The Traffic Light System: A user-friendly alternative for gait data representation.

BACKGROUND: Instrumented gait analysis is an established procedure in biomechanical assessment, requiring specially-trained analysts to interpret the complex graphical output generated. RESEARCH QUESTION: Does a new method of visual representation of lower limb kinematic gait analysis data provide a reliable and valid method of interpretation of biomechanical data for healthcare professionals? METHODS: An innovative system based on the Traffic Lights System (TLS) was developed. Simulated abnormal gait was captured using a 16-camera optoelectronic motion capture system, and the results were presented in both the Traditional Graphical System (TGS) format and the new TLS. An online form was filled by health professionals who attempted to interpret normal and abnormal motion in the joints presented in the 2 output formats. RESULTS: Out of 26 raters, 18 preferred the new system because of its user-friendliness and its ease of interpretation. 2 raters preferred the TGS, with one of these raters clarifying that the preference is due to colour blindness. For intra-rater reliability, 2 trained raters provided a second response for the TGS (Cronbach's Alpha ranging between 0.733 and 0.918), whilst the TLS resulted in Cronbach's Alpha between 0.817 and 1.00 amongst 3 untrained raters. The Fleiss Multi-rater Kappa Test demonstrated low inter-rater reliability amongst raters in the TGS, whereas the overall Fleiss Multi-rater Kappa values of the TLS surpassed the TGS in all 3 studies. SIGNIFICANCE: This study showed that whilst trained health professionals have high intra-rater reliability in interpreting traditional gait analysis results, those professionals inexperienced in the system, do not always comprehend the complex graphs generated by the system when presenting gait analysis data. When these graphs are transformed into coloured outputs representing the extent of the movement, the TLS has demonstrated high validity and high intra- and inter-rater reliability, significantly exceeding those of the TGS, especially in untrained health professionals.

The Kinematics of Fixed-Seat Rowing: A Structured Synthesis.

Olympic-style sliding-seat rowing is a sport that has been extensively researched, with studies investigating aspects related to the physiology, biomechanics, kinematics, and the performance of rowers. In contrast, studies on the more classic form of fixed-seat rowing are sparse. The aim of this study is to address this lacuna by analysing for the first time the specific kinematics of fixed-seat rowing as practised by able-bodied athletes, thus (i) documenting how this technique is performed in a manner that is replicable by others and (ii) showing how this technique compares and contrasts with the more standard sliding-seat technique. Fixed-seat rowing was replicated in a biomechanics laboratory where experienced fixed-seat rowers, marked with reflective markers following the modified Helen-Hayes model, were asked to row in a manner that mimics rowing on a fixed-seat boat. The findings from this study, complimented with data gathered through the observation of athletes rowing on water, were compared to sliding-seat ergometer rowing and other control experiments. The results show that, in fixed-seat rowing, there is more forward and backward thoracic movement than in sliding-seat rowing (75-77° vs. 44-52°, p < 0.0005). Tilting of the upper body stems was noted to result from rotations around the pelvis, as in sliding-seat rowing, rather than from spinal movements. The results also confirmed knee flexion in fixed-seat rowing with a range of motion of 30-35°. This is less pronounced than in standard-seat rowing, but not insignificant. These findings provide a biomechanical explanation as to why fixed-seat rowers do not have an increased risk of back injuries when compared with their sliding-seat counterparts. They also provide athletes, coaches, and related personnel with precise and detailed information of how fixed-seat rowing is performed so that they may formulate better and more specific evidence-based training programs to meliorate technique and performance.

On the Kinematics of the Forward-Facing Venetian-Style Rowing Technique.

This work presents a qualitative and quantitative pilot study which explores the kinematics of Venetian style forward-facing standing rowing as practised by able-bodied competitive athletes. The technique, made famous by the gondoliers, was replicated in a biomechanics laboratory by a cohort of four experienced rowers who compete in this style at National Level events in Malta. Athletes were marked with reflective markers following the modified Helen Hayes model and asked to row in a manner which mimics their on-water practise and recorded using a Vicon optoelectronic motion capture system. Data collected were compared to its equivalent using a standard sliding-seat ergometer as well as data collated from observations of athletes rowing on water, thus permitting the documentation of the manner of how this technique is performed. It was shown that this rowing style is characterised by rather asymmetric and complex kinematics, particularly upper-body movements which provides the athlete with a total-body workout involving all major muscle groups working either isometrically, to provide stability, or actively.

A Biomechanical Investigation of Children with Type 1 Diabetes Mellitus: Are Children's Feet a Precursor to Adulthood Foot Complications?

BACKGROUND: There is limited evidence on the biomechanical effects of type 1 diabetes mellitus (T1DM) on children's feet. This study aimed to determine whether children living with T1DM aged 10 to 16 years have altered foot structure and gait parameters compared with same-aged children without medical conditions. METHODS: A nonexperimental, case-control study was conducted. Thirty-four healthy children and children living with T1DM were recruited. Participants underwent a clinical biomechanical examination followed by instrumented gait analysis using the Oxford Foot Model to investigate foot segment motion. RESULTS: Children with T1DM demonstrated more dermatologic lesions and structural foot abnormalities, including claw toes (33.3%), hammertoes (22.2%), and hallux abducto valgus (11.1%), than their healthy counterparts. Gait analysis results indicate a significant difference between the two groups at the hindfoot-to-tibia angle at heel strike and toe-off, suggesting limited ankle joint motion. CONCLUSIONS: Children with T1DM demonstrated a higher frequency of structural foot pathologies than did healthy children possibly associated with limited ankle sagittal plane movement. Screening is warranted to identify and manage these conditions early to reduce their risk of more significant foot problems associated with DM in adulthood.