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BACKGROUND: Body-worn inertial measurement unit (IMU) sensors have been widely used in postural stability and balance studies because of their low cost and convenience. In most of these studies, a single IMU sensor is attached to a waist belt near the body's center of mass. Some populations such as pregnant women, however, may find a waist belt challenging in terms of fit and comfort. For this reason it may be useful to identify an alternative location for placement of an IMU and a more comfortable means for attaching the sensor to the body. Research question Does placing an IMU sensor in a pendant worn around the neck permit discrimination between conditions with varying postural stability? METHODS: Twenty-six healthy participants performed three standing tasks (double-leg, tandem, and single-leg standing) under eyes-open and eyes-closed vision conditions to preliminarily assess the ability of the pendant sensor to discriminate between balance conditions. Discrimination based upon data from a belt-mounted IMU was assessed in the same trials. Differences in standard deviation of acceleration components, sway area, and jerkiness due to trial condition and sensor were evaluated using analysis of variance followed by post hoc comparisons. These data were also incorporated into receiver-operator characteristic (ROC) curve analysis to assess the effectiveness of each sensor at discriminating between conditions. RESULTS: Stability was found to vary across conditions, but there was no interaction between stability and sensor location (all p ≥ 0.323). ROC curve analysis showed that sensors in both locations were good discriminators between conditions. Significance Placing an IMU in a pendant may be feasible for studying and monitoring postural instability. This approach may be especially valuable when considering populations for which wearing a belt is uncomfortable.
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Enfermedades del Sistema Nervioso , Dispositivos Electrónicos Vestibles , Aceleración , Femenino , Humanos , Equilibrio Postural , Embarazo , Posición de PieRESUMEN
Elastic energy storage and release can enhance performance that would otherwise be limited by the force-velocity constraints of muscle. Although functional influence of a biological spring depends on tuning between components of an elastic system (the muscle, spring-driven mass and lever system), we do not know whether elastic systems systematically adapt to functional demand. To test whether altering work and power generation during maturation alters the morphology of an elastic system, we prevented growing guinea fowl (Numida meleagris) from jumping. We compared the jump performance of our treatment group at maturity with that of controls and measured the morphology of the gastrocnemius elastic system. We found that restricted birds jumped with lower jump power and work, yet there were no significant between-group differences in the components of the elastic system. Further, subject-specific models revealed no difference in energy storage capacity between groups, though energy storage was most sensitive to variations in muscle properties (most significantly operating length and least dependent on tendon stiffness). We conclude that the gastrocnemius elastic system in the guinea fowl displays little to no plastic response to decreased demand during growth and hypothesize that neural plasticity may explain performance variation.
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Galliformes , Músculo Esquelético , Animales , Fenómenos Biomecánicos , TendonesRESUMEN
INTRODUCTION: Dynamic alignment of lower limb prostheses is subjective and time-consuming. Compensatory gait strategies caused by prosthesis misalignment can negatively affect lower limb amputees who cannot access a certified prosthetist for alignment adjustments. The objective of this study is to evaluate a novel six-degrees-of-freedom passive transtibial prosthetic adapter that self-aligns during various phases of gait. This self-aligning adapter may benefit service members and veterans stationed or living far from a clinical facility. METHODS: Four transtibial amputee subjects, aged 47 to 62 (mean: 55.75) years with mean weight of 163.6 lbs and mean K-level of 3.25, walked at self-selected speeds on a 10-m level walkway. Subjects walked with the self-aligning and a size- or weight-matched control adapter, assembled to a commercially available energy-storing-and-returning foot and their own socket, with 22-mm alignment perturbations in the anterior, posterior, medial, or lateral directions. Subjects were blinded to both adapter type and misalignment. Socket moments, spatiotemporal gait parameters, and subjective socket comfort were recorded. RESULTS: Preliminary results showed improvements in mean peak socket moments and step length differential with the self-aligning adapter across all alignments. Walking speed and prosthesis-side base of support showed little change in all configurations. Prosthesis-side stance duration and Functional Ambulation Profile Score increased with the self-aligning adapter in some alignments. Patient-reported socket comfort increased slightly with the self-aligning adapter across all misalignments. CONCLUSION: Subjects maintained similar walking speeds and experienced greater gait symmetry and reduced sagittal plane peak moments with the self-aligning adapter when exposed to misalignments. These trends suggest a benefit to transtibial amputees from a reduction in secondary gait effects from prosthesis misalignments. Additionally, a wider range of acceptable prosthesis alignments may be possible with the self-aligning adapter. Subsequent trials are underway to evaluate the self-aligning adapter in real-world environments like walking on uneven terrains, stairs, ramps, and abrupt turns.
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Biomimética , Amputados , Miembros Artificiales , Fenómenos Biomecánicos , Humanos , Persona de Mediana Edad , Tibia/cirugía , CaminataRESUMEN
Prior research on total ankle arthroplasty (TAA) has focused on improvements in pain and function following the surgical treatment of ankle arthritis, but its effect on ankle joint mechanics has received relatively little attention. The plantarflexion moment arm of the Achilles tendon is a critical determinant of ankle function with the potential to be altered by TAA. Here we investigate the effect of TAA on Achilles tendon moment arm assessed using two methods. Standing sagittal-plane radiographs were obtained for ten patients presurgery and postsurgery, from which anterior-posterior distance between the posterior calcaneus and the center of the talar dome was measured. Ultrasound imaging and three-dimensional (3D) motion capture were used to obtain moment arm pre- and post-TAA. The absolute changes in moment arm pre- to post-TAA were significantly different from zero for both methods (9.6 mm from ultrasound and 4.6% of the calcaneus length from radiographs). Only 46% of the variance in postoperative 3D Achilles tendon moment arm was explained by the preoperative value (r2 = 0.460; p = .031), while pre- and post-TAA values from radiographs were not correlated (r2 = 0.192, p = .206). While we did not find significant mean differences in Achilles tendon moment arm between pre- and post-TAA, we did find absolute changes in 3D moment arm that were significantly different from zero and these changes were partially explained by a change in location of the talar dome as indicated by measurements from radiographs (r2 = 0.497, p = .023).
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Tendón Calcáneo/fisiología , Artroplastia de Reemplazo de Tobillo/rehabilitación , Tendón Calcáneo/diagnóstico por imagen , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Radiografía , UltrasonografíaRESUMEN
Tendon mechanical properties respond to altered load in adults, but how load history during growth affects adult tendon properties remains unclear. To address this question, we adopted an avian model in which we altered the mechanical load environment across the growth span. Animals were divided at 2 weeks of age into three groups: (1) an exercise control group given the opportunity to perform high-acceleration movements (EXE, n = 8); (2) a sedentary group restricted from high-intensity exercise (RES, n = 8); and (3) a sedentary group also restricted from high-intensity exercise and in which the gastrocnemius muscles were partially paralyzed using repeated bouts of botulinum toxin-A injections (RES-BTX, n = 8). Video analysis of bird movement confirmed the restrictions eliminated high-intensity exercise and did not alter time spent walking and sitting between groups. At skeletal maturity (33-35 weeks) animals were sacrificed for analysis, consisting of high-field MRI and material load testing, of both the entire free Achilles tendon and the tendon at the bone-tendon junction. Free tendon stiffness, modulus, and hysteresis were unaffected by variation in load environment. Further, the bone-tendon junction cross-sectional area, stress, and strain were also unaffected by variations in load environment. These results suggest that: (a) a baseline level of low-intensity activity (standing and walking) may be sufficient to maintain tendon growth; and (b) if this lower threshold of tendon load is met, non-mechanical mediated tendon growth may override the load-induced mechanotransduction signal attributed to tendon remodeling in adults of the same species. These results are important for understanding of musculoskeletal function and tendon health in growing individuals.
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Accurate location of the axis of ankle rotation is critical to in vivo estimates of Achilles tendon moment arm. Here we investigated how the plantarflexion moment arm of the Achilles tendon is affected by using an instantaneous helical axis that moves with ankle motion as opposed to a single fixed joint axis that approximates the average axis of rotation. Twenty young healthy adults performed a series of weightbearing cyclical plantar- and dorsi-flexion motions. Motion analysis tracked the motions of markers placed on the foot and shank and also tracked an ultrasound probe imaging the Achilles tendon. Differences in ATma between the methods were investigated using a two-way repeated-measures ANOVA with factors of joint angle (+5°, 0°, -5°, -10°, -15°) and method (instantaneous helical axes, fixed axis). Moment arms computed between the two methods were moderately to strongly correlated, especially in the mid-range of motion (for 0° to 10° plantarflexion, all r2 > 0.619 and all p < 0.004). The two methods produced Achilles tendon moment arms that were comparable and not significantly different except in the most dorsiflexed position, when they differed on average by 9.35 ± 3.23 mm (p = 0.001). Our results suggest that either approach for locating the axis of ankle rotation would be appropriate for the purpose of estimating ATma, but that a fixed axis may be preferable because it is applicable over a greater range of ankle motion.
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Tendón Calcáneo , Tendón Calcáneo/diagnóstico por imagen , Adulto , Tobillo , Articulación del Tobillo , Humanos , Imagen por Resonancia Magnética , Rango del Movimiento ArticularRESUMEN
Decreases in activity levels in children worldwide are feared to have long-term health repercussions. Yet, because of the difficulty of performing controlled long-term studies in humans, we do not yet understand how decreases in childhood activity influence adult functional capacity. Here, in an avian bipedal model, we evaluated the elimination of all high-intensity activity during growth on adult performance. We evaluated three alternative hypotheses: Elimination of high-intensity activity 1) does not influence adult function, 2) results in task-specific deficits in adulthood, or 3) results in deficits that generalize across locomotor tasks. We found that animals restricted from jumping and sprinting during growth showed detriments as adults in maximal jump performance in comparison to controls, but did not require more metabolic energy during steady-state running or standing. From this, we conclude that functional deficits from elimination of high-intensity exercise are task specific and do not generalize across all locomotor functions.NEW & NOTEWORTHY Decreasing childhood activity levels are feared to have long-term health repercussions, but testing this hypothesis is hampered by restrictions of human experimentation. Here, in a bipedal animal model, we examine how the elimination of high-intensity activity during all of maturation influences adult locomotor capacity. We found restricted activity during growth reduced mechanical power capacity but not submaximal metabolic cost. This suggests that reduced childhood activity may result in task-specific, rather than generalized locomotor deficits.
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Galliformes/fisiología , Locomoción/fisiología , Músculo Esquelético/fisiología , Condicionamiento Físico Animal , Animales , Fenómenos Biomecánicos , Galliformes/crecimiento & desarrollo , Modelos AnimalesRESUMEN
The plantarflexor moment arm of the Achilles tendon determines the mechanical advantage of the triceps surae and also indirectly affects muscle force generation by setting the amount of muscle-tendon shortening per unit of ankle joint rotation. The Achilles tendon moment arm may be determined geometrically from an axis (or center) of joint rotation and the line of action of the tendon force, but such moment arms may be sensitive to the location of the joint axis. Using motion analysis to track an ultrasound probe overlying the Achilles tendon along with markers on the shank and foot, we measured Achilles tendon moment arm during loaded and unloaded dynamic plantarflexion motions in 15 healthy subjects. Three representations of the axis or center of rotation of the ankle were considered: (1) a functional axis, defined by motions of the foot and shank; (2) a transmalleolar axis; and (3) a transmalleolar midpoint. Moment arms about the functional axis were larger than those found using the transmalleolar axis and transmalleolar midpoint (all pâ¯<â¯0.001). Moment arms computed with the functional axis increased with plantarflexion angle (all pâ¯<â¯0.001), and increased with loading in the most plantarflexed position (pâ¯<â¯0.001) but these patterns were not observed when either using a transmalleolar axis or transmalleolar midpoint. Functional axis moment arms were similar to those estimated previously using magnetic resonance imaging, suggesting that using a functional axis for ultrasound-based geometric estimates of Achilles tendon moment arm is an improvement over landmark-based methods.
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Tendón Calcáneo/fisiología , Tobillo/fisiología , Movimiento , Rotación , Voluntarios Sanos , Humanos , Músculo Esquelético/fisiología , Procedimientos OrtopédicosRESUMEN
Geometric and tendon excursion methods have both been used extensively for estimating plantarflexor muscle moment arm in vivo. Geometric measures often utilize magnetic resonance imaging, which can be costly and impractical for many investigations. Estimating moment arm from tendon excursion measured with ultrasonography may provide a cost-effective alternative to geometric measures of moment arm, but how well such measures represent geometry-based moment arms remains in question. The purpose of this study was to determine whether moment arms from tendon excursion can serve as a surrogate for moment arms measured geometrically. Magnetic resonance and ultrasound imaging were performed on 19 young male subjects to quantify plantarflexor moment arm based on geometric and tendon excursion paradigms, respectively. These measurements were weakly correlated that approached statistical significance (R2â¯=â¯0.21, pâ¯=â¯0.052), and moment arm from tendon excursion under-approximated geometric moment arm by nearly 40% (pâ¯<â¯0.001). This weak correlation between methods is at odds with a prior report (Nâ¯=â¯9) of a strong correlation (R2â¯=â¯0.94) in a similar study. Therefore, we performed 92,378 regression analyses (19 choose 9) to determine if such a strong correlation existed in our study population. We found that certain sub-populations of the current study generated similarly strong coefficients of determination (R2â¯=â¯0.92), but 84% of all analyses revealed no correlation (pâ¯>â¯0.05). Our results suggest that the moment arms from musculoskeletal geometry cannot be otherwise obtained by simply scaling moment arms estimated from tendon excursion.
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Brazo/fisiología , Fenómenos Mecánicos , Tendones/fisiología , Adulto , Brazo/anatomía & histología , Brazo/diagnóstico por imagen , Fenómenos Biomecánicos , Humanos , Imagen por Resonancia Magnética , Masculino , Músculo Esquelético/fisiología , Tendones/anatomía & histología , Tendones/diagnóstico por imagen , UltrasonografíaRESUMEN
The "Oxford Rig" cadaveric simulator permits researchers and clinicians to study knee mechanics during a simulated squatting motion. The motion of the lower limb in the Oxford Rig is typically controlled by a single actuator that applies tension to the quadriceps tendon. The location of the quadriceps actuator, however, has differed across published descriptions of the Oxford Rig. Actuators have been placed on the femur and pelvis, and on "grounded" locations external to the specimen, but the consequences of this placement for knee kinematics and kinetics are unknown. The purpose of this study was to examine these effects using a validated computational musculoskeletal model. When the actuator was placed on the femur or pelvis, forces realistically increased with knee flexion, with quadriceps and patellofemoral contact forces exceeding 2000â¯N and 3000â¯N, respectively, at 100° flexion. When the actuator was grounded, however, forces were substantially reduced and did not monotonically increase with flexion. Articular joint contact forces were not strongly influenced by changing the location of the actuator from the femur to the pelvis, with small RMS differences in quadriceps forces (48.2â¯N), patellofemoral forces (83.6â¯N), and tibiofemoral forces (58.9â¯N) between these conditions. The location of the actuator did not substantially affect knee kinematics. The results of this study suggest that the quadriceps actuator of the Oxford Rig should be attached to either the femur or the pelvis when the goal is to make realistic estimates of quadriceps forces and articular contact forces within the knee joint.
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Articulación de la Rodilla/fisiología , Modelos Biológicos , Músculo Cuádriceps/fisiología , Artroplastia de Reemplazo de Rodilla , Fenómenos Biomecánicos , Fémur/fisiología , Humanos , Rótula/fisiología , Pelvis/fisiología , Postura/fisiología , Rango del Movimiento Articular , Tibia/fisiologíaRESUMEN
Variability in musculoskeletal structure has the potential to influence locomotor function. It has been shown, for example, that sprinters have smaller Achilles tendon moment arms and longer toes than non-sprinters, and toe length has been found to correlate with toe flexor work in running humans. These findings suggest that interindividual variation in human foot structure allows for function that is adapted to various motor tasks. The purpose of this study was to test for correlations between foot anthropometry and single-joint maximal-height jumping performance. Ten male subjects performed static jumps using only their ankles for propulsion. Several anthropometric measures were taken. Bivariate correlation analyses were performed between all anthropometric variables and the average jump height for each subject. Results showed that the best jumpers had longer lateral heel lengths (r=0.871; p=0.001) and longer toes (r=0.712; p=0.021). None of the other anthropometric variables (stature, mass, lower extremity lengths) measured were found to correlate significantly with jump height. A factor analysis was performed to investigate whether some underlying feature related to body stature could explain jumping performance. Taller subjects did not necessarily jump higher. Specific variations in foot structure, unrelated to other general stature measures, were associated with performance in this single-joint jumping task.
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Pie/anatomía & histología , Pie/fisiología , Movimiento/fisiología , Adulto , Pesos y Medidas Corporales , Humanos , Masculino , Adulto JovenRESUMEN
Several recent investigations have linked running economy to heel length, with shorter heels being associated with less metabolic energy consumption. It has been hypothesized that shorter heels require larger plantar flexor muscle forces, thus increasing tendon energy storage and reducing metabolic cost. The goal of this study was to investigate this possible mechanism for metabolic cost reduction. Fifteen male subjects ran at 16 kmâ h-1 on a treadmill and subsequently on a force-plate instrumented runway. Measurements of oxygen consumption, kinematics, and ground reaction forces were collected. Correlational analyses were performed between oxygen consumption and anthropometric and kinetic variables associated with the ankle and foot. Correlations were also computed between kinetic variables (peak joint moment and peak tendon force) and heel length. Estimated peak Achilles tendon force normalized to body weight was found to be strongly correlated with heel length normalized to body height (r = -.751, p = .003). Neither heel length nor any other measured or calculated variable were correlated with oxygen consumption, however. Subjects with shorter heels experienced larger Achilles tendon forces, but these forces were not associated with reduced metabolic cost. No other anthropometric and kinetic variables considered explained the variance in metabolic cost across individuals.
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Articulación del Tobillo/anatomía & histología , Articulación del Tobillo/fisiología , Antropometría/métodos , Metabolismo Energético/fisiología , Pie/anatomía & histología , Pie/fisiología , Carrera/fisiología , Tendón Calcáneo/anatomía & histología , Tendón Calcáneo/fisiología , Fenómenos Biomecánicos , Peso Corporal/fisiología , Humanos , Masculino , Consumo de Oxígeno/fisiología , Valor Predictivo de las Pruebas , Adulto JovenRESUMEN
Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p < 0.001) and increased the gear ratio (i.e., ratio of ground reaction force and plantar flexor muscle lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors' mechanical advantage.
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Fenómenos Biomecánicos/fisiología , Pie/fisiología , Músculo Esquelético/fisiología , Caminata/fisiología , Tobillo/fisiología , Marcha/fisiología , HumanosRESUMEN
Surgical technique is one factor that has been identified as critical to success of total knee arthroplasty. Researchers have shown that computer simulations can aid in determining how decisions in the operating room generally affect post-operative outcomes. However, to use simulations to make clinically relevant predictions about knee forces and motions for a specific total knee patient, patient-specific models are needed. This study introduces a methodology for estimating knee soft-tissue properties of an individual total knee patient. A custom surgical navigation system and stability device were used to measure the force-displacement relationship of the knee. Soft-tissue properties were estimated using a parameter optimization that matched simulated tibiofemoral kinematics with experimental tibiofemoral kinematics. Simulations using optimized ligament properties had an average root mean square error of 3.5° across all tests while simulations using generic ligament properties taken from literature had an average root mean square error of 8.4°. Specimens showed large variability among ligament properties regardless of similarities in prosthetic component alignment and measured knee laxity. These results demonstrate the importance of soft-tissue properties in determining knee stability, and suggest that to make clinically relevant predictions of post-operative knee motions and forces using computer simulations, patient-specific soft-tissue properties are needed.
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Artroplastia de Reemplazo de Rodilla , Articulación de la Rodilla/fisiología , Rodilla/fisiología , Modelos Biológicos , Medicina de Precisión , Adulto , Anciano , Simulación por Computador , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Increases in the rates and intensity of youth sports participation have led to an elevated incidence of anterior cruciate ligament (ACL) injuries and reconstruction in adolescents. Traditional reconstruction techniques in the skeletally immature patient may violate the growth plates and potentially lead to deformities. HYPOTHESIS/PURPOSE: The purpose of this study was to compare the volume and location of femoral growth plate violations resulting from anteromedial (AM) and transtibial (TT) techniques in ACL reconstruction. The hypothesis was that the more oblique angle used in femoral tunnels drilled with the AM portal technique would produce larger and more lateral violations compared with those resulting from TT tunnels. STUDY DESIGN: Controlled laboratory study. METHODS: Growth plate disturbances were quantified by performing simulated reconstructions in computer models created from magnetic resonance imaging scans of the knees of 17 adolescent participants. Locations of tunnels drilled with simulated AM and TT portal techniques were specified by an orthopaedic surgeon blinded to the locations of the femoral physes in the knee models. Tunnels with lengths of 20, 25, and 30 mm were placed in each model using simulated drill diameters of 7, 8, and 9 mm in addition to a 4.5-mm tunnel breaching the lateral cortex. Normalized measures of the volume and laterality of violations were computed. RESULTS: Tunnels drilled with the AM portal technique disrupted a significantly larger percentage of the physis (P = .007), but the difference was not substantial. Tunnels drilled with the AM portal technique produced violations that were more lateral in the physis than those drilled with the TT technique (P < .001). Tunnels drilled with the AM portal technique resulted in mean violations that were 5.1% ± 2.1% of the physis as compared with 4.7% ± 2.0% for TT tunnels. The mean value for a normalized measure of the laterality of the violation (L score) was 0.590 ± 0.115 for tunnels drilled with the AM portal technique and 0.290 ± 0.104 for TT tunnels. The AM approach produced 16 of 153 simulated reconstructions with growth plate violations greater than 8% compared with only 10 with the TT approach. CONCLUSION: Results suggest that the AM approach produces growth plate violations that are larger and more lateral than the violations generated using the TT technique. AM approaches were more likely to remove more than 8% of the physeal volume, a level previously identified as posing a greater risk of growth disturbances. While the difference in the mean physeal volume removed between the approaches was small, the violations for the AM approach were much more lateral, a finding of potentially greater clinical significance. CLINICAL RELEVANCE: As progressively younger patients are considered candidates for ACL reconstruction, knowledge of how variations in technique affect the developing knee is critical to preventing iatrogenic injuries.
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Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior/métodos , Placa de Crecimiento/cirugía , Tibia/cirugía , Adolescente , Simulación por Computador , Epífisis/cirugía , Fasciotomía , Femenino , Fémur/cirugía , Lateralidad Funcional/fisiología , Humanos , Traumatismos de la Rodilla/cirugía , Articulación de la Rodilla/cirugía , Ligamentos/cirugía , Imagen por Resonancia Magnética , MasculinoRESUMEN
BACKGROUND: Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson's disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. OBJECTIVE: We aimed to investigate the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. METHODS: Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. RESULTS: Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p = 0.0018), but not faster- (p = 0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p = 0.0046) and lower maximum cross-correlation (p = 0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p = 0.0182), but not faster- (p = 0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p = 0.0386), whereas maximum cross-correlation showed no change (p = 0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R = -0.73824, p = 0.0011). CONCLUSIONS: This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression.
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Brazo/fisiopatología , Trastornos Neurológicos de la Marcha/tratamiento farmacológico , Trastornos Neurológicos de la Marcha/etiología , Movimiento/efectos de los fármacos , Enfermedad de Parkinson/complicaciones , Anciano , Dopaminérgicos/farmacología , Dopaminérgicos/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Movimiento/fisiología , Enfermedad de Parkinson/tratamiento farmacológico , Desempeño Psicomotor/efectos de los fármacos , CaminataRESUMEN
Muscle volume is known to correlate with maximal joint torque in humans, but the role of muscle moment arm in determining maximal torque is less clear. Moderate correlations have been reported between maximal isometric knee extensor torque and knee extensor moment arm, but no such observations have been made for the ankle joint. It has been suggested that smaller muscle moment arms may enhance force generation at high rates of joint rotation, but this has not yet been observed for ankle muscles in vivo. The purpose of the present study was to correlate plantar flexor moment arm and plantar flexor muscle volume with maximal plantar flexor torque measured at different rates of plantar flexion. Magnetic resonance imaging was used to quantify the plantar flexor moment arm and muscle volume of the posterior compartment in 20 healthy young men. Maximal plantar flexor torque was measured isometrically and at three plantar flexion speeds using an isokinetic dynamometer. Plantar flexor torque was significantly correlated with muscle volume (0.222 < R(2) < 0.322) and with muscle moment arm at each speed (0.323 < R(2) < 0.494). While muscle volume was strongly correlated with body mass and stature, moment arm was not. The slope of the torque-moment arm regression line decreased as the rate of joint rotation increased, indicating that subjects with small moment arms experienced smaller reductions in torque at high speeds. The findings of this study suggest that plantar flexor moment arm is a determinant of joint strength that is at least as important as muscle size.
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Brazo/fisiología , Pie/fisiología , Movimiento/fisiología , Músculo Esquelético/anatomía & histología , Tendón Calcáneo/fisiología , Articulación del Tobillo/fisiología , Brazo/anatomía & histología , Fenómenos Biomecánicos , Pie/anatomía & histología , Humanos , Contracción Isométrica , Articulaciones/anatomía & histología , Articulaciones/fisiología , Modelos Lineales , Imagen por Resonancia Magnética , Masculino , Contracción Muscular/fisiología , Dinamómetro de Fuerza Muscular , Rotación , Torque , Adulto JovenRESUMEN
Synthesis of legged locomotion through dynamic simulation is useful for exploration of the mechanical and control variables that contribute to efficient gait. Most previous simulations have made use of periodicity constraints, a sensible choice for investigations of steady-state walking or running. Sprinting from rest, however, is aperiodic by nature and this aperiodicity is central to the goal of the movement, as performance is determined in large part by a rapid acceleration phase early in the race. The purpose of this study was to create a novel simulation of aperiodic sprinting using a modified spring-loaded inverted pendulum (SLIP) biped model. The optimal control problem was to find the set of controls that minimized the time for the model to run 20 m, and this problem was solved using a direct multiple shooting algorithm that converts the original continuous time problem into piecewise discrete subproblems. The resulting nonlinear programming problem was solved iteratively using a sequential quadratic programming method. The starting point for the optimizer was an initial guess simulation that was a slow alternating-gait "jogging" simulation developed using proportional-derivative feedback to control trunk attitude, swing leg angle, and leg retraction and extension. The optimized aperiodic sprint simulation solution yielded a substantial improvement in locomotion time over the initial guess (2.79 s versus 6.64 s). Following optimization, the model produced forward impulses at the start of the sprint that were four times greater than those of the initial guess simulation, producing more rapid acceleration. Several gait features demonstrated in the optimized sprint simulation correspond to behaviors of human sprinters: forward trunk lean at the start; straightening of the trunk during acceleration; and a dive at the finish. Optimization resulted in reduced foot contact times (0.065 s versus 0.210 s), but contact times early in the optimized simulation were longer to facilitate acceleration. The present study represents the first simulation of multistep aperiodic sprinting with optimal controls. Although the minimized objective function was simple, the model replicated several complex behaviors such as modulation of the foot contact and executing a forward dive at the finish line. None of these observed behaviors were imposed explicitly by constraints but rather were "discovered" by the optimizer. These methods will be extended by addition of musculotendon actuators and joints in order to gain understanding of the influence of musculoskeletal mechanics on gait speed.