Kinematic alignment matches functional alignment for the extension gap: a consecutive analysis of 749 primary varus osteoarthritic knees with stress radiographs.

PURPOSE: The alignment goal in total knee arthroplasty (TKA) remains debated. Two major strategies have emerged based on recreating the native knee: kinematic and functional alignment (KA and FA). Recently a new Coronal Plane Alignment of the Knee (CPAK) classification for KA, based on bony landmarks, was described considering joint line obliquity and the arithmetic HipKneeAnkle angle (aHKA). Valgus corrected HKA medial angle (vcHKA) was measured on distractive valgus preoperative radiographs compensating for cartilage wear and ligament balance in varus osteoarthritis. The purpose of this study was to determine if aHKA accounts for differences in medial laxity for the extension gap by comparing vcHKA to aHKA. The hypothesis was that no significant difference would be observed between the two measurements. METHODS: This is a retrospective analysis of 749 knees in consecutive patients presenting to a single-centre with primary medial osteoarthritis. Patients underwent standardized weight bearing long-leg and valgus stress radiographs. Tibial mechanical angle (TMA), femoral mechanical angle (FMA) and vcHKA were measured using digital software. aHKA and vcHKA were compared to determine differences due to soft tissue balancing. RESULTS: The mean FMA was 91.3 ± 2.2° (range 82°-97°), the mean TMA was 85.7 ± 2.5° (range 75°-98°), the mean aHKA was 177.0 ± 3.0° (range 164°-185°) and the mean vcHKA was 176.6 ± 3.1° (range 165°-192°). No significant difference was observed between aHKA and vcHKA (p = 0.06). A significant correlation was found between vcHKA and TMA (ρ = 0.3; p < 0.001) and between vcHKA and FMA (ρ = 0.41; p < 0.001). CONCLUSION: This study showed that vcHKA was similar to aHKA confirming that aHKA accounts for ligamentous medial laxity. Therefore, kinematic alignment based on the CPAK classification matches the pre-arthritic coronal alignment of the knee for the extension gap. LEVEL OF EVIDENCE: IV.

Increased valgus laxity in flexion with greater tibial resection depth following total knee arthroplasty.

PURPOSE: Soft tissue balancing is of central importance to outcome following total knee arthroplasty (TKA). However, there are lack of data analysing the effect of tibial bone cut thickness on valgus laxity. A cadaveric study was undertaken to assess the biomechanical consequences of tibial resection depth on through range knee joint valgus stability. We aimed to establish a maximum tibial resection depth, beyond which medial collateral ligament balancing becomes challenging, and a constrained implant should be considered. METHODS: Eleven cadaveric specimens were included for analysis. The biomechanical effects of increasing tibial resection were studied, with bone cuts made at 6, 10, 14, 18 and 24 mm from the lateral tibial articular surface. A computer navigation system was used to perform the tibial resection and to measure the valgus laxity resulting from a torque of 10 Nm. Measurements were taken in four knee positions: 0° or extension, 30°, 60° and 90° of flexion. Intra-observer reliability was assessed. A minimum sample size of eight cadavers was necessary. Statistical analysis was performed using a nonparametric Spearman's ranking correlation matrix at the different stages: in extension, at 30°, 60° and 90° of knee flexion. Significance was set at p < 0.05. RESULTS: There was no macroscopic injury to the dMCL or sMCL in any of the specimens during tibial resection. There was no significant correlation found between the degree of valgus laxity and the thickness of the tibial cut with the knee in extension. There was a statistically significant correlation between valgus laxity and the thickness of the tibial cut in all other knee flexion positions: 30° (p < 0.0001), 60° (p < 0.001) and 90° (p < 0.0001). We identified greater than 5° of valgus laxity, at 90° of knee flexion, after a tibial resection of 14 mm. CONCLUSION: Increased tibial resection depth is associated with significantly greater valgus laxity when tested in positions from 30° to 90° of flexion, despite stability in extension. Greater than 5° of laxity was identified with a tibial resection of 14 mm. When a tibial bone cut of 14 mm or greater is necessary, as may occur with severe preoperative coronal plane deformity, it is recommended to consider the use of a constrained knee prosthesis.

Gait changes of the ACL-deficient knee 3D kinematic assessment.

PURPOSE: Static, one-dimensional testing cannot predict the behaviour of the anterior cruciate ligament (ACL)-deficient knee under realistic loading conditions. Currently, the most widely accepted method for assessing joint movement patterns is gait analysis. The purpose of the study was in vivo evaluation of the behaviour of the anterior cruciate ligament-deficient (ACLD) knees during walking, using 3D, real-time assessment tool. METHODS: Biomechanical data were collected prospectively on 30 patients with ACL rupture and 15 healthy subjects as a control group, with KneeKg™ System. Kinematic data were recorded in vivo during treadmill walking at self-selected speed. Flexion/extension, abduction/adduction, anterior/posterior tibial translation and external/internal tibial rotation were compared between groups. RESULTS: The ACLD patients showed a significant lower extension of the knee joint during stance phase (p < 0.05; 13.2° ± 2.1° and 7.3° ± 2.7°, for ACLD and control group, respectively). A significant difference in tibial rotation angle was found in ACLD knees compared to control knees (p < 0.05). The patients with ACLD rotated the tibia more internally (-1.4° ± 0.2°) during the mid-stance phase, than control group (0.2° ± 0.3°). There was no significant difference in anteroposterior translation and adduction-abduction angles. CONCLUSION: Significant alterations of joint kinematics in the ACLD knee were revealed in this study by manifesting a higher flexion gait strategy and excessive internal tibial rotation during walking that could result in a more rapid cartilage thinning throughout the knee. The preoperative data obtained in this study will be useful to understand the post-ACL reconstruction kinematic behaviour of the knee. CLINICAL RELEVANCE: The findings in this study indicate that ACLD knee may adapt functionally to prevent excessive anterior-posterior translation but they fail to avoid rotational instability.

The influence of body posture on the kinematics of prehension in humans and gorillas (Gorilla gorilla).

Much of our current understanding of human prehension in a comparative context is based on macaque models in a sitting, constrained body posture. In a previous study, we clearly showed differences in the amplitude of the forelimb joints between five primate species (lemur, capuchin, chimpanzee, gorilla and human) during unconstrained grasping where the animals were free to choose their body posture. One of our interrogations was to know if these differences could be due to the body posture. To address this question, this study compares humans with new data for gorillas during an unconstrained food prehension task in two body postures, a sitting and a quadrupedal one. The objective is to determine the behavioral and kinematic strategies (amplitudes and patterns of evolution of the articular angles) as well as differences and invariants of trunk and forelimb motions between species. The subjects were recorded by five cameras, and landmarks were digitized frame by frame to reconstruct 3D movement. Our results show that (1) despite significant influences of body postures on ranges of motion in gorillas and humans, species preserve their specific forelimb joint and trunk contribution; (2) body posture has a limited effect on the basic pattern of wrist velocity. Our study indicates that different primate species have specific kinematic features of limb coordination during prehension, which dose not alter with changes in posture. Therefore, across varying species, it is possible to compare limb kinematics irrespective of postural constraints and unconstrained condition need to be explored in other primates to understand the evolution of primate prehension.

Toe-walking and its impact on first and second rocker in gait patterns with different degrees of artificially emulated soleus and gastrocnemius contracture.

BACKGROUND: Toe-walking is one of the most common gait deviations (due to soleus and/or gastrocnemius muscle contractures), compromising the first (heel rocker) and second (ankle rocker) of the foot during walking. The aim of this study is to evaluate the effect of emulated artificially gastrocnemius and soleus contractures on the first and second rocker during walking. METHOD: An exoskeleton was built to emulate contractures of the bilateral gastrocnemius and soleus muscles. Ten healthy participants were recruited to walk under the following conditions: without emulated contractures or with bilateral emulated contractures at 0°,10°, 20° and 30° of plantarflexion of the soleus or gastrocnemius in order to create an artificial restriction of dorsiflexion ankle movement. A linear regression from the ankle plantar-dorsiflexion angle pattern was performed on 0-5 % of the gait cycle (first rocker) and on 12-31 % of the gait cycle (second rocker) to compute the slope of the curve. The proportion of participants with the presence of the first and second rocker was then computed. A Statistical Parametric Mapping (SPM) analysis assessed the kinematic variations among different degrees of emulated contractures. FINDINGS: The first and second rockers are completely absent from 10° of plantarflexion emulated contracture. The data indicate there was a non-linear shift of the gait pattern of the ankle kinematics and an important shift toward plantarflexion values with the loss of the rockers. INTERPRETATION: This study suggests that toe-walking in the experimental simulation situation is not necessarily due to a high emulated contracture level and can occur with a small emulated contracture by an adaptation choice. This study may improve interpretation of clinical gait analysis and shows that the link between the level of gastrocnemius/soleus emulated contracture and progression of toe-walking (increased plantarflexion during gait) is not linear.

3D kinematic of bunched, medium and elongated sprint start.

The aim of this study was to test the influence of 3 different horizontal distances between the blocks (bunched, medium and elongated) on the velocity of the centre of mass (VCM) and the kinetic energy (KE) of the body segments and of the whole body. 9 well-trained sprinters performed 4 maximal 10 m sprints. An opto-electronic Motion Analysis® system (12 digital cameras 250 Hz) was used to collect the 3D trajectories of 63 markers during the starting block phase. The results demonstrated that the elongated start, compared to the bunched or medium start, induced an increase of VCM at block clearing (2.89±0.13; 2.76±0.11; 2.84±0.14 m.s - 1) and a decrease of the performance at 5 and 10 m. Both results were explained by a greater pushing time on the blocks in the elongated condition. During the starting block phase, the KE of the whole body was greater in the elongated start (324.3±48.0 J vs. 317.4±57.2 J, bunched and 302.1±53.2 J, medium). This greater KE of the whole body was mainly explained by the KE of the head-trunk segments. Thus, to improve the efficiency of the starting block phase, the athlete must produce greater KE of the head and trunk segments in the shortest time.

The effect of ankle and hindfoot malalignment on foot mechanics in patients suffering from post-traumatic ankle osteoarthritis.

BACKGROUND: Ankle and hindfoot malalignment is a common finding in patients suffering from post-traumatic ankle osteoarthritis. However, no studies have addressed the effect of concomitant foot deformities on intrinsic foot kinematics and kinetics. Therefore, the objective of this study was to investigate the effect of ankle and hindfoot malalignment on the kinematics and kinetics of multiple joints in the foot and ankle complex in patients suffering from post-traumatic ankle osteoarthritis. METHODS: Twenty-nine subjects with post-traumatic ankle osteoarthritis participated in this study. Standardized weight-bearing radiographs were obtained preoperatively to categorize patients as having cavus, planus or neutral ankle and hindfoot alignment, based on 4 X-ray measurements. All patients underwent standard gait assessment. A 4-segment foot model was used to estimate intrinsic foot joint kinematics and kinetics during gait. Statistical parametric mapping was used to compare foot kinematics and kinetics between groups. FINDINGS: There were 3 key findings regarding overall foot function in the 3 groups of post-traumatic ankle osteoarthritis: (i) altered frontal and transverse plane inter-segmental angles and moments of the Shank-Calcaneus and Calcaneus-Midfoot joints in the cavus compared to the planus group; (ii) in cavus OA group, Midfoot-Metatarsus joint abduction sought to compensate the varus inclination of the ankle joint; (iii) there were no significant differences in inter-segmental angles and moments between the planus and neutral OA groups. INTERPRETATION: Future studies should integrate assessment of concomitant foot and ankle deformities in post-traumatic ankle osteoarthritis, to provide additional insight into associated mechanical deficits and compensation mechanisms during gait.

A joint coordinate system proposal for the study of the trapeziometacarpal joint kinematics.

The International Society of Biomechanics (ISB) has recommended a standardisation for the motion reporting of almost all human joints. This study proposes an adaptation for the trapeziometacarpal joint. The definition of the segment coordinate system of both trapezium and first metacarpal is based on functional anatomy. The definition of the joint coordinate system (JCS) is guided by the two degrees of freedom of the joint, i.e. flexion-extension about a trapezium axis and abduction-adduction about a first metacarpal axis. The rotations obtained using three methods are compared on the same data: the fixed axes sequence proposed by Cooney et al., the mobile axes sequence proposed by the ISB and our alternative mobile axes sequence. The rotation amplitudes show a difference of 9 degrees in flexion-extension, 2 degrees in abduction-adduction and 13 degrees in internal-external rotation. This study emphasizes the importance of adapting the JCS to the functional anatomy of each particular joint.

Kinematics can help to discriminate the implication of iliopsoas, hamstring and gastrocnemius contractures to a knee flexion gait pattern.

BACKGROUND: Excessive Knee Flexion Gait Pattern (KFGP) is a common gait deviation in many pathological conditions. The contractures of the muscles that have been identified as being responsible of KFGP are: iliopsoas, hamstring and gastrocnemius. RESEARCH QUESTION: How do isolated contractures of the iliopsoas, hamstrings and gastrocnemius impact knee flexion during gait? METHODS: Three levels of contracture (mild, moderate and severe) were simulated bilaterally using an exoskeleton on 10 healthy participants for iliopsoas, hamstring and gastrocnemius muscles. A gait analysis session was performed to evaluate the joint kinematics according to the different simulated contractures. Thirty one parameters were chosen to analyze the kinematics of the thorax, pelvis, hip, knee and ankle. A principal component analysis (PCA) was used to determine the kinematic parameters influenced by contractures. RESULTS: In addition to a permanent knee flexion observed for the three muscles with contracture: the contracture of the iliopsoas induces a large hip flexion with pronounced anterior pelvis tilt; the contracture of the hamstrings induces an ankle dorsiflexion during the support phase with a posterior pelvis tilt; the contracture of the gastrocnemius induces an absence of first and second rocker of the ankle with a slight flexion of hip and a slight anterior pelvis tilt. SIGNIFICANCE: These results support the identification of the muscles responsible for a KFGP. A better knowledge of the interactions between contractures and associated joint kinematics of the same and adjacent joints will support the interpretation of gait analyses by more precisely and faster targeting the concerned muscle.

Hip and knee joints are more stabilized than driven during the stance phase of gait: an analysis of the 3D angle between joint moment and joint angular velocity.

Joint power is commonly used in orthopaedics, ergonomics or sports analysis but its clinical interpretation remains controversial. Some basic principles on muscle actions and energy transfer have been proposed in 2D. The decomposition of power on 3 axes, although questionable, allows the same analysis in 3D. However, these basic principles have been widely criticized, mainly because bi-articular muscles must be considered. This requires a more complex computation in order to determine how the individual muscle force contributes to drive the joint. Conversely, with simple 3D inverse dynamics, the analysis of both joint moment and angular velocity directions is essential to clarify when the joint moment can contribute or not to drive the joint. The present study evaluates the 3D angle between the joint moment and the joint angular velocity and investigates when the hip, knee and ankle joints are predominantly driven (angle close to 0 degrees and 180 degrees ) or stabilized (angle close to 90 degrees ) during gait. The 3D angle curves show that the three joints are never fully but only partially driven and that the hip and knee joints are mainly stabilized during the stance phase. The notion of stabilization should be further investigated, especially for subjects with motion disorders or prostheses.

[How to define the joint movements unambiguously: proposal of standardization for the trapezometacarpal joint]. / Comment définir sans ambiguïté les mouvements d'une articulation: proposition de standardisation pour l'articulation trapézométacarpienne.

In order to define the movements of a joint, clinicians usually use anatomic terms. These terms are clearly understandable for a simple movement, defined in an anatomic plane. However, these terms are ambiguous for complex movements or for movements out of an anatomic plane. This, for instance, is the case for the internal-external axial rotation of the trapezometacarpal joint. For the study of complex movements, engineers preferentially use methods such as Euler angles, which correspond to three angles about three axes chosen in a defined order or sequence. Thus, the International Society of Biomechanics has proposed a joint coordinate system definition where every axis is associated with a functional degree of freedom of the joint. The first and third axes are embedded in the proximal and distal segments whilst the second axis, called the "floating" axis, is always orthogonal to the other two. The present work deals with the application of this concept to the trapezometacarpal joint. The two principal degrees of freedom, of flexion-extension and of abduction-adduction are defined following classical anatomical axes of respectively the trapezium and first metacarpal. Conversely, internal-external axial rotation is defined about the "floating" axis which does not have anatomical definition but can be geometrically deduced from the two others.

Adjustments to McConville et al. and Young et al. body segment inertial parameters.

Body segment inertial parameters (BSIPs) are important data in biomechanics. They are usually estimated from predictive equations reported in the literature. However, most of the predictive equations are ambiguously applicable in the conventional 3D segment coordinate systems (SCSs). Also, the predictive equations reported in the literature all include two assumptions: the centre of mass and the proximal and distal endpoints are assumed to be aligned, and the inertia tensor is assumed to be principal in the segment axes. These predictive equations, restraining both position of the centre of mass and orientation of the principal axes of inertia, become restrictive when computing 3D inverse dynamics, when analyzing the influence of BSIP estimations on joint forces and moments and when evaluating personalized 3D BSIPs obtained from medical imaging. In the current study, the extensive data from McConville et al. (1980. Anthropometric relationships of body and body segment moments of inertia. AFAMRL-TR-80-119, Aerospace Medical Research Laboratory, Wright-Patterson Air Force Base, Dayton, Ohio) and from Young et al. (1983. Anthropometric and mass distribution characteristics of the adults female. Technical Report AFAMRL-TR-80-119, FAA Civil Aeromedical Institute, Oklaoma City, Oklaoma) are adjusted in order to correspond to joint centres and to conventional segment axes. In this way, scaling equations are obtained for both males and females that provide BSIPs which are directly applicable in the conventional SCSs and do not restrain the position of the centre of mass and the orientation of the principal axes. These adjusted scaling equations may be useful for researchers who wish to use appropriate 3D BSIPs for posture and movement analysis.

Validation of net joint loads calculated by inverse dynamics in case of complex movements: application to balance recovery movements.

The joint forces and moments driving the motion of a human subject are classically computed by an inverse dynamic calculation. However, even if this process is theoretically simple, many sources of errors may lead to huge inaccuracies in the results. Moreover, a direct comparison with in vivo measured loads or with "gold standard" values from literature is only possible for very specific studies. Therefore, assessing the inaccuracy of inverse dynamic results is not a trivial problem and a simple method is still required. This paper presents a simple method to evaluate both: (1) the consistency of the results obtained by inverse dynamics; (2) the influence of possible modifications in the inverse dynamic hypotheses. This technique concerns recursive calculation performed on full kinematic chains, and consists in evaluating the loads obtained by two different recursive strategies. It has been applied to complex 3D whole body movements of balance recovery. A recursive Newton-Euler procedure was used to compute the net joint loads. Two models were used to represent the subject bodies, considering or not the upper body as a unique rigid segment. The inertial parameters of the body segments were estimated from two different sets of scaling equations [De Leva, P., 1996. Adjustments to Zatsiorsky-Suleyanov's segment inertia parameters. Journal of Biomechanics 29, 1223-1230; Dumas, R., Chèze, L., Verriest, J.-P., 2006b. Adjustments to McConville et al. and Young et al. Body Segment Inertial Parameters. Journal of Biomechanics, in press]. Using this comparison technique, it has been shown that, for the balance recovery motions investigated: (1) the use of the scaling equations proposed by Dumas et al., instead of those proposed by De Leva, improves the consistency of the results (average relative influence up to 30% for the transversal moment); (2) the arm motions dynamically influence the recovery motion in a non negligible way (average relative influence up to 15% and 30% for the longitudinal force and the transversal moment, respectively).

A non-invasive protocol to determine the personalized moment arms of knee and ankle muscles.

One difficulty that comes with predicting muscular forces is the accuracy of experimental data, particularly the assessment of muscle moment arms with respect to each joint rotation axis. This paper presents a non-invasive experimental protocol to obtain the personalized muscle moment arms with respect to the ankle and knee joints. A specific pointer is used by a specialist of lower limb anatomy in order to define the local portion of the line of action of the different muscles closed to the joint on the standing subject's lower limb. With this pointer, the three-dimensional coordinates of several points representing the line of action of 12 ankle and knee muscles are collected by a Motion Analysis system. The collection is done five times by the same operator and one time by two different operators. From this data, the intra and inter operator repeatabilities are tested. Relative (ICC) and absolute (SEM) reliabilities are determined in order to evaluate the intra operator repeatability of this non-invasive protocol. The ICC values obtained are higher than 0.91 for 10 among 12 muscles. The intra operator repeatability is thus confirmed. From the records realized by the two operators, the differences are negligible. Thus, the inter operator repeatability is also confirmed. The moments arms obtained using this non-invasive experimental protocol are compared with those calculated from origin and insertion points reported in the literature, according to the work of Whites, Pierrynowskis and Kepples, respectively. The estimations obtained using the non-invasive experimental protocol are found, for some muscles, more realistic than those calculated using the literature data and are always coherent with the role of the muscles described in anatomical books.

3D inverse dynamics in non-orthonormal segment coordinate system.

The net joint forces and moments may be computed by several 3D inverse dynamic methods. To do so, an orthonormal segment coordinate system (SCS) is generally mandatory. However, the segment axes ought to be selected following anatomical, functional, and inertial requirements that are hardly compatible with orthogonal axes. An alternative method based on generalized coordinates allows computing inverse dynamics using directly a set of basic points and unitary vectors. A segment definition is put forward in order to follow all of the anatomical, functional, and inertial requirements and the inverse dynamics is performed in a non orthonormal segment coordinate system (NSCS). The NSCS seems a convenient definition in biomechanics as far as anatomical, functional and inertial axes are concerned, but providing that the 3D joint forces and moments are still computable. The inverse dynamic method in NSCS is applied to the gait of a knee valgus subject and compared to a classical inverse dynamic method. The inverse dynamic method in NSCS shows comparable results but implies further clinical interpretations.

Influence of different degrees of bilateral emulated contractures at the triceps surae on gait kinematics: The difference between gastrocnemius and soleus.

INTRODUCTION: Ankle plantarflexion contracture results from a permanent shortening of the muscle-tendon complex. It often leads to gait alterations. The objective of this study was to compare the kinematic adaptations of different degrees of contractures and between isolated bilateral gastrocnemius and soleus emulated contractures using an exoskeleton. METHODS: Eight combinations of contractures were emulated bilaterally on 10 asymptomatic participants using an exoskeleton that was able to emulate different degrees of contracture of gastrocnemius (biarticular muscle) and soleus (monoarticular muscle), corresponding at 0°, 10°, 20°, and 30° ankle plantarflexion contracture (knee-flexed and knee-extended). Range of motion was limited by ropes attached for soleus on heel and below the knee and for gastrocnemius on heel and above the knee. A gait analysis session was performed to evaluate the effect of these different emulated contractures on the Gait Profile Score, walking speed and gait kinematics. RESULTS: Gastrocnemius and soleus contractures influence gait kinematics, with an increase of the Gait Profile Score. Significant differences were found in the kinematics of the ankles, knees and hips. Contractures of soleus cause a more important decrease in the range of motion at the ankle than the same degree of gastrocnemius contractures. Gastrocnemius contractures cause greater knee flexion (during the stance phase) and hip flexion (during all the gait cycle) than the same level of soleus contractures. CONCLUSION: These results can support the interpretation of the Clinical Gait Analysis data by providing a better understanding of the effect of isolate contracture of soleus and gastrocnemius on gait kinematics.

Effects of the rider on the kinematics of the equine spine under the saddle during the trot using inertial measurement units: Methodological study and preliminary results.

Many factors associated with the saddle and the rider could produce pain in horses thus reducing performance. However, studies of horse-saddle-rider interactions are limited and determining their effects remains challenging. The aim of this study was to test a novel method for assessing equine thoracic and lumbar spinal movement under the saddle and collect data during trotting. Back movement was measured using inertial measurement units (n = 5) fixed at the levels of thoracic vertebrae T6, T12 and T16, and lumbar vertebrae L2 and L5. To compare unridden and ridden conditions, three horses were trotted in hand then at the rising trot (seated phase: left diagonal, rider seated; standing phase: right diagonal, rider standing). The protraction-retraction angles of the forelimbs and the hind limbs were also calculated in two dimensions (2D) using reflective markers. To compare conditions, linear mixed-effects regression models were used and estimated means (standard error) were calculated. The range of motion (ROM) of the caudal thoracic and thoracolumbar regions decreased respectively by -1.3 (0.4)° and -0.6 (0.2)° during the seated phase compared to the unridden condition. Concomitantly, the ROM of protraction and retraction angles increased in the ridden condition. This study demonstrated the ability of inertial measurement units to assess equine vertebral movements under the saddle. The rider, at the rising trot, affected the horse's global locomotion with measurable changes in the vertebral kinematics under the saddle.

[The trapezio-metacarpal joint: the strain of the ligaments as a function of the thumb position. Study on an enlarged model]. / L'articulation trapézométacarpienne: l'allongement des ligaments en fonction de la position du pouce. Etude sur modèle agrandi.

INTRODUCTION: The aim of this paper was to develop an enlarged anatomical model of the trapezio-metacarpal joint in order to measure the strains on the ligaments when this joint was passively moved in several directions under constant loading. MATERIAL AND METHOD: A model of the two first rays of the hand was made in polystyrene, at a X3 enlargement, and the ligaments substituted by rubber bands with well characterized mechanical properties so as to reproduce the actual ratio of stiffness (approximately = 10) of the different tissues (bones and ligaments) found in real life. The first metacarpal was moved in 6 directions as described by Ebskov (1970) and Pieron (1973, 1980) using a small spring exerting a constant force (1.5 N) tilted at 30 degrees with respect to the transverse plane. The strain was measured between two white marks for each model ligament and each direction respectively, and the percentage of lengthening was calculated. A statistical study was performed using the non-parametrical Test of Wilcoxon in order to compare the ligament strains obtained in the different directions of loading. RESULTS: The largest strains were observed in the intermetacarpal ligament and in the anterior oblique ligament reaching 26 to 39% in direction J (posteromedial) and in direction L (posterolateral). Deformations of the two parts of the dorsoradial ligament and of the posterior oblique ligament were equal or inferior to 12% and were observed in the other 4 directions: D, F, K, I (Anterolateral, maximal anteposition, anteromedial, medial) and their combinations. CONCLUSION: . These data may be useful for helping the understanding of the biomechanics of the basal joint of the thumb. Nevertheless, we are dealing here with a simplified model, which must be considered with caution if the results are to be applied to the living joint.

A simplified marker set to define the center of mass for stability analysis in dynamic situations.

The extrapolated center of mass (XCoM), a valuable tool to assess balance stability, involves defining the whole body center of mass (CoMWB). However, accurate three-dimensional estimation of the CoMWB is time consuming, a severe limitation in certain applications. In this study, twenty-four subjects (young and elderly, male and female) performed three different balance tasks: quiet standing, gait and balance recovery. Three different models, based on a segmental method, were used to estimate the three-dimensional CoMWB absolute position during these movements: a reference model based on 38 markers, a simplified 13-marker model and a single marker (sacral) model. CoMWB and XCoM estimations from the proposed simplified model came closer to the reference model than estimations from the sacral marker model. It remained accurate for dynamic tasks, where the sacral marker model proved inappropriate. The simplified model proposed here yields accurate three-dimensional estimation of both the CoMWB and the XCoM with a limited number of markers. Importantly, using this model would reduce the experimental and post-processing times for future balance studies assessing dynamic stability in humans.

Effect of the rider position during rising trot on the horse׳s biomechanics (back and trunk kinematics and pressure under the saddle).

Knowledge about the horse-saddle-rider interaction remains limited. The aim of this study was to compare the effect of the rider׳s position at rising trot on the pressure distribution, spine movements, stirrups forces and locomotion of the horse. The horse׳s back movements were measured using IMUs fixed at the levels of thoracic (T6, T12, T16) and lumbar (L2, L5) vertebrae, the pressure distribution using a pressure mat and stirrups forces using force sensors. The horse׳s and rider׳s approximated centres of mass (COM) were calculated using 2D reflective markers. To compare both trot phases (rider seated/rider standing), three horses were trotted at the rising trot by the same rider. Means±SD of each parameter for sitting and standing were compared using a Student׳s t test (p=0.05). Stirrups forces showed two peaks of equal magnitude in every stride cycle for left and right stirrups but increased during the standing phase. Simultaneously, the pressure for the whole mat significantly increased by +3.1kPa during the sitting phase with respect to standing phase. The T12-T16 and T16-L2 angular ranges of motion (ROM) were significantly reduced (-3.2° -1.2°) and the T6-T12 and L2-L5 ROM were significantly increased (+1.7° +0.7°) during sitting phase compared to standing phase. During rising trot, the sitting phase does not only increase the pressure on the horse׳s back but also reduces the back motion under the saddle compared to the standing phase. These results give new insights into the understanding of horse-rider interactions and equine back pain management.