Quantification of Equine Sacral and Iliac Motion During Application of Manual Forces and Comparison Between Motion Capture With Skin-Mounted and Bone-Fixated Sensors.

Diagnosis of sacroiliac dysfunction in horses includes manual motion palpation of the equine ilium and sacrum. Motion of the ilium and sacrum during manual force application to the equine pelvis has been measured previously in vitro. The aim of this study was to measure the amount and direction of motion in vivo, including comparison of bone-fixated and skin-mounted inertial sensors. Sensors were skin-mounted over tuber sacrale (TS) and third sacral spinous process of six Thoroughbred horses and later attached via Steinmann pins inserted into the same bony landmarks. Orientations of each TS and sacrum were recorded by one investigator during six trials of manual force applied to the pelvis, inducing cranial, caudal, and oblique rotations. Mean values were reported in Euler angles for the three orthogonal planes lateral bending, flexion-extension (FE), and axial rotation (AR). Differences between skin- and bone-fixated markers were determined with significance set at P < .05. The largest mean values recorded during rotations applied to the pelvises were for FE, (2.08° ± 0.35°) with bone-fixated sensors. AR gave the largest values recorded with skin mountings (1.70° ± 0.48°). There was a poor correlation between skin-mounted and bone-fixated markers with AR being the orthogonal plane in which results from skin mounting were closest to results from bone-fixated sensors Bony kinematics during external movement applied to the pelvis cannot be predicted from skin-mounted sensors, due to differences between skin- and bone-mounted sensors.

Effectiveness of a video-based exercise programme to reduce falls and improve health-related quality of life among older adults discharged from hospital: a pilot randomized controlled trial.

OBJECTIVE: Falls, loss of health-related quality of life and physical capacity, reduced participation in activities of daily living, and increased fear of falling are all potential outcomes for older adults discharged from hospital. A low-cost video based exercise programme may address this. DESIGN: This study was a randomized controlled trial with blinded outcomes assessment and a six-month follow-up. SUBJECTS AND SETTING: Participants were older adults (>65 years) using a mobility aid discharged from a tertiary hospital in Brisbane, Australia, without referral for community-based rehabilitation services. INTERVENTION: A digital video disk-based programme encompassing six exercise types each with six levels of difficulty. A home visit from a project physiotherapist was conducted to ensure patient safety. Control group patients received usual care. MAIN MEASURES: Falls, health-related quality of life, participation in activities of daily living, physical capacity and fear of falling. RESULTS: Study participants (n = 53, 19 intervention, 34 control) experienced decreasing health-related quality of life, several falls (72), and lower levels of participation in activities of daily living over the six-month follow-up. The intervention group did not differ significantly from the control group in terms of the outcomes examined, though a non-significant reduction in the rate of falls was observed. Intervention group participants complied with the exercise programme well during the first two weeks following discharge from hospital but then reduced their compliance levels thereafter. CONCLUSIONS: The intervention may be beneficial for reducing the rate of falls in this patient population though further research with a larger sample size is indicated.

Telephone reliability of the Frenchay Activity Index and EQ-5D amongst older adults.

BACKGROUND: Older adults may find it problematic to attend hospital appointments due to the difficulty associated with travelling to, within and from a hospital facility for the purpose of a face-to-face assessment. This study aims to investigate equivalence between telephone and face-to-face administration for the Frenchay Activities Index (FAI) and the Euroqol-5D (EQ-5D) generic health-related quality of life instrument amongst an older adult population. METHODS: Patients aged >65 (n = 53) who had been discharged to the community following an acute hospital admission underwent telephone administration of the FAI and EQ-5D instruments seven days prior to attending a hospital outpatient appointment where they completed a face-to-face administration of these instruments. RESULTS: Overall, 40 subjects' datasets were complete for both assessments and included in analysis. The FAI items had high levels of agreement between the two modes of administration (item kappa's ranged 0.73 to 1.00) as did the EQ-5D (item kappa's ranged 0.67-0.83). For the FAI, EQ-5D VAS and EQ-5D utility score, intraclass correlation coefficients were 0.94, 0.58 and 0.82 respectively with paired t-tests indicating no significant systematic difference (p = 0.100, p = 0.690 and p = 0.290 respectively). CONCLUSION: Telephone administration of the FAI and EQ-5D instruments provides comparable results to face-to-face administration amongst older adults deemed to have cognitive functioning intact at a basic level, indicating that this is a suitable alternate approach for collection of this information.

Wireless orientation sensors: their suitability to measure head movement for neck pain assessment.

The purpose of this study was to verify the performance and suitability of new generation 3D wireless orientations sensors to measure cervical range of movement against a criterion standard instrument, an electromagnetic motion analysis system (Fastrak-Polhemus). The wireless orientation sensor (InertiaCube 3) consists of 9 motion-sensing elements: 3 accelerometers, 3 angular velocity rate transducers and 3 magnetometers. Measurements of cervical range of motion in each primary plane, left-lateral flexion, flexion and left rotation were directly compared from both systems in 10 normal asymptomatic subjects. Results showed very high cross-correlations (.99-.97) and low average root mean square errors (0.7-2.5 degrees). We conclude that orientation sensors are a valid, accurate and suitable device for obtaining cervical joint ranges of motion in the primary plane of movement.

Gait event detection using linear accelerometers or angular velocity transducers in able-bodied and spinal-cord injured individuals.

We report on three different methods of gait event detection (toe-off and heel strike) using miniature linear accelerometers and angular velocity transducers in comparison to using standard pressure-sensitive foot switches. Detection was performed with normal and spinal-cord injured subjects. The detection of end contact (EC), normally toe-off, and initial contact (IC) normally, heel strike was based on either foot linear accelerations or foot sagittal angular velocity or shank sagittal angular velocity. The results showed that all three methods were as accurate as foot switches in estimating times of IC and EC for normal gait patterns. In spinal-cord injured subjects, shank angular velocity was significantly less accurate (p<0.02). We conclude that detection based on foot linear accelerations or foot angular velocity can correctly identify the timing of IC and EC events in both normal and spinal-cord injured subjects.

The development, validity, and reliability of a manual muscle testing device with integrated limb position sensors.

OBJECTIVE: To report the development and validation of a new hand-held muscle strength-testing device that is integrated with orientation sensors and designed to test the strength of major muscle groups at a given limb or joint position. DESIGN: Design description and validation study. SETTING: University-based human movement facility. PARTICIPANTS: Twenty-eight able-bodied, healthy subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: A device was developed based on a hand-held force dynamometer with integrated orientation sensors. The validity and reliability (interrater, intertrial) of 5 maximum isometric contractions of hip flexion, knee extension, and ankle plantarflexion and dorsiflexion were assessed. The results were compared with those from an isokinetic dynamometer (KinCom). RESULTS: The new manual muscle tester was highly reliable and valid in estimating muscle strength of the lower limbs. The coefficient of variation between trials of all movements was low, with a mean less than 10% (range, 3.7%-8.9%). The only significant difference in muscle strength between the new device and the isokinetic dynamometer was found for hip flexion. CONCLUSIONS: The new hand-held muscle strength tester appears to be a reliable and valid clinical assessment tool that can be used to objectively assess muscle strength at particular limb positions and/or joint angles. This feature appears to represent a technical advance in portable muscle strength devices, providing comparable information to those obtained by isokinetic dynamometers at a fraction of the cost and size. However, the device needs to be validated in clinical populations, such as patients with spinal cord injury and stroke, in order to demonstrate its general clinical utility.