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1.
Sci Rep ; 14(1): 10448, 2024 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714802

RESUMEN

Hip muscle weakness can be a precursor to or a result of lower limb injuries. Assessment of hip muscle strength and muscle motor fatigue in the clinic is important for diagnosing and treating hip-related impairments. Muscle motor fatigue can be assessed with surface electromyography (sEMG), however sEMG requires specialized equipment and training. Inertial measurement units (IMUs) are wearable devices used to measure human motion, yet it remains unclear if they can be used as a low-cost alternative method to measure hip muscle fatigue. The goals of this work were to (1) identify which of five pre-selected exercises most consistently and effectively elicited muscle fatigue in the gluteus maximus, gluteus medius, and rectus femoris muscles and (2) determine the relationship between muscle fatigue using sEMG sensors and knee wobble using an IMU device. This work suggests that a wall sit and single leg knee raise activity fatigue the gluteus medius, gluteus maximus, and rectus femoris muscles most reliably (p < 0.05) and that the gluteus medius and gluteus maximus muscles were fatigued to a greater extent than the rectus femoris (p = 0.031 and p = 0.0023, respectively). Additionally, while acceleration data from a single IMU placed on the knee suggested that more knee wobble may be an indicator of muscle fatigue, this single IMU is not capable of reliably assessing fatigue level. These results suggest the wall sit activity could be used as simple, static exercise to elicit hip muscle fatigue in the clinic, and that assessment of knee wobble in addition to other IMU measures could potentially be used to infer muscle fatigue under controlled conditions. Future work examining the relationship between IMU data, muscle fatigue, and multi-limb dynamics should be explored to develop an accessible, low-cost, fast and standardized method to measure fatiguability of the hip muscles in the clinic.


Asunto(s)
Electromiografía , Ejercicio Físico , Cadera , Fatiga Muscular , Humanos , Electromiografía/métodos , Fatiga Muscular/fisiología , Masculino , Ejercicio Físico/fisiología , Adulto , Cadera/fisiología , Femenino , Músculo Esquelético/fisiología , Adulto Joven , Rodilla/fisiología
2.
Anesthesiol Clin ; 42(2): 247-261, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38705674

RESUMEN

Anesthesia for patients undergoing knee procedures encompasses a large patient population with significant variation in patient age, comorbidities, and type of surgery. In addition, these procedures are performed in vastly different surgical environments, including large academic hospitals, private hospitals, and out-patient surgical centers. These variabilities require a thoughtful and individualized anesthetic approach tailored toward the medical and surgical needs of each patient. This article discusses anesthetic approaches to patients with acute, subacute, and chronic knee-related pathology requiring surgery. We will also review pertinent knee anatomy and innervation and discuss regional nerve blocks and their applications to knee-related surgical procedures.


Asunto(s)
Anestesia , Humanos , Anestesia/métodos , Articulación de la Rodilla/cirugía , Artroplastia de Reemplazo de Rodilla/métodos , Bloqueo Nervioso/métodos , Rodilla/cirugía
3.
BMC Med Educ ; 24(1): 500, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38711070

RESUMEN

BACKGROUND: According to the German Physiotherapy Education and Qualification Regulations, teaching of anatomical structures is one of the fundamental subjects of physiotherapy education. Besides exhibits and models, anatomy atlases are usually used as teaching and learning tools. These are available in both analog form such as printed books or in digital form as a mobile application. Furthermore, the use of digital teaching and learning tools is steadily increasing within the education of health professionals. AIM: To assess the efficacy of a digital educational tool in contrast to an analog anatomical atlas in acquiring knowledge about anatomical structures. MATERIAL AND METHOD: The data collection took place in the context of an anatomy tutorial for students of the bachelor's degree program in physiotherapy. In a cross-over design, the students completed two learning assignments, each, with different learning materials provided, either with an anatomy app on a tablet or with an anatomy atlas as a book. The tests to assess the newly acquired knowledge immediately after the task, consisted of questions about the anatomical structures of the knee as well as the shoulder. In addition, the students' satisfaction with the learning materials provided was surveyed using a questionnaire. The survey assessed their satisfaction, their assessment of learning success, and their affinity to digital learning materials. This was done using a 5-point Likert scale and a free-text field. The data was analyzed descriptively, and group differences were calculated using a t-tests. RESULTS: Thirty students participated. The group comparison showed a significantly better outcome for the group that prepared with the analog anatomy atlas for the questions on the knee than the comparison group that used the anatomy app (t(28) = 2.6; p = 0.007). For the questions concerning the shoulder, there was no significant difference between the digital and analog groups (t(28) = 1.14; p = 0.26). The questionnaire revealed that satisfaction with the analog anatomy atlas was significantly higher than with the anatomy app. A total of 93.34% rated their experience with the analog learning tool at least "somewhat satisfied". In contrast, 72.67% of students partially or fully agreed that they "enjoyed learning with digital learning tools". DISCUSSION: Learning anatomical structures with the Human Anatomy Atlas 2023 + app did not show a clear advantage when compared to an anatomy book in these two cohorts of physiotherapy students. The results of the questionnaire also showed greater satisfaction with the analog anatomy atlas than with the anatomy app, whereas most students stated that they frequently use digital learning tools, including some for anatomical structures. Satisfaction with the learning tool seems to play a central role in their effectiveness. In addition, sufficient time must be provided for users to familiarize themselves with the user interface of digital applications to use them effectively. REGISTRATION: Diese klinische Studie wurde nicht in einem Studienregister registriert.


Asunto(s)
Anatomía , Estudios Cruzados , Humanos , Anatomía/educación , Masculino , Instrucción por Computador/métodos , Evaluación Educacional , Especialidad de Fisioterapia/educación , Alemania , Femenino , Atlas como Asunto , Adulto , Encuestas y Cuestionarios , Adulto Joven , Aprendizaje , Hombro/anatomía & histología , Rodilla/anatomía & histología
4.
PLoS One ; 19(4): e0300447, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38564508

RESUMEN

Quantitative gait analysis is important for understanding the non-typical walking patterns associated with mobility impairments. Conventional linear statistical methods and machine learning (ML) models are commonly used to assess gait performance and related changes in the gait parameters. Nonetheless, explainable machine learning provides an alternative technique for distinguishing the significant and influential gait changes stemming from a given intervention. The goal of this work was to demonstrate the use of explainable ML models in gait analysis for prosthetic rehabilitation in both population- and sample-based interpretability analyses. Models were developed to classify amputee gait with two types of prosthetic knee joints. Sagittal plane gait patterns of 21 individuals with unilateral transfemoral amputations were video-recorded and 19 spatiotemporal and kinematic gait parameters were extracted and included in the models. Four ML models-logistic regression, support vector machine, random forest, and LightGBM-were assessed and tested for accuracy and precision. The Shapley Additive exPlanations (SHAP) framework was applied to examine global and local interpretability. Random Forest yielded the highest classification accuracy (98.3%). The SHAP framework quantified the level of influence of each gait parameter in the models where knee flexion-related parameters were found the most influential factors in yielding the outcomes of the models. The sample-based explainable ML provided additional insights over the population-based analyses, including an understanding of the effect of the knee type on the walking style of a specific sample, and whether or not it agreed with global interpretations. It was concluded that explainable ML models can be powerful tools for the assessment of gait-related clinical interventions, revealing important parameters that may be overlooked using conventional statistical methods.


Asunto(s)
Miembros Artificiales , Análisis de la Marcha , Humanos , Marcha , Caminata , Rodilla
5.
Scand J Med Sci Sports ; 34(4): e14615, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38556845

RESUMEN

We investigated the effects of far-infrared radiation (FIR) lamp therapy on changes in muscle damage and performance parameters following six sets of 15-min Loughborough intermittent shuttle test (LIST), a simulated soccer match. Twenty-four elite female soccer players (20-24 y) were assigned into FIR or sham treatment group (n = 12/group). The participants received a 60-min FIR or sham treatment (30 min per muscle) over knee extensors (KE) and flexors (KF) at 2, 25, 49, 73, and 97 h post-LIST. Maximal voluntary isometric contraction (MVC) torque and muscle soreness of the KE and KF, plasma creatine kinase (CK) activity as muscle damage markers, and several performance parameters including countermovement jump (CMJ) and Yo-Yo intermittent recovery test level 1 (YYIR1) were measured before and 1, 24, 48, 72, 96, and 120 h post-LIST. Changes in the measures were compared between groups by a mixed-design two-way ANOVA. The running distance covered during LIST and changes in the measures at 1-h post-LIST (before the treatment) were similar (p = 0.118-0.371) between groups. Changes in muscle damage markers at 24-120 h post-LIST were smaller (p < 0.05, η2 = 0.208-0.467) for the FIR (e.g., MVC-KE torque decrease at 48-h post-LIST: -1 ± 2%, peak KE soreness: 16 ± 10 mm, peak CK: 172 ± 42 IU/L) than sham group (-11 ± 9%, 33 ± 7 mm, 466 ± 220 IU/L, respectively). Performance parameters recovered faster (p < 0.05, η2 = 0.142-0.308) to baseline for the FIR (e.g., decreases at 48-h post-LIST; CMJ: 0 ± 1%, YYIR1: 0 ± 1%) than sham group (-6 ± 2%, -9 ± 6%, respectively). These results suggest that the FIR lamp therapy was effective for enhancing recovery from a soccer match.


Asunto(s)
Rendimiento Atlético , Fútbol , Humanos , Femenino , Fútbol/fisiología , Mialgia/radioterapia , Rodilla/fisiología , Articulación de la Rodilla , Rendimiento Atlético/fisiología
6.
J Neuroeng Rehabil ; 21(1): 50, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38594696

RESUMEN

BACKGROUND: The pendulum test is a quantitative method used to assess knee extensor spasticity in humans with spinal cord injury (SCI). Yet, the clinical implementation of this method remains limited. The goal of our study was to develop an objective and portable system to assess knee extensor spasticity during the pendulum test using inertial measurement units (IMU). METHODS: Spasticity was quantified by measuring the first swing angle (FSA) using a 3-dimensional optical tracking system (with external markers over the iliotibial band, lateral knee epicondyle, and lateral malleolus) and two wireless IMUs (positioned over the iliotibial band and mid-part of the lower leg) as well as a clinical exam (Modified Ashworth Scale, MAS). RESULTS: Measurements were taken on separate days to assess test-retest reliability and device agreement in humans with and without SCI. We found no differences between FSA values obtained with the optical tracking system and the IMU-based system in control subjects and individuals with SCI. FSA values from the IMU-based system showed excellent agreement with the optical tracking system in individuals with SCI (ICC > 0.98) and good agreement in controls (ICC > 0.82), excellent test-retest reliability across days in SCI (ICC = 0.93) and good in controls (ICC = 0.87). Notably, FSA values measured by both systems showed a strong association with MAS scores ( ρ  ~ -0.8) being decreased in individuals with SCI with higher MAS scores, reflecting the presence of spasticity. CONCLUSIONS: These findings suggest that our new portable IMU-based system provides a robust and flexible alternative to a camera-based optical tracking system to quantify knee extensor spasticity following SCI.


Asunto(s)
Extremidad Inferior , Traumatismos de la Médula Espinal , Humanos , Reproducibilidad de los Resultados , Espasticidad Muscular/etiología , Espasticidad Muscular/complicaciones , Rodilla , Traumatismos de la Médula Espinal/complicaciones
7.
J Biomech ; 166: 112066, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38574563

RESUMEN

Precise measurement of joint-level motion from stereo-radiography facilitates understanding of human movement. Conventional procedures for kinematic tracking require significant manual effort and are time intensive. The current work introduces a method for fully automatic tracking of native knee kinematics from stereo-radiography sequences. The framework consists of three computational steps. First, biplanar radiograph frames are annotated with segmentation maps and key points using a convolutional neural network. Next, initial bone pose estimates are acquired by solving a polynomial optimization problem constructed from annotated key points and anatomic landmarks from digitized models. A semidefinite relaxation is formulated to realize the global minimum of the non-convex problem. Pose estimates are then refined by registering computed tomography-based digitally reconstructed radiographs to masked radiographs. A novel rendering method is also introduced which enables generating digitally reconstructed radiographs from computed tomography scans with inconsistent slice widths. The automatic tracking framework was evaluated with stereo-radiography trials manually tracked with model-image registration, and with frames which capture a synthetic leg phantom. The tracking method produced pose estimates which were consistently similar to manually tracked values; and demonstrated pose errors below 1.0 degree or millimeter for all femur and tibia degrees of freedom in phantom trials. Results indicate the described framework may benefit orthopaedics and biomechanics applications through acceleration of kinematic tracking.


Asunto(s)
Articulación de la Rodilla , Rodilla , Humanos , Fenómenos Biomecánicos , Radiografía , Articulación de la Rodilla/diagnóstico por imagen , Rodilla/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Imagenología Tridimensional/métodos
10.
Sensors (Basel) ; 24(8)2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38676056

RESUMEN

This paper introduces a method for measuring 3D tibiofemoral kinematics using a multi-channel A-mode ultrasound system under dynamic conditions. The proposed system consists of a multi-channel A-mode ultrasound system integrated with a conventional motion capture system (i.e., optical tracking system). This approach allows for the non-invasive and non-radiative quantification of the tibiofemoral joint's six degrees of freedom (DOF). We demonstrated the feasibility and accuracy of this method in the cadaveric experiment. The knee joint's motions were mimicked by manually manipulating the leg through multiple motion cycles from flexion to extension. To measure it, six custom ultrasound holders, equipped with a total of 30 A-mode ultrasound transducers and 18 optical markers, were mounted on various anatomical regions of the lower extremity of the specimen. During experiments, 3D-tracked intra-cortical bone pins were inserted into the femur and tibia to measure the ground truth of tibiofemoral kinematics. The results were compared with the tibiofemoral kinematics derived from the proposed ultrasound system. The results showed an average rotational error of 1.51 ± 1.13° and a translational error of 3.14 ± 1.72 mm for the ultrasound-derived kinematics, compared to the ground truth. In conclusion, this multi-channel A-mode ultrasound system demonstrated a great potential of effectively measuring tibiofemoral kinematics during dynamic motions. Its improved accuracy, nature of non-invasiveness, and lack of radiation exposure make this method a promising alternative to incorporate into gait analysis and prosthetic kinematic measurements later.


Asunto(s)
Imagenología Tridimensional , Articulación de la Rodilla , Ultrasonografía , Humanos , Fenómenos Biomecánicos , Articulación de la Rodilla/fisiología , Articulación de la Rodilla/diagnóstico por imagen , Ultrasonografía/métodos , Imagenología Tridimensional/métodos , Tibia/diagnóstico por imagen , Tibia/fisiología , Rango del Movimiento Articular/fisiología , Fémur/fisiología , Fémur/diagnóstico por imagen , Rodilla/fisiología , Rodilla/diagnóstico por imagen
11.
Sensors (Basel) ; 24(8)2024 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-38676262

RESUMEN

Knee rehabilitation therapy after trauma or neuromotor diseases is fundamental to restore the joint functions as best as possible, exoskeleton robots being an important resource in this context, since they optimize therapy by applying tailored forces to assist or resist movements, contributing to improved patient outcomes and treatment efficiency. One of the points that must be taken into account when using robots in rehabilitation is their interaction with the patient, which must be safe for both and guarantee the effectiveness of the treatment. Therefore, the objective of this study was to assess the interaction between humans and an exoskeleton during the execution of knee flexion-extension movements under various configurations of robot assistance and resistance. The evaluation encompassed considerations of myoelectric activity, muscle recruitment, robot torque, and performed movement. To achieve this, an experimental protocol was implemented, involving an individual wearing the exoskeleton and executing knee flexion-extension motions while seated, with the robot configured in five distinct modes: passive (P), assistance on flexion (FA), assistance on extension (EA), assistance on flexion and extension (CA), and resistance on flexion and extension (CR). Results revealed distinctive patterns of movement and muscle recruitment for each mode, highlighting the complex interplay between human and robot; for example, the largest RMS tracking errors were for the EA mode (13.72 degrees) while the smallest for the CR mode (4.47 degrees), a non-obvious result; in addition, myoelectric activity was demonstrated to be greater for the completely assisted mode than without the robot (the maximum activation levels for the vastus medialis and vastus lateralis muscles were more than double those when the user had assistance from the robot). Tracking errors, muscle activations, and torque values varied across modes, emphasizing the need for careful consideration in configuring exoskeleton assistance and resistance to ensure effective and safe rehabilitation. Understanding these human-robot interactions is essential for developing precise rehabilitation programs, optimizing treatment effectiveness, and enhancing patient safety.


Asunto(s)
Dispositivo Exoesqueleto , Articulación de la Rodilla , Robótica , Humanos , Robótica/métodos , Articulación de la Rodilla/fisiología , Masculino , Rango del Movimiento Articular/fisiología , Fenómenos Biomecánicos , Electromiografía/métodos , Adulto , Torque , Músculo Esquelético/fisiología , Rodilla/fisiología , Movimiento/fisiología
12.
Exp Gerontol ; 190: 112430, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38608793

RESUMEN

PURPOSE: We investigated the effect of an unsupervised, body mass- home-based resistance training program in older adults performed at either a fast or slow contractile speed on changes to muscle-power, -volume, -architecture, and fatigue resistance of the knee extensors. METHODS: Thirty-two male older adults (age 65-88 years) were separated into 1) fast-speed exercise (Fast-group), 2) slow-speed exercise (Slow-group), and 3) no exercise (Control-group) groups. Participants in the exercise groups performed 30-45 repetitions of knee-extension and sit-to-stand exercises 3 times a week for 8 weeks with different exercise speed between the groups. Before and after the intervention period, the following variables were measured: Isotonic power, isometric strength, twitch contractile properties, muscle-activity, -architecture, and -quality, neuromuscular fatigue resistance of the knee extensors, and thigh muscle volume. RESULTS: Peak power was increased in both the Fast-group (+24 %, P < 0.01, d = 0.65) and Slow-group (+12 %, P < 0.05, d = 0.33) but not in the Control-group. Training increased pennation angle of the vastus lateralis in both the Fast-group (+8 %, P < 0.01, d = 0.42) and Slow-group (+8 %, P < 0.01, d = 0.42), while only the Fast-group showed increase in pennation angle of the rectus femoris (+12 %, P < 0.01, d = 0.64) and thigh muscle volume (+16 %, P < 0.01, d = 0.52). There was no time × group interaction effect for the other neuromuscular measures. CONCLUSIONS: Unsupervised, body mass- and home-based resistance training performed at either fast or slow speeds can improve muscle power in older adults, while fast-speed exercise may be preferable over slow-speed owing to the relatively greater improvement of muscle-power, -volume, -architecture, and better time efficiency.


Asunto(s)
Fuerza Muscular , Entrenamiento de Fuerza , Humanos , Entrenamiento de Fuerza/métodos , Anciano , Masculino , Fuerza Muscular/fisiología , Anciano de 80 o más Años , Fatiga Muscular/fisiología , Músculo Esquelético/fisiología , Contracción Isométrica/fisiología , Rodilla/fisiología , Contracción Muscular/fisiología
14.
Ann Biomed Eng ; 52(6): 1591-1603, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38558356

RESUMEN

Kinematic tracking of native anatomy from stereo-radiography provides a quantitative basis for evaluating human movement. Conventional tracking procedures require significant manual effort and call for acquisition and annotation of subject-specific volumetric medical images. The current work introduces a framework for fully automatic tracking of native knee anatomy from dynamic stereo-radiography which forgoes reliance on volumetric scans. The method consists of three computational steps. First, captured radiographs are annotated with segmentation maps and anatomic landmarks using a convolutional neural network. Next, a non-convex polynomial optimization problem formulated from annotated landmarks is solved to acquire preliminary anatomy and pose estimates. Finally, a global optimization routine is performed for concurrent refinement of anatomy and pose. An objective function is maximized which quantifies similarities between masked radiographs and digitally reconstructed radiographs produced from statistical shape and intensity models. The proposed framework was evaluated against manually tracked trials comprising dynamic activities, and additional frames capturing a static knee phantom. Experiments revealed anatomic surface errors routinely below 1.0 mm in both evaluation cohorts. Median absolute errors of individual bone pose estimates were below 1.0 ∘ or mm for 15 out of 18 degrees of freedom in both evaluation cohorts. Results indicate that accurate pose estimation of native anatomy from stereo-radiography may be performed with significantly reduced manual effort, and without reliance on volumetric scans.


Asunto(s)
Rodilla , Humanos , Rodilla/diagnóstico por imagen , Rodilla/anatomía & histología , Rodilla/fisiología , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/anatomía & histología , Articulación de la Rodilla/fisiología , Fantasmas de Imagen , Radiografía , Modelos Estadísticos
15.
J Sports Sci ; 42(5): 404-414, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38602304

RESUMEN

The purpose was to compare two non-laboratory based running retraining programs on lower limb and trunk kinematics in recreational runners. Seventy recreational runners (30 ± 7.3 years old, 40% female) were randomised to a barefoot running group (BAR), a group wearing a digital metronome with their basal cadence increased by 10% (CAD), and a control group (CON). BAR and CAD groups included intervals from 15 to 40 min over 10 weeks and 3 days/week. 3D sagittal kinematics of the ankle, knee, hip, pelvis, and trunk were measured before and after the retraining program, at comfortable and high speeds. A 3 × 2 mixed ANOVA revealed that BAR and CAD groups increased knee and hip flexion at footstrike, increased peak hip flexion during stance and flight phase, decreased peak hip extension during flight phase, and increased anterior pelvic tilt at both speeds after retraining. In addition, BAR increased ankle plantar flexion at footstrike and increased anterior trunk tilt. Both retraining programs demonstrated significant moderate to large effect size changes in parameters that could reduce the mechanical risks of injury associated with excessive knee stress, which is of interest to coaches, runners and those prescribing rehabilitation and injury prevention programs.


Asunto(s)
Extremidad Inferior , Pelvis , Carrera , Torso , Humanos , Carrera/fisiología , Fenómenos Biomecánicos , Femenino , Masculino , Torso/fisiología , Adulto , Extremidad Inferior/fisiología , Pelvis/fisiología , Pie/fisiología , Adulto Joven , Rodilla/fisiología , Tobillo/fisiología , Cadera/fisiología , Marcha/fisiología
16.
Scand J Med Sci Sports ; 34(4): e14621, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38597348

RESUMEN

Tendon properties impact human locomotion, influencing sports performance, and injury prevention. Hamstrings play a crucial role in sprinting, particularly the biceps femoris long head (BFlh), which is prone to frequent injuries. It remains uncertain if BFlh exhibits distinct mechanical properties compared to other hamstring muscles. This study utilized free-hand three-dimensional ultrasound to assess morphological and mechanical properties of distal hamstrings tendons in 15 men. Scans were taken in prone position, with hip and knee extended, at rest and during 20%, 40%, 60%, and 80% of maximal voluntary isometric contraction of the knee flexors. Tendon length, volume, cross-sectional area (CSA), and anteroposterior (AP) and mediolateral (ML) widths were quantified at three locations. Longitudinal and transverse deformations, stiffness, strain, and stress were estimated. The ST had the greatest tendon strain and the lowest stiffness as well as the highest CSA and AP and ML width strain compared to other tendons. Biceps femoris short head (BFsh) exhibited the least strain, AP and ML deformation. Further, BFlh displayed the highest stiffness and stress, and BFsh had the lowest stress. Additionally, deformation varied by region, with the proximal site showing generally the lowest CSA strain. Distal tendon mechanical properties differed among the hamstring muscles during isometric knee flexions. In contrast to other bi-articular hamstrings, the BFlh high stiffness and stress may result in greater energy absorption by its muscle fascicles, rather than the distal tendon, during late swing in sprinting. This could partly account for the increased incidence of hamstring injuries in this muscle.


Asunto(s)
Músculos Isquiosurales , Músculo Esquelético , Masculino , Humanos , Músculo Esquelético/fisiología , Tendones/diagnóstico por imagen , Tendones/fisiología , Músculos Isquiosurales/fisiología , Rodilla/diagnóstico por imagen , Rodilla/fisiología , Contracción Isométrica/fisiología , Ultrasonografía
17.
Medicina (Kaunas) ; 60(3)2024 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-38541093

RESUMEN

Background and Objectives: Hypermobility has been linked to decreased knee performance, including isokinetic and isometric knee strength. This study aimed to determine whether athletes with and without knee hyperextension have different hamstring-to-quadriceps strength (H/Q) ratios and to investigate the associations between knee hyperextension indices and H/Q ratios and anthropometric characteristics. Materials and Methods: The sample consisted of 47 healthy male athletes without knee injuries aged 23.48 ± 3.54 years. The variables included the degree of knee hypermobility, isokinetic parameters of the leg musculature, and anthropometric indices. Differences between athletes with and without hyperextension were calculated using an independent sample t-test, effect sizes, and discriminant analysis, while associations between the variables were checked by Pearson's correlation coefficient and multiple regression analysis. Results: Athletes with hyperextended knees had shorter legs (t value = -2.23, p = 0.03, moderate ES) and shins (t = -2.64, p = 0.01, moderate ES) and a lower H/Q ratio at an angular velocity of 60°/s (t = -2.11, p = 0.04, moderate ES) than those in the nonhyperextended group did; these differences were supported by discriminant analysis (Wilks' L = 0.60, p = 0.01). An increase in the H/Q ratio at an angular velocity of 60°/s was associated with the degree of knee hypermobility (R = -0.29, p = 0.04). Conclusions: This research showed that athletes with knee hypermobility have weaker hamstring strength and thus a lower H/Q strength ratio at lower angular velocities. These findings suggest that targeted strength training programs for leg (i.e., hamstrings) muscles should help individuals with knee hypermobility.


Asunto(s)
Articulación de la Rodilla , Rodilla , Masculino , Humanos , Articulación de la Rodilla/fisiología , Rodilla/fisiología , Fuerza Muscular/fisiología , Pierna/fisiología , Atletas , Músculo Esquelético/fisiología
18.
Medicina (Kaunas) ; 60(3)2024 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-38541224

RESUMEN

Background and Objectives: This study examined the influence of stationary bikes and elliptical machines on knee movement and joint load during exercise. Materials and Methods: Twelve healthy male participants engaged in pedaling exercises on stationary bikes and elliptical machines at speeds of 50 and 70 revolutions per minute (rpm). Knee movement and joint load were assessed using a motion analysis system. Results: The results indicated that elliptical machines induced higher knee joint torque compared to stationary bikes. Notably, peak torque occurred at different joint angles, with stationary bikes reaching an earlier peak at 70°-110° and elliptical machines showing a later peak at 135°-180°. Increased pedaling speed correlated with higher peak knee joint torque on both machines. With the elliptical machine, a higher pedaling frequency correlated with increased peak forces on the knee and ankle joints, as well as vertically. Interestingly, both types of equipment were associated with enhanced peak knee joint torques during high-speed pedaling. Conversely, constant pedaling on elliptical machines limited the ankle angle and could induce inward rotation. Conclusions: This study focused on knee joint torque variations during pedaling on indoor stationary bicycles and elliptical machines. Elliptical machines showed higher peak values of forces and torque, particularly during the propulsive and recovery phases, indicating potential challenges to the knee joint. Notably, peak pedal angles occurred earlier on indoor stationary bicycles, emphasizing the impact of equipment choice on joint kinetics.


Asunto(s)
Ciclismo , Articulación de la Rodilla , Humanos , Masculino , Fenómenos Biomecánicos , Rodilla , Extremidad Inferior
19.
Artículo en Inglés | MEDLINE | ID: mdl-38526884

RESUMEN

Joint hyper-resistance is a common symptom in neurological disorders. It has both neural and non-neural origins, but it has been challenging to distinguish different origins based on clinical tests alone. Combining instrumented tests with parameter identification based on a neuromechanical model may allow us to dissociate the different origins of joint hyper-resistance in individual patients. However, this requires that the model captures the underlying mechanisms. Here, we propose a neuromechanical model that, in contrast to previously proposed models, accounts for muscle short-range stiffness (SRS) and its interaction with muscle tone and reflex activity. We collected knee angle trajectories during the pendulum test in 15 children with cerebral palsy (CP) and 5 typically developing children. We did the test in two conditions - hold and pre-movement - that have been shown to alter knee movement. We modeled the lower leg as an inverted pendulum actuated by two antagonistic Hill-type muscles extended with SRS. Reflex activity was modeled as delayed, linear feedback from muscle force. We estimated neural and non-neural parameters by optimizing the fit between simulated and measured knee angle trajectories during the hold condition. The model could fit a wide range of knee angle trajectories in the hold condition. The model with personalized parameters predicted the effect of pre-movement demonstrating that the model captured the underlying mechanism and subject-specific deficits. Our model may help with the identification of neural and non-neural origins of joint hyper-resistance and thereby opens perspectives for improved diagnosis and treatment selection in children with spastic CP, but such applications require further studies to establish the method's reliability.


Asunto(s)
Parálisis Cerebral , Espasticidad Muscular , Niño , Humanos , Reproducibilidad de los Resultados , Movimiento , Rodilla , Músculo Esquelético/fisiología
20.
Sensors (Basel) ; 24(5)2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38475055

RESUMEN

The study aims to construct an inertial measuring system for the application of amputee subjects wearing a prosthesis. A new computation scheme to process inertial data by installing seven wireless inertial sensors on the lower limbs was implemented and validated by comparing it with an optical motion capture system. We applied this system to amputees to verify its performance for gait analysis. The gait parameters are evaluated to objectively assess the amputees' prosthesis-wearing status. The Madgwick algorithm was used in the study to correct the angular velocity deviation using acceleration data and convert it to quaternion. Further, the zero-velocity update method was applied to reconstruct patients' walking trajectories. The combination of computed walking trajectory with pelvic and lower limb joint motion enables sketching the details of motion via a stickman that helps visualize and animate the walk and gait of a test subject. Five participants with above-knee (n = 2) and below-knee (n = 3) amputations were recruited for gait analysis. Kinematic parameters were evaluated during a walking test to assess joint alignment and overall gait characteristics. Our findings support the feasibility of employing simple algorithms to achieve accurate and precise joint angle estimation and gait parameters based on wireless inertial sensor data.


Asunto(s)
Amputados , Miembros Artificiales , Humanos , Marcha , Caminata , Amputación Quirúrgica , Rodilla , Articulación de la Rodilla , Fenómenos Biomecánicos
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