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1.
Rehabilitación (Madr., Ed. impr.) ; 58(2): 1-9, abril-junio 2024. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-232114

RESUMO

Introduction: The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. However, quantitative studies on evaluate the postural control influence resulted from the ACL remnant preservation or not are scarce. The aim of this study is to evaluate the postural control of patients submitted to ACL reconstruction with and without preservation of the injured remnant in pre and postoperative periods.MethodsEighteen patients underwent ACL reconstruction and separated into 2 groups according to the preservation or not of the remnant: (I) submitted to ACL reconstruction with preservation of the remnant (10 patients); (II) submitted to ACL reconstruction without preservation of the remnant (8 patients). They were assessed using the Lysholm score and force plate, which evaluated the patient's postural stability for remnant and non-remnant preservation in ACL reconstruction surgery.ResultsGroup I showed statistically significant subjective and objective improvements, both at 3 and 6 months. Additionally, improvement of the Lysholm test at 6 months in Group II was also statistically significant. Furthermore, the results of the Friedman test for the VCOP and VY variables of Group I, with support of the injured side in the force plate, showed a statistically significant difference both for pre and postoperative period at 3 months, compared to the 6-month postoperative period. The variables EAC and VX were statistically different for Group II, considering the preoperative period, 3 and 6 months postoperatively.ConclusionPreserving the ACL remnant in patients with ACL injuries has a positive impact on postural stability during recovery.(AU)


Introducción: El ligamento cruzado anterior (LCA) es el ligamento de la rodilla que se lesiona con mayor frecuencia. Sin embargo, escasean los estudios cuantitativos sobre la evaluación de la influencia del control postural derivada de la preservación, o no, del remanente del LCA. El objetivo de este estudio es evaluar el control postural de los pacientes sometidos a la reconstrucción del LCA, con y sin preservación del remanente lesionado, en los periodos previo y posterior a la cirugía.MétodosDieciocho pacientes sometidos a reconstrucción del LCA separados en 2 grupos, de acuerdo con la preservación o no preservación del remanente: I) sometidos a reconstrucción del LCA con preservación del remanente (10 pacientes), y II) sometidos a reconstrucción del LCA sin preservación del remanente (8 pacientes). Los pacientes fueron evaluados utilizando la puntuación de Lysholm y una placa de aplicación de fuerza, que evaluó la estabilidad postural del paciente para la preservación y no preservación del remanente en la cirugía de reconstrucción del LCA.ResultadosEl grupo I mostró mejoras subjetivas y objetivas estadísticamente significativas, transcurridos 3 y 6 meses. Además, la mejora de la prueba de Lysholm transcurridos 6 meses en el grupo II fue también estadísticamente significativa. Asimismo, los resultados de la prueba de Friedman para las variables VCOP y VY en el grupo I, con apoyo del lado lesionado en la placa de aplicación de fuerza, reflejaron una diferencia estadísticamente significativa en ambos períodos pre y postoperatorio transcurridos 3 meses, en comparación con el período postoperatorio transcurridos 6 meses. Las variables EAC y VX fueron estadísticamente diferentes para el grupo II, considerando el periodo preoperatorio, y los 3 y 6 meses postoperatorios.ConclusiónPreservar el remanente del LCA en los pacientes con lesiones en dicho ligamento tiene un impacto positivo en la estabilidad postural durante la recuperación.(AU)


Assuntos
Humanos , Ligamento Cruzado Anterior , Ferimentos e Lesões , Reconstrução Pós-Desastre , Cirurgia Geral , Joelho
2.
PLoS One ; 19(6): e0302901, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38857230

RESUMO

OBJECTIVES: To investigate the relationships between handheld dynamometer (HHD), isokinetic and Nordic hamstrings exercise (NHE) measurements of knee flexor strength and their association with sprinting performance. DESIGN: Cross-sectional. METHODS: The relationships between HHD (prone isometric, prone break and supine break knee flexor strength tests), isokinetic and NHE peak knee flexor strength measures were examined using Pearson product correlations on 38 female footballers. A linear regression analysis was also performed for each pair of dependent variables (10 and 30 metre sprint times) and independent predictor variables (average relative peak torque for HHD, isokinetic and NHE testing). RESULTS: There were good correlations between HHD tests (r = 0.81-0.90, p < 0.001, R2 = 0.65-0.82), moderate correlations between HHD and isokinetic peak torque, (r = 0.61-0.67, p < 0.001, R2 = 0.37-0.44) and poor association between the HHD peak torques and isokinetic work (r = 0.44-0.46, p = 0.005-0.007, R2 = 0.20-0.21) and average power (r = 0.39-0.45, n = 36, p = 0.006-0.019, R2 = 0.15-0.22). There was a poor association between NHE peak torque and isokinetic total work (r = 0.34, p = 0.04, R2 = 0.12). No associations between knee flexor strength and sprint times were observed (p = 0.12-0.79, r2 = 0.002-0.086). CONCLUSIONS: Moderate to good correlations within HHD testing and poor to moderate correlations between HHD and isokinetic testing were observed. HHD knee flexor torque assessment may be useful to regularly chart the progress of hamstring rehabilitation for female footballers. Knee flexor strength assessments were not associated with sprint times in female footballers. Other aspects of knee flexor strength and sprint performance should be investigated to assist clinicians in making return to running and sprinting decisions in this population.


Assuntos
Desempenho Atlético , Músculos Isquiossurais , Força Muscular , Corrida , Humanos , Feminino , Força Muscular/fisiologia , Músculos Isquiossurais/fisiologia , Estudos Transversais , Adulto Jovem , Corrida/fisiologia , Desempenho Atlético/fisiologia , Modelos Lineares , Adulto , Dinamômetro de Força Muscular , Adolescente , Torque , Joelho/fisiologia
3.
Eur Rev Med Pharmacol Sci ; 28(10): 3493-3502, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38856124

RESUMO

OBJECTIVE: This study explored the correlation between body mass index (BMI) and knee angle during ascending and descending stairs in healthy young adults. The hypothesis was that higher BMI would be associated with altered knee angles during stair ambulation. PATIENTS AND METHODS: Participants' (n = 43) demographic characteristics, including age, height, weight, BMI, leg preference, and thigh lengths, were recorded. Gait parameters, such as cycle duration, stride phase, velocity, and knee angles, were analyzed using Kinovea® software. Inferential statistical tests, including ANOVA, t-tests, and correlation analysis, were performed to explore the relationships and differences between variables. RESULTS: No significant effect of BMI on knee angle was found [ascending stairs: F (2, 40) = 0.75, p = 0.47; descending stairs: F (2, 40) = 0.58, p = 0.56]. However, gait parameters differed significantly, with shorter cycle duration during ascending stairs (M = 4.52 s, SD = 0.76 s) compared to descending stairs (M = 4.72 s, SD = 0.81 s). The stride phase varied across BMI categories [F (2, 40) = 3.82, p < 0.05], with the ideal weight group (M = 47.12%, SD = 3.21%) exhibiting a distinct stride phase. Positive correlations were found between knee angle and thigh length difference during ascending (r = 0.42, p < 0.05) and descending stairs (r = 0.38, p < 0.05). CONCLUSIONS: This study demonstrated that BMI did not significantly affect knee angle during stair ambulation. However, gait parameters such as cycle duration, stride phase, and velocity differed between ascending and descending stairs. The positive correlation between knee angle and thigh length difference suggests that individuals with more significant thigh length differences may exhibit larger knee angles during stair climbing. The findings of this study have clinical implications for rehabilitation programs and the design of assistive devices. Understanding the relationship between BMI, thigh length difference, and knee angle during stair climbing can help clinicians better assess and manage gait abnormalities in individuals navigating stairs.


Assuntos
Índice de Massa Corporal , Software , Humanos , Adulto Jovem , Masculino , Feminino , Adulto , Articulação do Joelho/fisiologia , Marcha , Caminhada/fisiologia , Joelho , Subida de Escada/fisiologia , Voluntários Saudáveis
4.
Artigo em Inglês | MEDLINE | ID: mdl-38833397

RESUMO

Designing an exoskeleton that can improve user capabilities is a challenging task, and most designs rely on experiments to achieve this goal. A different approach is to use simulation-based designs to determine optimal device parameters. Most of these simulations use full trajectory tracking limb kinematics during a natural gait as a reference. However, exoskeletons typically change the natural gait kinematics of the user. Other types of simulations assume that human gait is optimized for a cost function that combines several objectives, such as the cost of transport, injury prevention, and stabilization. In this study, we use a 2D OpenSim model consisting of 10 degrees of freedom and considering 18 muscles, together with the Moco optimization tool, to investigate the differences between these two approaches with respect to running with a passive knee exoskeleton. Utilizing this model, we test the effect of a full trajectory tracking objective with different weights (representing the importance of the objective in the optimization cost function) and show that when using weights that are typically used in the literature, there is no deviation from the experimental data. Next, we develop a multi-objective cost function with foot clearance term based on peak knee angle during swing, that achieves trajectories similar (RMSE=7.4 deg) to experimental running data. Finally, we investigate the effect of different parameters in the design of a clutch-based passive knee exoskeleton (1.5 kg at each leg) and find that a design that utilizes a 2.5 Nm/deg spring achieves an improvement of up to 8% in net metabolic energy. Our results show that tracking objectives in the cost function, even with a low weight, hinders the simulation's ability to change the gait trajectory. Thus, there is a need for other predictive simulation methods for exoskeletons.


Assuntos
Simulação por Computador , Exoesqueleto Energizado , Marcha , Corrida , Humanos , Fenômenos Biomecânicos , Marcha/fisiologia , Corrida/fisiologia , Músculo Esquelético/fisiologia , Desenho de Equipamento , Algoritmos , Joelho/fisiologia , Articulação do Joelho/fisiologia , Desenho de Prótese
5.
J Sports Sci Med ; 23(2): 425-435, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38841632

RESUMO

Non-local muscle fatigue (NLMF) refers to a transient decline in the functioning of a non-exercised muscle following the fatigue of a different muscle group. Most studies examining NLMF conducted post-tests immediately after the fatiguing protocols, leaving the duration of these effects uncertain. The aim of this study was to investigate the duration of NLMF (1-, 3-, and 5-minutes). In this randomized crossover study, 17 recreationally trained participants (four females) were tested for the acute effects of unilateral knee extensor (KE) muscle fatigue on the contralateral homologous muscle strength, and activation. Each of the four sessions included testing at either 1-, 3-, or 5-minutes post-test, as well as a control condition for non-dominant KE peak force, instantaneous strength (force produced within the first 100-ms), and vastus lateralis and biceps femoris electromyography (EMG). The dominant KE fatigue intervention protocol involved two sets of 100-seconds maximal voluntary isometric contractions (MVIC) separated by 1-minute of rest. Non-dominant KE MVIC forces showed moderate and small magnitude reductions at 1-min (p < 0.0001, d = 0.72) and 3-min (p = 0.005, d = 0.30) post-test respectively. The KE MVIC instantaneous strength revealed large magnitude, significant reductions between 1-min (p = 0.021, d = 1.33), and 3-min (p = 0.041, d = 1.13) compared with the control. In addition, EMG data revealed large magnitude increases with the 1-minute versus control condition (p = 0.03, d = 1.10). In summary, impairments of the non-exercised leg were apparent up to 3-minutes post-exercise with no significant deficits at 5-minutes. Recovery duration plays a crucial role in the manifestation of NLMF.


Assuntos
Estudos Cross-Over , Eletromiografia , Contração Isométrica , Joelho , Fadiga Muscular , Força Muscular , Humanos , Fadiga Muscular/fisiologia , Feminino , Masculino , Contração Isométrica/fisiologia , Força Muscular/fisiologia , Adulto Jovem , Joelho/fisiologia , Fatores de Tempo , Adulto , Músculo Quadríceps/fisiologia , Músculo Esquelético/fisiologia , Músculos Isquiossurais/fisiologia
6.
J Sports Sci Med ; 23(2): 326-341, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38841639

RESUMO

In the recent past, practical blood flow restriction (pBFR) using non-pneumatic, usually elastic cuffs has been established as a cost-effective alternative to traditional blood flow restriction (BFR) using pneumatic cuffs, especially for training in large groups. This study investigated whether low-load resistance exercise with perceptually primed pBFR using an elastic knee wrap is suitable to induce similar motor performance fatigue as well as physiological and perceptual responses compared to traditional BFR using a pneumatic nylon cuff in males and females. In a randomized, counterbalanced cross-over study, 30 healthy subjects performed 4 sets (30-15-15-15 repetitions) of unilateral knee extensions at 20% of their one-repetition-maximum. In the pBFR condition, each individual was perceptually primed to a BFR pressure corresponding to 60% of their arterial occlusion pressure. Before and after exercise, maximal voluntary torque, maximal muscle activity, and cuff pressure-induced discomfort were assessed. Moreover, physiological (i.e., muscle activity, muscle oxygenation) and perceptual responses (i.e., effort and exercise-induced leg muscle pain) were recorded during exercise. Moderate correlations with no differences between pBFR and BFR were found regarding the decline in maximal voluntary torque and maximal muscle activity. Furthermore, no to very strong correlations between conditions, with no differences, were observed for muscle activity, muscle oxygenation, and perceptual responses during exercise sets. However, cuff pressure-induced discomfort was lower in the pBFR compared to the BFR condition. These results indicate that low-load resistance exercise combined with perceptually primed pBFR is a convenient and less discomfort inducing alternative to traditional BFR. This is especially relevant for BFR training with people who have a low cuff-induced discomfort tolerance.


Assuntos
Estudos Cross-Over , Fadiga Muscular , Músculo Esquelético , Treinamento Resistido , Humanos , Feminino , Treinamento Resistido/métodos , Masculino , Fadiga Muscular/fisiologia , Adulto , Adulto Jovem , Músculo Esquelético/fisiologia , Músculo Esquelético/irrigação sanguínea , Fluxo Sanguíneo Regional , Torque , Mialgia/etiologia , Mialgia/prevenção & controle , Percepção/fisiologia , Consumo de Oxigênio , Terapia de Restrição de Fluxo Sanguíneo/métodos , Eletromiografia , Joelho/fisiologia
7.
Eur J Sport Sci ; 24(6): 682-692, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38874937

RESUMO

The aim of our study was to compare the effects of two different plyometric training programs (targeting knee extensors or plantar flexors) on jump height and strength of leg muscles. Twenty-nine male basketball players were assigned to the knee-flexed (KF), knee-extended (KE), or control groups. In addition to regular training, the KF group performed plyometric jumps (10 sets of 10 jumps, 3 sessions/week, 4 weeks) from 50 cm boxes with the knee flexed (90°-120°), whereas the KE group performed the jumps from 30 cm boxes with the knee much more extended (130°-170°). Jumping ability was evaluated with squat jumps (SJs), countermovement jumps (CMJs), and drop jumps from 20 cm (DJ20) and 40 cm (DJ40). Knee and ankle muscles were assessed during maximal isokinetic and isometric tests, and EMG activity was recorded from vastus lateralis and medial gastrocnemius. The KF group increased SJ (+10%, d = 0.86) and CMJ (+11%, d = 0.70) but decreased DJ40 height (-7%, d = -0.40). Conversely, the KE group increased DJ20 (+10%, d = 0.74) and DJ40 (+12%, d = 0.77) but decreased SJ height (-4%, d = -0.23). The reactivity index during DJs increased (+10% for DJ20, d = 0.47; +20% for DJ40, d = 0.91) for the KE group but decreased (-10%, d = -0.48) for the KF group during DJ40. Plantar flexor strength increased for the KE group (d = 0.72-1.00) but not for the KF group. Negative transfer across jumps is consistent with the principle of training specificity. Basketball players interested to perform fast rebounds in their training should avoid plyometric jumps with large knee flexions and long contact times.


Assuntos
Desempenho Atlético , Basquetebol , Eletromiografia , Força Muscular , Músculo Esquelético , Exercício Pliométrico , Humanos , Masculino , Basquetebol/fisiologia , Exercício Pliométrico/métodos , Desempenho Atlético/fisiologia , Adulto Jovem , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Joelho/fisiologia , Tornozelo/fisiologia , Adulto
8.
BMC Med Imaging ; 24(1): 113, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760778

RESUMO

BACKGROUND: Recent Convolutional Neural Networks (CNNs) perform low-error reconstruction in fast Magnetic Resonance Imaging (MRI). Most of them convolve the image with kernels and successfully explore the local information. Nonetheless, the non-local image information, which is embedded among image patches relatively far from each other, may be lost due to the limitation of the receptive field of the convolution kernel. We aim to incorporate a graph to represent non-local information and improve the reconstructed images by using the Graph Convolutional Enhanced Self-Similarity (GCESS) network. METHODS: First, the image is reconstructed into the graph to extract the non-local self-similarity in the image. Second, GCESS uses spatial convolution and graph convolution to process the information in the image, so that local and non-local information can be effectively utilized. The network strengthens the non-local similarity between similar image patches while reconstructing images, making the reconstruction of structure more reliable. RESULTS: Experimental results on in vivo knee and brain data demonstrate that the proposed method achieves better artifact suppression and detail preservation than state-of-the-art methods, both visually and quantitatively. Under 1D Cartesian sampling with 4 × acceleration (AF = 4), the PSNR of knee data reached 34.19 dB, 1.05 dB higher than that of the compared methods; the SSIM achieved 0.8994, 2% higher than the compared methods. Similar results were obtained for the reconstructed images under other sampling templates as demonstrated in our experiment. CONCLUSIONS: The proposed method successfully constructs a hybrid graph convolution and spatial convolution network to reconstruct images. This method, through its training process, amplifies the non-local self-similarities, significantly benefiting the structural integrity of the reconstructed images. Experiments demonstrate that the proposed method outperforms the state-of-the-art reconstruction method in suppressing artifacts, as well as in preserving image details.


Assuntos
Encéfalo , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Redes Neurais de Computação , Imageamento por Ressonância Magnética/métodos , Humanos , Encéfalo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Joelho/diagnóstico por imagem , Algoritmos , Artefatos
9.
Semin Musculoskelet Radiol ; 28(3): 248-256, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38768590

RESUMO

Neoplastic and non-neoplastic soft tissue masses around the knee are often incidental findings. Most of these lesions are benign with typical imaging characteristics that allow a confident diagnosis. However, some of these incidental neoplastic masses are characterized by morbidity and potential mortality. This review highlights the typical aspects of these lesions, facilitating a correct diagnosis.


Assuntos
Neoplasias de Tecidos Moles , Humanos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Diagnóstico Diferencial , Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia
10.
Semin Musculoskelet Radiol ; 28(3): 225-247, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38768589

RESUMO

Numerous anatomical variants are described around the knee, many of which look like bony lesions, so it is important to know them to avoid unnecessary complementary tests and inadequate management. Likewise, several alterations in relation to normal development can also simulate bone lesions.However, numerous pathologic processes frequently affect the knee, including traumatic, inflammatory, infectious, and tumor pathology. Many of these entities show typical radiologic features that facilitate their diagnosis. In other cases, a correct differential diagnosis is necessary for proper clinical management.Despite the availability of increasingly advanced imaging techniques, plain radiography is still the technique of choice in the initial study of many of these pathologies. This article reviews the radiologic characteristics of tumor and nontumor lesions that may appear around the knee to make a correct diagnosis and avoid unnecessary complementary radiologic examinations and inadequate clinical management.


Assuntos
Doenças Ósseas , Neoplasias Ósseas , Humanos , Neoplasias Ósseas/diagnóstico por imagem , Diagnóstico Diferencial , Doenças Ósseas/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos
11.
J Sports Sci ; 42(7): 599-610, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38734986

RESUMO

Unanticipated trunk perturbation is commonly observed when anterior cruciate ligament (ACL) injuries occur during direction-changing manoeuvres. This study aimed to quantify the effect of mid-flight medial-lateral external trunk perturbation directions/locations on ACL loading variables during sidestep cuttings. Thirty-two recreational athletes performed sidestep cuttings under combinations of three perturbation directions (no-perturbation, ipsilateral-perturbation, and contralateral-perturbation relative to the cutting leg) and two perturbation locations (upper-trunk versus lower-trunk). The pushing perturbation was created by customised devices releasing a slam ball to contact participants near maximum jump height prior to cutting. Perturbation generally resulted in greater peak vertical ground reaction force and slower cutting velocity. Upper-trunk contralateral perturbation showed the greatest lateral trunk bending away from the travel direction, greatest peak knee flexion and abduction angles, and greatest peak internal knee adduction moments compared to other conditions. Such increased ACL loading variables were likely due to the increased lateral trunk bending and whole-body horizontal velocity away from the cutting direction caused by the contralateral perturbation act at the upper trunk. The findings may help understand the mechanisms of indirect contact ACL injuries and develop effective cutting techniques for ACL injury prevention.


Assuntos
Lesões do Ligamento Cruzado Anterior , Tronco , Humanos , Tronco/fisiologia , Fenômenos Biomecânicos , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Masculino , Adulto Jovem , Feminino , Ligamento Cruzado Anterior/fisiologia , Movimento/fisiologia , Joelho/fisiologia , Adulto
12.
PLoS One ; 19(5): e0301263, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38820390

RESUMO

The diagnosis of human knee abnormalities using the surface electromyography (sEMG) signal obtained from lower limb muscles with machine learning is a major problem due to the noisy nature of the sEMG signal and the imbalance in data corresponding to healthy and knee abnormal subjects. To address this challenge, a combination of wavelet decomposition (WD) with ensemble empirical mode decomposition (EEMD) and the Synthetic Minority Oversampling Technique (S-WD-EEMD) is proposed. In this study, a hybrid WD-EEMD is considered for the minimization of noises produced in the sEMG signal during the collection, while the Synthetic Minority Oversampling Technique (SMOTE) is considered to balance the data by increasing the minority class samples during the training of machine learning techniques. The findings indicate that the hybrid WD-EEMD with SMOTE oversampling technique enhances the efficacy of the examined classifiers when employed on the imbalanced sEMG data. The F-Score of the Extra Tree Classifier, when utilizing WD-EEMD signal processing with SMOTE oversampling, is 98.4%, whereas, without the SMOTE oversampling technique, it is 95.1%.


Assuntos
Eletromiografia , Processamento de Sinais Assistido por Computador , Humanos , Eletromiografia/métodos , Aprendizado de Máquina , Articulação do Joelho/fisiopatologia , Masculino , Adulto , Análise de Ondaletas , Feminino , Joelho/fisiopatologia , Algoritmos
13.
J Bodyw Mov Ther ; 38: 554-561, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38763608

RESUMO

INTRODUCTION: The effects of stretching exercises on muscle strength have been widely researched in the literature, however, there are no studies investigating the effects of Pilates stretching. OBJECTIVE: To compare the effects of static stretching and Pilates stretching on the concentric muscle strength of the knee extensors and flexors. METHOD: 102 trained young adults were randomized into three groups: static stretching (n = 33); Pilates stretching (n = 34); control (n = 35). Isokinetic evaluation of the knee extensor and flexor muscles was performed at 60°/s and 180°/s, pre and post acute intervention with stretching. Interventions in the static stretching and Pilates stretching groups occurred in 3 sets x 30 s for each body region considered (a-knee extensor muscles; b-knee flexor muscles). The control group did not perform any intervention. RESULTS: No difference (p > 0.05) was observed between the groups after the intervention. There was only a significant intragroup improvement for the control group on the isokinetic muscle strength of the knee flexors at 180°/s, with a moderate effect size, considering the entire sample (p = 0.040; d = 0.42) and when considering only male gender (p = 0.010; d = 0.60). CONCLUSION: Static stretching or Pilates stretching performed as a warm-up did not impair or enhance the concentric muscle strength performance of the knee extensors and flexors. In this way, both forms of stretching can be considered as preparatory exercises before muscle strength training.


Assuntos
Técnicas de Exercício e de Movimento , Força Muscular , Exercícios de Alongamento Muscular , Músculo Esquelético , Humanos , Exercícios de Alongamento Muscular/fisiologia , Masculino , Feminino , Força Muscular/fisiologia , Adulto Jovem , Técnicas de Exercício e de Movimento/métodos , Músculo Esquelético/fisiologia , Adulto , Joelho/fisiologia , Articulação do Joelho/fisiologia , Amplitude de Movimento Articular/fisiologia
14.
Anesthesiol Clin ; 42(2): 247-261, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38705674

RESUMO

Anesthesia for patients undergoing knee procedures encompasses a large patient population with significant variation in patient age, comorbidities, and type of surgery. In addition, these procedures are performed in vastly different surgical environments, including large academic hospitals, private hospitals, and out-patient surgical centers. These variabilities require a thoughtful and individualized anesthetic approach tailored toward the medical and surgical needs of each patient. This article discusses anesthetic approaches to patients with acute, subacute, and chronic knee-related pathology requiring surgery. We will also review pertinent knee anatomy and innervation and discuss regional nerve blocks and their applications to knee-related surgical procedures.


Assuntos
Anestesia , Humanos , Anestesia/métodos , Articulação do Joelho/cirurgia , Artroplastia do Joelho/métodos , Bloqueio Nervoso/métodos , Joelho/cirurgia
15.
Sci Rep ; 14(1): 10448, 2024 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714802

RESUMO

Hip muscle weakness can be a precursor to or a result of lower limb injuries. Assessment of hip muscle strength and muscle motor fatigue in the clinic is important for diagnosing and treating hip-related impairments. Muscle motor fatigue can be assessed with surface electromyography (sEMG), however sEMG requires specialized equipment and training. Inertial measurement units (IMUs) are wearable devices used to measure human motion, yet it remains unclear if they can be used as a low-cost alternative method to measure hip muscle fatigue. The goals of this work were to (1) identify which of five pre-selected exercises most consistently and effectively elicited muscle fatigue in the gluteus maximus, gluteus medius, and rectus femoris muscles and (2) determine the relationship between muscle fatigue using sEMG sensors and knee wobble using an IMU device. This work suggests that a wall sit and single leg knee raise activity fatigue the gluteus medius, gluteus maximus, and rectus femoris muscles most reliably (p < 0.05) and that the gluteus medius and gluteus maximus muscles were fatigued to a greater extent than the rectus femoris (p = 0.031 and p = 0.0023, respectively). Additionally, while acceleration data from a single IMU placed on the knee suggested that more knee wobble may be an indicator of muscle fatigue, this single IMU is not capable of reliably assessing fatigue level. These results suggest the wall sit activity could be used as simple, static exercise to elicit hip muscle fatigue in the clinic, and that assessment of knee wobble in addition to other IMU measures could potentially be used to infer muscle fatigue under controlled conditions. Future work examining the relationship between IMU data, muscle fatigue, and multi-limb dynamics should be explored to develop an accessible, low-cost, fast and standardized method to measure fatiguability of the hip muscles in the clinic.


Assuntos
Eletromiografia , Exercício Físico , Quadril , Fadiga Muscular , Humanos , Eletromiografia/métodos , Fadiga Muscular/fisiologia , Masculino , Exercício Físico/fisiologia , Adulto , Quadril/fisiologia , Feminino , Músculo Esquelético/fisiologia , Adulto Jovem , Joelho/fisiologia
16.
BMC Med Educ ; 24(1): 500, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711070

RESUMO

BACKGROUND: According to the German Physiotherapy Education and Qualification Regulations, teaching of anatomical structures is one of the fundamental subjects of physiotherapy education. Besides exhibits and models, anatomy atlases are usually used as teaching and learning tools. These are available in both analog form such as printed books or in digital form as a mobile application. Furthermore, the use of digital teaching and learning tools is steadily increasing within the education of health professionals. AIM: To assess the efficacy of a digital educational tool in contrast to an analog anatomical atlas in acquiring knowledge about anatomical structures. MATERIAL AND METHOD: The data collection took place in the context of an anatomy tutorial for students of the bachelor's degree program in physiotherapy. In a cross-over design, the students completed two learning assignments, each, with different learning materials provided, either with an anatomy app on a tablet or with an anatomy atlas as a book. The tests to assess the newly acquired knowledge immediately after the task, consisted of questions about the anatomical structures of the knee as well as the shoulder. In addition, the students' satisfaction with the learning materials provided was surveyed using a questionnaire. The survey assessed their satisfaction, their assessment of learning success, and their affinity to digital learning materials. This was done using a 5-point Likert scale and a free-text field. The data was analyzed descriptively, and group differences were calculated using a t-tests. RESULTS: Thirty students participated. The group comparison showed a significantly better outcome for the group that prepared with the analog anatomy atlas for the questions on the knee than the comparison group that used the anatomy app (t(28) = 2.6; p = 0.007). For the questions concerning the shoulder, there was no significant difference between the digital and analog groups (t(28) = 1.14; p = 0.26). The questionnaire revealed that satisfaction with the analog anatomy atlas was significantly higher than with the anatomy app. A total of 93.34% rated their experience with the analog learning tool at least "somewhat satisfied". In contrast, 72.67% of students partially or fully agreed that they "enjoyed learning with digital learning tools". DISCUSSION: Learning anatomical structures with the Human Anatomy Atlas 2023 + app did not show a clear advantage when compared to an anatomy book in these two cohorts of physiotherapy students. The results of the questionnaire also showed greater satisfaction with the analog anatomy atlas than with the anatomy app, whereas most students stated that they frequently use digital learning tools, including some for anatomical structures. Satisfaction with the learning tool seems to play a central role in their effectiveness. In addition, sufficient time must be provided for users to familiarize themselves with the user interface of digital applications to use them effectively. REGISTRATION: Diese klinische Studie wurde nicht in einem Studienregister registriert.


Assuntos
Anatomia , Estudos Cross-Over , Humanos , Anatomia/educação , Masculino , Instrução por Computador/métodos , Avaliação Educacional , Especialidade de Fisioterapia/educação , Alemanha , Feminino , Atlas como Assunto , Adulto , Inquéritos e Questionários , Adulto Jovem , Aprendizagem , Ombro/anatomia & histologia , Joelho/anatomia & histologia
17.
Commun Biol ; 7(1): 513, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38769351

RESUMO

Sarcopenia is a common skeletal muscle disease in older people. Lower limb muscle strength is a good predictive value for sarcopenia; however, little is known about its genetic components. Here, we conducted a genome-wide association study (GWAS) for knee extension strength in a total of 3452 Japanese aged 60 years or older from two independent cohorts. We identified a significant locus, rs10749438 which is an intronic variant in TACC2 (transforming acidic coiled-coil-containing 2) (P = 4.2 × 10-8). TACC2, encoding a cytoskeleton-related protein, is highly expressed in skeletal muscle, and is reported as a target of myotonic dystrophy 1-associated splicing alterations. These suggest that changes in TACC2 expression are associated with variations in muscle strength in older people. The association was consistently observed in young and middle-aged subjects. Our findings would shed light on genetic components of lower limb muscle strength and indicate TACC2 as a potential therapeutic target for sarcopenia.


Assuntos
Estudo de Associação Genômica Ampla , Força Muscular , Humanos , Idoso , Masculino , Feminino , Força Muscular/genética , Pessoa de Meia-Idade , Japão , Sarcopenia/genética , Sarcopenia/fisiopatologia , Polimorfismo de Nucleotídeo Único , Músculo Esquelético/metabolismo , Joelho , Povo Asiático/genética , População do Leste Asiático
18.
PLoS One ; 19(5): e0301872, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38776288

RESUMO

BACKGROUND: The current clinical gold standard for assessing isometric quadriceps muscle strength is an isokinetic dynamometer (IKD). However, in clinics without an IKD, clinicians default to using handheld dynamometers (HHD), which are less reliable and accurate than the IKD, particularly for large muscle groups. A novel device (ND) was developed that locks the weight stack of weight machines, and measures forces applied to the machine, turning this equipment into an isometric dynamometer. The objectives of this study were to characterize the test-retest reliability of the ND, determine the within-day and between-days inter-rater reliability and concurrent validity compared with that of the HHD, in healthy volunteers (HV) and individuals with knee osteoarthritis (OA) for measuring knee extensors isometric muscle force. MATERIALS AND METHODS: 29 healthy (age = 28.4 ± 7.4 years) and 15 knee OA (age = 37.6 ± 13.4 years) participants completed three maximum force isometric strength testing trials on dominant side knee extensor muscles on three devices (ND, HHD, and IKD) in two separate sessions by two raters. The maximum force (Fmax) produced, and the force-time series were recorded. Reliability and validity were assessed using Intraclass Correlation Coefficient (ICC), Bland-Altman Plots, Pearson's r, and cross-correlations. RESULTS: The ND demonstrated excellent test-retest reliability (ICC2,3 = 0.97). The within-day (ICC2,3 = 0.88) and between-day inter-rater reliability (ICC2,3 = 0.87) was good for HHD. The ND showed excellent within-day (ICC2,3 = 0.93) and good between-day (ICC2,3 = 0.89) inter-rater reliability. The Bland-Altman analysis revealed HHD systematic bias and underestimation of force particularly with quadriceps force values exceeding 450 N. Mean differences were found in maximum force between HHD vs. IKD (MDabs = 58 N, p < .001) but not the HHD vs. ND (MDabs = 24 N, p = .267) or ND vs. IKD (MDabs = 34 N, p = .051). The concurrent validity of Fmax (r = 0.81) and force-time curve correlation (0.96 ± 0.05) were the highest between the ND and IKD. CONCLUSIONS: The ND's test-retest reliability and concurrent validity make it a potential strength assessment tool with utility in physical therapy and fitness settings for large muscle groups such as the knee extensors.


Assuntos
Contração Isométrica , Dinamômetro de Força Muscular , Força Muscular , Humanos , Adulto , Masculino , Feminino , Reprodutibilidade dos Testes , Força Muscular/fisiologia , Pessoa de Meia-Idade , Contração Isométrica/fisiologia , Osteoartrite do Joelho/fisiopatologia , Músculo Quadríceps/fisiologia , Adulto Jovem , Articulação do Joelho/fisiologia , Articulação do Joelho/fisiopatologia , Joelho/fisiologia , Joelho/fisiopatologia
19.
J Neuroeng Rehabil ; 21(1): 50, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594696

RESUMO

BACKGROUND: The pendulum test is a quantitative method used to assess knee extensor spasticity in humans with spinal cord injury (SCI). Yet, the clinical implementation of this method remains limited. The goal of our study was to develop an objective and portable system to assess knee extensor spasticity during the pendulum test using inertial measurement units (IMU). METHODS: Spasticity was quantified by measuring the first swing angle (FSA) using a 3-dimensional optical tracking system (with external markers over the iliotibial band, lateral knee epicondyle, and lateral malleolus) and two wireless IMUs (positioned over the iliotibial band and mid-part of the lower leg) as well as a clinical exam (Modified Ashworth Scale, MAS). RESULTS: Measurements were taken on separate days to assess test-retest reliability and device agreement in humans with and without SCI. We found no differences between FSA values obtained with the optical tracking system and the IMU-based system in control subjects and individuals with SCI. FSA values from the IMU-based system showed excellent agreement with the optical tracking system in individuals with SCI (ICC > 0.98) and good agreement in controls (ICC > 0.82), excellent test-retest reliability across days in SCI (ICC = 0.93) and good in controls (ICC = 0.87). Notably, FSA values measured by both systems showed a strong association with MAS scores ( ρ  ~ -0.8) being decreased in individuals with SCI with higher MAS scores, reflecting the presence of spasticity. CONCLUSIONS: These findings suggest that our new portable IMU-based system provides a robust and flexible alternative to a camera-based optical tracking system to quantify knee extensor spasticity following SCI.


Assuntos
Extremidade Inferior , Traumatismos da Medula Espinal , Humanos , Reprodutibilidade dos Testes , Espasticidade Muscular/etiologia , Espasticidade Muscular/complicações , Joelho , Traumatismos da Medula Espinal/complicações
20.
J Biomech ; 166: 112066, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38574563

RESUMO

Precise measurement of joint-level motion from stereo-radiography facilitates understanding of human movement. Conventional procedures for kinematic tracking require significant manual effort and are time intensive. The current work introduces a method for fully automatic tracking of native knee kinematics from stereo-radiography sequences. The framework consists of three computational steps. First, biplanar radiograph frames are annotated with segmentation maps and key points using a convolutional neural network. Next, initial bone pose estimates are acquired by solving a polynomial optimization problem constructed from annotated key points and anatomic landmarks from digitized models. A semidefinite relaxation is formulated to realize the global minimum of the non-convex problem. Pose estimates are then refined by registering computed tomography-based digitally reconstructed radiographs to masked radiographs. A novel rendering method is also introduced which enables generating digitally reconstructed radiographs from computed tomography scans with inconsistent slice widths. The automatic tracking framework was evaluated with stereo-radiography trials manually tracked with model-image registration, and with frames which capture a synthetic leg phantom. The tracking method produced pose estimates which were consistently similar to manually tracked values; and demonstrated pose errors below 1.0 degree or millimeter for all femur and tibia degrees of freedom in phantom trials. Results indicate the described framework may benefit orthopaedics and biomechanics applications through acceleration of kinematic tracking.


Assuntos
Articulação do Joelho , Joelho , Humanos , Fenômenos Biomecânicos , Radiografia , Articulação do Joelho/diagnóstico por imagem , Joelho/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Imageamento Tridimensional/métodos
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