Finger counting to relieve working memory in children with developmental coordination disorder: Insights from behavioral and three-dimensional motion analyses.

A limited number of studies have attempted to understand how motor deficits affect numerical abilities in children with developmental coordination disorder (DCD). The purpose of this study was to explore the functionality of finger-counting (FC) in children with DCD. The participants, 15 children with DCD and 15 typically developing (TD) children matched on school level and fluid reasoning abilities, were asked to use FC to solve an ordinal task with high working memory (WM) load. Behavioral measures supplemented with biomechanical measures, from three-dimensional motion analysis synchronized to a voice recording were used to assess children's performance and FC functionality (total duration, inter-finger [IF] transition, IF variance, finger/voice synchronization, and automatization of FC movements). Children with DCD were less accurate than TD children in using FC to solve ordinal problems with high WM load. This group difference could not be accounted for by poor FC skills given that FC movement turned out to be as functional in children with DCD as in their TD peers. When added to the model as a covariate, WM captured a greater proportion of intergroup variability than manual dexterity, further suggesting that their difficulties would be better accounted for by limited WM resources than by fine motor skills.

Reliability of Xsens IMU-Based Lower Extremity Joint Angles during In-Field Running.

The Xsens Link motion capture suit has become a popular tool in investigating 3D running kinematics based on wearable inertial measurement units outside of the laboratory. In this study, we investigated the reliability of Xsens-based lower extremity joint angles during unconstrained running on stable (asphalt) and unstable (woodchip) surfaces within and between five different testing days in a group of 17 recreational runners (8 female, 9 male). Specifically, we determined the within-day and between-day intraclass correlation coefficients (ICCs) and minimal detectable changes (MDCs) with respect to discrete ankle, knee, and hip joint angles. When comparing runs within the same day, the investigated Xsens-based joint angles generally showed good to excellent reliability (median ICCs > 0.9). Between-day reliability was generally lower than the within-day estimates: Initial hip, knee, and ankle angles in the sagittal plane showed good reliability (median ICCs > 0.88), while ankle and hip angles in the frontal plane showed only poor to moderate reliability (median ICCs 0.38-0.83). The results were largely unaffected by the surface. In conclusion, within-day adaptations in lower-extremity running kinematics can be captured with the Xsens Link system. Our data on between-day reliability suggest caution when trying to capture longitudinal adaptations, specifically for ankle and hip joint angles in the frontal plane.

The Use of Embedded IMU Insoles to Assess Gait Parameters: A Validation and Test-Retest Reliability Study.

Wireless wearable insoles are interesting tools to collect gait parameters during daily life activities. However, studies have to be performed specifically for each type of insoles on a big data set to validate the measurement in ecological situations. This study aims to assess the criterion validity and test-retest reliability of gait parameters from wearable insoles compared to motion capture system. Gait of 30 healthy participants was recorded using DSPro® insoles and a motion capture system during overground and treadmill walking at three different speeds. Criterion validity and test-retest reliability of spatio-temporal parameters were estimated with an intraclass correlation coefficient (ICC). For both systems, reliability was found higher than 0.70 for all variables (p < 0.001) except for minimum toe clearance (ICC < 0.50) with motion capture system during overground walking. Regardless of speed and condition of walking, Speed, Cadence, Stride Length, Stride Time and Stance Time variables were validated (ICC > 0.90; p < 0.001). During walking on treadmill, loading time was not validated during slow speed (ICC < 0.70). This study highlights good criterion validity and test-retest reliability of spatiotemporal gait parameters measurement using wearable insoles and opens a new possibility to improve care management of patients using clinical gait analysis in daily life activities.

Upper Limb Kinematics of Handwriting among Children with and without Developmental Coordination Disorder.

Background: Children with developmental coordination disorder (DCD) often experience difficulties with handwriting legibility and speed. This study investigates the relationship between handwriting and upper limb kinematics to characterize movement patterns of children with DCD and typically developing (TD) children. Methods: 30 children with and without DCD matched for age, gender, and parent education were compared across handwriting abilities using a standardized handwriting assessment of both copied and dictated tasks (A-A Handwriting). The 3D motion capture system (Qualysis) was used to analyze upper limb kinematics and characterize movement patterns during handwriting and contrasted with written output. Results: Children with DCD wrote fewer legible letters in both copying and dictation. Children with DCD also showed poor automatization of key writing concepts. Atypical wrist postures were associated with reduced legibility for children with DCD (F (1,27) 4.71, p = 0.04, p-η2 = 0.15); whereas for TD children, better legibility was associated with greater variations in movement speed, particularly of the wrist (rho = −0.578, p < 0.05). Conclusion: Results reflect different movement parameters influencing handwriting in children with DCD. An improved understanding of the movement characteristics during handwriting of these children may assist intervention design.

Agreement between Azure Kinect and Marker-Based Motion Analysis during Functional Movements: A Feasibility Study.

(1) Background: The present study investigated the agreement between the Azure Kinect and marker-based motion analysis during functional movements. (2) Methods: Twelve healthy adults participated in this study and performed a total of six different tasks including front view squat, side view squat, forward reach, lateral reach, front view lunge, and side view lunge. Movement data were collected using an Azure Kinect and 12 infrared cameras while the participants performed the movements. The comparability between marker-based motion analysis and Azure Kinect was visualized using Bland-Altman plots and scatter plots. (3) Results: During the front view of squat motions, hip and knee joint angles showed moderate and high level of concurrent validity, respectively. The side view of squat motions showed moderate to good in the visible hip joint angles, whereas hidden hip joint angle showed poor concurrent validity. The knee joint angles showed variation between excellent and moderate concurrent validity depending on the visibility. The forward reach motions showed moderate concurrent validity for both shoulder angles, whereas the lateral reach motions showed excellent concurrent validity. During the front view of lunge motions, both the hip and knee joint angles showed moderate concurrent validity. The side view of lunge motions showed variations in concurrent validity, while the right hip joint angle showed good concurrent validity; the left hip joint showed poor concurrent validity. (4) Conclusions: The overall agreement between the Azure Kinect and marker-based motion analysis system was moderate to good when the body segments were visible to the Azure Kinect, yet the accuracy of tracking hidden body parts is still a concern.

Hip joint range of motion is restricted by pain rather than mechanical impingement in individuals with femoroacetabular impingement syndrome.

INTRODUCTION: Discerning whether range of motion (ROM) is restricted by morphology or other pain sources is challenging in patients with femoroacetabular impingement syndrome (FAIS). Computed tomography (CT) motion simulation provides a hypothetical ROM based on morphology. This study aimed to explore associations between ROM measured using CT motion simulation and maximum passive ROM measured clinically using three dimensional (3D) motion analysis in patients with FAIS, prior to and post arthroscopic hip surgery. MATERIALS AND METHODS: Eight males with FAIS (in total 12 hip joints) were included in this explorative feasibility study. Participants were examined using CT according to a low-dose protocol prior to and 7-months post arthroscopic surgery. Software was used to simulate at which ROM the impingement would occur. With the hip in 90 degrees' flexion, maximum passive range of internal hip rotation, and maximum passive internal hip rotation coupled with adduction was examined clinically using 3D motion analysis pre- and postoperatively. Spearman rank correlation coefficients and linear regressions examined associations between methods. RESULTS: Preoperatively, the correlation between maximum internal hip rotation measured using CT motion simulation and 3D motion analysis was strong (r = 0.71, p = 0.009). Linear regressions demonstrated that maximal internal rotation measured using CT motion simulation was predominantly larger than when measured using 3D motion analysis. Postoperatively, and when maximum internal rotation was coupled with adduction, no correlations were found between the two methods. CONCLUSIONS: The hypothetical morphology restricted ROM is larger than clinically assessed pain restricted ROM, both prior to and post hip arthroscopy. These findings suggest that ROM is restricted by pain rather than mechanical, morphology-based impingement in individuals with FAIS.

Reliability of three-dimensional motion analysis during single-leg side drop landing test after anterior cruciate ligament reconstruction: An in vivo motion analysis study.

Background: Anterior cruciate ligament (ACL) injury is a common sport injury and investigation of landing biomechanics is helpful in injury prevention and rehabilitation. Recent study found a lateral single-leg drop landing test resulted in the highest peak knee valgus angle (PKVA), but its reliability on patients who received ACL reconstruction (ACLR) is unknown. Objective: This study aimed to investigate the reliability in both within and between days on the normalized vertical ground reaction force (NVGRF) and kinematics of lower limbs after receiving ACLR. The findings can form the cornerstone for further study related to lateral jumping-and-landing biomechanics in patients with ACLR. Methods: This was a test-retest reliability study. Twelve patients (four females and eight males) who received ACLR with mean age of 29.4 (SD ± 1.66) were recruited. The subjects were instructed to jump laterally from 30 cm height and landed with single-leg for five times. The procedure was conducted on both legs for comparison. The NVGRF and local maxima of the hip, knee and ankle angles during the first 100 ms in all three planes were analyzed. The measurement was conducted by the same assessor to evaluate the within-session reliability, and the whole procedure was repeated one week later for the evaluation of the between-session reliability. Intra-class correlation coefficient (ICC) test was used to assess the within- and between-session reliability by ICC (3, 1) and ICC (3, K) respectively. Results: The within-session reliability of NVGRF [ICC (3, 1)] was 0.899-0.936, and its between-session reliability [ICC (3, K)] was 0.947-0.923. Overall reliability for kinematics within-session [ICC (3, 1)] was 0.948-0.988, and the between-session reliability [ICC (3, K)] was 0.618-0.982, respectively. Good to excellent reliability for the lateral single-leg drop landing test was observed in most of the outcome measures for within- and between-session. The ICC value of NVGRF of ACLR leg was lower than that of the good leg in the within-session which may associate with lower neuromuscular control in ACLR leg than that of the good leg. Conclusion: The results of this study support the use of a lateral single-leg drop landing test to evaluate lower limb biomechanics for ACLR.

Quantitative description of upper extremity function and activity of people with spinal muscular atrophy.

BACKGROUND: Therapeutic management of the upper extremity (UE) function of people with spinal muscular atrophy (SMA) requires sensitive and objective assessment. Therefore, we aimed to measure physiologic UE function of SMA patients with different functional abilities and evaluate the relation between these physiologic measures and functional UE scales. METHODS: 12 male and 5 female SMA patients (mean age 42 years; range 6-62 years) participated in this explorative study. Concerning the physiologic level, the maximal muscle torque, the maximal and normalized surface electromyography (sEMG) amplitudes, and the maximal passive and active joint angles were measured. Concerning the activity level, the Performance of the Upper Limb (PUL) scale was used, and hand function was examined using the Nine-Hole Peg Test and the Timed Test of In-Hand Manipulation (TIHM). RESULTS: Outcome measures that significantly related to the functional ability were: the PUL score (all dimensions); the finger to palm task of the Timed TIHM; biceps, triceps, and forearm extensor strength; and the active range of motion of shoulder abduction, shoulder flexion, and wrist extension. In addition, the following physiologic variables were related to the activity level (PUL score): hand function (the Nine-Hole Peg Test; Rs = - 0.61), the Timed TIHM (Rs = - 0.53), the maximal muscle torque (Rs = 0.74), the maximal sEMG amplitude (Rs = 0.79), and the maximal active joint angle (Rs = 0.88). CONCLUSIONS: Muscle functions in SMA patients are already affected before activity limitations are noticeable. Consequently, monitoring the maximal muscle strength and the normalized muscle activity during task performance could play a role in the early detection of UE limitations. The mechanism behind the loss of arm activities due to SMA is primarily caused by decreasing muscle capacity, which influences the ability to move an arm actively. In clinical practices, these dimensions should be considered separately when monitoring disease progression in order to better evaluate the need for interventions.

Validity of a New 3-D Motion Analysis Tool for the Assessment of Knee, Hip and Spine Joint Angles during the Single Leg Squat.

AIM: Study concurrent validity of a new sensor-based 3D motion capture (MoCap) tool to register knee, hip and spine joint angles during the single leg squat. DESIGN: Cross-sectional. SETTING: University laboratory. PARTICIPANTS: Forty-four physically active (Tegner ≥ 5) subjects (age 22.8 (±3.3)) Main outcome measures: Sagittal and frontal plane trunk, hip and knee angles at peak knee flexion. The sensor-based system consisted of 4 active (triaxial accelerometric, gyroscopic and geomagnetic) sensors wirelessly connected with an iPad. A conventional passive tracking 3D MoCap (OptiTrack) system served as gold standard. RESULTS: All sagittal plane measurement correlations observed were very strong for the knee and hip (r = 0.929-0.988, p < 0.001). For sagittal plane spine assessment, the correlations were moderate (r = 0.708-0.728, p < 0.001). Frontal plane measurement correlations were moderate in size for the hip (ρ = 0.646-0.818, p < 0.001) and spine (ρ = 0.613-0.827, p < 0.001). CONCLUSIONS: The 3-D MoCap tool has good to excellent criterion validity for sagittal and frontal plane angles occurring in the knee, hip and spine during the single leg squat. This allows bringing this type of easily accessible MoCap technology outside laboratory settings.

The relationship of elbow alignment and kinematics on shoulder torque during the softball pitch: a biomechanical analysis of female softball pitchers.

BACKGROUND: Female softball pitchers commonly throw more pitches per game and season than their baseball counterparts. The greatest stress to the shoulder during a softball windmill pitch is at ball release (BR). This study investigated shoulder torques at BR among female softball pitchers and identified relationships to the kinematics of the elbow and forearm and alignment of the elbow (carrying angle and elbow extension). METHODS: High-speed 3-dimensional biomechanical analyses were performed in 33 pitchers (25 high school, 8 collegiate). Elbow and shoulder biomechanics at BR during fastball pitches and goniometric measures of carrying angle and elbow extension were collected and analyzed. RESULTS: Carrying angle correlated positively with shoulder extension torque at BR (rs = 0.371, P = .048) and forearm pronation at BR (rs = 0.370, P = .048). During the windmill pitch, the greater the elbow flexion, the greater shoulder adduction torque at BR (rs = -0.522, P = .007). Multiple regression analysis revealed that the carrying angle, passive elbow extension, and elbow flexion/extension angle at BR predicted shoulder flexion/extension torque at BR (F3,24 = 3.463, R2 = .302, P = .032.) CONCLUSIONS: Our findings demonstrate that shoulder torques during the softball fastpitch are influenced by the carrying angle and the kinematic elbow flexion angle at BR. Sports medicine clinicians and coaches should consider the role that the elbow carrying angle plays in creating shoulder stress when treating and training fastpitch softball players.

Validation of a Single RGB-D Camera for Gait Assessment of Polyneuropathy Patients.

Motion analysis systems based on a single markerless RGB-D camera are more suitable for clinical practice than multi-camera marker-based reference systems. Nevertheless, the validity of RGB-D cameras for motor function assessment in some diseases affecting gait, such as Transthyretin Familial Amyloid Polyneuropathy (TTR-FAP), is yet to be investigated. In this study, the agreement between the Kinect v2 and a reference system for obtaining spatiotemporal and kinematic gait parameters was evaluated in the context of TTR-FAP. 3-D body joint data provided by both systems were acquired from ten TTR-FAP symptomatic patients, while performing ten gait trials. For each gait cycle, we computed several spatiotemporal and kinematic gait parameters. We then determined, for each parameter, the Bland Altman's bias and 95% limits of agreement, as well as the Pearson's and concordance correlation coefficients, between systems. The obtained results show that an affordable, portable and non-invasive system based on an RGB-D camera can accurately obtain most of the studied gait parameters (excellent or good agreement for eleven spatiotemporal and one kinematic). This system can bring more objectivity to motor function assessment of polyneuropathy patients, potentially contributing to an improvement of TTR-FAP treatment and understanding, with great benefits to the patients' quality of life.

Correlations between Angular Velocities in Selected Joints and Velocity of Table Tennis Racket during Topspin Forehand and Backhand.

The aim of this study was to determine the correlations between angular velocities in individual joints and racket velocity for different topspin forehand and backhand strokes in table tennis. Ten elite female table tennis players participated, presenting different kinds of topspin forehands and backhands - after a no-spin ball (FH1, BH1), after a backspin ball (FH2, BH2) and "heavy" topspin (FH3, BH3). Range of motion was measured with the BTS Smart-E (BTS Bioengineering, Milan, Italy) motion analysis system with a specially developed marker placement protocol for the upper body parts and an acoustic sensor attached to the racket to identify ball-racket contact. In forehand strokes angular velocities of internal arm rotation and adduction in shoulder joint correlated with racket velocity. Racket velocity was correlated with angular velocities (hip extension on the playing side; hip flexion on the opposite side; ankle flexion) in the case of a topspin forehand performed with maximal force -"heavy" topspin (FH3). In backhand strokes the velocities of arm abduction and shoulder girdle rotation towards the playing side correlated with racket velocity. The angular velocity of internal arm rotation and adduction in shoulder joint may be important components of a coordinated stroke, whilst angular velocity can substantially affect the racket speed when one is changing the type of stroke.

The effect of overhead target on the lower limb biomechanics during a vertical drop jump test in elite female athletes.

The purpose of the study was to investigate the effect of an overhead target on the jump height and lower limb biomechanics in all three planes of motion in a vertical drop jump (VDJ) task among elite female handball and football (soccer) players. The hypothesis was that adding an overhead target to the VDJ task improves jump height, increases joint loading, and decreases frontal plane knee control. Five hundred and twenty-three female handball and football players (mean ± SD: 21 ± 4 years, 168 ± 6 cm, 65 ± 8 kg) completed the test. The overhead target increased jumping height by 5.8%. Furthermore, the overhead target led to statistically significant changes in many of the lower limb biomechanical variables examined. However, all the changes in kinematics and kinetics were clinically insignificant, as indicated by the small effect sizes. Strong to moderate positive Spearman's rank correlations were found between the two conditions. Therefore, an overhead target is unlikely to increase the range of responses in biomechanical variables in elite female handball and football athletes.

Functional midterm follow-up comparison of stemless total shoulder prostheses versus conventional stemmed anatomic shoulder prostheses using a 3D-motion-analysis.

BACKGROUND: The aim of this study is to compare the functional midterm outcome of stemless shoulder prostheses with standard anatomical stemmed shoulder prostheses and to show that the STEMLESS results are comparable to the STEMMED with respect to active maximum range of shoulder motion (ROM) and Constant score (CS). METHODS: Seventeen patients underwent total shoulder arthroplasty (TSA) in 25 shoulder joints. Stemless TSA was performed in 12 shoulder joints (group STEMLESS), third-generation stemmed TSA in 13 shoulder joints (group STEMMED). Functional results were documented using the CS. 3D-motion-analysis using the Heidelberg upper extremity model (HUX) was conducted to measure active maximum (ROM). RESULTS: The group STEMLESS achieved a CS of 67.9 (SD 12.0) points and the group STEMMED of 70.2 (SD 5.8 points) without significant difference between the groups (p = 0.925). The maximum ROM of the group STEMLESS, ascertained by 3-D-motion-analysis, was in forward flexion 125.5° (SD 17.2°), in extension 49.4° (SD 13.8°), in abduction 126.2° (SD 28.5°) and in external rotation 40.3° (SD 13.9°). The maximum ROM of the group STEMMED, also ascertained by 3-D-motion analysis, was in forward flexion 135.0° (SD 16.8°), in extension 47.2° (SD 11.5°), in abduction 136.3° (SD 24.2°) and in external rotation 40.1° (SD 12.2°). The maximum ROM of the STEMLESS group was lower in forward flexion and abduction, higher in extension and almost identical in external rotation. But there was no significant difference (forward flexion p = 0.174, extension p = 0.470, abduction p = 0.345, external rotation p = 0.978). CONCLUSION: Both types of shoulder prostheses achieve a similar and good active ROM and similar results in CS. TRIAL REGISTRATION: DRKS00013166 , retrospectively registered, 11.10.2017.

Dynamic arm study: quantitative description of upper extremity function and activity of boys and men with duchenne muscular dystrophy.

BACKGROUND: Therapeutic management of upper extremity (UE) function of boys and men with Duchenne Muscular Dystrophy (DMD) requires sensitive and objective assessment. Therefore, we aimed to measure physiologic UE function of healthy subjects and DMD patients in different disease stages, and to evaluate the relation between these physiologic measures and functional UE scales. METHODS: Twenty-three DMD patients and twenty healthy controls (7-23 years) participated in this explorative case-control study. Maximal muscle torque, maximal and normalized surface electromyography (sEMG) amplitudes, muscle thickness, echogenicity and maximal passive and active joint angles were measured. At activity level, Brooke upper extremity rating scale and the Performance of Upper Limb (PUL) scale were used. RESULTS: Outcome measures related to proximal UE function could discriminate between disease stages. Increased normalized sEMG amplitudes were found in patients, even in early disease stages. Maximal active joint angles showed the strongest relation to Brooke scale (R 2 = 0.88) and PUL scale (R 2 = 0.85). CONCLUSIONS: The decline of muscle functions precedes the decline in performance of UE activities, and therefore may play a role in early detection of UE limitations. Increased sEMG levels demonstrate that DMD patients use more of their muscle capacity compared to healthy subjects, to perform daily activities. This might result in increased fatigability. Active maximal joint angles are highly related to functional scales, so preserving the ability to use the full range of motion is important for the performance of daily activities. Close monitoring of active joint angles could therefore help in starting interventions that minimize functional UE decline in DMD patients timely.

The relevance of body positioning and its training effect on badminton smash.

One of the dominant skills in badminton is the forehand overhead smash, which consists of 1/5 attacks during games. Empirical evidences show that one has to adjust the body position in relation to the coming shuttlecock to produce a powerful and accurate smash. Therefore, positioning is a fundamental aspect influencing smash quality. Unfortunately, a search of literature has shown that there is a dearth/lack of study on this fundamental aspect. The goals of this study were to determine the influence of positioning and training experience on smash quality in order to discover information that could help learn/acquire the skill. Using 3D motion capture and full-body biomechanical modelling, 14 skilled and 15 novice players were analysed. Results have revealed that the body positioning has direct influence on shuttlecock release angle and clearance height of the offensive player. The results also suggest that, for training the positioning of beginners, one could conduct a self-selected comfort position towards a statically hanged shuttlecock and then step one foot back - a practical reference marker for learning. As one gains experience through repetitive training, improved limbs' coordination would increase smash quality further. We hope our findings will benefit practitioners for developing effective training programmes for beginners.

A quantitative evaluation of the high elbow technique in front crawl.

Many coaches often instruct swimmers to keep the elbow in a high position (high elbow position) during early phase of the underwater stroke motion (pull phase) in front crawl, however, the high elbow position has never been quantitatively evaluated. The aims of this study were (1) to quantitatively evaluate the "high elbow" position, (2) to clarify the relationship between the high elbow position and required upper limb configuration and (3) to examine the efficacy of high elbow position on the resultant swimming velocity. Sixteen highly skilled and 6 novice male swimmers performed 25 m front crawl with maximal effort and their 3-dimensional arm stroke motion was captured at 60 Hz. An attempt was made to develop a new index to evaluate the high elbow position (Ihe: high elbow index) using 3-dimensional coordinates of the shoulder, elbow and wrist joints. Ihe of skilled swimmers moderately correlated with the average shoulder internal rotation angle (r = -0.652, P < 0.01) and swimming velocity (r = -0.683, P < 0.01) during the pull phase. These results indicate that Ihe is a useful index for evaluating high elbow arm stroke technique during the pull phase in front crawl.

3D motion analysis of the wrist splint effect to wrist joint movement.

[Purpose] This study aimed to investigate the degree of straightness of the wrist joint, depending on the use of a wrist splint while opening a bottle cap. Its results may provide data for later studies on preventing accidents at workplaces and improving efficiency. [Subjects and Methods] Thirty Male and Female in their twenties who did not have hand-related diseases, fractures, or history that included neurological impairments associated with the hand were selected as subjects of the study. Wrist splints were made to fit the hand and lower arm of each subject. Evaluation assignments were carried out without and with the splints after 10 minutes of rest. To analyze the wrist movement in opening the bottle cap, a three-dimensional movement analyzing system by Zebris was used. [Results] Wrist angle decreased while opening caps of four different diameters while wearing splints, but not when splints were not worn. This means that wearing a splint may aid weakened wrist muscles. [Conclusion] Future studies should be conducted among subjects with damaged wrist muscles and evaluate the subjects in actual workplaces to obtain more objective and more valid data.

Effects of Global Postural Reeducation on gait kinematics in parkinsonian patients: a pilot randomized three-dimensional motion analysis study.

The Global Postural Reeducation (GPR) method is a physical therapy based on the stretching of antigravity muscle chains with the parallel enhancement of the basal tone of antagonistic muscles addressed to improve static and dynamic stability. Through a three-dimensional motion analysis (3DMA) system, our study aims to investigate whether in Parkinson's disease (PD) patients a GPR program results in a more physiological gait pattern. The kinematic parameters of gait of twenty subjects with clinically diagnosed PD were calculated. The patients were randomly assigned to a study (10 or control (10) group. All subjects underwent neurological and 3DMA assessments at entry time (t 0), at 4 weeks (t 1, end of GPR program), and at 8 and 12 weeks (t 2 and t 3, follow-up evaluation). The study group underwent a four-week GPR program, three times a week, for 40 min individual sessions. Kinematic gait parameters of thigh (T), knee (K) and ankle (A) and UPDRS-III scores were evaluated. At the end of the GPR program, we observed an improvement of the kinematic gait pattern, documented by the increase in KΔc and TΔc values that respectively express the flexion amplitude of knee and thigh. The amelioration was persistent at follow-up assessments, with a parallel enhancement in clinical parameters. GPR intervention shows a long-term efficacy on gait pattern in PD patients. Furthermore, we validated 3DMA as a valuable tool to study the kinematics of gait thus refining the understanding of the effects of specific rehabilitation programs.

Three-dimensional motion analysis of facial movement during verbal and nonverbal expressions in healthy subjects.

Functional impairments of facial expressions alter the quality of life and their quantitative analysis is key to describing and grading facial function and dysfunction. The aim of this investigation was to quantify 3D lip movements in a group of healthy young subjects. Lip movements during five repetitions of common and random sequences of vowels and nonverbal expressions were recorded using an optoelectronic 3D motion analyzer. The mean maximum displacement of facial landmarks was used to compute 3D unilateral mobility and the symmetry indices (SI) separately for each sex. Facial mobility was significantly greater during open-mouth than closed-mouth smiles. Facial movement among the subjects was largest during articulation of the vowel /a/ and smallest for /i/. Lips were pursed with a SI very close to 95%, while smiles were slightly more asymmetric. The vowel /a/ was articulated with significantly greater symmetry than /e/, /i/ and /u/. The outcomes suggest that the proposed method characterized normal facial animations satisfactorily, so it could be a useful tool for assessing patients with facial lesions and dentofacial deformities. Patient assessment would profit from this quantitative approach, which would reduce discrepancies among several clinical examinations. Clin. Anat. 29:991-997, 2016. © 2016 Wiley Periodicals, Inc.