narrative review, therefore, describes considerations relative to the definition and measurement of muscle strength. Thereafter, practical options for measuring muscle strength are described and their clinimetric properties are delineated. Information provided herein may help students, clinicians, and researchers select the strength tests best suited to their research needs and limitations.
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Affiliation(s)
- Richard W. Bohannon
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University, Lillington, NC, USA
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