Muscular activity during uphill cycling: effect of slope, posture, hand grip position and constrained bicycle lateral sways.

Despite the wide use of surface electromyography (EMG) to study pedalling movement, there is a paucity of data concerning the muscular activity during uphill cycling, notably in standing posture. The aim of this study was to investigate the muscular activity of eight lower limb muscles and four upper limb muscles across various laboratory pedalling exercises which simulated uphill cycling conditions. Ten trained cyclists rode at 80% of their maximal aerobic power on an inclined motorised treadmill (4%, 7% and 10%) with using two pedalling postures (seated and standing). Two additional rides were made in standing at 4% slope to test the effect of the change of the hand grip position (from brake levers to the drops of the handlebar), and the influence of the lateral sways of the bicycle. For this last goal, the bicycle was fixed on a stationary ergometer to prevent the lean of the bicycle side-to-side. EMG was recorded from M. gluteus maximus (GM), M. vastus medialis (VM), M. rectus femoris (RF), M. biceps femoris (BF), M. semimembranosus (SM), M. gastrocnemius medialis (GAS), M. soleus (SOL), M. tibialis anterior (TA), M. biceps brachii (BB), M. triceps brachii (TB), M. rectus abdominis (RA) and M. erector spinae (ES). Unlike the slope, the change of pedalling posture in uphill cycling had a significant effect on the EMG activity, except for the three muscles crossing the ankle's joint (GAS, SOL and TA). Intensity and duration of GM, VM, RF, BF, BB, TA, RA and ES activity were greater in standing while SM activity showed a slight decrease. In standing, global activity of upper limb was higher when the hand grip position was changed from brake level to the drops, but lower when the lateral sways of the bicycle were constrained. These results seem to be related to (1) the increase of the peak pedal force, (2) the change of the hip and knee joint moments, (3) the need to stabilize pelvic in reference with removing the saddle support, and (4) the shift of the mass centre forward.

[Locked volar plating for complex distal radius fractures: maintaining radial length]. / Ostéosynthèse par plaque antérieure verrouillée des fractures complexes de l'extrémité distale du radius: contribution au maintien de la longueur radiale.

PURPOSE OF THE STUDY: Maintaining radial length, likely to be the main challenge in the treatment of complex distal radius fractures, is necessary for complete grip-strength and pro-supination range recovery. In spite of frequent secondary displacements, bridging external-fixation has remained the reference method, either isolated or in association with additional percutaneous pins or volar plating. Also, there seems to be a relation between algodystrophy and the duration of traction applied on the radio-carpal joint. Fixed-angle volar plating offers the advantage of maintaining the reduction until fracture healing, without bridging the joint. MATERIAL AND METHODS: In a prospective study, forty-three consecutive fractures of the distal radius with a positivated ulnar variance were treated with open reduction and fixed-angle volar plating. Results were assessed with special attention to the radial length and angulation obtained and maintained throughout treatment, based on repeated measurements of the ulnar variance and radial angulation in the first six months postoperatively. RESULTS: The correction of the ulnar variance was maintained until complete recovery, independently of initial metaphyseal comminution, and of the amount of radial length gained at reduction. Only 3 patients lost more than 1 mm of radial length after reduction. The posterior tilt of the distal radial epiphysis was incompletely reduced in 13 cases, whereas reduction was partially lost in 6 elderly osteoporotic female patients. There was 8 articular malunions, all of them less than 2 mm. Secondary displacements were found to be related to a deficient locking technique. Eight patients developed an algodystropy. The risk factors for algodystrophy were articular malunion, associated posterior pining, and associated lesions of the ipsilateral upper limb. CONCLUSION: Provided that the locking technique was correct, this type of fixation appeared efficient in maintaining the radial length in complex fractures of the distal radius. The main challenge remains the reduction of displaced articular fractures. Based on these results, it is not possible to conclude that this method is superior to external fixation.

Validity and reliability of the PowerTap mobile cycling powermeter when compared with the SRM Device.

The SRM power measuring crank system is nowadays a popular device for cycling power output (PO) measurements in the field and in laboratories. The PowerTap (CycleOps, Madison, USA) is a more recent and less well-known device that allows mobile PO measurements of cycling via the rear wheel hub. The aim of this study is to test the validity and reliability of the PowerTap by comparing it with the most accurate (i.e. the scientific model) of the SRM system. The validity of the PowerTap is tested during i) sub-maximal incremental intensities (ranging from 100 to 420 W) on a treadmill with different pedalling cadences (45 to 120 rpm) and cycling positions (standing and seated) on different grades, ii) a continuous sub-maximal intensity lasting 30 min, iii) a maximal intensity (8-s sprint), and iiii) real road cycling. The reliability is assessed by repeating ten times the sub-maximal incremental and continuous tests. The results show a good validity of the PowerTap during sub-maximal intensities between 100 and 450 W (mean PO difference -1.2 +/- 1.3 %) when it is compared to the scientific SRM model, but less validity for the maximal PO during sprint exercise, where the validity appears to depend on the gear ratio. The reliability of the PowerTap during the sub-maximal intensities is similar to the scientific SRM model (the coefficient of variation is respectively 0.9 to 2.9 % and 0.7 to 2.1 % for PowerTap and SRM). The PowerTap must be considered as a suitable device for PO measurements during sub-maximal real road cycling and in sub-maximal laboratory tests.

Muscular activity level during pedalling is not affected by crank inertial load.

The aim of the present study was to investigate the influence of gear ratio (GR) and thus crank inertial load (CIL), on the activity levels of lower limb muscles. Twelve competitive cyclists performed three randomised trials with their own bicycle equipped with a SRM crankset and mounted on an Axiom ergometer. The power output ( approximately 80% of maximal aerobic power) and the pedalling cadence were kept constant for each subject across all trials but three different GR (low, medium and high) were indirectly obtained for each trial by altering the electromagnetic brake of the ergometer. The low, medium and high GR (mean +/- SD) resulted in CIL of 44 +/- 3.7, 84 +/- 6.5 and 152 +/- 17.9 kg.m(2), respectively. Muscular activity levels of the gluteus maximus (GM), the vastus medialis (VM), the vastus lateralis (VL), the rectus femoris (RF), the medial hamstrings (MHAM), the gastrocnemius (GAS) and the soleus (SOL) muscles were quantified and analysed by mean root mean square (RMS(mean)). The muscular activity levels of the measured lower limb muscles were not significantly affected when the CIL was increased approximately four fold. This suggests that muscular activity levels measured on different cycling ergometers (with different GR and flywheel inertia) can be compared among each other, as they are not influenced by CIL.

[Calcification and hernia of an intervertebral disc in a child (author's transl)]. / Un cas de calcification d'un disque intervertébral avec hernie.

Cervicobrachial neuralgia and torticolis in a 7 year old child were found to be due to calcification and hernia of an intervertebral disc. Similar cases reported in the published literature are reviewed.