Lower limb muscle activation during outdoor running: differences between sprinters, middle-distance and long-distance runners.

Running is one of the most popular sport practices in the world. However, to our knowledge, none of the previous research about the characteristics of outdoor running makes a distinction between the different modalities of runners. Sixty-five healthy runners classified in sprinters, middle distance and long-distance runners performed five series of 100 metres on the synthetic outdoor track at competition pace. Muscle activity of lower limb muscles at initial contact and toe-off, involving the gluteus medius (GMED), gluteus maximus (GMAX), biceps femoris (BF), rectus femoris (RF), tiabilis anterior (TA) and medial gastrocnemius (MGAS), and spatiotemporal parameters were analysed. Sprinters showed high percentages of muscle activity at initial contact, in particular, the TA activity was the highest. The RF activity was significantly the lowest activity registered. At toe-off, sprinters showed the highest activity in all muscles analysed. Middle-distance runners had the highest activity of GMAX, BF and MGAS during the initial contact. In long-distance runners, the GMED and RF activity during the initial contact is highlighted, showing the highest activity of this phase. Different patterns of lower limb muscle activity and spatiotemporal parameters exist depending on the modality of the runner.

[Effectiveness of the Armeo ® device in the rehabilitation of the upper limb of stroke's patients. A review of the literature]. / Efectividad del dispositivo Armeo ® en la rehabilitación del miembro superior en pacientes que han sufrido un ictus. Revisión de la bibliografía.

INTRODUCTION: The stroke affects the functionality and quality of life of the person. Therefore, one of the main objectives is the functional recovery of the upper limb. Robotic therapy is a new tool of rehabilitation in stroke patients. The aim of this paper is to accomplish a bibliographic review about the effectiveness of the Armeo ® device in the rehabilitation of the upper limb in patients with stroke. DEVELOPMENT: This review includes studies dated until April 2019, which investigate the rehabilitation of the upper limb through Armeo in patients with stroke. The following databases were consulted: PubMed, Web of Science, Medline Complete, Scopus, CINAHL and BRAIN. Six articles were selected and analyzed, including randomized controlled trials and clinical trials. The main results of the studies indicate a positive trend of the robotic therapy with Armeo combined with conventional therapy. CONCLUSION: The low quality and the limitations found on the studies determine the need for future studies that investigate the effectiveness of the device. Despite this, the positive effect observed motivates new research.

TITLE: Efectividad del dispositivo Armeo ® en la rehabilitación del miembro superior en pacientes que han sufrido un ictus. Revisión de la bibliografía.Introducción. El ictus afecta gravemente a la funcionalidad y la calidad de vida de la persona. Por ello, uno de los objetivos principales es la recuperación funcional del miembro superior. La terapia robótica supone una nueva orientación hacia la cual dirigir la rehabilitación del paciente con ictus. Por ello, se realizó una revisión bibliográfica sobre la efectividad del dispositivo Armeo ® en la rehabilitación del miembro superior en pacientes con ictus. Desarrollo. Se recopilaron artículos que investigaran la rehabilitación del miembro superior a través de Armeo en pacientes con ictus hasta abril de 2019. Se consultaron las siguientes bases de datos: PubMed, Web of Science, Medline Complete, Scopus, CINAHL y BRAIN. Se analizaron seis artículos, entre los cuales había ensayos controlados aleatorizados y ensayos clínicos. Los principales resultados de los estudios indican una tendencia positiva de la terapia robótica con Armeo combinada con terapia convencional. Conclusión. La baja calidad metodológica y las limitaciones encontradas en los estudios determinan la necesidad de estudios futuros que investiguen la efectividad del dispositivo. A pesar de ello, el efecto positivo observado motiva a nuevas investigaciones.

[Treadmill training with partial body weight support in subjects with incomplete spinal cord injury: a systematic review]. / Entrenamiento en cinta rodante con soporte parcial del peso corporal en pacientes con lesión medular incompleta: revisión sistemática.

INTRODUCTION: The partial body weight supported treadmill training is a common therapeutic strategy in rehabilitation of people with spinal cord injuries. AIM: To analyze its effects on gait, balance and muscle strength in people with incomplete spinal cord injury compared to conventional treatment or overground gait training. PATIENTS AND METHODS: A compilation of clinical trials from 2007 to 2019 was carried out. We included articles that evaluate the effects of body weight supported treadmill training on gait, balance and muscle strength in subjects with incomplete spinal cord injury. RESULTS: A total of six articles were analyzed. The walking cadence, speed and resistance improved in the participants that received the intervention compared to those that were treated with conventional training. The functionality, balance and strength improved in most studies, but there were not differences between them. CONCLUSIONS: Body weight supported treadmill training improves the spatiotemporal parameters of walking and resistance in subjects with incomplete spinal cord injury, but in most variables analyzed (balance, functionality and strength) the changes are not superior to those observed after conventional training.

TITLE: Entrenamiento en cinta rodante con soporte parcial del peso corporal en pacientes con lesión medular incompleta: revisión sistemática.Introducción. El entrenamiento de la marcha sobre pasarela rodante con soporte parcial del peso corporal es una estrategia terapéutica frecuente en la rehabilitación de personas con lesión medular. Objetivo. Analizar los efectos de esta intervención en la marcha, el equilibrio y la fuerza muscular en personas con lesión medular incompleta en comparación con un tratamiento de fisioterapia convencional o con un entrenamiento de la marcha sobre suelo. Pacientes y métodos. Se realizó una recopilación de ensayos clínicos desde 2007 hasta 2019. Se incluyeron trabajos que evaluasen el entrenamiento de la marcha con soporte parcial del peso corporal en cinta rodante en pacientes con lesión medular incompleta y que analizasen la marcha, el equilibrio y la fuerza muscular. Resultados. Se analizaron seis artículos. Según los resultados de los estudios incluidos, la cadencia, la velocidad y la resistencia de marcha mejoraron en los participantes que recibieron entrenamiento sobre pasarela rodante con soporte parcial del peso corporal respecto al grupo de control. Las variables de funcionalidad, equilibrio y fuerza mejoraron en ambos los grupos de intervención. Conclusiones. El entrenamiento de la marcha con soporte parcial del peso corporal sobre cinta rodante mejora los parámetros espaciotemporales de la marcha y la resistencia de los pacientes con lesión medular incompleta, pero, en la mayoría de las variables analizadas, los cambios no son superiores a los observados tras un entrenamiento convencional.

[Observational gait scale for persons with lower extremity amputation. Design and content validity]. / Escala observacional de la marcha del sujeto con amputación de la extremidad inferior: diseño y validez de contenido.

INTRODUCTION: Gait pattern is altered in persons with lower extremity amputation. To assess gait pattern, it is important to use observational gait scales with a good content validity. OBJECTIVES: To design an observational gait scale and to analyze its content validity. MATERIAL AND METHODS: An expert committee was formed to obtain a version of the scale. The same committee was responsible for evaluating the scale. The content validity index (CVI) was calculated, both for each item and for the global scale. RESULTS: The main kinematic and spatiotemporal alterations were selected to design the items. The scale consists of 2sections and 25 items, with a maximum score of 35 points. An overall CVI score of 0.90 was obtained, and an index of validity for most items with values higher than 0.78. CONCLUSION: The Observational gait scale for persons with amputation of the lower extremity showed excellent content validity according to the CVI obtained. Future studies should evaluate its reliability and construct validity.

[Effectiveness of the virtual reality in the rehabilitation of the upper limb in the spinal cord injury. A systematic review]. / Efectividad de la realidad virtual en la rehabilitacion del miembro superior en la lesion de la medula espinal. Revision sistematica.

INTRODUCTION: Spinal cord injury is a complex and life-disrupting condition. The functional recovery of the upper limb has been considered as an important objective in tetraplegia because it improves significantly the quality of living in these patients. Virtual reality is a new emerging tool of rehabilitation in spinal cord injured patients. AIM: To carry out a systematic review about the information about the application of these systems in spinal cord injury in the rehabilitation of the upper limb. PATIENTS AND METHODS: This review includes clinical trials dated until April 2018, which investigate the functional recovery of the upper limb through virtual reality systems in patients with complete or incomplete tetraplegia. The following databases were used to search for those clinical trials: Scopus, Web of Science, PubMed, Medline Complete, Science Direct, CINHAL and Brain. RESULTS: Five articles were selected for this review, including randomized clinical trials and clinical trials. The main results show a good tendency on the functional recovery with the combination of virtual reality systems and conventional therapy. CONCLUSIONS: The main limitations and the low quality of the studies show the necessity of further investigations with this new tool of rehabilitation. However, the incorporation of virtual reality systems as a rehabilitation supplement might be a beneficial tool on the functional recovery in spinal cord injury.

TITLE: Efectividad de la realidad virtual en la rehabilitacion del miembro superior en la lesion de la medula espinal. Revision sistematica.Introduccion. La lesion de la medula espinal es un estado funcional complejo que limita gravemente la vida de la persona. Por ello, la recuperacion de la funcionalidad del miembro superior en la tetraplejia se considera un objetivo primordial, ya que mejora significativamente la calidad de vida de estas personas. Ademas de las terapias convencionales, la realidad virtual supone un nuevo enfoque terapeutico en la rehabilitacion del lesionado medular. Objetivo. Realizar una revision sistematica sobre la efectividad de la rehabilitacion del miembro superior en pacientes con lesion medular a traves de la realidad virtual. Pacientes y metodos. Se recopilaron datos de ensayos clinicos hasta abril de 2018 que investigaran la rehabilitacion con sistemas de realidad virtual en los miembros superiores de pacientes con lesion medular completa e incompleta. Las bases de datos consultadas en esta revision incluyeron: Scopus, Web of Science, PubMed, Medline Complete, Science Direct, CINHAL y Brain. Resultados. Se analizaron cinco articulos, los cuales incluyeron ensayos controlados aleatorizados y ensayos clinicos. Los principales resultados de los estudios muestran buena tendencia de la rehabilitacion a traves de la realidad virtual en combinacion con terapia convencional. Conclusiones. Las limitaciones encontradas en los estudios, asi como su baja calidad metodologica, suponen la necesidad de mayores investigaciones acerca de la efectividad de esta nueva herramienta. Aun asi, la buena tendencia de los estudios se considera de interes para futuras investigaciones.

[Instrumental gait analysis in stroke patients]. / Analisis instrumental de la marcha en pacientes con ictus.

INTRODUCTION: The motor control deficits after stroke affect the gait pattern. There is a significant variability between subjects. AIMS: To analyse, by using a capture motion system, the gait pattern in stroke patients with different levels of motor function, and to establish, despite the participants heterogeneity, what alterations in the gait pattern are usual in each participant. SUBJECTS AND METHODS: Nine stroke subjects with independent gait and ten control subjects participated in this study. Motion capture was performed using the VICON Motion System ®. The motion of the pelvis, hip, knee and ankle were analyzed in the sagittal plane. Also, the spatio-temporal parameters of gait were observed. RESULTS: The motor function evaluated using the Flug-Meyer Assessment (lower limb section) varied between 15 and 33 points. Participants had alterations in the kinematic pattern which were common between each of them. In stroke patients it was observed: an increment of the pelvis range of motion in both sides; at the hip joint, a decrease of the maximum peak of extension during the stance phase in the affected side and a greater flexion during the stance and the swing periods in the non-affected side; at the knee, a major knee flexion during the initial contact; and at the ankle joint, an slight ankle plantar flexion during the initial contact on the affected side. CONCLUSIONS: There are several landmarks in stroke gait that the clinicians should keep attention during the walking observation.

TITLE: Analisis instrumental de la marcha en pacientes con ictus.Introduccion. Las alteraciones en el control motor consecuentes al ictus afectan al patron de marcha, existiendo una importante variabilidad intersujeto. Objetivos. Valorar, a traves de un sistema de captura del movimiento, el patron cinematico de la marcha en sujetos con ictus y establecer que alteraciones del patron de la marcha son comunes entre los participantes. Sujetos y metodos. Participaron nueve pacientes con ictus con capacidad de marcha y diez sujetos controles. Para la captura del movimiento se empleo el sistema VICON Motion System ®. Se analizaron los movimientos articulares de pelvis, cadera, rodilla y tobillo en el plano sagital, y los parametros espaciotemporales de la marcha. Resultados. La funcion motora de los participantes, valorada mediante la escala Fugl-Meyer (seccion del miebro inferior), oscilo entre 15 y 33 puntos. Los participantes presentaron alteraciones en la cinematica comunes entre ellos. En los pacientes con ictus se registro: aumento de la amplitud de movimiento de la pelvis en ambos hemicuerpos (lado afecto y no afecto frente a control, p < 0,01); en la cadera, disminucion de la maxima extension durante la fase de apoyo en el lado afecto (p < 0,01) e incremento de la flexion en las fases de apoyo y oscilacion en el no afecto (p = 0,025); en la rodilla, mayor flexion durante la fase de contacto inicial (lado afecto frente a control, p < 0,01; lado no afecto frente a control, p = 0,02); y en el tobillo, ligera flexion plantar durante la fase de contacto inicial en el lado afecto. Conclusiones. A pesar de la variabilidad clinica, existen alteraciones especificas comunes de la marcha en sujetos con ictus.

Upper limb posture estimation in robotic and virtual reality-based rehabilitation.

New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.